Category Archives: General PH&RM

Scene time not linked to outcome in large cohort

Okay – I admit to loving this paper, partly because it blows away the dogma of short scene times and ‘scoop & run’, and the oft-quoted but obnoxious assertion that the only pre-hospital fluid of benefit is gasoline. A massive … Continue reading

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

Increased mortality with non-trauma centre care

A trauma database was analysed to see if patients who were transported from the field to a non-trauma centre (NTC) and subsequently sent on to a trauma centre (TC) for definitive care fared worse than similar patients who were transferred … Continue reading

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

Peripheral vasoactive infusions

It is often recommended that vasoactive agents are infused via central lines because of the risk of infiltration and tissue injury. The Children’s Hospital Boston transport team describe transport of 73 infants and children who were treated during interhospital transport … Continue reading

Posted in General PH&RM | Tagged , , | 1 Comment

rFVIIa did not reduce trauma mortality

An industry sponsored placebo-controlled multicentre randomised controlled trial has shown no mortality reduction from recombinant activated Factor VII (rFVIIa) in patients with trauma. rFVIIa acts physiologically by enhancing clot formation in the presence of tissue factor expressed on injured or … Continue reading

Posted in General PH&RM | Tagged , , | 1 Comment

Paediatric Tube Cuff Pressures

A paediatric critical care transport service encountered elevated tracheal tube cuff pressures (>30 cmH20) in 41% of 60 consecutive care studied, and over 60 cmH20 in 30%. This measurement was taken on arrival at the bedside, not in flight. Cuffed … Continue reading

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

Alternative toothless mask position

An alternative position for holding the facemask when bag-mask ventilating edentulous patients is described and evaluated. 49 patients with inadequate seal and air leak during two-hand positive-pressure ventilation had significantly improved ventilation as measured by reduced air leak and increased … Continue reading

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

Taming the Ketamine Tiger

A paper of great interest for those of us who spend a lot of time teaching the use of ketamine describes its history from initial synthesis in the early 1960s. Ketamine pioneer Edward F. Domino, M.D describes how it was … Continue reading

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

Unexpected survivors after pre-hospital intubation

Data on patients with moderate to severe traumatic brain injury from the San Diego Trauma Registry were analysed using modified TRISS methodology to determine predicted survival, from which an observed-predicted survival differential (OPSD) was calculated. The mean OPSD was calculated … Continue reading

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

Weight formula for kids

The traditional ‘APLS formula’ for weight estimation in children based on age (wt in kg = [age+4] x 2) is recognised as underestimating weight in ‘developed’ countries, with the degree of underestimation increasing with increasing age. Several authors have attempted … Continue reading

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

ETCO2 and ROSC

One for the ‘hardly surprising’ category…. A study of end-tidal CO2 during out-of-hospital adult and child cardiac arrest resuscitation showed a sudden rise in CO2 was associated with return of spontaneous circulation (ROSC), suggesting that witnessing this would be a … Continue reading

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