Monthly Archives: June 2010

Infant CPR: two thumbs even when alone

Infant CPR guidelines recommend two-finger chest compressions with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. A manikin study revealed more effective compressions with … Continue reading

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Surviving avalanche burial

Avalanche burial has a high mortality and yet in some cases there have been some amazing saves despite prolonged cardiac arrest. An international working group undertook a systematic review to examine 4 critical prognostic factors for burial victims in cardiac … Continue reading

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Pre-hospital RSI

Physicians from HEMS London document their experience of 400 pre-hospital rapid sequence induction / intubations. Their data are consistent with the experience of other similar services and with the emergency airway management literature in general: Failure to intubate is rare … Continue reading

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Poor pre-hospital intubation success

A Scottish study of 628 pre-hospital intubation attempts in cardiac arrest patients records the rate of successful intubations, oesophageal intubations, and endobronchial intubations. Prehospital tracheal intubation was associated with decreased rates of survival to admission. This study has the limitations … Continue reading

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Oxygen in AMI – no benefit, possible harm

A Cochrane review examined the evidence from randomised controlled trials to establish whether routine use of inhaled oxygen in acute myocardial infarction (AMI) improves patient-centred outcomes, the primary outcomes being death, pain and complications. Three trials involving 387 patients were included … Continue reading

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Traumatic Aortic Injury

Two recent papers expand our knowledge of blunt traumatic aortic injury. UK crash data identified risk factors for low impact blunt traumatic aortic rupture, or ‘LIBTAR’ (crashes at relatively low speed): age >60, lateral impacts and being seated on the … Continue reading

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Junior pre-hospital doctors spend a bit longer on scene

More junior pre-hospital doctors took longer on scene than their senior colleagues according to a German study, although patient clinical factors were the main determinant of scene time. The majority of cases were non-trauma presentations Duration of mission time in … Continue reading

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