Medical Emergency Workload of a Regional UK HEMS Service.

Objective: Regionalized trauma networks have been established in England to centralize specialist care at dedicated centers of excellence throughout the country. Helicopter emergency medical services (HEMS) in the West Midlands region have been redesigned to form an integrated component of such systems. The continued use of such valuable and scarce resources for medical emergencies requires evaluation.

Does the use of dedicated dispatch criteria by Emergency Medical Services optimise appropriate allocation of advanced care resources in cases of high severity trauma? A systematic review.

Background And Objectives: The deployment of Enhanced Care Teams (ECTs) capable of delivering advanced clinical interventions for patients at the scene of incidents is commonplace by Emergency Medical Services in most developed countries. It is unclear whether primary dispatch models for ECT resources are more efficient at targeting deployment to patients with severe trauma than secondary dispatch, following requests from EMS personnel at scene. The objective of this study was to review the evidence for primary and secondary models in the targeted dispatch of ECT resources to patients with severe traumatic injury.

Enhanced care team response to incidents involving major trauma at night: are helicopters the answer?

Introduction: Challenges exist in how to deliver enhanced care to patients suffering severe injury in geographically remote areas within regionalised trauma networks at night. The physician led Enhanced Care Teams (ECTs) in the West Midlands region of England do not currently utilise helicopters to respond to incidents at night. This study describes this remote trauma workload at night within the regional network in terms of incident location; injury profile and patient care needs and discusses various solutions to the delivery of ECTs to such incidents, including the need for helicopter based platforms.

Utilisation of a Helicopter Emergency Medical Service (HEMS) for equestrian accidents in a regional major trauma network in the United Kingdom.

Introduction: The utilisation of Helicopter Emergency Medical Services (HEMS) in response to equestrian accidents has been an integral part of operations for many years throughout the UK. The recent establishment of major trauma networks in the UK has placed great emphasis on the appropriate tasking of HEMS units to cases where added benefit can be provided and the incidence of time critical injury in cases of equestrian accidents has been shown to be low. This study assesses the impact made on the utilisation of the different HEMS resources for cases of equestrian accidents within the West Midlands following the launch of the regional trauma network.

Summertime and the patient is itchy.

A 21-year-old man presented to the emergency department with a 36 h history of a painful, itchy maculopapular rash and associated vesicles to his arms and neck. He had no history of exposure to new chemicals or hygiene products and no significant medical history. His physiological observations were normal and systemic examination was unremarkable.

Prehospital anaesthesia performed by physician/critical care paramedic teams in a major trauma network in the UK: a 12 month review of practice.

Introduction: In the West Midlands region of the UK, delivery of pre-hospital care has been remodelled through introduction of a 24 h Medical Emergency Response Incident Team (MERIT). Teams including physicians and critical care paramedics (CCP) are deployed to incidents on land-based and helicopter-based platforms. Clinical practice, including delivery of rapid sequence induction of anaesthesia (RSI), is underpinned by standard operating procedures (SOP).

An injured climber.

Climbing incidents present a myriad of challenges to prehospital teams. Management decisions are often influenced by factors including difficulties in accessing patients, limited available resources and safe egress from scenes. This case illustrates the importance of an adaptable and innovative approach to scene management and clinical decision making in such cases.

'Interception': a model for specialist prehospital care provision when helicopters are not available.

The deployment of specialist teams to incident scenes by helicopter and the delivery of critical care interventions such as Rapid Sequence Induction of anaesthesia to patients are becoming well-established components of trauma care in the UK. Traditionally in the UK, Helicopter Emergency Medical Services (HEMS) are limited to daylight operations only. The safety and feasibility of operating HEMS services at night is a topic of debate currently in the UK HEMS community.

Impact of introducing a major trauma network on a regional helicopter emergency medicine service in the UK.

Introduction: In the West Midlands region of the UK, the delivery of prehospital trauma care has recently been remodelled through the introduction of a regionalised major trauma network (MTN). Helicopter emergency medical services (HEMS) are integral to the network, providing means of delivering highly skilled specialist teams to scenes of trauma and rapid transfer of patients to major trauma centres. This study reviews the impact of introducing the West Midlands MTN on the operation of one its regional HEMS units.

A stroke in the woods.

Responding to incidents where access by conventional land-based ambulance assets is limited is an important facet of helicopter emergency medical services operations in rural areas. Often in such cases extra resources must be utilised to enable access to patients and facilitate egress to transport platforms. This case illustrates the importance of coordination and integration with additional resources that can be utilised in remote rural locations.

The delivery of the new prehospital emergency medicine curriculum: reflections on a pilot programme in the UK.

Introduction: Pre-hospital Emergency Medicine is a subspecialty of Emergency Medicine and Anaesthesia in the UK, overseen by the Inter-collegiate Board for Training in Pre-hospital Emergency Medicine (IBTPHEM). Organisations delivering General Medical Council (GMC) approved programmes require clear educational governance frameworks to ensure high standards of training. This study outlines the experiences of an Emergency Medicine trainee during an Out of Programme Year with a regional Air Ambulance service in the UK.

Health care in a unique setting: applying emergency medicine at music festivals.

The last 25 years has seen an explosion in the popularity of outdoor music festivals, especially in the UK. Coupled with this has been the development of the trend for major sporting events that were once confined to stadia to be accompanied by mass gatherings of spectators and fans in "fan parks" and public places. The majority of music festivals and sporting events are considered to be mass gatherings, using the popular definition of more than 1000 people in one place.

Care of children at a large outdoor music festival in the United Kingdom.

Introduction: Limited data exist on the standard of care provided for children at mass gatherings and special events (MGSE). Some studies provide valuable insight into the proportion of pediatric patients that can be expected at various types of MGSEs, but an accurate breakdown of the range of pediatric conditions treated at major events has yet to be produced. Such data are essential for the preparation of MGSEs so that the health and safety of children at such events can be adequately safeguarded.

Retrospective audit of triage of acute traumatic shoulder dislocation by emergency nurses.

Introduction: Acute traumatic shoulder dislocation (ATSD) is a relatively common presentation to the emergency department. Research into nurse-led triage shows emergency nurses to be accurate at identifying patients with bony injuries and follow protocols to expedite appropriate care. The aim of this study was to assess the quality of triage decisions made by emergency nursing staff in cases of confirmed ATSD, in an emergency department in the United Kingdom.