Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2017
A review of the burns caseload of a physician-based helicopter emergency medical service.
The aim of this study was to describe patient demographics, injuries, physiology and interventions performed by retrieval physicians in the care of burns patients in both a pre-hospital and interhospital setting. ⋯ The Service cares for 80-100 burns patients annually, a proportion of whom require complex interventions such as intubation and escharotomy, which was performed by retrieval physicians appropriately. Associated traumatic injuries were infrequent in patients who sustained burns from flashes or explosions.
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Emerg Med Australas · Aug 2017
Consistency of total body surface area assessment in severe burns: Implications for practice.
Paediatric burn injury is common and often serious. Injuries occur across New South Wales (NSW), with specialised treatment provided in a centralised burns unit. Early management prior to transfer is essential but variation is seen. ⋯ Our review demonstrated significant differences between the TBSA assessment of referring hospitals and the NSW Burns Unit. These inconsistencies may have resulted in children receiving treatment and transport not indicated based on accurate TBSA assessment. Potentially unnecessary transfers have implications for the displacement of children and families but also impact overall health costs and resource availability.
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Emerg Med Australas · Aug 2017
Integrated major haemorrhage management in the retrieval setting: Damage control resuscitation from referral to receiving facility.
Major haemorrhage is a leading cause of death in critically ill or injured patients requiring medical retrieval and presents significant clinical and logistic challenges irrespective of patient location, primary pathophysiology or mode of transport. It is essential that all care providers involved in the retrieval patient pathway, including referring hospitals, ambulance services, retrieval teams and tertiary receiving centres, adopt a common approach to the management of this complex patient group through the use of retrieval-specific, integrated protocols. These should incorporate the latest clinical evidence base, recognise the differences between primary and inter-facility missions and clearly define the roles and responsibilities of the retrieval clinical coordinator. By unifying the response across services, the aim is to facilitate seamless transition of care with ongoing damage control resuscitation from point of referral, during transfer and on arrival at the receiving centre.