Archive for the ‘Abstract’ Category

Having a Heatwave

This post was written by Matthew Harris , Wednesday, July 1st, 2015

cc Flikr Jim Legans, JrCan you suffer a heat related emergency indoors? On the hottest day of the year most Paramedics already know that the emergency 999 call volume will steadily climb in direct relation to the outside temperature. A mini heat wave means health agencies issuing warnings to stay hydrated and the sales of factor 50 suntan lotion rocketing. For the average Paramedics the day is a long drawn out shift in the back of a vehicle with poor or no air conditioning at all. Unlike most of the “normal” working population in their climate controlled office, the Paramedic does feel the heat. But what about that elderly population, insulated in their small poorly ventilated one bedroom boxed room, the thermostat routinely stuck on high.   (more…)

Can Paramedics differentiate between Asthma and COPD?

This post was written by Matthew Harris , Wednesday, March 4th, 2015

nebuliser

Can Paramedics differentiate between the individual  presentations of Asthma or COPD ? Here in the UK, each of these two condition has it’s own clinical management plan, set out by the JRCALC, a Paramedic  guideline for clinical practice. Having two separate guidelines would be practical only if the Paramedic clinicians can differentiate between the two, but how well do they do? Can you tell your Asthma from your COPD? I’ve found a journal article abstract that asks this same question.

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UltraSound in Resuscitation

This post was written by admin , Saturday, December 29th, 2012

Using Ultrasound to determine cardiac activity in trauma patients during resuscitation to limit futile attempts at revival.

Original Article
The heart of the matter: Utility of ultrasound of cardiac activity during traumatic arrest Cureton, Elizabeth L. MD et al, full Abstract here. Journal Trauma Acute Care Surg. 2012;73: 102–110.

RSI causes Hypertention

This post was written by admin , Tuesday, June 5th, 2012

79% of patients undergoing RSI in a pre hospital environment, experience a hypertensive responce during laryngoscopy and tracheal intubation. A study involving physician led Helicopter Emergency Medical Service (HEMS) and including the Kent, Surrey and Sussex Air Ambulance Trust and the London HEMS found that the procedure provoked a sympathetic responce haemodynamic , which occurring in the traumatic brain injured patient could be detrimental.

Full Article
The haemodynamic response to pre-hospital RSI in injured patients
Perkins ZB, Gunning M, Crilly J, Lockey D, O’Brien B. via Elsevier

AF, women more at risk of stroke

This post was written by admin , Monday, June 4th, 2012

Patients with atrial fibrillation (AF) have a risk of stroke that is five times greater than that of the general population. Moreover, it has previously been described that women with atrial fibrillation have a higher annual rate of stroke than men (3% vs. 1.6%).

In this retrospective study published by the BMJ HEART journal, an international peer review journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease, it is suggested women admitted to hospital with AF were at a higher risk of stroke than men, regardless of warfarin use.

Full Article
Atrial Fibrillation: Women at higher stroke risk by Alistair Lindsay Heart Journal Scan here

Great Western Air Ambulance review

This post was written by admin , Saturday, June 2nd, 2012

A study in the EMJ, reviews patients conveyed by the Great Western Air Ambulance to its main receiving hospital Frenchay Hospital between 1 June 2008 and 1 March 2010.

Patients were conveyed up to 85 km, 79% bypassing the closest emergency department (ED). 51% of these patients had major trauma and 35% were intubated at the scene. On arrival, the mean time to CT scan was 78 min, reduced to 63 min for those with a head injury

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Full Article
Characteristics of patients transported by an air ambulance critical care team Emergency medicine journal : EMJ. 2012 May 29; via Pubmed here[/amember_protect]

Using Microwave Oven to Warm Crystaloid fluids.

This post was written by admin , Saturday, June 2nd, 2012

Ever wonder if a microwave oven is a safe and practical method for warming crystalloid fluids?

Hypothermia is a common complication in the hypovolemic patient. Warm intravenous fluids have proven valuable at preventing this complication during volume replacement. The microwave oven could be considered an applicable alternative method for warming fluids on scene.
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Additional Reading
Microwave oven: how to use it as a crystalloid fluid warmer: J Med Assoc Thai. 2009 Nov; vol. 92(11) pp. 1428-33. Full article available via Pubmed here[/amember_protect]

External laryngeal manipulation

This post was written by admin , Tuesday, May 29th, 2012

External laryngeal manipulation (ELM) is a technique used in cases of poor glottic view in direct laryngoscopy. Studies investigating ELM in the pediatric population are lacking. The objective of this study was to examine if use of ELM by inexperienced intubators improves the success rate of pediatric intubation.
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Full Article
External laryngeal manipulation does not improve the intubation success rate by novice intubators in a manikin study. American Journal Emerg Med. 2012 Mar 16, Article available at Pubmed here[/amember_protect]

A callers’ experiences in calling 999 at the onset of a stroke.

This post was written by admin , Saturday, May 26th, 2012

Many callers will seek advice from a friend, family member or advice centre before contacting EMS for somebody who is believed to be having a stroke. With the onset of acute stroke symptoms many feel this does not warrant an immediate 999 call. More public education is needed to improve awareness of stroke and the need for an urgent response.
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Full Article
Callers’ experiences of making emergency calls at the onset of acute stroke: a qualitative study Emerg Med Journal 2012;29:502-505[/amember_protect]

CRM in the ED

This post was written by admin , Wednesday, May 23rd, 2012

Crew resource management is the buzz word. The practice has been widely accepted in every other profession where a critical action could impact on the lives of a team and others around them, fire men, airline pilots and nuclear power employees all use this systems approach. The BMJ asks why trauma teams have been slow to adopt this approach?

Crew Resource Management (CRM) is creeping into clinical practice and, despite the cynicism of sceptics, it is having a positive impact. The ability of individuals to work as part of a team, and for that team to then work as an efficient single entity in a reliable and reproducible way, must be the goal of ED teams and CRM offers simple and logical ways to support this.

Find the full BMJ article here