In memory of Dr John Hinds
*Conditions apply: You ARE required to have a medical qualification that was not purchased over the internet, and you WILL occasionally have to share your flight with a patient or patients with varying pathologies. Oh, and you will occasionally have to make an appearance at the hospital too (which fortunately has a top-notch helipad)
From ALiEM:
“CRM and SBT… just another set of acronyms in the world of medical education? Don’t we already have enough??
Not quite! Rather, Crisis Resource Management (CRM) is a complementary approach to Simulation Based Training (SBT). It can enhance current ongoing medical simulations or provide foundation for a vigorous curriculum when launching new simulation programs.
Crisis Resource Management is the ability to translate medical knowledge to real world actions, in the setting of an emergency.
Rather than a separate entity from medical simulation, CRM principles can be looked at as a way to focus and shape medical simulation curriculum and especially the objectives of each case to focus upon development of critical skill-sets that contribute to optimal team function and success during crisis.”
Read the rest HERE…
Continue reading “Falling head over heels – Part One”
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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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.
This paper examined the feasibility, limitations, and costs involved in providing prehospital trauma teams with blood products (2 units of O-negative red cells)
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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
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!)
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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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.
Prehospital and Retrieval Medicine - THE PHARM dedicated to the memory of Dr John Hinds 
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