Pre-hospital airway podcast

And you thought a neonate was a challenging intubation! How about a King Cobra?

As much as you may look like a stud pulling up to the Mechanics Bay carpark wearing your flight suit and playing The Backstreet Boys at high volume, the time spent driving to work is much better spent educating yourself than listening to poor-taste music and failing to be hip.

Below is the first in a series of HEMS-relevant podcasts from various sources around the interweb. This podcast comes from prehospitalmed.com, a FOAM (free-open-access-medication website) created by Dr Minh Le Cong, a Queensland RFDS doctor. This site looks like a fantastic educational resource.

The podcast is an interview with Dr Brian Burns, an Emergency Physician and Retrieval Specialist with the Greater Sydney Area HEMS. It is a discussion of two recently-published papers:

Abnormal End-Tidal Carbon Dioxide Levels on Emergency Department Arrival in Adult and Pediatric Intubated Patients

The haemodynamic response to pre-hospital RSI in injured patients

Full text pdfs are here (secure area limited to ADHB staff only – ADHB has subscription access for staff to these journals through the Philson Library at the University of Auckland School Of Medicine)

Read the full post, including the key conclusions here

… and be sure kick The Backstreet Boys into touch and play or download (by right-clicking) the podcast here

Go on.

You know being cool is overrated.

Pre-hospital RSI Resources

Pre-Hospital Intubation: Why all the controversy?

A 2007 review of reasons why pre-hospital intubation is controversial, with positive and negative evidence. By David Lockey, Frenchay Hospital, Bristol, and London HEMS

Read more here…

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Pre-Hospital Rapid Sequence Intubation

A review of method, controversy, and evidence, by Dr Peter Sherren (London HEMS), delivered to Australian College of Ambulance Professionals, October 2012

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Pre-Hospital Rapid Sequence Intubation Improves Functional Outcome For Patients With Severe Traumatic Brain Injury

Bernard et al, Annals of Surgery, 2010

A total of 312 patients with severe TBI were randomly assigned to paramedic rapid sequence intubation or hospital intubation. The success rate for paramedic intubation was 97%. At 6 months, the median GOSe score was 5 (interquartile range, 1–6) in patients intubated by paramedics compared with 3 (interquartile range, 1–6) in the patients intubated at hospital (P = 0.28). The proportion of patients with favorable outcome (GOSe, 5–8) was 80 of 157 patients (51%) in the paramedic intubation group compared with 56 of 142 patients (39%) in the hospital intubation group (risk ratio, 1.28; 95% confidence interval, 1.00–1.64; P = 0.046).

Read more here… (pdf source – Ambulance Victoria)

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Head Injury Retrieval Trial Results

A presentation by Alan Garner, Medical Director of Careflight, at ICEM 2012

Physician led prehospital trauma teams decrease the length of ICU stay for patients with severe head injury. Sensitivity analyses indicate that there may also be significant benefits in mortality and morbidity for transportation injury patients that was obscured by the highly selective cross overs in this trial

Read more here…

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Greater Sydney Area HEMS Pre-Hospital RSI Manual

Read more here…