Dr Anne Weaver London s Air Ambulance CODE RED THE BLEEDING PATIENT
|
|
- Duane Lang
- 8 years ago
- Views:
Transcription
1 Dr Anne Weaver London s Air Ambulance CODE RED THE BLEEDING PATIENT
2
3 Objectives Describe the background to Code Red Describe our Standard Operating Procedure Share our data
4 The bleeding problem Major haemorrhage is still a leading cause of death in trauma patients The average time for a trauma patient in London to reach a hospital is 66 minutes Few pre-hospital services in the UK routinely carry blood
5 The problem in London HEMS traumatic cardiac arrest 12 per month die at scene 909 traumatic cardiac arrests only one hypovolaemic patient survived (Lockey et al. Ann Emerg Med 2006) Resuscitation with 0.9% saline 200 pts / yr to Royal London serious blood loss Delay to obtain plasma in hospital
6
7
8
9
10 London HEMS patients 24% patients were coagulopathic on arrival in ED No difference in volume of fluid given on scene ie not dilutional effect In ED already behind the game!
11 Mortality rate normal coagulation: 11% coagulopathic: 46%
12
13
14
15 Catastrophic haemorrhage in PHC C ABC Tourniquets Novel haemostatic agents Handling and packaging Splintage Permissive hypotension Damage control resuscitation
16 Code Red pre-alert to MTC Call-sign, Age, sex, mechanism of injury, CODE RED, specific requests eg by-pass, cardio-thoracic surgeon
17 Pelvic injury
18 Time to definitive care..
19
20
21
22
23 SENIOR MEMBER OF TRAUMA TEAM MUST DECLARE CODE RED if: Systolic BP < 90 Poor response to initial fluid resuscitation Suspected active haemorrhage Activation based on PHYSIOLOGY NOT LABORATORY
24 CODE RED PROTOCOL Pre-alert from HEMS team More than a massive transfusion protocol
25 London & SE England Air Ambulances Physician paramedic model Senior clinicians Dispatch protocol targets seriously injured patients Ability to pre-alert any London MTC for a CODE RED
26 CODE RED what happens? HEMS pre-alert to ED Unique ID generated Blood bank informed of CODE RED hot line 2 units PRBC to helipad Belmont / level 1 - primed with blood Porter sent to lab for FFP (Pack A)
27 Prehospital CODE RED activation do we get it right? 30 months data 176 CODE RED pre-alerts to MTCs 129 patients to Royal London MOI (129 pts) RTC 58 (45%) Penetrating injury 39 (30%) Fall from height 18 (14%) Other 14 (11%)
28 Prehospital CODE RED activation Full data set for 126 pts 84 (67%) survived 20 (16%) died in ED or OR 22 (17%) died on ICU 5 cardiac arrest on arrival in ED all died
29 Prehospital CODE RED Injury Severity Score (126 pts) ISS Mean Median Overall (126) Survivors (84) Died (42) Full data available for 126 patients 42 died (33%)
30 Prehospital CODE RED Blood products given in first 24hrs Blood products Mean 95% CI PRBC FFP patients did not receive any blood products
31
32 March 2012 Blood on Board
33 Golden Hour box 4 units O negative PRBC Data logger Paperwork
34 Belmont buddy lite Light weight Battery powered Temp sensor Extracts air from circuit Warms blood or saline Pressure limited 300mmHg
35 SOP - Indications CODE RED in extremis or Traumatic arrest where hypovolaemia is considered to be a contributing factor
36 SOP - logistics Blood on aircraft and car Reserve box helipad Boxes packed by hospital transfusion team Restock / recirculated every 24 hrs
37 >1000 missions 50 prehospital transfusions 28 Code Red in extremis 22 traumatic cardiac arrests 11 PLE on scene 10 ROSC 1 infant in arrest to ED
38 39 PH Txn to ED 24 survived 8 died in ED 3 died in OR 4 died on ICU
39 Mean age 35yrs 80% male 45% ROSC from TCA
40 2.4 units PRBC transfused On-scene time 36 mins Hb 14.0 ph 7.07 BE 12.8
41 10.5u PRBC in 24hrs 8.3u FFP in 24 hrs 141 units PRBC transfused onscene 100% traceability 1 unit PRBC wasted
42 18 months data 2841 missions 140 pre-hospital transfusions 77 Code Red in extremis 63 traumatic cardiac arrest (45 thoracotomies) 31 PLE on scene 32 ROSC
43
44 26 months data 223 patients 535 units PRBC transfused onscene 100% traceability 1 unit PRBC wasted
45 National impact of blood on board Kent, Surrey and Sussex Air Ambulance Thames Valley AA Coming soon Great North AA (Cumbria and Teeside) East Anglia AA Essex and Herts AA West Midlands CARE team
46 Ultimate Code Red case 32M Jumped from 6 th floor of car park A patent B tachypnoeic, chest clear C cool, weak radial, HR 130, BP 70, abdo soft, pelvis asymmetrical. D E4 V3 M5, moving left arm, PERL
47 On-scene management MILS, Oxygen, IV access Procedural sedation Packaging with pelvic splint RSI and bilateral thoracostomies REBOA via right femoral artery 4 u PRBC on scene, 2 u PRBC on helipad TXA and calcium chloride REBOA / Code Red alert
48 Injuries Vertical shear pelvic fracture Open right humeral fracture Open right ankle fracture Bilateral calcaneal fractures Suspected lumbar spinal compression fractures Suspected tibial plateau fractures
49 REBOA Resuscitative Endovascular Balloon Occlusion of the Aorta Control of non-compressible bleeding in pelvis / lower limbs Old procedure, new launch in Emergency dept First patient to receive this intervention outside hospital Package of care
50 The bleeding patient is dying Physician paramedic teams Recognition of serious haemorrhage Utility of pre-alert protocols Massive haemorrhage protocols Pre-hospital transfusion Emergency reversal of warfarin Novel anti-coagulants Aggressive vascular control in the field
51
HEMS in an urbansetting. Anne Weaver RESUS 2013, Limerick 27 th April 2013
HEMS in an urbansetting Anne Weaver RESUS 2013, Limerick 27 th April 2013 Car at night 12 minutes by air 40 minutes by road 10 million people 25 mile radius London HEMS Pan London service Operates as
More information- Lessons from SHOT Haemorrhage cases
- Lessons from SHOT Haemorrhage cases Tony Davies Patient Blood Management Practitioner SHOT / NHSBT Patient Blood Management Team SHOT Annual Symposium 2013 For action by Trusts by April 2011 Decision
More informationGWAS Competency Mapping Levels of Medical Support Within GWAS
GWAS Competency Mapping Levels of Medical Support Within GWAS Great Western Ambulance Service NHS Trust is pleased to be able to work with a range of doctors in delivering effective pre-hospital care.
More informationPEER REVIEW VISIT REPORT (MULTI-DISCIPLINARY TEAM)
PEER REVIEW VISIT REPORT (MULTI-DISCIPLINARY TEAM) Regional Trauma Network Trauma Centre Trauma Service RMTN Network Organisation Measures (T13-1C-1) - 2013/14 Peer Review Visit Date 27th February 2014
More informationPlumbing 101:! TXA and EMS! Jay H. Reich, MD FACEP! EMS Medical Director! City of Kansas City, Missouri/Kansas City Fire Department!
Plumbing 101:! TXA and EMS! Jay H. Reich, MD FACEP! EMS Medical Director! City of Kansas City, Missouri/Kansas City Fire Department! EMS Section Chief! Department of Emergency Medicine! University of Missouri-Kansas
More informationChapter 6. Hemorrhage Control UNDER FIRE KEEP YOUR HEAD DOWN
Hemorrhage Control Chapter 6 Hemorrhage Control The hemorrhage that take[s] place when a main artery is divided is usually so rapid and so copious that the wounded man dies before help can reach him. Colonel
More informationDamage Control in Abdominal Trauma
Damage Control in Abdominal Trauma Steven Stylianos, MD Surgeon-in-Chief, Morgan Stanley Children s Hospital Rudolph Schullinger Professor of Surgery, Columbia University College of Physicians & Surgeons
More informationSouthern Stone County Fire Protection District Emergency Medical Protocols
TITLE Pediatric Medical Assessment PM 2.4 Confirm scene safety Appropriate body substance isolation procedures Number of patients Nature of illness Evaluate the need for assistance B.L.S ABC s & LOC Focused
More informationEarly Warning Scores (EWS) Clinical Sessions 2011 By Bhavin Doshi
Early Warning Scores (EWS) Clinical Sessions 2011 By Bhavin Doshi What is EWS? After qualifying, junior doctors are expected to distinguish between the moderately sick patients who can be managed in the
More informationTo FLY or to DRIVE? Helicopter Transport of Trauma Patients
To FLY or to DRIVE? Helicopter Transport of Trauma Patients Jeffrey Lubin, MD, MPH Division Chief, Transport Medicine Penn State Hershey Medical Center Life Lion EMS and Critical Care Transport Hershey,
More informationTrauma systems Prof Chris Moran, Nottingham, National Clinical Director for Trauma. (3A10)
Trauma systems Prof Chris Moran, Nottingham, National Clinical Director for Trauma. (3A10) Early trauma CT in trauma - early diagnosis directs ongoing care. The sicker the patient, the greater the benefit
More informationThe Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy
The Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy Cindy Goodrich RN, MS, CCRN Content Description Sepsis is caused by widespread tissue injury and systemic inflammation resulting
More informationField Trauma Triage & Air Ambulance Utilization. SWORBHP Answers
Field Trauma Triage & Air Ambulance Utilization SWORBHP Answers Presented by : Dr. Mike Lewell, Regional Medical Director Dr. Mike Peddle, Local Medical Director Introduction/History What s this all about?
More informationEMS POLICIES AND PROCEDURES
EMS POLICIES AND PROCEDURES POLICY #: 13 EFFECT DATE: xx/xx/05 PAGE: 1 of 4 *** DRAFT *** SUBJECT: TRIAGE OF TRAUMA PATIENTS *** DRAFT *** APPROVED BY: I. PURPOSE Art Lathrop, EMS Director Joseph A. Barger,
More informationEngland & Wales SEVERE INJURY IN CHILDREN
England & Wales SEVERE INJURY IN CHILDREN 2012 THE TRAUMA AUDIT AND RESEARCH NETWORK The TARNlet Committee Mr Ross Fisher Co-chairman of TARNlet Consultant in Paediatric Surgery Sheffi eld Children s NHS
More informationResults of streamlined regional ambulance transport and subsequent treatment of acute abdominal aortic aneurysm
CHAPTER 6 Results of streamlined regional ambulance transport and subsequent treatment of acute abdominal aortic aneurysm JW Haveman, A Karliczek, ELG Verhoeven, IFJ Tielliu, R de Vos, JH Zwaveling, JJAM
More informationAktuelle Literatur aus der Notfallmedizin
05.02.2014 Aktuelle Literatur aus der Notfallmedizin prä- und innerklinisch Aktuelle Publikationen aus 2012 / 2013 PubMed hits zu emergency medicine 12,599 Abstract OBJECTIVES: Current American Heart
More informationHelicopter emergency medical services (HEMS) response to out-of-hospital cardiac arrest
Lyon and Nelson Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2013, 21:1 ORIGINAL RESEARCH Open Access Helicopter emergency medical services (HEMS) response to out-of-hospital cardiac
More informationNORTH REGION EMS & TRAUMA CARE SYSTEM Operational Guidelines
PATIENT CARE PROCEDURES #1 Access to Prehospital EMS Care To define elements of the Regional EMS and trauma system necessary to assure rapid universal access to 911 and E-911, rapid identification of emergent
More informationResuscitation in cardiac arrest the role of the HEMS physician
Resuscitation in cardiac arrest the role of the HEMS physician Dr Anne Weaver Consultant in Emergency Medicine & Pre-hospital Care AIRMED World Congress Rome 2014 Aims Describe standard care for cardiac
More informationRuchika D. Husa, MD, MS Assistant t Professor of Medicine in the Division of Cardiology The Ohio State University Wexner Medical Center
Modified Early Warning Score (MEWS) Ruchika D. Husa, MD, MS Assistant t Professor of Medicine i in the Division of Cardiology The Ohio State University Wexner Medical Center MEWS Simple physiological scoring
More informationTITLE 836 INDIANA EMERGENCY MEDICAL SERVICES COMMISSION. ARTICLE 1.5 Trauma Field Triage and Transport Destination Requirements
TITLE 836 INDIANA EMERGENCY MEDICAL SERVICES COMMISSION ARTICLE 1.5 Trauma Field Triage and Transport Destination Requirements 836 IAC 1.5-1 Purpose Affected: [IC 10-14-3-12; IC 16-18; IC 16-21-2; IC 16-31-2-9;
More informationThe importance of the initial assessment in trauma patients /in a prehospital setting: Therapeutic decisions Patient outcomes
The importance of the initial assessment in trauma patients /in a prehospital setting: Therapeutic decisions Patient outcomes Reporter: Intern 鄭 琬 蓉 Supervisor: Dr. 朱 健 銘 Date: Sep. 16th, 2014 The nonspecific
More informationTraining Bulletin. June 2014. Emergency Health Services Branch Ministry of Health and Long-Term Care. Issue Number 113 version 1.0
Training Bulletin Field Trauma Triage and Air Ambulance Utilization Standards June 2014 Issue Number 113 version 1.0 Emergency Health Services Branch Ministry of Health and Long-Term Care Training Bulletin,
More informationThe OPALSO Prehospital Research Group OPALS
The O Prehospital Research Group The Resuscitation Outcomes Consortium Studies: Trauma Study Hypertonic Resuscitation following Traumatic Injury Purpose of the Study To determine if Hypertonic Saline with
More informationMedical Direction and Practices Board WHITE PAPER
Medical Direction and Practices Board WHITE PAPER Use of Pressors in Pre-Hospital Medicine: Proper Indication and State of the Science Regarding Proper Choice of Pressor BACKGROUND Shock is caused by a
More informationReport by the Comptroller and. SesSIon 2009 2010 5 february 2010. Major trauma care in England
Report by the Comptroller and Auditor General HC 213 SesSIon 2009 2010 5 february 2010 Major trauma care in England Our vision is to help the nation spend wisely. We promote the highest standards in financial
More informationBasic ATLS. The Primary Survey. Jason Smith MD DMI FRCS(Gen.Surg) Consultant Surgeon
Basic ATLS The Primary Survey Jason Smith MD DMI FRCS(Gen.Surg) Consultant Surgeon Trauma - expression comprising a spectrum of severity of mechanical violation of tissues, from a little scratch to a multiply
More informationPre-hospital management of patients with severe thoracic injury
Injury Vol. 26, No. 9, pp. 581-585. 1995 Copyright c 1995 Elsevier Science Ltd Printed in Great Britain. All rights reserved 002s1383195 $lo.oo+o.oo 0020-1383(95)00107-7 Pre-hospital management of patients
More informationPhysician Insertion via Helicopter Emergency Medical Services (HEMS) to Improve patient care in the time of disaster response.
Physician Insertion via Helicopter Emergency Medical Services (HEMS) to Improve patient care in the time of disaster response. JD Boston University Medical School Practicum Each of us should strive "to
More informationTRAUMA PATIENT TRANSPORT
TRAUMA PATIENT TRANSPORT I. Region XI EMS uses a pre-hospital scoring system (see Attachment 1, Trauma Field Triage Criteria) to assist with the identification of injured adult and pediatric patients and
More informationITLS & PHTLS: A Comparison
ITLS & PHTLS: A Comparison International Trauma Life Support (ITLS) is a global organization dedicated to preventing death and disability from trauma through education and emergency care. ITLS educates
More informationRapid Sequence Intubation in Pre-Hospital Care
Rapid Sequence Intubation in Pre-Hospital Care Dr Adam Chesters Specialist Registrar in Emergency Medicine and Pre-Hospital Care London s Air Ambulance CV University of Leicester Medical School Emergency
More informationEnables MDA Medical Teams to categorize victims in mass casualty scenarios, in order to be able to triage and treat casualties
MDA Disposable ALS + BLS Medical Ambulance Equipment Prices shown in CDN. Funds Items Description Picture Mass Casualty ID tag 1000 units = $350 Enables MDA Medical Teams to categorize victims in mass
More informationKing County EMS Stroke Quality Improvement Program
King County EMS Stroke Quality Improvement Program A Report from the King County EMS Medical QI Section March 2012 Prepared by Sofia Husain, Jim Duren, and Norm Nedell OBJECTIVE The goal of the King County
More informationENT Emergencies. Injuries of the Neck. Registrar Dept Trauma and emergency Medicine Tygerberg Hospital
ENT Emergencies Injuries of the Neck Registrar Dept Trauma and emergency Medicine Tygerberg Hospital Neck Injuries Blunt and Penetrating Trauma Blunt Injuries Blunt trauma direct/indirect Trauma to larynx
More information(a) Glasgow coma scale less than or equal to thirteen; (b) Loss of consciousness greater than five minutes;
ACTION: Original DATE: 09/11/2014 3:19 PM 4765-14-02 Determination of a trauma victim. Emergency medical service personnel shall use the criteria in this rule, consistent with their certification, to evaluate
More informationINTERFACILITY TRANSFERS
POLICY NO: 7013 PAGE 1 OF 8 EFFECTIVE DATE: 07-01-06 REVISED DATE: 03-15-12 APPROVED: Bryan Cleaver EMS Administrator Dr. Mark Luoto EMS Medical Director AUTHORITY: Health and Safety Code, Section 1798.172,
More informationA National Early Warning Score for the NHS
A National Early Warning Score for the NHS Professor Gary B Smith FRCA FRCP Centre of Postgraduate Medical Research & Education, School of Health and Social Care, Bournemouth University - from local data
More informationCOUNTY OF KERN EMERGENCY MEDCAL SERVICES DEPARTMENT. EMS Aircraft Dispatch-Response-Utilization Policies & Procedures
COUNTY OF KERN EMERGENCY MEDCAL SERVICES DEPARTMENT Final - May 2, 2002 Russ Blind Interim Director Robert Barnes, M.D. Medical Director TABLE OF CONTENTS Section: Topic: Page #: I. Definitions 3-4 II.
More informationKids, Cars, Falls and Brawls The Pediatric Golden Hour. Kids, Cars, Falls and Brawls The Pediatric Golden Hour. The Pediatric Golden Hour
Kids, Cars, Falls and Brawls Kids, Cars, Falls and Brawls M. Jeffrey Fein RN, CFRN Educator Critical Care Transport Team The Golden Hour The idea has been propagated from intuition and the writings of
More informationDISCHARGE CRITERIA FOR PHASE I & II- POST ANESTHESIA CARE
REFERENCES: The Joint Commission Accreditation Manual for Hospitals American Society of Post Anesthesia Nurses: Standards of Post Anesthesia Nursing Practice (1991, 2002). RELATED DOCUMENTS: SHC Administrative
More informationSuffolk County Community College School of Nursing NUR 133 ADULT NURSING I
Suffolk County Community College School of Nursing NUR 133 ADULT NURSING I Page # 1 Instructions for students: Case study # 1 For this lab, you are planning to provide care to the following client: CB
More informationsection operational issues Helicopters in mountain rescue RAF and Air Ambulance by Dr Theo Weston MBBS, DRCOG, MRCGP, DipIMC (Ed) Patterdale MRT
by Dr Theo Weston MBBS, DRCOG, MRCGP, DipIMC (Ed) Patterdale MRT The mountain arena provides for a unique set of circumstances and challenges to mountain rescuers attempting to provide medical help for,
More informationSummary of State Emergency Medical Control Committee (SEMCC) Approved Protocol Revisions September 1, 2015 NALOXONE
October 22, 2015 Summary of State Emergency Medical Control Committee (SEMCC) Approved Protocol Revisions September 1, 2015 NALOXONE Summary: Expand Naloxone down to the Emergency Medical Technician (EMT)
More informationMichigan Adult Cardiac Protocols CARDIAC ARREST GENERAL. Date: May 31, 2012 Page 1 of 5
Date: May 31, 2012 Page 1 of 5 Cardiac Arrest General This protocol should be followed for all adult cardiac arrests. Medical cardiac arrest patients undergoing attempted resuscitation should not be transported
More informationMEDEVAC112 IRELAND S FIRST EMERGENCY AEROMEDICAL SERVICE
MEDEVAC112 www.greypencils.com IRELAND S FIRST EMERGENCY AEROMEDICAL SERVICE On June 4th of this year the National Ambulance Service (NAS) saw a huge leap forward in their rapid response capabilities with
More informationClinical Guideline N/A. November 2013
State if the document is a Trust Policy/Procedure or a Clinical Guideline Clinical Guideline Document Title: Document Number 352 Version Number 1 Name and date and version number of previous document (if
More informationSTATE OF CONNECTICUT
STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH June 7, 2010 The Following Will Be Policy For Emergency Medical Service Care Providers: GUIDELINES FOR EMR, EMT, AEMT, and Paramedic DETERMINATION OF DEATH/DISCONTINUATION
More informationPeter A. Burke, MD Chief of Trauma Services Boston Medical Center
Peter A. Burke, MD Chief of Trauma Services Boston Medical Center Faculty/Presenter Disclosure Faculty: Peter A Burke MD Relationships with commercial interests: Grants/Research Support: None Speakers
More informationPennsylvania Trauma Nursing Core Curriculum. Posted to PTSF Website: 10/30/2014
Pennsylvania Trauma Nursing Core Curriculum Posted to PTSF Website: 10/30/2014 PREFACE Care of the trauma patient has evolved since 1985, when the Pennsylvania Trauma Systems Foundation (PTSF) Board of
More informationCALIFORNIA EMERGENCY MEDICAL SERVICES (EMS) MECHANICAL CIRCULATORY SUPPORT (MCS) DEVICES BEST PRACTICES GUIDELINE
CALIFORNIA EMERGENCY MEDICAL SERVICES (EMS) MECHANICAL CIRCULATORY SUPPORT (MCS) DEVICES BEST PRACTICES GUIDELINE Purpose: To provide information and direction regarding the care of patients who have a
More informationCardiac Catheterisation. Cardiology
Cardiac Catheterisation Cardiology Name: Cardiac catheterisation Version: 1 Page 1 of 7 Contents Page Number(s) 1. Introduction 3 2. Management pre operative 3 3. Management post operative 5 4. Discharge
More informationVersion 7 Related Documents Monitoring; Handover; Emergency Anaesthesia Alasdair Corfield
Emergency Medical Retrieval Service (EMRS) www.emrs.scot.nhs.uk Standard Operating Procedure Public Distribution Title Patient Documentation Version 7 Related Documents Monitoring; Handover; Emergency
More informationTelemedicine Resuscitation & Arrest Trials (TreAT)
Telemedicine Resuscitation & Arrest Trials (TreAT) Telemedicine within the ED for treating Severe Sepsis: A Hub and Spoke Telemedicine pilot SUMR Intern: Karole Collier Mentor: Dr. Brendan Carr & Dr. Anish
More informationTOPIC 1: What do we know about injury and mortality from cycling?
1 Cycling Seminar Can advances in medicine and research at Barts Health impact the number of killed or seriously injured people from cycling incidents? A hotly debated topic with wider implications across
More informationCOALINGA STATE HOSPITAL. Effective Date: August 31, 2006
COALINGA STATE HOSPITAL NURSING POLICY AND PROCEDURE MANUAL SECTION Emergency Procedures POLICY NUMBER: 715 Effective Date: August 31, 2006 SUBJECT: EMERGENCY CARE OF HEMORRHAGE 1. PURPOSE: The management
More informationTHE EFFECT OF AIR MEDICAL TRANSPORT ON SURVIVAL AFTER TRAUMA IN JOHANNESBURG, SOUTH AFRICA
THE EFFECT OF AIR MEDICAL TRANSPORT ON SURVIVAL AFTER TRAUMA IN JOHANNESBURG, SOUTH AFRICA Ari Jack Buntman, Keith Antony Yeomans Objectives. To assess the difference in survival of trauma patients transported
More informationPrehospital care - a UK perspective
Prehospital care - a UK perspective C J Carney Bedfordshire & Hertfordshire Ambulance and Paramedic Service NHS Trust, Bedford, UK In the UK, emergency ambulances are responding to astonishing increases
More informationA REVIEW OF THE COSTS AND BENEFITS OF HELICOPTER EMERGENCY AMBULANCE SERVICES IN ENGLAND AND WALES
Final version 3/7/03 A REVIEW OF THE COSTS AND BENEFITS OF HELICOPTER EMERGENCY AMBULANCE SERVICES IN ENGLAND AND WALES Final Report to the Department of Health An independent study carried out by the
More informationOperations Modified On:Nov 24, 2010 12:37
NOTE: EMS Aircraft utilized in Alameda County for prehospital emergency care will meet the qualifications specified in Title 22, Chapter 8. 1. DEFINITIONS 1.1 "EMS Aircraft" any aircraft utilized for the
More information2014 Tactical Emergency Casualty Care (TECC) Guidelines
2014 Tactical Emergency Casualty Care (TECC) DIRECT THREAT CARE (DTC) Goals: Guidelines 1. Accomplish the mission with minimal casualties 2. Prevent any casualty from sustaining additional injuries 3.
More informationVanderbilt University Medical Center Division of Trauma & Surgical Critical Care. Clinical Management Guideline: Standard Trauma Resuscitation
Vanderbilt University Medical Center Division of Trauma & Surgical Critical Care Clinical Management Guideline: Standard Trauma Resuscitation Global Communication is the key to a well organized and efficient
More informationPaediatric Major Trauma Guidelines
Paediatric Major Trauma Guidelines Acknowledgements to BCH Trauma Group Management of Traumatic Cardiac Arrest Traumatic cardiac arrest caused by trauma has a very high mortality, with an overall survival
More informationFrontline First Aid EMR Scenario Examples
Course Type: Start Date: Instructors initial scenarios as they are completed CPR-AED Scenarios CPR with Hypothermia Load and Go CPR with Obstructed Airway Continue CPR after airway clears with NO obvious
More informationThoracoabdominal aortic aneurysm
Thoracoabdominal aortic aneurysm Patient (1) - 69 PMH: 2013 - MVP, aortic root replacement with biological valve (Perimount) and subtotal aortic arch replacement Analysis for oppressive chest complaints
More informationAmbulance Trust Feedback Report. Progress in improving stroke care
Feedback Report Ambulance Trust Feedback Report Progress in improving stroke care Progress in improving stroke care Ambulance Trust Feedback Report Introduction In February 2010 we published a report on
More informationHow To Treat A Heart Attack
13 Resuscitation and preparation for anaesthesia and surgery Key Points 13.1 MANAGEMENT OF EMERGENCIES AND CARDIOPULMONARY RESUSCITATION ESSENTIAL HEALTH TECHNOLOGIES The emergency measures that are familiar
More informationTrauma Audit & Research Network. CORE Screens user guide
Trauma Audit & Research Network CORE Screens user guide Launched January 2011 BACKGROUND From January 2011 onwards the TARN Electronic Data Collection & Reporting (edcr) system will allow users to choose
More informationSeven steps to patient safety The full reference guide. Second print August 2004
Seven steps to patient safety The full reference guide Second print August 2004 National Patient Safety Agency Seven steps to patient safety 113 Appendix Four F Examples of events according to severity
More informationSIERRA-SACRAMENTO VALLEY EMS AGENCY PROGRAM POLICY REFERENCE NO. 450
SIERRA-SACRAMENTO VALLEY EMS AGENCY PROGRAM POLICY REFERENCE NO. 450 PURPOSE: To establish minimum standards for the integration of EMS aircraft and flight personnel into the EMS prehospital patient transport
More informationTo assist clinicians in the management of minor, major, and/or life-threatening bleeding in patients receiving new oral anticoagulants (NOACs).
MANAGEMENT OF BLEEDING IN PATIENTS WHO ARE RECEIVING A NEW ORAL ANTICOAGULANT (DABIGATRAN, RIVAROXABAN, APIXABAN) TARGET AUDIENCE: All Canadian health care professionals. OBJECTIVE: To assist clinicians
More informationcars and buses/coaches had much lower casualty rates of 241 and 151 per billion passenger kilometres, respectively,
Provisional 1 monthly topic of interest: admitted patient care emergency admissions 2 and unplanned accident and emergency attendances 3 caused by road traffic accidents This report focuses on hospital
More informationFirst Aid as a Life Skill. Training Requirements for Quality Provision of Unit Standard-based First Aid Training
First Aid as a Life Skill Training Requirements for Quality Provision of Unit Standard-based First Aid Training New Zealand Qualifications Authority 2010 2 Index Introduction 3 Section One: Framework outline
More informationGuidelines for diagnosis and management of acute pulmonary embolism
Guidelines for diagnosis and management of acute pulmonary embolism By Dr. Ahmed Zaghloul M.D. Anesthesia & Critical Care 2014 Predisposing factors for VTE Predisposing factor Strong predisposing factors
More informationHow To Be A Medical Flight Specialist
Job Class Profile: Medical Flight Specialist Pay Level: CG-36 Point Band: 790-813 Accountability & Decision Making Development and Leadership Environmental Working Conditions Factor Knowledge Interpersonal
More informationThe Challenge of Aero-medical Critical Care Transport. Focus on critical cases air-ambulance only
The Challenge of Aero-medical Critical Care Transport. Focus on critical cases air-ambulance only In-flight 8,000 Ft. Logistics of intrahospital transfers Is the transfer absolutely necessary? What are
More informationHead Injury. Dr Sally McCarthy Medical Director ECI
Head Injury Dr Sally McCarthy Medical Director ECI Head injury in the emergency department A common presentation 80% Mild Head Injury = GCS 14 15 10% Moderate Head Injury = GCS 9 13 10% Severe Head Injury
More informationPeter Aldrick, Chief Executive Officer
Peter Aldrick, Chief Executive Officer February 1993 Following concerns from Hospital Consultants over survival rates during transportation to hospitals in the region, a group of farmers in Lincolnshire
More informationCurrent Management of Major Burns Cocoanut Grove Fire Nov. 28 1942
Burn Injury An Update with focus on Oil and Gas Industry Current Management of Major Burns Cocoanut Grove Fire Nov. 28 1942 422 died 166 injured Boston City Hospital 300 dead on arrival; 127 alive - 39
More informationIntro Who should read this document 2 Key Messages 2 Background 2
Classification: Policy Lead Author: Nathan Griffiths, Consultant Nurse Paediatric Emergency Medicine Additional author(s): N/A Authors Division: Salford Healthcare Unique ID: DDCPan04(14) Issue number:
More informationIntermedix Inc. EMR 2006 Data Element Name. Compliant. Data Number. Elements
D01_01 EMS Agency X D01_02 EMS Agency D01_03 EMS Agency State X D01_04 EMS Agency County X D01_05 Primary Type of Service D01_06 Other Types of Service D01_07 Level of Service X D01_08 Organizational Type
More informationHow To Determine Pad
Process Representation #1 : The PAD algorithm as a sequential flow thru all sections An exploded version of the above scoped section flow is shown below. Notes: The flow presupposes existing services (
More informationNew Approaches for Prehospital Cardiac Arrest Management 2010 NCEMSF Conference
New Approaches for Prehospital Cardiac Arrest Management 2010 NCEMSF Conference Mark E. Pinchalk, MS, EMT-P Paramedic Crew Chief City of Pittsburgh EMS Out of Hospital Cardiac Arrest Poor outcomes: Arizona
More informationCENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health
CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health Manual Emergency Medical Services Administrative Policies and Procedures Policy Subject Helicopter
More informationLiau DW : Injuries and Liability Related to Peripheral Catheters: A Closed Claims Analysis. ASA Newsletter 70(6): 11-13 & 16, 2006.
Citation Liau DW : Injuries and Liability Related to Peripheral Catheters: A Closed Claims Analysis. ASA Newsletter 70(6): 11-13 & 16, 2006. Full Text An anesthesiologist inserted a 14-gauge peripheral
More informationDeveloping a Dynamic Team Approach to Stroke Care. Emergency Medical Services 2015
Developing a Dynamic Team Approach to Stroke Care Emergency Medical Services 2015 Why Stroke, Why now? A recent study showed that 80 percent of people in the United States live within an hour s drive of
More informationMLFD Standard Operating Guidelines SOG# 12-22 Subject: Patient Transfer of Care Initiated 1/30/2013
MLFD Standard Operating Guidelines SOG# 12-22 Subject: Patient Transfer of Care Initiated 1/30/2013 Approved: Revised PURPOSE It is the purpose of this SOG to provide and ensure the highest level of patient
More informationCritical Bleeding Reversal Protocol
Critical Bleeding Reversal Protocol Coagulopathy, either drug related or multifactorial, is a major contributing factor to bleeding related mortality in a variety of clinical settings. Standard therapy
More informationGlossary of Terms and Acronyms
Glossary of Terms and Acronyms Term/Abbreviation Accident and Emergency (A&E) Service Advanced Medical Priority Dispatch System (AMPDS) Ambulance Quality Indicators (AQIs) Ambulance Service Cardiovascular
More information14 TRAINING. 2 2011 I Vol. 2 I AirRescue I 14
14 TRAINING 2 2011 I Vol. 2 I AirRescue I 14 TRAINING 15 Fig. 1: LAA is one out of 18 air ambulance charities in the UK, overall operating around 30 helicopters and flying a total of nearly 20,000 missions
More informationFirst Responder: The National EMS Scope of Practice changes the name to Emergency Medical Responder.
APPROVED SCOPE 2/8/08 BOARD MTG First Responder: The National EMS Scope of Practice changes the name to Emergency Medical Responder. Emergency Medical Responder (EMR) Description of the Profession The
More informationAdoption of the National Early Warning Score: a survey of hospital trusts in England, Northern Ireland and Wales
The UK s European university Adoption of the National Early Warning Score: a survey of hospital trusts in England, Northern Ireland and Wales Ugochi Nwulu, University of Kent Professor Jamie Coleman, University
More informationVacuum mattress, Bariatric Transfer, Monitoring Documents Lisa Curatolo / Pete Davis Reviewer Stephen Hearns / Alistair Kennedy
Emergency Medical Retrieval Service (EMRS) www.emrs.scot.nhs.uk Standard Operating Procedure Public Distribution Title Packaging Version 9 Related Vacuum mattress, Bariatric Transfer, Monitoring Documents
More informationON SCENE CONVEYANCE AND REFERRAL PROCEDURE
East Midlands Ambulance Service NHS Trust ON SCENE CONVEYANCE AND REFERRAL PROCEDURE Links The following documents are closely associated with this procedure: Transfer of Patients Policy Capacity to Consent
More informationResuscitation in congenital heart disease. Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto
Resuscitation in congenital heart disease Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto Evolution of Congenital Heart Disease Extraordinary success: Overall
More informationPediatric Consultation and Transfer Guidelines
Pediatric Consultation and Transfer Guidelines Introduction Hospitals that are designated trauma centers must have transfer guidelines in place as part of the designation process. In response to the many
More informationCommunity Ambulance Service of Minot ALS Standing Orders Legend
Legend Indicates General Information and Guidelines Indicates Procedures Indicates Medication Administration Indicates Referral to Other Protocol Indicates Referral to Online Medical Direction Pediatric
More informationSE5h, Sepsis Education.pdf. Surviving Sepsis
Surviving Sepsis 1 Scope and Impact of the Problem: Severe sepsis is a major healthcare problem that affects millions of people around the world each year with an extremely high mortality rate of 30 to
More informationEmergency Medical Technician - Basic
Washington State Specific Objectives for Emergency Medical Technician - Basic OFFICE OF EMERGENCY MEDICAL AND TRAUMA PREVENTION September 1996 Emergency Medical Technician - Basic Definition: Emergency
More information