tactical combat casualty care

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In: Critical Care, Pre-Hospital, Trauma

The Tactical Combat Casualty Care (TCCC) Guidelines are the standard of care for the modern battlefield. TCCC offers operational guidelines for a range of combat personnel – from recommendations for all combatants to combat paramedics and SOF medics. Though these guidelines represent years of cumulative civilian and battlefield experience andRead More →

mechanical CPR

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In: cardiac arrest, Critical Care, Featured, Grand Round Summaries, Pre-Hospital, Resuscitation

Mechanical CPR is a technology whereby a machine performs chest compressions in place of a human provider. These devices are becoming increasingly prevalent in the prehospital and in-hospital arenas, and it is inevitable that healthcare providers will interact with them in some capacity. Given the variable evidence in the literature,Read More →

damage control

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In: Critical Care, Featured, Pre-Hospital, Resuscitation, Trauma

Hemorrhage is the leading cause of preventable death on the battlefield. Damage Control Resuscitation (DCR) works synergistically with Damage Control Surgery (DCS) and prioritizes non-surgical interventions that reduce morbidity and mortality due to trauma and hemorrhage. DCR aims to restore homeostasis and prevent or mitigate tissue hypoxia and coagulopathy. ThisRead More →

Mass Gathering Medicine

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In: Grand Round Summaries, Mass Casualty / Disaster, Pre-Hospital

Mass gathering medicine (MGM) is an exciting niche field of emergency medicine focused on providing emergency medical care at large events. Mass gatherings, as the name implies, are events in which “large numbers of people assemble in public or private spaces to celebrate or participate in musical, sporting, cultural, religious,Read More →

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In: Full Article, Journal Club, Pre-Hospital, Trauma

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5 /5 Sperry JL, et al. N Engl J Med. 2018 Jul 26;379(4):315-326.  Question and Methods: Determine the efficacy of prehospital plasma compared with standard-care resuscitation in injured patients at risk for hemorrhagic shock during air medical transport to level 1 traumaRead More →

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In: Airway, cardiac arrest, Critical Care, Featured, Full Article, Journal Club, Pre-Hospital

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Jabre P, et al. JAMA. 2018 Feb 27;319(8):779-787. Question and Methods: This was a multicenter randomized trial comparing bag valve mask ventilation with endotracheal intubation performed by emergency physicians in 2043 patients with out-of-hospital cardiac arrest in France and Belgium Findings: Their primary outcome ofRead More →

pre-hospital

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In: Mass Casualty / Disaster, Medical Education, Pre-Hospital

As dedicated in-hospital emergency providers, few of us truly understand or get to experience the difficulties and unique challenges facing our pre-hospital colleagues. Beyond the EMS handover and transfer of patient care, we seldom interact with this large and extremely important facet of our medical system. It is easy toRead More →

tactical

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In: Featured, Mass Casualty / Disaster, Pre-Hospital

TCCC (Tactical combat casualty care) outlines the priorities of care for casualties in combat applications Nearly 90% of combat fatalities occur before reaching a medical treatment facility Prehospital phase is the focus of efforts to reduce deaths in combat TCCC Working Group includes trauma surgeons, EM physicians, internists, family physicians,Read More →

pre-hospital

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In: Grand Round Summaries, Pre-Hospital

In this post, we will review several recent updates related to pre-hospital medicine. Specifically, we will: Review the role of tranexamic acid (TXA) in pre-hospital trauma Discuss the use of ketamine in Excited Delirium Examine the new Ottawa ROSC bypass protocol and new modifications to the Trauma bypass protocol forRead More →