• Polytrauma: a case report

      Hitt, Andy (2011-01)
      Abstract published with permission. In the prehospital setting, the ‘foot of the bed inspection’ becomes an ‘over the ambulance dashboard inspection’. A mangled wreck at the foot of a tree is usually a good indication that someone has been injured and that timely clinical intervention may be required. By considering the mechanisms involved and performing a thorough primary survey, time critical patients can be triaged and treated with efficiency. As paramedics’ assessment skills continue to improve and doctors gain prehospital experience, it is anticipated that a well balanced team will emerge. A team that is aware of their limitations and limit their interventions to the time permitted to intervene. This case study is based on the young male driver of a vehicle that has been involved in a high speed collision with a tree. It aims to identify the probable pathologies, explain the pathophysiology of clinical signs and discuss, with evidence, the treatment options and appropriate destination for the patient.
    • Therapeutic hypothermia in cardiac arrest

      Hart, Lindsay; Newton, Paul (2017-03)
      Abstract published with permission. Therapeutic hypothermia (TH) following cardiac arrest is commonplace in many hospitals. It is thought to improve survival rates and offer neuroprotective benefits. However, its use in the pre-hospital arena is still uncertain. The objective of this literature review is to collect and consider evidence and address these uncertainties with a view to offering recommendations for practice. A systematic search was undertaken, and from the literature reviewed, there was no unanimous evidence that pre-hospital TH improves patient survival or neurological outcomes. It is clear that all of the different modes of initiating TH that were evaluated were effective in reducing patient temperature on arrival at hospital.