Resuscitation
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The Federal Islamic Republic of the Comoros lies off between Madagascar and the Southeast Coast of Africa, and comprises a group of three islands with a total population of 651,901. The average annual income per capita is US$ 470 and life expectancies at birth are 59.3 years for men and 63.9 years for women. ⋯ The main focus of emergency medicine is disaster management and hospital-based clinical practice. There is a paucity of literature on emergency medicine in Comoros and this is the first article to report the current status of emergency medicine in Comoros Islands.
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In Lithuania pre-hospital medical services were started at the end of the 19th century. Emergency care for patients is provided free of charge and funded from a Compulsory Health Insurance Fund and by Government. ⋯ In the near future it is expected that paramedics will replace ambulance drivers. The emergency medical system is in a transition period: Admission departments are developing into emergency departments, residency programmes for emergency medicine are being prepared, and emergency medicine is going to be recognised as a separate specialty.
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We present a case of a patient with severe multiple trauma who was treated at the scene by a physician-staffed trauma life support team. Due to a complete tracheal transection, a "cannot ventilate, cannot intubate"-situation occurred. The patient was then intubated using a fiberoptic bronchoscope in the prehospital setting. The current literature concerning fiberoptic intubation in emergencies is discussed.