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This consensus paper on the burns patient management in prehospital
care1 is an important development in the standardised care of these
patients by providers of early emergency care. However, there appear to be
a few anomalies in the paper.
The authors fail to mention the role of the fire service in the early
management of these patients, although several services carry burns first
aid equipment and me...
This consensus paper on the burns patient management in prehospital
care1 is an important development in the standardised care of these
patients by providers of early emergency care. However, there appear to be
a few anomalies in the paper.
The authors fail to mention the role of the fire service in the early
management of these patients, although several services carry burns first
aid equipment and medical gases and have undergone first aid training,
sometimes in conjunction with their local ambulance service.
Standard first aid, emergency department and trauma training has
historically placed the “ABCs” after the SAFE approach and before
treatment of non-life threatening injuries. The consensus guidelines
appear to place this assessment after the treatment of the burn. Unless
there is ABC compromise directly from the burn this would seem
inappropriate.
Although Clingfilm dressings are generally appropriate, mention of the
management with significant facial burns with other dressings may have
been a useful addition.
Also many ED staff are unfamiliar with the use of serial halves to assess
burns and a reference for this would be helpful.
Overall this paper is a vital step in the integration of prehospital and
emergency care for patients with burns.
References
1. Allison K, Porter K. Consensus on the prehospital approach to burns
patient management. Emerg Med J 2004;21:112-14.
On the 8th of this month, the large mutlicentre European
Resuscitation Council study comparing the effects of adrenaline and
vasopressin in out-of-hospital cardiac arrest was published. This was a
mutlicentre study conducted between 1999 and 2002 in Austria, Germany and
Switzerland. Patients with an out-of-hospital cardiac arrest requiring
cardiopulmonary resuscitation and intravenous vasopressor the...
On the 8th of this month, the large mutlicentre European
Resuscitation Council study comparing the effects of adrenaline and
vasopressin in out-of-hospital cardiac arrest was published. This was a
mutlicentre study conducted between 1999 and 2002 in Austria, Germany and
Switzerland. Patients with an out-of-hospital cardiac arrest requiring
cardiopulmonary resuscitation and intravenous vasopressor therapy were
included. The study shows no statistically significant benefit in primary
(overall survival to hospital) or secondary (overall survival to
discharge) end points. A subset analysis demonstrated that more patients
in asystolic arrest survived to hospital after the administration of
vasopressin as compared to adrenaline. Notably, the survival to discharge
did not reach clinical significance. The sub-analysis further
demonstrated that of those who did not respond to two doses of research
drug and went on to be administered adrenaline, significantly more
patients in the vasopressin group reached both end points.
This is the largest study addressing the question whether vasopressin
should be employed in an arrest. As normal practice, the Best BET
comparing these two entities has been updated to include this evidence.
Dear Editor
This consensus paper on the burns patient management in prehospital care1 is an important development in the standardised care of these patients by providers of early emergency care. However, there appear to be a few anomalies in the paper. The authors fail to mention the role of the fire service in the early management of these patients, although several services carry burns first aid equipment and me...
Dear Editor
On the 8th of this month, the large mutlicentre European Resuscitation Council study comparing the effects of adrenaline and vasopressin in out-of-hospital cardiac arrest was published. This was a mutlicentre study conducted between 1999 and 2002 in Austria, Germany and Switzerland. Patients with an out-of-hospital cardiac arrest requiring cardiopulmonary resuscitation and intravenous vasopressor the...
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