A review of the burns caseload of a physician‐based helicopter emergency medical service

Hall, Karina; Burns, Brian

doi:10.1111/1742-6723.12810

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…They were more likely to be admitted to the ICU, and their ICU length of stay was longer, as was their hospital stay in general. These findings are similar to those of previous studies [26][27][28]37].…”

Section: Discussionsupporting

confidence: 93%

“…The present study, which included 86 patients, is one of the few to specifically assess the prehospital civilian medical management of burned patients. As in other groups described in Europe, North America and Australia, our patients were predominantly men, of working age, and were injured at home or at work [3,26,27]. The agreement between the prehospital and hospital burn size estimations was clinically correct in most cases (within the limits of agreement in 93.8% of cases).…”

Section: Discussionsupporting

confidence: 72%

“…As expected, the evolution of these parameters during prehospital management tends to standardize [39], except the systolic blood pressure, which fell in both groups at the measurement at hospital arrival. A pressure drop during burn prehospital treatment has already been reported [27], and the role of opioid analgesic has been evoked [33]. Finally, more largely affected patients had higher NACA and ISS scores.…”

Section: Discussionmentioning

confidence: 93%

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Prehospital management of burns requiring specialized burn centre evaluation: a single physician-based emergency medical service experience

Maudet

Pasquier

Pantet

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: Emergency medical services regularly encounter severe burns. As standards of care are relatively wellestablished regarding their hospital management, prehospital care is comparatively poorly defined. The aim of this study was to describe burned patients taken care of by our physician-staffed emergency medical service (PEMS). Methods: All patients directly transported by our PEMS to our burn centre between January 2008 and December 2017 were retrospectively enrolled. We specifically addressed three "burn-related" variables: prehospital and hospital burn size estimations, type and volume of infusion and pain assessment and management. We divided patients into two groups for comparison: TBSA < 20% and ≥ 20%. We a priori defined clinically acceptable limits of agreement in the small and large burn group to be ±5% and ± 10%, respectively. Results: We included 86 patients whose median age was 26 years (IQR 12-51). The median prehospital TBSA was 10% (IQR 6-25). The difference between the prehospital and hospital TBSA estimations was outside the limits of agreement at 6.2%. The limits of agreement found in the small and large burn groups were − 5.3, 4.4 and − 10.1, 11, respectively. Crystalloid infusion was reported at a median volume of 0.8 ml/kg/TBSA (IQR 0.3-1.4) during the prehospital phase, which extrapolated over the first 8 h would equal to a median volume of 10.5 ml/kg/TBSA. The median verbal numeric rating scale on scene was 6 (IQR 3-8) and 3 (IQR 2-5) at the hospital (p < 0.001). Systemic analgesia was provided to 61 (71%) patients, predominantly with fentanyl (n = 59; 69%), followed by ketamine (n = 7; 8.1%). The median doses of fentanyl and ketamine were 1.7 mcg/kg (IQR 1-2.6) and 2.1 mg/kg (IQR 0.3-3.2), respectively. Conclusions: We found good agreement in burn size estimations. The quantity of crystalloid infused was higher than the recommended amount, suggesting a potential risk for fluid overload. Most patients benefited from a correct systemic analgesia. These results emphasized the need for dedicated guidelines and decision support aids for the prehospital management of burned patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 72%