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Push hard, push fast
It is known that the quality of cardiopulmonary resuscitation (CPR) has a huge impact on survival. The deterioration of the quality of CPR with time is well recognised and as a result, guidelines have recommended changeovers of CPR providers every 2 minutes. However, this changeover is usually not possible during emergency transportation, owing to staffing and space constraints. A study from Austria reports that feedback may be particularly effective in improving quality during longer periods of single rescuer CPR (Resuscitation 2010;81:59–64). Real-time automated feedback during transport in moving ambulances and helicopters improved CPR, especially in terms of chest compression rates.
Prehospital spinal immobilisation
Issues related to spinal immobilisation continue to be a source of controversy. Spine immobilisation is often part of the current prehospital treatment for patients with penetrating injuries to the head, neck and torso. A large retrospective study from the USA concludes that placing spinal precautions wastes precious time that could be spent transporting patients to definitive treatment centres. Patients who underwent immobilisation were more than twice as likely to die. It …