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Essex and Herts Air Ambulance: a focused case series for pre-hospital practice

02 January 2015
Volume 7 · Issue 1


Pelvic fractures cause significant mortality and morbidity in major trauma patients and contribute to early deaths both pre-hospital and in-hospital. Traditional teaching that few pre-hospital interventions benefit patients with major pelvic fractures has been challenged in recent years and a number of key early interventions are now seeing many such patients survive to reach a surgeon or interventional radiologist for definitive care. We outline the case of a 38-year-old male who sustained a crush injury resulting in a severe lateral compression fracture of his pelvis with associated haemodynamic instability. Fundamental principles of pre-hospital pelvic fracture management are explained including core techniques of patient handling, splinting and packaging along with analgesic strategies and triage principles. Novel theories and interventions for haemostasis are described. The additional care that can be provided by an enhanced care team is also discussed.

Essex and Herts Air Ambulance Trust (EHAAT) is a publically funded charity that operates two doctor-paramedic pre-hospital care teams to provide support to land ambulance crews in two counties in the South East of England. The service is predominantly helicopter-based but operates a rapid response car outside daylight hours or in poor weather. The total population covered numbers approximately 1.8 million. The team responds to major trauma and medical emergencies, with the latter accounting for approximately 20% of all taskings. The paramedics who work for the service are all employed by the East of England Ambulance Service NHS Trust, and are seconded to EHAAT for a period of 24 months. A comprehensive selection process is undertaken and an extensive training programme covering aviation practice and extended clinical management is in place for successful candidates. In addition, EHAAT paramedics have been among the first to enrol and undergo enhanced skill training in anaesthetics and intensive care medicine as part of a post graduate certificate in advanced paramedic practice in critical care. We believe that one of the strengths of the service provided by EHAAT lies in our paramedics acting as role models and ambassadors for both our service and the ambulance service in general.

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