INTRODUCTION Management of mass-casualty incidents should optimize outcomes by appropriate prehospital care, and patient triage to the most capably facilities. The number of patients, the nature of injuries, transportation needs, distances, and hospital capabilities and availabilities are all factors to be considered. Patient maldistributions such as overwhelming individual facilities, or trans...

OVERVIEW For time-sensitive, critical-care scenarios requiring transport—such as stroke, high-risk pregnancy, trauma, and pediatric care—reducing the elapsed time between symptom onset and treatment can be of great benefit to the patient while reducing the health care costs to the individual, the hospital, and the public. With mobile telemedicine, valuable prehospital transport time can be used...

INTRODUCTION Road traffic injuries (RTIs) and attendant fatalities on Nigerian roads have been on an increasing trend over the past three decades. Mortality from RTIs in Nigeria is estimated to be 162 deaths/100,000 population. This study aims to compare and identify best prehospital trauma care practices in Nigeria and some other African countries where prehospital services operate. METHODS ...

Disease or illness can strike at any time. If the condition is acute, or if the injury is life-threatening or limbthreatening, immediate care is needed. These timedependent conditions that affect both adults and children may be due to medical, surgical, or obstetric conditions. They may result from acute injuries or illnesses or from exacerbations of chronic disease. In lowand middle-income cou...

The diagnosis and treatment of dyspnea in the emergency department and in the prehospital setting is a challenge faced by the emergency physician and other prehospital care providers. While the use of lung ultrasound as a diagnostic tool in dyspneic patients has been well researched, there has been limited evaluation of its use in the prehospital setting. In the previous issue of Critical Care,...

The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint W...

Davis M, Lewell M, McLeod S, Dukelow A. A prospective evaluation of the utility of the prehospital 12-lead electrocardiogram to change patient management in the emergency department. Prehosp. Emerg. Care 2013;18(June 2012):9-14. doi:10.3109/10903127.2013.825350. [PubMed] ● Reviewer: Mat Goebel, NREMT-P, MS1, UC San Diego School of Medicine ● Why is this important?: ECG changes occur during preh...

IMPORTANCE Implementation of prehospital stroke triage is a public policy intervention that can have an immediate impact on acute stroke care in a region. OBJECTIVE To evaluate the impact that a citywide policy recommending prehospital triage of patients with suspected stroke to the nearest primary stroke center had on intravenous tissue plasminogen activator (tPA) use in Chicago, Illinois. D...

Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation of status epilepticus in the prehospital and emergency department setting. In sum...

BACKGROUND High blood pressure (BP) during acute stroke is associated with poorer stroke outcome. Trials of treatments to lower BP have not resulted in improved outcome, but this may be because treatment commenced too late. Emergency medical service staff (paramedics) are uniquely placed to administer early treatment; however, experience of prehospital randomised controlled trials (RCTs) is ver...