Prehospital tranexamic acid is associated with a survival benefit without an increase in complications: Results of two harmonized randomized clinical trials – PMC

A secondary analysis was performed using harmonized data from two large, double-blinded, randomized prehospital TXA trials. Prehospital TXA is safe and independently associated with a dose-dependent lower 28-day mortality risk and lower 24-hour red …
— Read on pmc.ncbi.nlm.nih.gov/articles/PMC11422517/

Our Medicine

www.sbs.com.au/ondemand/tv-series/our-medicine

Episode 2 at 20min mark shows a psychiatric aeromedical retrieval from RFDS Cairns team with use of ketamine infusion for sedation . The patient is unintubated and responsive to voice but clearly calm and not agitated . As far as I know this is the first ever recorded televised footage of such a procedure in aeromedical setting anywhere at anytime in the world . My research and publications on the use of ketamine sedation in psychiatric aeromedical retrieval were all based on my 18yrs aeromedical work with RFDS and Cairns base and the first time I ever administered ketamine sedation for acute agitation during aeromedical retrieval was on a mission from Horn Island to Cairns . 18yrs later this documentary series records footage of a very similar retrieval mission and shows that ketamine sedation is effective and safe in the aeromedical setting for acute mental health related agitation.

Prehospital ECPR in metropolitan Australia

Survival from refractory out of hospital cardiac arrest (OHCA) without timely return of spontaneous circulation (ROSC) utilising conventional advanced cardiac life support (ACLS) therapies is dismal. CHEER3 was a safety and feasibility study of pre-hospital deployed extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) for refractory OHCA in metropolitan Australia. This was a single jurisdiction, single-arm feasibility study. Physicians, with pre-existing ECMO expertise, responded to witnessed OHCA, age < 65 yrs, within 30 min driving-time, using an ECMO equipped rapid response vehicle. If pre-hospital ECPR was undertaken, patients were transported to hospital for investigations and therapies including emergent coronary catheterisation, and standard intensive care (ICU) therapy until either cardiac and neurological recovery or palliation occurred. Analyses were descriptive. From February 2020 to May 2023, over 117 days, the team responded to 709 “potential cardiac arrest” emergency calls. 358 were confirmed OHCA. Time from emergency call to scene arrival was 27 min (15–37 min). 10 patients fulfilled the pre-defined inclusion criteria and all were successfully cannulated on scene. Time from emergency call to ECMO initiation was 50 min (35–62 min). Time from decision to ECMO support was 16 min (11–26 min). CPR duration was 46 min (32–62 min). All 10 patients were transferred to hospital for investigations and therapy. 4 patients (40%) survived to hospital discharge neurologically intact (CPC 1/2). Pre-hospital ECPR was feasible, using an experienced ECMO team from a single-centre. Overall survival was promising in this highly selected group. Further prospective studies are now warranted. — Read on sjtrem.biomedcentral.com/articles/10.1186/s13049-023-01163-0