Category Archives: General PH&RM

Is cervical spine protection always necessary following penetrating neck injury?

This short cut review in the Best Bets format attempted to answer the question: “is cervical spine protection always necessary following penetrating neck injury?” From the available evidence they draw the following conclusions: In stab wounds to the neck (with … Continue reading

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Spinal imaging and immobilisation may be unnecessary in many GSW patients

A retrospective review of 4204 patients sustaining gunshot wounds (GSW) to the head, neck or torso examined the incidence of spinal cord injury and bony spinal column injury required operative spinal intervention. None of the patients demonstrated spinal instability requiring … Continue reading

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Cuffed tracheal tubes for children

In a prospective randomised controlled multi-centre trial, cuffed tracheal tubes were compared with uncuffed tubes in 2246 children aged from birth to five years undergoing general anaesthesia. There was no significant difference in post-extubation stridor but the need for tube … Continue reading

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First Aid for Burns

A review of burn first aid treatments highlights the paucity of evidence on which to make firm recommendations. The authors recommend using cold running tap water (between 2 and 15 degrees C) and to avoid ice or alternative therapies. The … Continue reading

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Physicians didn't improve outcome from nontraumatic cardiac arrest

A Norwegian study retrospectively compared outcomes from non-traumatic cardiac arrest between ambulances staffed by physicians (PMA) and non-physician ambulances (non-PMA). There were no differences in any of the clinical outcome measures used in this study of 977 patients, in which … Continue reading

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Fluids for cooling post cardiac arrest

Large volume cold fluid resuscitation after return of spontaneous circulation can contribute to effective cooling but does it impair cardiac or respiratory function? A retrospective review of 52 resuscitated cardiac arrest patients suggests that the infusion of large volumes of … Continue reading

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Pre-hospital intubation for head injury: ?no benefit

A systematic review of pre-hospital intubation for head injured patients failed to show evidence of benefit of tracheal intubation or invasive ventilation. The authors acknowledge the lack of methodological quality in the studies reviewed and the predominance of US paramedic-delivered … Continue reading

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Pre-hospital intubation 'success' at a US centre

Of 203 patients attending a US Level 1 trauma centre who had pre-hospital airway management, 25 (12%) had unrecognised oesophageal intubations. Patients were treated in the field by fire rescue personnel of various municipalities and with different experience levels. Patients … Continue reading

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Vehicle Rollover

Vehicle rollover as an indicator of mechanism of injury was investigated in a study examining accident databases and the medical literature. Only 2.4% of crashes involved rollovers but they accounted for one third of occupant deaths. Some facts on vehicle … Continue reading

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Paramedics apply cervical spine rule successfully

The Canadian C-Spine rule – a decision instrument designed to clinically rule out important cervical spine injuries in alert patients – was successfully and safely applied by Canadian paramedics in a study of 1949 patients. Any misinterpretation erred on the … Continue reading

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