Prehospital advanced life support provided by specially trained physicians: is there a benefit in terms of life years gained?

Lossius, Hans Morten; Søreide, Eldar; Hotvedt, Ragnar; Hapnes, S.; Eielsen, Olav; Førde, Olav Helge; Steen, Petter Andreas

doi:10.1034/j.1399-6576.2002.460703.x

Cited by 110 publications

(79 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Advanced treatment was provided in more than two thirds of these missions, which cannot be expected from ambulance personnel or regular GPs. Indeed, many patients with serious conditions and a high rate of providing advanced medical treatment may indicate the need for an anesthesiologist or at least a physician well‐trained in emergency medicine; however, the benefit of physician‐staffed HEMS has been debated for decades 9, 13, 15, 21, 22. In addition, the advantage of an experienced anesthesiologist capable of early and sound clinical judgment may be of more value than performing advanced interventions, as the avoidance of an intervention is best practice in some cases.…”

Section: Discussionmentioning

confidence: 99%

Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

Østerås

Brattebø

Heltne

2015

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

BackgroundThe Helicopter Emergency Medical Service (HEMS) in Norway is operated day and night, despite challenging geography and weather. In Western Norway, three ambulance helicopters, with a rapid response car as an alternative, cover close to 1 million inhabitants in an area of 45,000 km2. Our objective was to assess patterns of emergency medical problems and treatments in HEMS in a geographically large, but sparsely populated region.MethodsData from all HEMS dispatches during 2004–2013 were assessed retrospectively. Information was analyzed with respect to patient treatment and characteristics, in addition to variations in services use during the day, week, and seasons.ResultsA total of 42,456 dispatches were analyzed. One third of the patients encountered were severely ill or injured, and two thirds of these received advanced treatment. Median activation time and on‐scene time in primary helicopter missions were 5 and 11 min, respectively. Most patients (95%) were reached within 45 min by helicopter or rapid response car. Patterns of use did not change. More than one third of all dispatches were declined or aborted, mostly due to no longer medical indication, bad weather conditions, or competing missions.ConclusionOne third of the patients encountered were severely ill or injured, and more than two thirds of these received advanced treatment. HEMS use did not change over the 10‐year period, however HEMS use peaked during daytime, weekends, and the summer. More than one third of all dispatches were declined or aborted.

show abstract

Section: Discussionmentioning

confidence: 99%

Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

Østerås

Brattebø

Heltne

2015

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…Stavanger University Hospital (SUH) serves as the primary hospital for a well-defined local population of 280,000 people in the Stavanger area (23,24). Paramedic-staffed ground ambulances are supported by an emergency physician-staffed (anaesthesiologists only) ambulance helicopter and rapid response car (24).…”

Section: Methodsmentioning

confidence: 99%

“…Paramedic-staffed ground ambulances are supported by an emergency physician-staffed (anaesthesiologists only) ambulance helicopter and rapid response car (24). Comatose OHCA survivors not responding to verbal command and without terminal illness are admitted to the 12-bed general intensive care unit (ICU) for 2-3 days of ventilator therapy before weaning (23).…”

Section: Methodsmentioning

confidence: 99%

Rapid implementation of therapeutic hypothermia in comatose out‐of‐hospital cardiac arrest survivors

Busch

Søreide

Lossius

et al. 2006

Acta Anaesthesiol Scand

Self Cite

149

View full text Add to dashboard Cite

Background: The implementation of therapeutic hypothermia (TH) into daily clinical practice appears to be slow. We present our experiences with rapid implementation of a simple protocol for TH in comatose out-of-hospital cardiac arrest (OHCA) survivors. Methods: From June 2002, we started cooling pre-hospitally with sport ice packs in the groin and over the neck. In the intensive care unit (ICU), we used ice-water soaked towels over the torso. All patients were endotracheally intubated, on mechanical ventilation and sedated and paralysed. The target temperature was 33 AE 1 8C to be maintained for 12-24 h. We used simple inclusion criteria: (i) no response to verbal command during the ambulance transport independent of initial rhythm and cause of CA; (ii) age 18-80 years; and (iii) absence of cardiogenic shock (SBP < 90 mmHg despite vasopressors). We compared the first 27 comatose survivors with a presumed cardiac origin of their OHCA with 34 historic controls treated just before implementation. Results: TH was initiated in all 27 eligible patients. The target temperature was reached in 24 patients (89% success rate). ICUand hospital-length of stay did not differ significantly before and after implementation of TH. Hypokalemia (P ¼ 0.001) and insulin

show abstract

“…I Norge er det vist en sammenheng mellom alvorlighetsgrad og helsemessig gevinst av utrykning med anestesilege (Lossius et al, 2002).…”

Section: Nytteeffekten Av Legebemannet Ambulanseunclassified

For en bedre akuttmedisinsk tjeneste i Norge

Lund¹,

Ness²,

Rørtveit³

et al. 2016

Tidsskriftet

View full text Add to dashboard Cite

Prehospital advanced life support provided by specially trained physicians: is there a benefit in terms of life years gained?

Abstract: The expert panels found LYG in every 14th patient assisted by this anesthesiologist-manned prehospital EMS. There was no difference in LYG between the helicopter and the rapid response car missions. The role of the anesthesiologist was crucial for health benefits.

Cited by 110 publications

References 39 publications

Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

Rapid implementation of therapeutic hypothermia in comatose out‐of‐hospital cardiac arrest survivors

For en bedre akuttmedisinsk tjeneste i Norge

Contact Info

Product

Resources

About