Monthly Archives: March 2010

Spine immobilisation in penetrating trauma

Posted on March 25, 2010 by

In a retrospective study of 45,284 penetrating trauma patients, unadjusted mortality was twice as high in the 4.3% of  patients who underwent spine immobilisation, compared with those who were not immobilised. An accompanying editorial comments: ‘The number needed to treat with … Continue reading →

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College of Paramedics stands its ground

Posted on March 21, 2010 by

Articles in this month’s EMJ demonstrate an interesting conflict within UK pre-hospital care. The Joint Royal Colleges Ambulance Liaison Committee Airway Working Group, heavily represented by anaesthetists, recommend the removal of tracheal intubation from UK paramedic practice. The College of … Continue reading →

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Intubation harder on the floor or in an ambulance

Posted on March 18, 2010 by

An abstract from the The National Association of EMS Physicians® 2010 Scientific Assembly published in a Supplement of Prehospital Emergency Care describes a study comparing cadaveric intubation success rates by paramedics in different positions: on the floor, on an elevated … Continue reading →

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Is defibrillation an electric threat for bystanders?

Posted on March 16, 2010 by

No rescuer or bystander has ever been seriously harmed by receiving an inadvertent shock while in direct or indirect contact with a patient during defibrillation. New evidence suggests that it might even be electrically safe for the rescuer to continue … Continue reading →

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Stopping infusions before PCI transfer

Posted on March 14, 2010 by

An interhospital transport service introduced a no infusions policy for patients being transferred for primary coronary intervention, instead giving a bolus of heparin and glycoprotein 2b-3a inhibitor prior to transfer, along with non-intravenous nitrates (if needed). Discontinuing infusions during transport resulted … Continue reading →

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Better TBI outcome with HEMS

Posted on March 14, 2010 by

A retrospective study from Italy compared outcomes of head injured patients cared for by a ground ambulance service (GROUND) with those managed by a HEMS team that included an experienced pre-hospital anaesthetist. Interestingly 73% of the ground group were also … Continue reading →

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Ketamine use by paramedics

Posted on March 9, 2010 by

A poster presentation at the Australasian College of Emergency Medicine’s Annual Scientific Conference in Melbourne in November 2009 reports 100 cases of pre-hospital ketamine use for analgesia by paramedics in New Zealand – reproduced below with permission of the author: … Continue reading →

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Cardiocerebral resuscitation

Posted on March 8, 2010 by

An emergency medical service introduced a cardiocerebral resuscitation protocol and compared outcomes with a standard ACLS protocol. Cardiocerebral resuscitation (CCR) was defined as: initiation of 200 immediate, uninterrupted chest compressions at a rate of 100 compressions ⁄ min analyzing the … Continue reading →

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