Coming to you a little later than the release date, here are the top coffee and cases learning snippets from November 2023.

1. In cases of major haemorrhage or difficult IV access – consider inserting a trauma line.
2. If you feel that a job is running too slowly, declare this to the team and ensure both members are matching their speeds. Slow is smooth, smooth is fast.
3. Promethazine 12.5mg IV – effective for motion sickness and light sedation for long transport times to hospital.
4. QuikClot is for compressible haemorrhage. It requires pressure for at least 3 minutes in order to be effective. Consider it as an extension of your finger into the hole.
5. If a patient is haemodynamically unstable or has a labile BP, double pump your inotropes. The medical team should be prepared to maintain oversight of this at BOTH ends of the transfer.
6. Two NPAs and an OPA with jaw thrust (“tripod” or “supported tripod” with jaw thrust) should be used if there is difficulty maintaining an open airway.
7. Apply a pelvic binder, when indicated, ASAP. There can be a tendency to lay the binder across the stretcher and apply it after moving the patient there – this may however involve multiple moves with the pelvis not stabilised. Try to get the binder onto the spine board (which is used for extrication) or slide it directly under the patient prior to rolling/extrication.

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