Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2022
Out-of-hospital cardiac arrest outcomes, end-tidal carbon dioxide and extracorporeal cardiopulmonary resuscitation eligibility: New South Wales pilot data.
To describe on-scene times for out-of-hospital cardiac arrests (OHCA) transferred to hospital, the number of these that were extracorporeal cardiopulmonary resuscitation (ECPR) eligible and potential association between end-tidal carbon dioxide (ETCO2 ) and survival so as to inform planned interventional studies. ⋯ Average on-scene time did not differ on survivorship. A small number of transferred patients with OHCA were ECPR eligible. ETCO2 less than 20 mmHg portends adverse prognosis. Our data will be used for future interventional studies.
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Emerg Med Australas · Jun 2022
Profiling helicopter emergency medical service winch operations involving physicians in Queensland, Australia.
To analyse the mission profiles of helicopter emergency medical service (HEMS) winch operations involving LifeFlight Retrieval Medicine physicians in Queensland, Australia, specifically focusing on patients' clinical characteristics, extrication methods and scene times. ⋯ Winch operations involving physicians occur infrequently in Queensland HEMS, although almost a third of missions occur overwater. Drowning victims are encountered more frequently than reported elsewhere in Australian HEMS and comprised half of the patients who underwent endotracheal intubation. Patients' severity of illness and injury may contribute to the associations between winching of physicians, increased scene times and increased use of the winch stretcher.
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Emerg Med Australas · Jun 2022
ReviewReview article: Impact of pandemics on rural emergency departments: A scoping review.
Pandemics can cause much distress to communities and present a major burden to the resources and functioning of hospitals. This scoping review aimed to identify, evaluate and summarise current literature regarding how pandemics impact rural EDs in terms of staff wellbeing, structure, function and resources. A systematic search of six databases using search terms including pandemic, ED and rural and remote was undertaken. ⋯ Rural ED functioning was affected in terms of input; with an increase in patient presentations and time to physician assessment during H1N1, but a decrease in patient presentations and transfers during COVID-19. Rural ED resources were impacted in regard to staffing, difficulty in obtaining stocks of personal protective equipment and medication, and community response. Further research to understand and address the short- and long-term impacts pandemics may have on rural EDs is required.
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Emerg Med Australas · Jun 2022
Randomized Controlled TrialRandomised controlled trial in cadavers investigating methods for intubation via a supraglottic airway device: Comparison of flexible airway scope guided versus a retrograde technique.
A supraglottic airway device (SAD) may be utilised for rescue re-oxygenation following a failed attempt at endotracheal intubation with direct or video laryngoscopy. However, the choice of subsequent method to secure a definitive airway is not clearly established. The aim of the present study was to compare two techniques for securing a definitive airway via the in-situ SAD. ⋯ Successful tracheal intubation of cadavers by EPs is achievable, without iatrogenic airway trauma, via a SAD using either a FAS or RIT, but was 35 s quicker with the FAS.