Category Archives: Interhospital

Should HAVL Be Used “Universally”?

At Greater Sydney Area HEMS, we carry a hyper-angulated (D-blade) option for our C-MAC video laryngoscope, but in our inter-hospital equipment bag. This means that it is not necessarily immediately to hand for pre-hospital missions (in part to avoid accidental … Continue reading

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Ventilating Severe Asthma

Ventilating a severe asthmatic can be a humbling experience. Even though its principles are often discussed, there are nuances to avoiding dynamic hyperinflation that often leave us wondering if we’ve done everything possible to safely ventilate the patient in front … Continue reading

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

Care of EVDs & Temporary Pacing Wires in Retrieval

Some patients require transfer with medical equipment that we may not deal with frequently, or at least in the context of an inter-hospital environment. Examples of such equipment include external ventricular drains (EVDs) and temporary pacing wires. Our very own … Continue reading

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Coffee and Cases Snippets: Intubating the patient with a HAGMA

Every morning our team discusses cases over coffee. Here is a useful snippet… Patients with a severe high anion gap metabolic acidosis (e.g. from severe DKA, AKI, toxic ingestions, severe lactataemia from bleeding/sepsis/some other form of badness) have a markedly … Continue reading

Posted in acid-base, Airway, General PH&RM, Interhospital | Tagged , , , , , , , , | 3 Comments

One Lung Ventilation in Retrieval Medicine

Part of our education day on Jan 4th 2023 focussed on the rare but confronting need to move to one lung ventilation (OLV) in the pre-hospital or retrieval environment. We heard from Dr John Floridis, a rural generalist and emergency … Continue reading

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Getting the hang of the Hamilton Ventilator:

About the Hamilton we use: Most common Vent settings we use and how to set them up: (S)-CMV: Synchronised Continuous Mandatory Ventilation mode- a pressure- regulated volume controlled mode SIMV: Synchronized intermittent mandatory ventilation- a volume-controlled mode. Power on. Complete … Continue reading

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Sydney HEMS Supervisor of Training assaulted by registrars…..for training.

This week on the HEMS base, our fearless Supervisor of Training, Dr Cliff Reid has again proven himself willing to go above and beyond in the name of medical education. This time by asking to be fibreoptically intubated. So how … Continue reading

Posted in Interhospital, simulation, training | 1 Comment

OXY’s LOG – ‘Between shock and a hard place…’

Cardiogenic shock – occurs in 10% of uncomplicated myocardial infarctions, suggests greater than 40% loss of functional left ventricule and has an 85% mortality.1, 2  John Hunter, a famous London surgeon during the 18th century, described his personal experience of myocardial infarction. … Continue reading

Posted in Cases, Interhospital | Tagged | 1 Comment

OXY’s LOG – ‘Anisocoria and Stardust…’

Take caution if you ever get tasked to a pre-hospital trauma at David Bowie’s house. His reduced level of consciousness and blown pupil might just be due to a copious amount of mind-bending drugs and the accident as a school-boy … Continue reading

Posted in Cases, Interhospital, Neurological | Tagged | 4 Comments

OXY’s LOG – ‘Tourner sur une nouvelle feuille de route…’

The term tourniquet originated from the French ‘‘tourner’’ meaning ‘‘to turn”. The first reported use of a tourniquet for haemorrhage control after wounding was by a french army surgeon called Etienne Morel in 1674. 1  . . Tourniquets: villain or … Continue reading

Posted in Cases, Interhospital, Neurological | Tagged | 3 Comments