prehospital

Methoxyflurane (Penthrox®)—a case series of use in the prehospital setting

These case reports are from prehospital settings and involve patients experiencing traumatic injuries who were attended by rapid response doctors. The cases are from the UK and Ireland..

Acute traumatic coagulopathy: the lethal triad of trauma

The prehospital clinician is often the first to manage a patient with a reduced temperature as a result of loss in circulatory volume caused by trauma so has an important early role in the management...

Splinting of injuries: best practice guidance

A splint is a device that is used to support an injury that has caused a body part (normally an extremity) and the associated joints not to function in a normal manner; it achieves this by...

Tourniquets in the treatment of prehospital haemorrhage

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Correct pulse measurement

When the heart contracts and blood is ejected from the left ventricle, a pressure wave is generated and transmitted into the aorta and arterial tree. The flexible and elastic nature of artery walls...

Hyperventilation syndrome: diagnosis and reassurance

The term hyperventilation syndrome (HVS) was first mentioned in 1938 by Kerr et al who attributed their patients' tetany to hyperventilation associated with anxiety. Since then, the term has been...

Recognising ECG landmarks

Electrocardiograms (ECGs) have become an integrated part of an ambulance clinician's toolkit, with thousands being performed each year (Brady et al, 2012). Invented in 1903 by Willem Einthoven, a...

Point-of-care ultrasound use in the pre-hospital setting

Since its introduction, POCUS has been used to enhance the assessment of a wide range of clinical conditions across medical and traumatic pathologies. For example, the ‘focused assessment with...

Hand hygiene compliance in the pre-hospital setting

Health professionals' compliance with hand hygiene remains a universal problem in health care (Gould et al, 2017; Sunley et al, 2018). While poor hand hygiene is prevalent in the inpatient and...

Using haemostats effectively in pre-hospital care

The purpose of this month's Clinical Skills column is to provide safe and effective best practice guidance for the use of haemostatic agents, or haemostats, in the pre-hospital environment. The topic...

Traumatic cardiac arrest: what's HOT and what's not

Treatment and management is increasingly being directed at the rapid identification and reversal of potential causes. Reversing hypovolaemia, oxygenation and tension pneumothorax (HOT) as a priority...

Intraosseous access: a safe alternative route

IO infusion is a method of administration of medications or fluids directly into the marrow of a bone (Figure 1)..