Tag Archives: helicopter

HEMS vs GEMS: by ground or by air, which is the best way to take care of traumatized patients

25 Apr

HEMS

Take home points:

Speed

Mission Time

  • –In case of simultaneous activation HEMS is competitive for distance >10 miles from Trauma Center
  • In case of non simultaneous activation HEMS is faster  for distances >45 miles from Trauma Center

 

On scene time

 

  • –HEMS > GEMS

Severity

  • –HEMS patients are generally more severely injured than GEMS patients

Trauma Center Access

  • –HEMS transported patients have more chances to be referred to a level I Trauma Center

Crew

  • –More time on scene (beyond the golden hour)
  • –More procedures performed
  • –The accuracy of prehospital documented diagnoses was not increased in HEMS compared to GEMS rescue

Survival 

  • –No definitive evidences on HEMS benefits on survival rate
  • –Recent literature points on a trend toward an increased chances of survival in some categories of trauma patients transported by HEMS

 

 

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Search and Rescue operation on Apuane Alpes

20 Lug

Interesting mission yestarday on Alps in Tuscany. See the video of the winch rescue of a 35 yrs old male injuried when climbing on Tuscany slope of Apuane Alps.

MEDEST you tube

Winch bag. Can it be a FOAMED experience?

22 Feb

We are tryng to assemble a special bag dedicated to winch operations.

This need came from many of us who found very difficult to be winched on the scene with the actual rescue bag, cause of his weight and size.

So we decided to assemble a smaller bag, less heavy with just the essentials to supply the team for a short period of time  in order to stabilize the patients before winching him on board.

We have to choose what is important and what is not in the actual bag.

Analyzing the majority of our missions, found that mostly of the procedures we perform where linked to some specific situations:

  • Traumatic cardiac arrest
  • Advanced airway management/RSI
  • Traumatic Emo/pneumo
  • Brain trauma
  • Traumatic shock (hemorragic, obstructive, spinal)
  • Anaphylaxis
  • Non traumatic shock

On this basis we decided to allocate a limited amount of drugs and equipment specifically targeted for this emergency situations.

The rest of drugs and equipment is ready on the helicopter and it can be winched in case of needing.

This is the link to visualize the preliminary list.

It will be really FOAMingful if any of you will give us a hint based on your personal experience.

What you think we are missing, and why.

Please fill the form below to submit your suggestions.

Any suggestion will be welcome and carefully analyzed.

Thanks!

MEDEST you tube

Intubare o non intubare questo è il dilemma…..

6 Gen

amleto_laringo

Siete di turno in elisoccorso, sono le 3 di un pomeriggio invernale. Vi chiamano per trasferire una donna di 44 anni affetta da stroke ischemico con emiplegia dell’emisoma destro ed afasia. La paziente non collaborante è a tratti agitata. GCS E4 V1 M5. Respiro efficace ma sbuffante, emodinamica compensata.

In anamnesi sindrome depressiva trattata con Paroxetina ed Alprazolam. Nessuna altra malattia degna di nota.

I sintomi sono insorti alle 10 della mattina e la paziente è stata trasportata, dopo sedazione (Midazolam) al DEA con ambulanza medicalizzata. Giunta in DEA viene deciso che la paziente è elegibile per la trombolisi sitemica che viene effettuata, ma a 5 ore quasi dall’insorgenza dei sintomi non ha prodotto miglioramenti clinici apprezzabili.

Motivo del trasferimento è effettuare una procedura “rescue” in locoregionale. Il tempo di trasporto verso il presidio che ospita la radiologia inteventistica è di 20-25 minuti di volo (Elicottero modello EC 145).

L’anestesista di turno e la neurologa del presidio inviante non individuano criteri per l’intubazione orotracheale.

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