London Trauma Conference 2015: Air Ambulance & Pre-hospital Care Day

Auteur Topic: London Trauma Conference 2015: Air Ambulance & Pre-hospital Care Day  (gelezen 17134 keer)

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oma

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Reactie #10 Gepost op: 10 december 2015, 16:22:38
Citaat van: -Joost- link=msg=1390903 date=1449756325
Ik snap dat de tijd tot ROSC bij een TCA van het grootste belang is, maar is het gebruikelijk om te wachten met intubatie/RSI tot na de thoracotomie op straat? Nou zal er in een echte situatie hopelijk al een tube geplaatst zijn door de verpleegkundige of paramedic, maar het riep wel deze vraag bij me op.

Bij ons is het ook gebruikelijk dat tijdens de thoracotomie iemand zorgt voor goede IV-toegang en gaat intuberen (als het nog niet gedaan is).

Anesthesie is pas noodzakelijk op moment van ROSC, in de eerste fase van de ingreep is het niet van grootste belang.


oma

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Reactie #11 Gepost op: 10 december 2015, 19:04:45
Citaat van: Oma link=msg=1390829 date=1449730374
Methoxyflurane in Practice - Experiences from the SEC Ambulance Trust - Paul Cloves

John Wood @johnboy237
Methoxyflurane being used now in the UK @SECAmbulance. Interesting presentation on Penthrox @swasFT #LTC2015 pic.twitter.com/SZosp8lE60







oma

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Reactie #12 Gepost op: 10 december 2015, 19:06:38
Samuel Bulford @SamuelBulford
Ready for the REBOA simulation #LTC2015



James Turbett @JamesTurbett
REBOA demonstrated at #LTC2015 pic.twitter.com/0rCTs38bxD



Tom Konig @Tomkonig
@LDNairamb REBOA demonstration @LDNtrauma #LTC2015. No mannequins were harmed in the process pic.twitter.com/xXuObTR4Zd



Duncan Bew @duncanbew
#REBOA demonstration at #LTC2015 @pryormedical



Samuel Bulford @SamuelBulford
Brilliant REBOA sim at #LTC2015 - great to get familiar with this potentially lifesaving intervention pic.twitter.com/WbySBTx2sD





oma

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Reactie #13 Gepost op: 10 december 2015, 19:29:46
Citaat van: Oma link=msg=1390829 date=1449730374
Pre-hospital Sepsis - Prof. Kai Zacharowski
Q1: How to make the diagnosis?
Q2: What early interventions count?
Q3: Are biomarkers the future?

James Tooley @jamestooley
Incidence and mortality of sepsis at home #LTC2015 pic.twitter.com/kyGJqJUHAN





Alistair Quaile @aliquaile
Sepsis should be a serious consideration among ambulance services as care can begin pre-hospital #LTC2015 pic.twitter.com/JGscq1r3Zr



Alistair Quaile @aliquaile
Evidence of infection during examination #LTC2015 pic.twitter.com/qoxvIST02n



Chris Gray @cgraydoc
Remember to consider sepsis pre-hospitally, prompt recognition can help on arrival to hospital. Prof Dr Dr (!) Kai Zacharowski #LTC2015

Alistair Quaile @aliquaile
Therapy at the site given by emergency medical services #LTC2015 pic.twitter.com/zowAj5csCb



Brad Gander @BG_999_
Clinical indicators of systemic inflammatory reaction, very similar to the @SECAmbQIG #CodeYellow criteria #LTC2015 pic.twitter.com/FYH9OYKbMU



Chris Gray @cgraydoc
It's up to prehospital provider to hand over the suspicion of sepsis to the hospital so they can prioritise patient correctly KZ #LTC2015

Brad Gander @BG_999_
Feedback to amb staff vital in quality improvement & assurance. Should happen in UK. Prof Kai Zacharowski #LTC2015 pic.twitter.com/6dQ51AOoBW



Louisa Chan @louisa_chan
No surprises here! Prehospital fluids given to severe sepsis patients reduces mortality #LTC2015 pic.twitter.com/YvVRyUMPDI



Mike Christian @DrMikeChristian
#LTC2015 sepsis mgmt in prehosp setting needs to be more of a focus, a good tool @UKSepsisTrust

http://sepsistrust.org/wp-content/uploads/2013/10/PrehospitalSepticScreeningTool_EEAST.pdf


oma

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Reactie #14 Gepost op: 10 december 2015, 19:43:52
Alistair Quaile @aliquaile
Prof Zacharowski now giving quick fire session on point-of-care testing in pre-hospital haemorrhage #LTC2015

Chris Gray @cgraydoc
Trauma induced coagulopathy is not simple. It's a complex disease resulting from inflammation, bleeding, organ damage. KZ #LTC2015

Chris Gray @cgraydoc
Conventional lab testing in coagulopathy takes ages, and by the time it is back, it might not be useful anymore. KZ #LTC2015



Chris Gray @cgraydoc
No evidence for standard lab coagulation tests in trauma. Use POC ROTEM/TEG to better assess patient's needs. KZ #LTC2015

James Tooley @jamestooley
Newer methods of measuring trauma coagulapathy #LTC2015 pic.twitter.com/jtI0mnEb3o



James Tooley @jamestooley
Importance of clot lysis #LTC2015 pic.twitter.com/hr6ibykRUV



Chris Gray @cgraydoc
If your trauma patient continues to bleed, it's probably their platelet function. Check the platelets and give them platelets! KZ #LTC2015

Chris Gray @cgraydoc
Correcting coagulopathy leads to decreased blood product consumption. KZ #LTC2015

http://www.ccforum.com/content/19/1/83


oma

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Reactie #15 Gepost op: 10 december 2015, 19:46:05
Citaat van: Oma link=msg=1390829 date=1449730374
Prehospital REBOA a year on - does it work? - Dr. Samy Sadek

James Tooley @jamestooley
Reboa - does it work #LTC2015 pic.twitter.com/AI0pIS6k07



Chris Gray @cgraydoc
REBOA is for pelvic trauma pts who won't survive to theatre, and you are certain of diagnosis, as a bridge to damage control. Sadek #LTC2015

Chris Gray @cgraydoc
REBOA isn't for people with bit of low BP, it's for truly sick patients who are going to die before they reach hospital. Sadek #LTC2015

Alistair Quaile @aliquaile
Lack of REBOA cases illustrates how it is only considered in the sickest patients #LTC2015

Mike Christian @DrMikeChristian
REBOA outcome @LDNairamb #LTC2015 in past ~24m pic.twitter.com/qJcaSXJmNJ



Alistair Quaile @aliquaile
A year on from last year's talk a number of questions can be answered #LTC2015 pic.twitter.com/GrALPdTpfd



Alistair Quaile @aliquaile
Current evidence surrounding REBOA #LTC2015 pic.twitter.com/xY0liD7fyy



Brad Gander @BG_999_
Dr Samy Sadek "endovascular resuscitation is an avenue we should all look to explore" #LTC2015 pic.twitter.com/PSljIyfSYa



oma

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Reactie #16 Gepost op: 10 december 2015, 20:05:41
Citaat van: Oma link=msg=1390829 date=1449730374
PALM: Elegant rescue technique or dangerous compromise? - Dr Matt Thomas

James Tooley @jamestooley
Our @mjcthomas74 from @GWAAC talking about PALM #LTC2015 pic.twitter.com/9mxDhiF7JA



Alistair Quaile @aliquaile
Dr Matt Thomas speaking on pharmacologically assisted laryngeal mask insertion (PALM) #LTC2015

James Tooley @jamestooley
Anaesthesia ABC - Anaesthesia , biscuit , coffee ? #LTC2015 pic.twitter.com/Gkho643rNw



Chris Gray @cgraydoc
Check out @PHEM_cast LMA podcast here - @mjcthomas74 #LTC2015

http://phemcast.co.uk/2015/08/11/podcast-september-2015/

James Tooley @jamestooley
PALM for the truly trapped #LTC2015 pic.twitter.com/SLbPKF51bx



John Wood @johnboy237
This is who should be PALMED #LTC2015 pic.twitter.com/IWH89EHiVn



James Tooley @jamestooley
PALM is a rescue technique (not a primary technique) - we all have it as plan B in our failed airway algorithm even those that RSI #LTC2015

Brad Gander @BG_999_
Dr Matt Thomas with some great advice... "just because you've seen it on twitter, doesn't always make it a good idea" #LTC2015

James Tooley @jamestooley
The 10,000 hour rule - to become an expert #LTC2015 - how do you become an expert in PALM pic.twitter.com/XLHEZFfLFw



Chris Gray @cgraydoc
PALM - a great plan B but why use it as plan A? Then your only plan B is surgical airway! Thomas #LTC2015

John Wood @johnboy237
@mjcthomas74 final verdict on PALM #LTC2015 pic.twitter.com/aHQnfhzYaV



helm

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Reactie #17 Gepost op: 11 december 2015, 16:24:57
In de demo van de prehospitale thoracotomie zag ik dat er, voorafgaand aan de ingreep, thoraxcompressies gegeven werden.

Kan je dat niet beter achterwege laten?


oma

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Reactie #18 Gepost op: 11 december 2015, 18:02:51
Citaat van: René van der Helm link=msg=1391091 date=1449847497
In de demo van de prehospitale thoracotomie zag ik dat er, voorafgaand aan de ingreep, thoraxcompressies gegeven werden.

Kan je dat niet beter achterwege laten?

Ja, bij traumatisch arrest wel.


helm

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Reactie #19 Gepost op: 11 december 2015, 18:39:50
Citaat van: Oma link=msg=1391126 date=1449853371
Ja, bij traumatisch arrest wel.

Volgens mij maken de reanimatierichtlijnen 2015 voor BLS geen onderscheid en moet iedereen, dus ook bij een traumatisch arrest, gemasseerd worden. Of heb ik iets over het hoofd gezien?