HEMS LONDON - Condition Critical 1/3

[SpassMacher2000]

does HEMS utilize Flight Nurses or is it strictly Flight Paramedics and Doctors.

[MrFuwi]

Why are there always firemen at the helicopter station?

[leegt5]

@MrFuwi Think its a Civil Aviation requirement to have fire cover.

[Swissair171]

@leegt5 Which is presumably why they use Halon

[MrOverdriver]

@leegt5 Correct.

[gixertrix]

HEMS data shows a significant amount of patients dropping one or 2 points on GCS have intercranial damage / bleeds.

Hence the high suspicion and RSI. Manage her appropriatly, reduce/Control ICP , Ventilation etc.

[digitalis112]

"Intercranial" eh? Between who's crania exactly

[DeltaTango45]

@digitalis112 Lining of the brain, Pia mater, Dura mater and Arachnoid.

[CVBGuatemala]

GCS 2? minimum is 3 or am I wrong?

[kungfucapaill]

minimum is 3, but gixertrix said that it dropped by one or two, not that it was two.

[SpassMacher2000]

@CVBGuatemala minimum is 3. You can't have a GCS below 3.

[gixertrix]

All intubations in london and HEMS passed over bougie. That part of kent nearest neuro is KINGS. fair old trot! The HEMS rsi would facilitate her speed through scan / surgery.

[NickEMT]

Hmm seem I jumped the gun a bit. She had a GCS of 12 which isn't bad at all.

[NickEMT]

In the UK is it commonplace to intubate using a bougie? That is, passing a stylet through the cords then advancing the ET tube around that? When I used to work on the ambulance we had those as well but I never saw them used.

[mrbearbear83]

In Ireland, at least in resus we have bougies, but I haven't seen a pre hospital intubation yet so otherwise I'd only be guessing

[shabzmaya]

bougies are only used when intubation is difficult using an ET.

[arisscott]

35 minutes on scene! She should have been a 'load and go' patient. That is not good practice for trauma patients.

[EmuFrog]

Yes but she had to be RSI for her to travel safely in the helicopter

[arisscott]

She was conscious, alert, but disoriented and in need of a neurosurgeon, there was no need to RSI here at the scene, that is just my opinion. She would have been better off being transported to a hospital that could provide her with definitive care.

[kingkeir12]

I think given her combatitiveness, it may have been more dangerous to transport her by air while conscious.

[digitalis123]

Would you load someone in her state into a helo which would have increased her confusion? The reg clearly states when he gets on scene that apart from the fact that she probably has an extradural haemorrhage causing the raised ICP, she is most likely hypoxic which is adding to her delirious state. Hence the need to intubate, get a proper airway and oxygen in without faffing about.

[NickEMT]

We don't know how her SpO2 was. If it was low then the intubation should not be questioned. Even if her SpO2 was fine, it would not have been safe and prudent to Tx her while combative. Just my humble opinion. Also I'm curious to know what her Glascow Coma Scale was. You know the old phrase, Less than 8, intubate!

[EmuFrog]

Oh sorry! Slight Blonde moment there!

[tom90m]

increased ICP do we think?

[EmuFrog]

Increased ICP What?

[leegt5]

Increased Intracranial pressure I beleive !!

It is the pressure exerted by the cranium on the brain tissue.

[tom90m]

Intracranial pressure as said above...classic signs show, combative, repetitive, nausea, forgetfulness etc.

[J999ACK]

And Alistair is retiring soon

[J999ACK]

this is gr8

[amyneave]

get more vids like this

[UGetMeLike]

dude u dnt need to..jus go on channel 254..if u have sky

and its usually on frm 5:00pm..if not this there is another one called A&E..its o nthe dicovary health channel..x

[EmuFrog]

What condition critical is on from 5pm? I thought that was A&E! Didnt realise it was the same thing

[leegt5]

A&E features the Warwickshire & Northamptonshire Air Ambulance !!

Condition Critical what I have uploaded was broadcast on channel 5 in 2000!

[EmuFrog]

Thank you. Got a bit confused there. Do you have any more episodes of it?

[leegt5]

I could only find this episode after going through my old VHS tapes though Im sure I would have taped the whole series. If I do find the rest I will upload them.. I will soon upload some clips of another series I have found called "The Golden Hour" from the Discovery Channel which features HEMS.

[EmuFrog]

Ok thank you :D Unfortunately my old trauma VHS' were erased.

[EmuFrog]

What channel is it aired on as 254 is now Discovery Home and Health. There's one called Critical condition? Thats a seperate one agai I think. As theres no mention of LAA

[EmuFrog]

Thank you for uploading this