Blast injuries resulting from explosions have the capacity to cause life-threatening multisystem injuries in multiple victims simultaneously. The biggest potential challenge in managing blast injuries is the creation of large numbers of simultaneous critically ill casualties. Once notified of a possible bombing or explosion, Emergency Physicians should immediately consider activatingRead More →
There was a significant amount of pre-hospital research published in 2018; many trials were that will no doubt inform future guidelines and change practice. This post seeks to look at some of the historical features of prehospital research and give us a road map for how we got here. Pre-HospitalRead More →
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 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 →
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 (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 →
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 →
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 →
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 →
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 →