BACKGROUND Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third generation. METHODS A routine ambulance was equipped with a system for real-time bidirectional a...

BACKGROUND Prehospital ultrasound has been shown to aid in the diagnosis of multiple conditions that do not generally change prehospital management. On the other hand, the diagnoses of cardiac tamponade, tension pneumothorax, or cardiac standstill may directly impact patient resuscitation in the field. STUDY OBJECTIVE To determine if prehospital care providers can learn to acquire and recogni...

INTRODUCTION The use of focused cardiac ultrasound (FoCUS) in a prehospital setting is recommended. Pocket ultrasound devices (PUDs) appear to be well suited to prehospital FoCUS. The main aim of our study was to evaluate the interpretability of echocardiography performed in a prehospital setting using a PUD based on the experience of the emergency physician (EP). METHODS This was a monocentr...

Point-of Care analysis is increasingly being applied in the prehospital scene. Arterial blood gas analysis is one of many new initiatives adding to the diagnostic tools of the prehospital physician. In this paper we present a study on the feasibility of the Radiometer ABL-90 in a ground-based Mobile Emergency Care Unit and report on some clinical situations in which the apparatus has proven ben...

OBJECTIVE Timely reperfusion therapy for ST-elevation myocardial infarction (STEMI) is an important determinant of outcome, yet targets for time to treatment are frequently unmet in North America. Prehospital strategies can reduce time to reperfusion. We sought to determine the extent to which emergency medical services (EMS) use these strategies in Canada. METHODS We carried out a cross-sect...

This paper describes a simple approach to emergency thoracotomy that can be used by a doctor in the prehospital environment and in the resuscitation room.

Background: The inability to secure a patient’s airway in the prehospital setting is a major cause of potentially preventable death in the field of trauma and emergency medicine. Methods: The University of Arizona in Tucson has established two telepresence programs, the Southern Arizona Teletrauma and Telepresence Program and Tucson Emergency Room (ER)-Link for assisting with trauma and emergen...

BACKGROUND Severe traumatic brain injury (TBI) is a significant health concern and a major burden for society. The period between trauma event and hospital admission in an emergency department (ED) could be a determinant for secondary brain injury and early survival. The aim was to investigate the relationship between prehospital factors associated with secondary brain injury (arterial hypotens...

OBJECTIVE Preclinical actions in the primary assessment of victims of blunt trauma may prolong the time to definitive clinical care. The aim of this study was to examine the duration of performed interventions and to study the effect of on-scene time (OST) and interventions performed before admission to hospital on hospital resuscitation time. METHODS 147 consecutive patients with high-energy...

The prehospital emergency airway management is a key moderating factor for patient survival and mortality rates. There has been much debate around the optimum method of management. This commentary critically appraises recent systematic review which assesses harms benefits three different strategies range clinical scenarios. Commentary on: Carney N, Totten AM, Cheney T et al. Prehospital Airway ...