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Helicopter emergency medical services demonstrate reduced time to emergency anaesthesia in an undifferentiated trauma population: a retrospective observational analysis across three major trauma networks.
Scand J Trauma Resusc Emerg Med
December 2024
Air Ambulance Charity Kent Surrey Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK.
Background: Early rapid sequence induction of anaesthesia (RSI) and tracheal intubation for patients with airway or ventilatory compromise following major trauma is recommended, with guidance suggesting a 45-min timeframe. Whilst on-scene RSI is recommended, the potential time benefit offered by Helicopter Emergency Medical Services (HEMS) has not been studied. We compared the time from 999/112 emergency call to delivery of RSI between patients intubated either in the Emergency Department or pre-hospital by HEMS.
View Article and Find Full Text PDFFrom Prone to Prepared: Airway Management in a Patient With Penetrating Thoracic Trauma.
Cureus
December 2024
Anesthesiology, Unidade Local de Saúde de São José, Lisbon, PRT.
Perioperative and critical care management following penetrating thoracic trauma represents a complex challenge. Those who survive the early trauma approach and reach the hospital alive often remain in critical condition, with cardiocirculatory complications and major pulmonary injuries. Additional difficulty arises from the presence of a weapon , particularly in a dorsal location, which limits patient positioning, and the safe manipulation of both the weapon and the patient.
View Article and Find Full Text PDFAssessing the evolution of pre-hospital combat casualty care: A comparative study of two conflicts a decade apart.
Am J Emerg Med
November 2024
Israel Defense Forces, Medical Corps, Kiryat Ono, Israel; The Institute of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Article Synopsis
- Combat casualty care has improved due to evidence-based protocols, with a study comparing prehospital care and outcomes of patients from conflicts in 2014 and 2023 in southern Israel.
- The study found that the number of evacuated patients increased significantly from 251 in 2014 to 940 in 2023, while the time to hospital arrival decreased.
- There was an increase in the proportion of severely injured patients, a decrease in some advanced prehospital interventions, and an increase in prehospital blood transfusions, but in-hospital mortality rates remained stable across both conflicts.
Standard Gum Elastic Bougie Versus Flexible Tip Bougie: Evaluation of Airway Adjuncts for Intubation by Paramedics in Entrapped Manikins with Difficult Airway Access-A Randomised, Controlled Trial.
Healthcare (Basel)
November 2024
Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, 90-153 Lodz, Poland.
Airway management in pre-hospital settings is often challenging and difficult to perform. This is particularly true during tracheal intubation of entrapped patients with difficult airway access. There are various airway adjuncts available in the current practice.
View Article and Find Full Text PDFPrehospital endotracheal intubation for traumatic out-of-hospital cardiac arrest and improved neurological outcomes.
Emerg Med J
November 2024
Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan.
Background: Patients with traumatic out-of-hospital cardiac arrest (t-OHCA) require on-scene airway management to maintain tissue oxygenation. However, the benefits of prehospital endotracheal intubation remain unclear, particularly regarding neurological outcomes. Therefore, this study aimed to evaluate the association between prehospital intubation and favourable neurological outcomes in patients with t-OHCA.
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