Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Randomized Clinical Trial.

Importance: Early administration of supplemental oxygen for all severely injured trauma patients is recommended, but liberal oxygen treatment has been associated with increased risk of death and respiratory complications.

Objective: To determine whether an early 8-hour restrictive oxygen strategy compared with a liberal oxygen strategy in adult trauma patients would reduce death and/or major respiratory complications.

Design, Setting, And Participants: This randomized controlled trial enrolled adult trauma patients transferred directly to hospitals, triggering a full trauma team activation with an anticipated hospital stay of a minimum of 24 hours from December 7, 2021, to September 12, 2023.

Prehospital ultrasound constitutes a potential distraction from the observation of critically ill patients: a prospective simulation study.

Background: Prehospital point-of-care ultrasound allows an unstable patient to be rapidly and accurately assessed. However, we are concerned that an excessive focus on the ultrasound device, in an already demanding emergency medical service environment, may distract from patient care, potentially leading to reduced situational awareness and the neglect of other crucial instruments, such as the patient monitor. Thus, in this study, we examined the influence of prehospital ultrasound on situational awareness, by studying the degree to which physicians were distracted from the patient monitor.

Avalanche Survival Rates in Switzerland, 1981-2020.

Importance: Survival probability among individuals critically buried by avalanche is highly time dependent, which was demonstrated 30 years ago. However, it remains unclear whether avalanche survival probability has changed over time.

Objective: To assess the avalanche survival rate and probability as well as the rescue probability over the past 4 decades.

Feasibility of quality indicators on prehospital advanced airway management in a physician-staffed emergency medical service: survey-based assessment of the provider point of view.

Objective: We aimed to determine the feasibility of quality indicators (QIs) for prehospital advanced airway management (PAAM) from a provider point of view.

Design: The study is a survey based feasibility assessment following field testing of QIs for PAAM.

Setting: The study was performed in two physician staffed emergency medical services in Switzerland.

Favourable neurological outcome following paediatric out-of-hospital cardiac arrest: a retrospective observational study.

Background: Out-of-hospital cardiac arrest (OHCA) in children is rare and can potentially result in severe neurological impairment. Our study aimed to identify characteristics of and factors associated with favourable neurological outcome following the resuscitation of children by the Swiss helicopter emergency medical service.

Materials And Methods: This retrospective observational study screened the Swiss Air-Ambulance electronic database from 01-01-2011 to 31-12-2021.

Pre-hospital endotracheal intubation in severe traumatic brain injury: ventilation targets and mortality-a retrospective analysis of 308 patients.

Background: Traumatic brain injury (TBI) remains one of the main causes of mortality and long-term disability worldwide. Maintaining physiology of brain tissue to the greatest extent possible through optimal management of blood pressure, airway, ventilation, and oxygenation, improves patient outcome. We studied the quality of prehospital care in severe TBI patients by analyzing adherence to recommended target ranges for ventilation and blood pressure, prehospital time expenditure, and their effect on mortality, as well as quality of prehospital ventilation assessed by arterial partial pressure of CO (PaCO) at hospital admission.

The forgotten cohort-lessons learned from prehospital trauma death: a retrospective cohort study.

Background: Trauma related deaths remain a relevant public health problem, in particular in the younger male population. A significant number of these deaths occur prehospitally without transfer to a hospital. These patients, sometimes termed "the forgotten cohort", are usually not included in clinical registries, resulting in a lack of information about prehospitally trauma deaths.

Factors influencing on-scene time in a physician-staffed helicopter emergency medical service (HEMS): a retrospective observational study.

Background: For helicopter emergency service systems (HEMS), the prehospital time consists of response time, on-scene time and transport time. Little is known about the factors that influence on-scene time or about differences between adult and paediatric missions in a physician-staffed HEMS.

Methods: We analysed the HEMS electronic database of Swiss Air-Rescue from 01-01-2011 to 31-12-2021 (N = 110,331).

Oral transmucosal fentanyl citrate analgesia in prehospital trauma care: an observational cohort study.

Background: Pain is one of the major prehospital symptoms in trauma patients and requires prompt management. Recent studies have reported insufficient analgesia after prehospital treatment in up to 43% of trauma patients, leaving significant room for improvement. Good evidence exists for prehospital use of oral transmucosal fentanyl citrate (OTFC) in the military setting.

Stability of Drugs Stored in Helicopters for Use by Emergency Medical Services: A Prospective Observational Study.

Study Objective: Drugs stored in rescue helicopters may be subject to extreme environmental conditions. The aim of this study was to measure whether drugs stored under the real-life conditions of a Swiss helicopter emergency medical service (HEMS) would retain their potency over the course of 1 year.

Methods: A prospective, longitudinal study measuring the temperature exposure and concentration of drugs stored on 2 rescue helicopters in Switzerland over 1 year.

Helicopter inter-hospital transfer for patients undergoing extracorporeal membrane oxygenation: a retrospective 12-year analysis of a service system.

Background: Patients undergoing extracorporeal membrane oxygenation (ECMO) are critically ill and show high mortality. Inter-hospital transfer of these patients has to be safe, with high survival rates during transport without potentially serious and life-threatening adverse events. The Swiss Air-Rescue provides 24-h/7-days per week inter-hospital helicopter transfers that include on-site ECMO cannulation if needed.

Airway management in a Helicopter Emergency Medical Service (HEMS): a retrospective observational study of 365 out-of-hospital intubations.

Background: Airway management is a key skill in any helicopter emergency medical service (HEMS). Intubation is successful less often than in the hospital, and alternative forms of airway management are more often needed.

Methods: Retrospective observational cohort study in an anaesthesiologist-staffed HEMS in Switzerland.

Helicopter emergency medical service for time critical interfacility transfers of patients with cardiovascular emergencies.

Background: The goal of improving quality through centralisation of specialised medical services must be balanced against potential harm caused by delayed access to emergency treatments in rural areas. This study aims to assess the duration of transfers of critically ill patients with cardiovascular emergencies from smaller hospitals to major medical centres by a helicopter emergency medical service (HEMS) in Switzerland.

Methods: This retrospective observational cohort study includes all consecutive emergency interfacility transfers (IFTs) conducted by Switzerland's largest HEMS provider between July 3rd, 2019, and March 31st, 2021.

Crevasse accidents in the Swiss Alps Epidemiology and mortality of 405 victims of crevasse accidents from 2010 to 2020.

Introduction: The clinical spectrum of injuries in crevasse accidents can range from benign to life-threatening, even including death. To date, little is known about incidence and causes.

Methods: We retrospectively analyzed mountain rescue missions that included crevasse accidents and took place in Switzerland from 2010 to 2020.

Incidence and challenges of helicopter emergency medical service (HEMS) rescue missions with helicopter hoist operations: analysis of 11,228 daytime and nighttime missions in Switzerland.

Objective: We aimed to investigate the medical characteristics of helicopter hoist operations (HHO) in HEMS missions.

Methods: We designed a retrospective study evaluating all HHO and other human external cargo (HEC) missions performed by Swiss Air-Rescue (Rega) between January 1, 2010, and December 31, 2019.

Results: During the study period, 9,963 (88.

Survival probability in avalanche victims with long burial (≥60 min): A retrospective study.

Background: The survival of completely buried victims in an avalanche mainly depends on burial duration. Knowledge is limited about survival probability after 60 min of complete burial.

Aim: We aimed to study the survival probability and prehospital characteristics of avalanche victims with long burial durations.

Simulation-based medical education for Ambulance Jet and Helicopter Emergency Medical Services: A program description and evaluation.

This article was migrated. The article was marked as recommended. In aviation, crew resource management trainings are established methods to enhance safety, a method that also gained popularity in medicine.

End-tidal to arterial carbon dioxide gradient is associated with increased mortality in patients with traumatic brain injury: a retrospective observational study.

Early definitive airway protection and normoventilation are key principles in the treatment of severe traumatic brain injury. These are currently guided by end tidal CO as a proxy for PaCO. We assessed whether the difference between end tidal CO and PaCO at hospital admission is associated with in-hospital mortality.

Analysis of tracheal intubation in out-of-hospital helicopter emergency medicine recorded by video laryngoscopy.

Background: Tracheal intubation remains the gold standard of airway management in emergency medicine and maximizing safety, intubation success, and especially first-pass intubation success (FPS) in these situations is imperative.

Methods: We conducted a prospective observational study on all 12 helicopter emergency medical service (HEMS) bases of the Swiss Air Rescue, between February 15, 2018, and February 14, 2019. All 428 patients on whom out-of-hospital advanced airway management was performed by the HEMS crew were included.

Nasal nalbuphine analgesia in prehospital trauma managed by first-responder personnel on ski slopes in Switzerland: an observational cohort study.

Background: Pain is one of the major symptoms complained about by patients in the prehospital setting, especially in the case of trauma. When there is mountainous topography, as in Switzerland, there may be a time delay between injury and arrival of professional rescuers, in particular on ski slopes. Administration of a safe opioid by first responders may improve overall treatment.

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective.

Background: COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services-particularly helicopter services-caring for suspected or confirmed COVID-19 patients. We aimed to describe the issues faced by air ambulance services in Europe as they transport potential COVID-19 patients.