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About Scott Orman

Emergency Medicine Specialist, Auckland Hospital; Auckland HEMS Doctor

Prehospital tranexamic acid use in primary and secondary air medical evacuation

BC_AmbulanceIn the latest edition of Air Medical Journal the British Columbia Ambulance Service’s AirEvac And Critical Care Operations has published a case series detailing the use of tranexamic aid by flight paramedics.

The abstract for the paper can be found HERE. The paper details 13 patients who recieved TXA over a 4 month period, with 9 patients from MVAs, 3 patients who had fallen, and one industrial accident. The average time to administration of TXA from first patient contact was 32 minutes. No complications were reported.

The authors make the point that while tranexamic acid in theory has more benefit in major trauma the earlier it is administered, the importance of it should not be overplayed. Its use occurs in their protocol after a primary survey has occurred, critical interventions have been done, and transport has been initiated. They also mention several cases where the patient met the criteria for TXA use but it was not administered, as the practitioners (who were balancing critical interventions, resuscitation, and short flight times) felt other elements of care had to take priority.

Click HERE to access the pdf (ADHB staff only)

With thanks to Russell Clarke

Crisis Resource Management – from Academic Life in Emergency Medicine

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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.

WHAT IS IT?

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