Apneic preoxygenation without nasal prongs: the "Hungarian Air Ambulance method".

The Hungarian Air Ambulance has recently adopted oxygen supplementation during laryngoscopy, also known as apneic preoxygenation, to prevent desaturation during rapid sequence intubation. Despite its simplicity the nasal cannula method has some limitations relevant to our practice. First, the cannula can dislodge if the head is manipulated during preparation or intubation, especially if nasopharyngeal airways are chosen to maximise preoxygenation.

[Hungarians fallen ill abroad: questions of repatriation].

In the previous part of the paper authors described the repatriation process, the complex medical task of the patient returning home from abroad, and in particular its most crucial phase, the patient repatriation. Authors reviewed the indications and the basic terms of the patient-repatriation. Vehicles and their availability for the different type of repatriation modalities were analyzed as well.

[Repatriation of patients fallen ill abroad].

Due to our medical ethics, welfare of the patient is the first to consider. The therapy applied should not be influenced by any financial, administrative or political considerations. Yet, patient repatriation is such a special medical field, where the interest of an insurance company can often owerwrite medical considerations.

Femoral nerve blockade administered preclinically for pain relief in severe knee trauma is more feasible and effective than intravenous metamizole: a randomized controlled trial.

Background: Before clinical treatment and during transportation, the analgesic therapy offered to patients with painful knee trauma may be quite insufficient. We hypothesize that a femoral nerve blockade for analgesia can be administered in a preclinical setting at the injury site and provides better pain relief than intravenous metamizole, whose analgesic effect is comparable with that of opioids.

Methods: After an initial clinical investigation, 52 patients were randomized according to computer-generated codes; 26 patients received a femoral nerve blockade and 26 received metamizole.

A randomized controlled trial of femoral nerve blockade administered preclinically for pain relief in femoral trauma.

Background: Analgesia at the location of the accident and on transport for femoral trauma is often delayed or insufficient. In this prospective, randomized, controlled study, we evaluated the preclinical use of femoral nerve blockade for reducing pain and anxiety compared with IV analgesia using metamizol.

Methods: Patients with painful femoral trauma, such as fracture or severe contusion, were randomized to receive at the site of the accident a femoral nerve blockade (n = 31) or IV analgesia with metamizol (n = 31).

Capnography in non-tracheally intubated emergency patients as an additional tool in pulse oximetry for prehospital monitoring of respiration.

Unlabelled: Victims of minor trauma transported by paramedic-based rescue systems are usually monitored with pulse oximetry. Under the difficult surroundings of prehospital trauma care, pulse oximeters show considerable periods of malfunction. We tested the hypothesis that capnography is a good, easy to use tool for monitoring in nonintubated trauma victims.