European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Ketamine is a widely used drug that, depending on the dose administered, may be used as an analgesic or as a sedative or anaesthetic agent. A number of features make it attractive for prehospital use. At Essex and Herts Air Ambulance Trust, as with other services and under the guidance of a standard operating procedure, ketamine is used for both procedural sedation and as an anaesthetic agent for rapid sequence intubation. Guidelines exist that define levels of sedation and detail minimum standards of monitoring and personnel required for each level. ⋯ We describe the use of ketamine over a 4-year period for prehospital procedural sedation. Minimum standards for patient monitoring were documented in only around a quarter of cases.
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Observational Study
Training paramedics in focussed echo in life support.
The aim of this study was to determine whether paramedics can be trained to perform and interpret focussed Echo in Life Support (ELS) for the assessment of cardiac movement and the recognition of reversible causes of cardiac arrest. ⋯ Paramedics can perform focused ELS, integrate attempts into simulated cardiac arrest scenarios and retain some of this knowledge. Further work is required to assess the feasibility of incorporating this into real-world cardiac arrest management.
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The aim of this study was to determine the use of procedural sedation for head trauma-related computed tomography of the brain (CTB) in children and its association with age and Glasgow Coma Scale (GCS) scores. ⋯ Children with head injuries who require CTB are infrequently sedated. Younger children are more likely to receive sedation. These data will be useful for the assessment of CTB-associated risks.
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Comparative Study
The effect of the introduction of a regional major trauma network on triage decisions made by a physician-staffed helicopter emergency medical service.
A major trauma network (MTN) has been in place in the East of England, with a single hospital operating as the major trauma centre (MTC). The primary aim of this retrospective cohort study was to determine whether triage destination decisions with regard to trauma patients made by a helicopter-based doctor-paramedic team are affected by the introduction of a regional trauma network. In addition, we will describe and discuss the logistics of transfer of injured patients attended by the service. ⋯ The introduction of a regional MTN has not significantly affected the triage decisions made by our physician-paramedic teams.