Air medical journal
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Air medical journal · Nov 2014
Case ReportsPlacement of a central venous catheter in the antecubital vein using a modified seldinger technique.
To describe a case of a patient requiring inotropic support without central venous access in which the central venous catheter (CVC) was placed in the antecubital vein using a modified seldinger technique. ⋯ This case represents a dilemma faced in the prehospital environment by retrieval teams and offers a novel technique as a temporizing solution until appropriate CVC access can be gained.
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Trauma accounts for a significant portion of overall mortality globally. Hemorrhage is the second major cause of mortality in the prehospital environment. Air medical retrieval services throughout the world have been developed to help improve the outcomes of patients suffering from a broad range of medical conditions, including trauma. ⋯ However, studies have suggested that IO access cannot reach acceptable rates for massive transfusion. We review the subject to find the answer of whether IO access should be performed by air medical teams in the prehospital setting, or would central venous (CVC) access be more appropriate? We decided to assess the literature for capacity of IO access to meet resuscitation requirements in the prehospital management of trauma. We also decided to compare the insertion and complication characteristics of IO and CVC access.
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Air medical journal · May 2014
Evaluation of Dutch Helicopter Emergency Medical Services in transporting children.
In the Netherlands, helicopter emergency medical services (HEMS) function as an adjunct to paramedic ambulance service delivering hospital-level medical care to a prehospital location. The main goal of Dutch HEMS is to provide on-scene medical expertise and not primarily to serve as transport. The transportation of patients to specialized hospitals is sometimes mandatory, especially in cases of critically ill or wounded children. In the literature, no support can be found to support the safety of transportation by helicopter. We retrospectively evaluated the safety of this type of transportation and if any problems were encountered transporting children by helicopter. ⋯ We conclude that transporting children by helicopter is a safe method of transportation for critically ill children to adequately equipped medical centers.