[Thoracocentesis: wright indication and wright placement?].

The incidence of a tension pneumothorax is very low. The initial treatment of a tension pneumothorax is needle thoracocentesis. This procedure is not a routine treatment and this invasive treatment is not without risks.

Characteristics of trauma patients treated by Helicopter Emergency Medical Service and transported to the hospital by helicopter or ambulance.

Introduction: Trauma patients treated by the Helicopter Emergency Medical Services (HEMS) can be transported to the hospital either by helicopter or by ambulance, in both cases accompanied by the HEMS physician. The objectives of this study are first to compile an overview of patients treated and transported by the HEMS team with either the helicopter (patients transported by helicopter, PTH) or with the ambulance (patients transported by ambulance, PTA). In addition, to evaluate whether the existing information systems obtain relevant data for researching the decision-making process.

Topical Anaesthesia Using a Soft Mist Spray Device Allows Comfortable Awake Visualisation of the Airway via Self-Videolaryngoscopy in Volunteers.

: During endotracheal intubation, there is a 10% incidence of difficult laryngoscopy, which may result in serious complications. It is important to obtain as much information about the visibility of laryngeal structures before the patient is anaesthetised. Performing awake (video-) laryngoscopy on a patient is uncomfortable and can trigger gagging and coughing reflexes, making visualisation nearly impossible.

Therapeutic communication improves patient comfort during venipuncture in children: a single-blinded intervention study.

The aim of this study was to examine whether therapeutic communication improves children's comfort during venipuncture compared to standard communication. This study was registered in the Dutch trial register (NL8221), December 10, 2019. This single-blinded interventional study was carried out in an outpatient clinic of a tertiary hospital.

Serum concentrations of local anesthetics after unilateral interpectoral-pectoserratus plane block in breast cancer surgery: a pharmacokinetic study.

Introduction: The ultrasound-guided interpectoral-pectoserratus plane block is a fascial plane block for superficial surgery of the anterolateral chest wall. This technique involves injecting a relatively large volume of local anesthetics (typically 30 mL of 0.25%-0.

Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output.

Background: During the COVID-19 pandemic in The Netherlands, critically ill ventilated COVID-19 patients were transferred not only between hospitals by ambulance but also by the Helicopter Emergency Medical Service (HEMS). To date, little is known about the physiological impact of helicopter transport on critically ill patients and COVID-19 patients in particular. This study was conducted to explore the impact of inter-hospital helicopter transfer on vital signs of mechanically ventilated patients with severe COVID-19, with special focus on take-off, midflight, and landing.

An Approved Landing Site (ALS) improves the logistics of interhospital transfer of critically ill patients by helicopter.

The COVID-19 pandemic limited hospital resources and necessitated interhospital transport of ICU-patients in order to provide critical care to all patients in the Netherlands. However, not all hospitals have an approved landing site. The ICU-transport operation was executed under HEMS-license and landing on non-aerodrome terrain was permitted.

Helicopter transport of critical care COVID-19 patients in the Netherlands: protection against COVID-19 exposure-a challenge to critical care retrieval personnel in a novel operation.

Background: During the Coronavirus Disease 2019 (COVID-19) outbreak in the Netherlands, the demand for intensive care beds exceeded availability within days. Initially, patients were redistributed regionally by ground transport. When transport over longer distances became necessary, we initiated a new Helicopter Emergency Medical Service (HEMS) operation.

Comparative in-vitro Study of the Trachospray, a New Device for Topical Anaesthesia of the Upper Airway.

Background: Obtaining complete topical anaesthesia of the airway remains a clinical challenge. Particle size is one of the most important variables for the dose deposited and the distribution of aerosols in the airways. The mass median aerodynamic diameter of the particles should be in the range of 5-20 µm.

Non-invasive electrical cardiometry cardiac output monitoring during prehospital helicopter emergency medical care: a feasibility study.

Purpose: Introducing advanced hemodynamic monitoring might be beneficial during Helicopter Emergency Medical Service (HEMS) care. However, it should not increase the on-scene-time, it should be easy to use and should be non-invasive. The goal of this study was to investigate the feasibility of non-invasive cardiac output measurements by electrical cardiometry (EC) and the quality of the EC signal during pre-hospital care provided by our HEMS.

Unpredictable Injectate Spread of the Erector Spinae Plane Block in Human Cadavers.

We performed bilateral ultrasound-guided erector spinae plane blocks at the second and eighth thoracic vertebrae in 11 fresh frozen cadavers. Methylene blue dye spread variably and extensively deep to the erector spinae muscles fascia with involvement of the spinal rami and paravertebral space in 1 of 11 cadavers when injected at the eighth thoracic vertebra, and in 4 of 11 cadavers at the second thoracic vertebra, with crossover to the contralateral side of the spine. Our study demonstrates that in cadavers, an erector spinae plane block follows the fascial planes with unpredictable spread, which might explain its varying clinical efficacy.

The pecs anesthetic blockade: A correlation between magnetic resonance imaging, ultrasound imaging, reconstructed cross-sectional anatomy and cross-sectional histology.

The interfascial thoracic wall blockades Pecs I and Pecs II are increasingly applied in breast and axillary surgery. Despite the clear anatomical demarcations depicted at their introduction, the clinical outcome is more variable than would be expected based upon the described anatomy. In order to elucidate factors that explain this variability, we evaluated the spread of each injection-medial Pecs I, lateral Pecs I, the deep injection of the Pecs II-separately.

ABCDE of prehospital ultrasonography: a narrative review.

Prehospital point-of-care ultrasound used by nonradiologists in emergency medicine is gaining ground. It is feasible on-scene and during aeromedical transport and allows health-care professionals to detect or rule out potential harmful conditions. Consequently, it impacts decision-making in prioritizing care, selecting the best treatment, and the most suitable transport mode and destination.

Optical signature of nerve tissue-Exploratory ex vivo study comparing optical, histological, and molecular characteristics of different adipose and nerve tissues.

Background: During several anesthesiological procedures, needles are inserted through the skin of a patient to target nerves. In most cases, the needle traverses several tissues-skin, subcutaneous adipose tissue, muscles, nerves, and blood vessels-to reach the target nerve. A clear identification of the target nerve can improve the success of the nerve block and reduce the rate of complications.

Emergency physician-performed ultrasound-guided nerve blocks in proximal femoral fractures provide safe and effective pain relief: a prospective observational study in The Netherlands.

Background: The treatment of acute pain in the emergency department is not always optimal. Peripheral nerve blocks using "blind" or nerve stimulator techniques have substantial disadvantages. Ultrasound-guided regional anesthesia may provide quick, safe, and effective pain relief in patients with proximal femoral fractures with severe pain.

Prehospital Echocardiography During Resuscitation Impacts Treatment in a Physician-Staffed Helicopter Emergency Medical Service: an Observational Study.

Background: Patients in cardiac arrest must receive algorithm-based management such as basic life support and advanced (cardiac) life support. International guidelines dictate diagnosing and treating any factor that may have caused the arrest or may be complicating the resuscitation. Ultrasound may be of potential value in this process and can be used in a prehospital setting.

Proper training and use of ultrasonography facilitates lumbar puncture.

With great interest, we read the study of Line Dussourd et al. concluding that ultrasonography allows better identification of anatomical structures before performing a lumbar puncture. We cannot concur with the conclusions of the study because the authors did not visualize the conus medullaris directly, nor did they assess the individual intervertebral levels.

Nerve detection using optical spectroscopy, an evaluation in four different models: In human and swine, in-vivo, and post mortem.

Objective: Identification of peripheral nerve tissue is crucial in both surgery and regional anesthesia. Recently, optical tissue identification methods are presented to facilitate nerve identification in transcutaneous procedures and surgery. Optimization and validation of such techniques require large datasets.

Helping Children Cope with Medical Tests and Interventions.

Medical procedures and tests become a challenge when anxiety and pain make it difficult for the patient to cooperate or remain still when needed. Fortunately a short intervention with hypnoidal language at the onset of a procedure induces a positive and sustained change in the way pain and anxiety are processed. While anesthesia may appear to be a simple solution to eliminate pain, the adverse effects of pre-anesthesia anxiety on postoperative behavior and recovery are often not fully appreciated.

Prospective double blind randomized placebo-controlled clinical trial of the pectoral nerves (Pecs) block type II.

Study Objective: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery.

Design: A prospective randomized double blind placebo-controlled study.

Setting: A secondary hospital.