Journal of the Royal Army Medical Corps
-
Creating opportunities for pre-hospital emergency care Army medical staff to maintain their clinical and medical management skills whilst in barracks has always been a challenge for Commanding Officers. In the past there have been informal relationships between some units and Ambulance Trusts; however, these have usually faltered and been seen as unsustainable. Memoranda of Understanding (MoU) between 5 General Support Medical Regiment and the North West and Yorkshire Ambulance Service NHS Trusts, using the Ministry of Defence/Department of Health Concordat as a backdrop, has hopefully created a more formal training relationship which will produce a sustainable collaboration to create training opportunities for both parties. This article highlights the training opportunities available, the factors to consider in planning MoUs and the benefits to be gained.
-
Following in the footsteps of Victor Horsley, the 'father of British neurosurgery', Hugh Cairns continued the tradition ofgreat neurosurgeons associated with the Royal Army Medical Corps. He was a central figure in the acceptance of neurosurgery as a specialty in its own right in Britain, was instrumental in the foundation of Oxford University Medical School, and can legitimately claim to have significantly improved mortality figures in neurosurgical casualties in the Second World War. He was also the driving force in the acceptance of crash helmets for motorcyclists, which have substantially reduced the mortality rates of motorcyclists in those countries in which they have been introduced.
-
Comparative Study
Airway management at floor level: a comparison of tracheal intubation using the Macintosh and Airtraq laryngoscopes.
Practitioners providing pre-hospital care during civilian practice and on military operations may be required to perform airway management and tracheal intubation at floor level. It has been shown that intubation using the Airtraq laryngoscope is easier to learn than standard Macintosh laryngoscopy. We hypothesised that the Airtraq would be easier to use and have shorter intubation times than Macintosh intubation. ⋯ The Airtraq was found to be superior in ease of use (VAS 30 mm, P < 0.001), had a shorter total intubation time (19.4seconds) and a higher intubation success rate (P = 0.012) than the Macintosh laryngoscope (VAS 50 mm, 20.4 seconds). Rotating the tracheal tube 90 degrees anticlockwise during loading into the guiding channel, made the Airtraq intubation easier (VAS 30 mm, P = 0.001) and faster (19.4 seconds, P < 0.001) than with standard orientation of the tube (VAS 40 mm, 25.3 seconds). Airtraq intubation may prove to be easier than Macintosh intubation, when utilised in the clinical pre-hospital setting, though randomised controlled clinical trials are required to confirm this.