Where in the World of EMS is (Flat) A.J. Heightman?

It’s not yet noon and I’ve got my finger poking through the side of a sow, knuckle deep. The large surgical lamps are beating down upon me and the other five members of my group and, combined with the assortment of protective gear we’re wearing, we’re—well, sweating like pigs. The lung at my fingertip continues to expand and fall as we imagine it belongs to a man who just fell from a third-story window. Ten minutes prior, it belonged to a geriatric man who’d crashed his motorcycle. Before that, our swine was a woman ejected from her vehicle during a crash. This is all part of the porcine lab conducted at Baylor College of Medicine (BCM) for the paramedics at Montgomery County Hospital District (MCHD) in Texas. Pigs are anesthetized and placed in different scenarios for the paramedics to respond and react to while a BCM resident monitors the vital signs to ensure the animal never feels a thing. MCHD Clinical Services Manager Jordan Anderson, Medical Director Robert Dickson, and Quality Coordinator Kevin Crocker with the system’s first simple thoracostomy save. It’s a level of training that can only come from working on a living, breathing creature. In the first scenario, our patient has been deeply cut in four areas and she’s hemorrhaging fast. The crew is soaking up blood with 4x4s but the fear of her exsanguinating is too real. And that’s where this training lab excels. It’s one thing to teach a medic how to ...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Training Source Type: news

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ConclusionsHoist rescue was performed in 10% (148) of the SAR operations. New information about hoist extrication time intervals can improve rescue helicopter dispatch accuracy.
Source: Wilderness and Environmental Medicine - Category: Environmental Health Source Type: research
Conclusions: The DC-TAV program is an ambitious, civilian-military, nationwide and long-term program, based on a harmonised standard of care and including multidimensional training. Further studies are required to assess its efficacy.
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Conclusions: The therapeutic efficacy of rFVIIa is dependent on the adequacy of hemostatic resuscitation; restoration of normal serum fibrinogen, INR, and platelet counts>100 K/mL may provide an adequate substrate for rFVIIa to be effective in managing refractory postoperative cardiac surgical bleeding. PMID: 31621674 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
We present descriptive data and discussion about the first 100 cases managed by this new trauma service. Some call-outs involved multiple cases. The data covers a period of 130 days from late July 2018 to late November 2018. Methods: Information from all HEMS cases was captured manually and records retained for governance purposes. For the purpose of this paper we conducted a hand trawl of records relating to the first 100 cases managed by the HEMS team. Data was entered into a database for the purpose of analysis. Measured data included: location of incident, mode of dispatch, patient demographics, mechanism of injur...
Source: The Ulster Medical Journal - Category: General Medicine Authors: Tags: Ulster Med J Source Type: research
CONCLUSION Among elderly fall patients, CT-identified rib fractures were associated with increased hospital admissions. However, there was no difference in procedural interventions, ICU admission, hospital/ICU LOS or mortality for patients with and without radiographically occult fractures. LEVEL OF EVIDENCE Diagnostic, level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research
​Seventy-five percent of trauma injuries involve some kind of thoracic insult, a quarter of which need a procedural intervention like a chest tube. (Surg Clin North Am 2007;87[1]:95; http://bit.ly/2HaoX90.) Long-term illness, lung disease, and post-operative complications may cause pleural effusions or a pneumothorax, so treating these conditions quickly can significantly decrease patient morbidity and mortality. Other indications for chest tube placement include:Trauma: Pneumothorax, hemopneumothorax, or tension pneumothoraxLong-term illness: Pleural effusion (cancer, pneumonia)Infection: Empyema, purulent pleuriti...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Purpose of review Hemorrhage is the major cause of early death in severely injured patients. In civilian emergency medical services, the majority of life-threatening bleedings are found in noncompressible body regions (e.g. abdomen and pelvis). Resuscitative endovascular balloon occlusion of the aorta (REBOA) has therefore been discussed in recent years as a possible lifesaving procedure and numerous studies, meta-analyses and guidelines have been published. In this review, the data situation of REBOA in the management of bleeding trauma patients is discussed and practical implementation is depicted. Recent findings T...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: TRAUMA AND TRANSFUSION: Edited by Corey Scher Source Type: research
Publication date: Available online 5 December 2018Source: The Annals of Thoracic SurgeryAuthor(s): Kimihiro Shimizu, Yoichi Ohtaki, Seshiru Nakazawa, Kai Obayashi, Toshiteru Nagashima, Toshiki Yajima, Akira Mogi, Ken ShirabeAbstractWe herein report the technical details of minimally invasive open-window thoracostomy using wound edge protectors for postoperative pyothorax following bronchopleural fistula with acute exacerbation of idiopathic pulmonary fibrosis under epidural and local anesthesia.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract We herein report the technical details of minimally invasive open-window thoracostomy using wound edge protectors for postoperative pyothorax following bronchopleural fistula with acute exacerbation of idiopathic pulmonary fibrosis under epidural and local anesthesia. PMID: 30529214 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
We report an extremely rare case of accidental insertion of a chest tube into the left atrium via the right pulmonary vein during an interventional radiology-guided placement of the catheter. To our knowledge, such a case has not been reported to date. The anesthetic and surgical management of this injury are discussed.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
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