Prehospital and Retrieval Medicine – THE PHARM dedicated to the memory of Dr John Hinds

A Podcast with Minh Le Cong on beginner RSI. Recorded for my own personal reference but its such a great resource for Paramedics, Paramedic Students and a good all round touch up on the subject with a person much more knowledgeable than I.

If your not listening to Minh I highly suggest you start! His podcast was my first step into #FOAMed, so its an absolute honor to have him on my own.

You can find the Podcast over on I-Tunes:  https://itunes.apple.com/au/podcast/downstairs-care-outthere-podcast/id876296199c (please take time to leave a review or rating!!)

Below you will find some of the papers, trial and websites that we mention throughout, all are a good read. There’s also a number of different checklist ideas.

PHARM Podcast 61:
https://prehospitalmed.com/2013/02/19/pharm-podcast-61-rapid-sequence-intubation/

The Original RSII Article;

http://journals.lww.com/anesthesia-analgesia/Citation/1970/07000/Rapid_Induction_Intubation_for_Prevention_of.27.aspx

The study protocol for the Head Injury Retrieval Trial (HIRT): a single centre randomised controlled trial of physician prehospital management of severe…

This is a post put together by Dr Andrew Weatherall as background preparation for a talk at the SPANZA Paeds Update from March 14, 2015. This is an update for the occasional paeds anaesthetist. It’s not about covering it all but hopefully there’s a few useful points in there to prompt a little thought and discussion.

For lots of people who do a bit of paediatric care, there’s a bit of nervousness around little people. It’s a bit disproportionate to the numbers of actual cases of course because paeds trauma is not common. In fact, rates are slowly going down.

There is also a common paediatric conundrum to deal with – what do you do with adult evidence? This is because overwhelmingly trauma literature deals in the bigger, smellier version of Homo sapiens.

So the challenge is to provide a refresher on something that is getting less common for…

Not much research has been done in this area relating to interhospital transport, but a lot of good practice from the hospital can apply to us. You obviously have fews sedating medications available but the principle remains the same.

Take your safety into account and if your concerned raise it with your partner, the sending and receiving hospitals.

It takes a few minutes to sort out any issues and can prevent a major mishap further down the road.

All view and opinions are my own, always observe local protocols and procedures.

Work Hard and be good to your patients!

What to read;

ABC’s Transfer and Retrieval Medicine; Chapter 42, Acute Behavioural Disturbance M. Le Cong

ABC’s Prehospital Emergency Medicine; Chapter 4, Scene Safety V. Calland & P. Williams

What evidence exists about the safety of physical restraint when used by law enforcement and medical staff to control individuals with acute…

Spinal immobilization is performed in all trauma patients from the rescuers in EMS systems all over the world, regardless the mechanism of injury and the clinical signs.
This kind of approach is nowadays been rebutted from the recents evidences and the actual guidelines.
ACEP, in Jan 2015, released a policy statement entitled :”EMS Management of Patients with Potential Spinal Injury” clarifying the right indications, and contraindications, for spinal immobilization in prehospital setting.
The lack of evidence of beneficial use of devices such as spinal backboards, cervical collars etc… is in contrast with the demonstrated detrimental effects of such instruments: airway compromise, respiratory impairment, aspiration, tissue ischemia,increased intracranial pressure, and pain, consequent to spinal immobilization tools, can result in increased use of diagnostic imaging and mortality.

Already in 2009 a Cochrane review demonstrated the lack of evidences on use of spinal restriction strategies in trauma.

Recently the out of hospital validation…