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Out-of-hospital cardiac arrest following trauma: What does a helicopter emergency medical service offer?

ter Avest, E., Griggs, J., Prentice, C., Jeyanathan, J. and Lyon, R.M. (2019) Out-of-hospital cardiac arrest following trauma: What does a helicopter emergency medical service offer? Resuscitation, 135. pp. 73-79.

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Abstract

Introduction

Helicopter emergency medical services (HEMS) are often dispatched to patients in traumatic cardiac arrest (TCA) as they can provide treatments and advanced interventions in the pre-hospital environment that have the potential to contribute to an increased survival. This study, aimed to investigate the added value of HEMS in the treatment of TCA.

Methods

We performed a retrospective cohort study of all patients with a pre-hospital TCA who were attended by a non-urban HEMS (Kent, Surrey and Sussex Air Ambulance trust) between July 1st 2013 and May 1st 2018. We investigated how many patients got return of spontaneous circulation (ROSC) at scene, which HEMS specific advanced interventions were performed in these patients, and how these interventions were related to ROSC.

Results

During the study period 263 patients with a TCA were attended by HEMS with an average response time of 30 min [range 13–109]. 51 patients (20%) regained ROSC at scene (28 before- and 23 after arrival of HEMS). The HEMS specific interventions of blood product administration (OR 8.54 [2.84–25.72]), and RSI (2.95 [1.32–6.58]) were positively associated with ROSC. Most patients who had a ROSC had one or more HEMS specific interventions being performed – RSI (n = 19, 37%), blood product administration (n = 32, 62%), thoracostomies (n = 36, 71%) and thoracotomy (n = 1, 2%). HEMS also delivered other important interventions to these patients as IV/IO access (n = 20, 39.2%) and endotracheal intubation without drugs (n = 9, 17.6%).

Conclusion

HEMS teams should be involved in the treatment of patients with a TCA, even in non-urban areas with prolonged response times, as they provide knowledge and skills that contribute to regaining and maintaining a sustained ROSC in this critically ill and injured cohort of patients.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
ter Avest, E.
Griggs, J.
Prentice, C.
Jeyanathan, J.
Lyon, R.M.r.lyon@surrey.ac.uk
Date : February 2019
DOI : 10.1016/j.resuscitation.2018.12.019
Copyright Disclaimer : © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Uncontrolled Keywords : Traumatic cardiac arrest; HEMS; Interventions
Depositing User : Clive Harris
Date Deposited : 22 Jan 2019 09:16
Last Modified : 22 Jan 2019 09:16
URI: http://epubs.surrey.ac.uk/id/eprint/850264

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