Monthly Archives: June 2010

Infant CPR: two thumbs even when alone

Posted on June 28, 2010 by

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

Posted on June 26, 2010 by

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

Posted on June 25, 2010 by

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

Posted on June 23, 2010 by

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

Posted on June 20, 2010 by

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

Posted on June 13, 2010 by

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

Posted on June 12, 2010 by

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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Guideline improved pre-hospital RSI in kids

Posted on June 6, 2010 by

French physicians provide pre-hospital critical care in medical teams of regional SAMU (service d’aide me ́dicale urgente). A national guideline was introduced in France to guide the management of traumatic brain injury (TBI), which included airway management. A study was conducted … Continue reading →

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Paediatric Retrieval – what's the rush?

Posted on June 5, 2010 by

The Children’s Acute Transport Service (CATS) in the UK performed 2106 interfacility transports between April 2006 and March 2008. The stabilisation time averaged just over 2 hrs. Stabilisation time was prolonged by the number of major interventions required to stabilise the … Continue reading →

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Pre-hospital intubation experience and outcomes

Posted on June 1, 2010 by

Hospitals and medical personnel performing high volumes of procedures demonstrate better patient outcomes and fewer adverse events. The relationship between rescuer experience and patient survival for out-of-hospital endotracheal intubation is unknown. An American study analysing 3 statewide databases with 26,000 … Continue reading →

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