Auckland HEMS prehospital blood transfusion – coming soon to a helicopter near you

Scott Orman's avatarAuckland HEMS

Bloody hell.

Pretty much summarizes the severe traumas that define the essence of our trade.

And sometimes, the answer to critical bleeding is to give blood.

We are grateful to our colleagues at Sydney HEMS, who advise: “blood is provided to transfuse patients with life-threatening bleeding after meticulous attention to hemorrhage control.”

Auckland HEMS is poised to begin providing prehospital blood as part of our bundle of critical clinical interventions. We are fortunate to collaborate with the New Zealand Blood Service and with our local District Health Board to provide this service. http://www.nzblood.co.nz

Herein, please find our training video. We welcome your feedback.

Our draft Blood SOP is undergoing usability testing with our clinical teams. Once finalized, we will share this for FOAM.

This is an unsystematic review of the current literature. A few themes are emerging:

1. There is now evidence of survival benefit in the military and in…

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Episode 17 – The Spleen!

FOAMcast's avatarFOAMcast

(ITUNES OR LISTEN HERE)

The Free Open Access Medical Education (FOAM)

We review Dr. Scott Weingart’s episode 133 on pre-hospital REBOA (resuscitative endovascular balloon occlusion of the aorta). Weingart interviews Dr. Gareth Davies about the encounter, underscoring the increasing use of REBOA.

For a quick REBOA refresher, check out Episode 121.

REBOA (Review of REBOA) – First described in 1954 in the Korean War, this is a form of hemorrhage control below the level of the chest without having to do a thoracotomy with aortic cross clamping, which has sparse mortality benefit and can be dangerous to providers.  Most of the REBOA literature is from swine models and case-series, although there are currently larger trials underway.

  • Outline of procedure – Obtain arterial access through the common femoral artery, pass a vascular sheath, float a balloon catheter to the appropriate section of the aorta, and inflate the…

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d-loop Bougie and a King Vision enabled Mac 4 laryngoscope from Jim DuCanto

d loop Pocket Bougie and MacGyver King Vision enabled Mac 4

Our good friend Jim DuCanto continues to innovate and experiment with airways. Here is his newest idea to help manage tube delivery with shorter bougies in an efficient manner: the “d-loop”!

Continue reading “d-loop Bougie and a King Vision enabled Mac 4 laryngoscope from Jim DuCanto”

The Elaine Bromiley case – “That others may learn, so that others may live”


One of the greatest FOAMEd projects I have ever seen come to fruition, please thank Dr Nicholas Chrimes and Martin Bromiley for their tireless endeavours into human factors and improving patient safety.
Check out Nick’s education site here for more information on this video recreation.

Auckland HEMS Checklist Reference Manual

cjmdenny's avatarAuckland HEMS

Dear colleagues,

In June of this year our Canadian HEMS Fellow Dr. Robert Gooch shared one of our emergency checklists with the Prehospital and Retrieval Medicine (PHARM) community. Thank you to those of you who provided feedback on this initiative. We continue to draw inspiration from the work of Dr. Atul Gawande. http://atulgawande.com/

Now, in the spirit of Free Open Access Medicine, we are keen to share our complete Auckland HEMS Checklist Reference Manual with the PHARM community. At the start of September we made this manual operational within our service.

Innovation is one element of success; implementation is another core element.  http://www.sjtrem.com/content/19/1/53/abstract This article emphasizes the importance of end-users ‘the sharp end’ being involved throughout the checklist development process. We are fortunate to have input into this checklist from our pilots, crewmen, paramedics and doctors. Even our CEO (who is also a pilot) has shared his experience.

We see…

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