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Algorithms are helpful to improve survival outcomes for Pre-hospital management in severe patients
(Tueben et al. 2019)
(Thim et al. 2012) & the Resus Council explains the more details on what to look for on each ABCDE
algorithm assessment and treatment
2015 American Heart Association and European Resuscitation Guideline suggest each CPR
compression should be at least 5cm and less than 6cm
Schmicker et al. 2021 show 30:2 is better than chest compressions if done correctly
Goyal et al. 2022 shows how the first 30 seconds of the CPR did to the casualty
Zemaitis et al. 2023 shows only start secondary survey when casualty shows ROSC and explanation
for the head to toe examination
Planas et al. 2022 explain the procedure of checking circulation, disability and exposure in primary
survey post trauma
Sujan et al. 2013 on the importance of filling in ATMIST and SAMPLE to pass on across care
boundaties
AVPU Scale:
➢ Romanelli & Farrell (2023) suggested that it is quick and simple way to detect altered mental
status, primarly used in trauma and first aid. As a decreased mental status could indicate
inadequate circulation of oxygenated blood to the brain.
➢ can be monitored in situations where player breathing but unconscious & unresponsive.
➢ Dooley (2011) mentioned the Testing the ANS of the brainstem and check for potential
brainstem injury
➢ Planas et al. (2023) said GCS <8 indicated the patient may have reduced airway reflexes
making them unable to protect their airways
Cardiac Arrest
➢ Kleinman et al. (2010) mentioned paediatric cardiac arrest mainly happen due to respiratory
failure, while it is usually cardiac issues in adults. That’s why 5 initial rescue breath for
children.
➢ De Jong et al. (2019) provides S&S on how to look for sudden cardiac arrest on the field, from
7 seconds start losing consciousness and 36 to 120 seconds start stopping to breath
CPR
➢ After cardiac arrest a combination of basic and advanced airway and ventilation techniques
are used during cardiopulmonary resuscitation (Newell et al, 2018)
➢ The main difference between normal Adult Life support and Advanced
➢ Idris 2012 suggested that 100-120 compression per minute is optimal blood flow
➢ Giberson et al. 2016 on the 4 reasons to stop CPR
➢ Vogt 2020 suggested that BVM is better to have 2 rescuers
AED
➢ Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (VT) are shockable rhythms
➢ Pulseless Electrical Activity (PEA) and Asystole are non-shockable rhythms
➢ Casualties in a shockable rhythm have an increased chance of survival
Laryngeal Trauma
Effectiveness of IGEL:
➢ Theiler et al. (2012) – proved to be effective supraglottic device - a high overall insertion and
ventilation success rate of 96%,
➢ American Heart Association (AHA) and American College of Cardiology (ACC) (Maron et al
2007) about the pathology of the 5 cardiac problems
➢ Jouven et al. (2017) S&S should remind them to be aware
➢ Bille, K., Figueiras, D., Schamasch, P., Kappenberger, L., Brenner, J.I., Meijboom, F.J. and
Meijboom, E.J.(2006) Sudden cardiac death
➢ in athletes: the Lausanne Recommendations. European Journal of Cardiovascular
Prevention and Rehabilitation 13(6):859-875.
➢ Basso, C. and Corradoon, D on behalf of the Sport Cardiology Section of the EACPR of the
ESC (2016) Sudden cardiac arrest in
➢ sports – need for uniform registration: A position paper from theSport Cardiology Section
of the European Association for
➢ Cardiovascular Prevention and Rehabilitation. European Journal of Preventive Cardiology
23(6):657-667
Scat 5 assessment:
➢ Fuller et al. 2021 showed it is effective to use on pitchside – sensitivity 95%
Maddocks 1995
Chest Trauma:
➢ Jain & Waseem et al. 2023 – hypoxia is the main problem, MOI include direct contact to
chest, penetrate by object, rapid deceleration force, rupture blood vessels
➢ Newton First law of motion – equilibrium force to stop
➢ Joules = ½ Kg x M/S
➢ Kostiuk & Burns 2023 – red flags S&S for chest injury
➢ Lee et al. 2007 – sitting up is best position if only chest injury
➢ The pre-hospital management of chest injury: a consensus statement” was published by the
Faculty of Prehospital Care, Royal College of Surgeons of Edinburgh in 2007. – The life
threatening condition of chest injury
➢ Ludwig & Koryllos (2017) on management of chest injury
➢ Chauncey & Wieters 2023 - Tranexamic acid to control heavy bleeding
➢ Levy et al. (2023) suggested analgesia to reduce blood pressure and HR if tachycardia while
vasopressors for hypotension to limit further dissection before surgery
Wound Management:
➢ Haverkamp et al. 2018: the best way to manage hypothermia in a prehospital setting is to
reduce further heat loss by placing the patient in a warm and dry environment and applying
insulation in combination with a vapor barrier. Heat packs, blanket and hooded sleeping bag
if not warm up.
➢ (Duong & Patel 2022) Pathophysiology: the most common mechanism of developing
accidental hypothermia is by convective heat loss to cold air and when in cold water or wet
clothing via immersion or excessive sweating. Below 35 degree is mild
➢ When the temperature drops and affect the metabolic, neurologic, respiration, causes
reduce workload in organs. Lead to atrial fibrillation
➢ Glucose too
➢ Basic rationale is to provide protection and support for an injured part whilst permitting
optimal functional movement (Austin, Gwynn-Brett, Marshall, 1996).
➢ Cupler et al. (2020) – allowed early controlled activity, control swelling, proprioceptive
feedback.
➢ Pre & Post Taping Consideration guideline (Austin, Gwynn-Brett, Marshall, 1996) – VAS 2/3
out of 10 – Avoid premature participation, seek expert opinion, monitor circulation, do not
apply ice beforehand,
➢ Zinc Oxide for non-contractile tissues, Elastic Adhesive Bandage for contractile tissues,
Balsam (Vicenzino 2000)
Peripheral Injuries: