Category Archives: General PH&RM

Clinical Governance Day

The next GSA-HEMS Clinical Governance Day will take place at Bankstown Airport on Wednesday 22nd December 2010

Posted in General PH&RM | Leave a comment

Clinical currencies

Clinical currency assessments are now underway for GSA-HEMS consultants. All SRCs will go through the process first as we refine it. The components are: written test (online via the VLE) practical assessment to be repeated every three months At the … Continue reading

Posted in General PH&RM | Leave a comment

UK Military Clinical Guidelines

In the United Kingdom, The Academic Department of Military Emergency Medicine at the Royal Centre for Defence Medicine produces Clinical Guidelines for Operations on behalf of Surgeon General under the direction of Defence Professor of Emergency Medicine. These guidelines, last … Continue reading

Posted in General PH&RM | Tagged , , , , | Leave a comment

Needle crike: low rate and allow exhalation

Two dedicated devices for transtracheal oxygen delivery through a cricothyroidotomy needle are available, the ENK Oxygen Flow Modulator (ENK) and the Manujet. Both maintain oxygenation, but the ENK is thought to achieve better ventilation (as previously shown in a pig … Continue reading

Posted in General PH&RM | Tagged , , , , | Leave a comment

LMA to stoma ventilation

Level 1 evidence is great, but for useful tips that can add options to your resuscitation toolbox there are some great finds in journal letters pages. Try this one: An apneoic patient requires assisted ventilation in your resuscitation room. Bag-mask … Continue reading

Posted in General PH&RM | Tagged , , , | Leave a comment

Fetal monitoring during EMS transport

Can cardiotocography be applied in the pre-hospital setting? French physicians assessed its feasibility in 145 patients enrolled during 119 interhospital transfers and 26 primary prehospital missions. Their physician-staffed ambulance teams included 19 emergency physicians and one anaesthetist. Interpretable tracings were … Continue reading

Posted in General PH&RM | Tagged , , , , | Leave a comment

Pre-hospital amputation

British trauma surgeon and pre-hospital pioneer Professor Keith Porter describes how to do a pre-hospital amputation in this months EMJ. Thankfully the procedure is only rarely necessary and often only requires cutting remaining skin bridges with scissors. The indications are: … Continue reading

Posted in General PH&RM | Tagged , , , , | Leave a comment

Pelvic splint improved shock

Splinted any pelvises lately? Karim Brohi’s excellent trauma.org article outlines the strengths and weaknesses of the different devices on the market. One such is the T-POD, which has now been described in a small series in which its application to … Continue reading

Posted in General PH&RM | Tagged , , , | Leave a comment

LMA not always successful; needle crike fails often

A meta-analysis of pre-hospital airway control techniques evaluated alternative techniques to tracheal intubation. The outcome was placement success; there were no data on effectiveness of ventilation or other clinical outcomes. Although limited by poor quality studies, there are some interesting … Continue reading

Posted in General PH&RM | Tagged , , | Leave a comment

High flow O2 and mortality in COPD

An Australian randomised controlled trial of pre-hospital oxygen therapy in COPD patients compared titrated oxygen therapy with high flow oxygen. The primary outcome was prehospital and in-hospital mortality. Titrated oxygen treatment was delivered by nasal prongs to achieve arterial oxygen … Continue reading

Posted in General PH&RM | Tagged , , , | Leave a comment