Continue reading “Australian & New Zealand Specialist Airway Course”
Ticket to Ride
RAPID: Ticagrelor e Copidogrel a confronto nel paziente con STEMI.
Dont let language barrier stop the FOAMED..use Google Chrome translator to convert Italian to English in one click!
Comparison of Prasugrel and Ticagrelor Loading Doses in ST-Segment Elevation Myocardial Infarction Patients
RAPID (Rapid Activity of Platelet Inhibitor Drugs) Primary PCI Study
Guido Parodi, MD, PHD, Renato Valenti, MD, Benedetta Bellandi, MD, Angela Migliorini, MD, Rossella Marcucci, MD, Vincenzo Comito, MD, Nazario Carrabba, MD, Alberto Santini, MD, Gian Franco Gensini, MD, Rosanna Abbate, MD, David Antoniucci, MD Florence, Italy
OBJECTIVES: This study sought to compare the action of prasugrel and ticagrelor in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). BACKGROUND: It has been documented that prasugrel and ticagrelor are able to provide effective platelet inhibition 2 h after a loading dose (LD). However, the pharmacodynamic measurements after prasugrel and ticagrelor LD have been provided by assessing only healthy volunteers or subjects with stable coronary artery disease. METHODS: Fifty patients with STEMI undergoing PPCI with bivalirudin monotherapy were randomized to receive 60 mg…
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Beyond BASIC: Everything you ever wanted to know about the kidney but were afraid to ask.
Assassin’s Creed & Preintubation hypotension
All ashore
Prehospital blood product use
Auckland HEMS is currently exploring the use of blood products in our prehospital environment.
Two interesting papers regarding prehospital blood product use were recently published by the Queensland Ambulance Service. The Queensland Ambulance Service maintains a 24/7 doctor/paramedic trauma response team that is dispatched to significant trauma cases in the greater Brisbane area.
Despite the fact that the prehospital service in these studies is road-based, the patient cohort (predominantly blunt trauma), prehospital staffing (often initially ambulance crew followed by doctor/paramedic team), and prehospital times are highly applicable to our service.
The feasibility of civilian prehospital trauma teams carrying and administering packed red blood cells
This paper examined the feasibility, limitations, and costs involved in providing prehospital trauma teams with blood products (2 units of O-negative red cells)
- Of 500 units of RBCs provided to the service over 18 months, 26% were transfused
- 97.8% of non-transfused units were returned to the…
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Greater Sydney Area HEMS podcasts
Our colleagues from Sydney have created an excellent group of podcasts about pre-hospital and retrieval medicine:
NEUROPROTECTION – covers retrieval of patients with neurological and neurosurgical emergencies; also view their helicopter operating procedure HERE
INTERHOSPITAL PATIENT ASSESSMENT – overview of the assessment of a critically ill patient requiring transfer from one facility to another
THE TRAPPED PATIENT – overview of the approach to a patient trapped in a vehicle
Human factors in aviation errors – The Dirty Dozen
Following a spate of aviation accidents in the 1980’s and 1990’s, Transport Canada and the aviation industry came up with the aviation ‘Dirty Dozen’ – human factors in aviation maintenance that commonly lead to errors.
Consider these in the context of your prehospital or emergency service:
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(thanks to Tim Leeuwenburg at KIdocs.org for this one!)
Prehospital amputation
For all your prehospital amputation needs!
Auckland HEMS has recently added a Gigli saw to the medical pack in case a patient requires prehospital amputation. Fortunately the team has not yet been required to perform this procedure. Anecdotally, prehospital amputations that have been performed by paramedic staffed EMS in the Auckland area in recent years have involved near-total amputation due to injury itself, with limbs attached with minimal skin or soft tissue.
EMJ published an excellent review article of the procedure in 2010, which covers indications, contraindications, and technique. Click HERE for the full pdf (secure area limited to ADHB staff, who have access to this journal via the Philson Library at the University of Auckland School of Medicine)
The Medical College of Wisconsin has produced 3 educational videos, and made available a field manual for physicians who provide assistance to fire crews and EMS in the field.
Click HERE for a brief case report…
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How to deliver Nasal Positive Pressure Oxygenation & allow free access to oropharynx
AmboFOAM Podcast: Post Cardiac Arrest Care.
Many moons ago it was common practice that as soon as we had a pulse back from an arrested patient we would throw them in the ambulance and drive fast to hospital with little, if any, further management…
This has changed and now there are a number of goals we try to achieve prior too and during transport. This podcast is about the management of the post-arrest patient and why we do what we do in these situations.
I hope you enjoy it and as always feedback is appreciated.
AmboFOAM Podcast: Cardiac Arrest
AMBOFOAM Arrest PODCAST Pt 1. TUne in and listen up to Rob!
Welcome again to the AmboFOAM podcast. This is part one of two episodes on cardiac arrest. These podcasts are again designed for the new paramedic or paramedic student. This time we are discussing cardiac arrest, primarily why we do what we do at an arrest. Part two will deal with the post-arrest patient and why we do what we do with them.
Please feel free to drop me a line with any comments or questions you may have.
Click to play, or right click and select “Save as” to download the MP3 version to play later.
Enjoy
Outbreak
VBG v ABG
Thanks Ben and Anne!
Prehospital and Retrieval Medicine - THE PHARM dedicated to the memory of Dr John Hinds 
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