Monthly Archives: February 2010

Pre-hospital thoracotomy and aortic clamping in blunt trauma

Posted on February 14, 2010 by

This is one of those ‘wow they really do that!?‘ papers…Patients undergoing thoracotomy and aortic clamping for pre-hospital blunt traumatic arrest either in the field or in the ED were evaluated for the outcome of survival to ICU admission. None … Continue reading →

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Self-extrication with a collar on

Posted on February 9, 2010 by

Using a sophisticated infrared six camera motion capture system, investigators demonstrated decreased cervical spine movement when collared volunteers self-extricated from a mock smashed up Toyota Corolla, when compared with extrication by paramedics using a backboard. The authors conclude that in … Continue reading →

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Standard medication kit for prehospital and retrieval physicians

Posted on February 9, 2010 by

A very comprehensive (hence the title of the paper) review of medications required for pre-hospital & retrieval medicine missions was undertaken, resulting in recommendations. While the casemix seen by various services may be influenced by local geography or tasking restrictions, … Continue reading →

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External jugular vein a tricky one

Posted on February 4, 2010 by

Emergency medicine residents and paramedics cannulated patients who were anaesthetised. The external jugular vein (EJV) took longer to cannulate and had a higher failure rate than an antecubital vein. More than a quarter of the paramedics and a third of … Continue reading →

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IO in OI

Posted on February 4, 2010 by

A case report describes three failed attempts to flush or secure an intraosseous needle placed using the EZ-IO drill during cardiac arrest of an adult patient subsequently noted to have osteogenesis imperfecta (OI) type III. While not listed as a … Continue reading →

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HEMS paramedic intubation success

Posted on February 4, 2010 by

All medical out of hospital cardiac arrests attended by the Warwickshire and Northamptonshire Air Ambulance (WNAA) over a 64-month period were reviewed. There were no significant differences in self-reported intubation failure rate, morbidity or clinical outcome between doctor-led and paramedic-led … Continue reading →

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DC shock? I want my blankie!

Posted on February 4, 2010 by

A blanket made of nonconducting material was used to allow CPR to continue during defibrillation of arrested swine. Coronary perfusion pressure was maintained when the blanket was used but fell when there was a hands-off interruption for defibrillation. Also, the … Continue reading →

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Precordial thump

Posted on February 4, 2010 by

The precordial thump is recommended for witnessed and monitored ventricular fibrillation/ventricular tachycardia (VF/VT) cardiac arrest when a defibrillator is not immediately available. Haman et al investigated the precordial thump in patients in whom VT or VF was initiated during an … Continue reading →

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Naloxone in cardiac arrest

Posted on February 4, 2010 by

Previous case reports and animal studies have suggested a possible role for naloxone in cardiac arrest even in the absence of opioid overdose. Possible mechanisms include reducing the myocardial depressant effect of endogenous opioids, stimulating catecholamine release, and providing antiarryhthmic … Continue reading →

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