Joacim Linde
@HEMS_Doc
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Consultant AnesthesiaCriticalcareEMSPHCC MedicalDirector CountyAmbulance Consult Health&Social Care Inspectorate Director Swedish P-EMS/PHCC course
Sweden
Joined October 2014
Anyone out there have data on how Bergamo is doin with C-19 now? Cnsdrng their hi serology numbers one would hope they have low counts now?
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Motivated pilots do the trick: "Mate, we´ve been here for 15 minutes by now, anything that prevents us from getting out of here?"
Tick Tock! We lose accurate awareness of time when under pressure. Does making a HEMS team actively aware of passing minutes improve on-scene time? Yes! Latest @airambulancekss paper https://t.co/O67QJ4yVq9
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Unfortunately, we see a lot of this in SWE as well. Triage & prority is a resposibility for healthcare services, not prmrly the patient
The only people who listen to advice like this are the unwell patients who “don’t want to make a fuss” about their central chest tightness which has been going on for 2 hours and now they feel dizzy. They’ll just see their GP tomorrow, right? What is an “emergency” ?
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And then go fast to theatre with the sickest ones.. rebleed is a real danger for the sickest... and triples mortality... Also implications for retrieval.... competent retrieval’s !!!!!!!!!!!
Important work from our Norwegian colleagues. Take home message: Don’t go local with a patient with suspected SAH and a GCS<9; go directly to neurosurgery.
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@BenStretch @LeechCaroline Preload resuscitation with products then safe dose adjusted RSI.
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Yet another reason to put the quality of care we deliver under scrutiny?
Here is the paper suggesting that PHEA for awake hypovolaemic trauma patients may be harmful - do not RSI for flight safety or predicted clinical course!! https://t.co/FgANmIASXI
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NEVER to sick to be retreived.. a matter of skills, experience, tools, platforms and the TEAM. #oslohems
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Perhaps some of us would benefit by a slightly more moderate approach in our tweets?
Lots of AMAZING people out there... but maybe always putting “the amazing” in front of names make others feel LES valuable?? Thought of that?? Maybe we all should think about it whilst promoting courses, talks, boards etc.....
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Great to be back at @HEMS_Doc s impressive #prehospitalkurs I get to teach how to make your own simulations. Right now though listening w/ great interest to @VikingOne_ who with loads of experience, humor (and biased as hell as he disclaimed😊) is talking about resc thoracotomy
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After 30 years of cardiac arrest resuscitation research, a few reflection. I think we're on the threshold of substantially increasing survival from cardiac arrest.
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Sjukvårdens larmcentral: SOS larmar ut många ambulanser i onödan - P4 Västmanland https://t.co/wTtMGq7aId via @p4vastmanland
sverigesradio.se
Det har blivit betydligt färre ambulanser som larmas ut i Västmanland sedan Sjukvårdens larmcentral tog över efter SOS Alarm.
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@cjpoynter @GongGasGirl Yes, all people placed on ECMO during CPR are dead, but some don't stay dead. Some go home. Indications are limited and finite. Each jurisdiction should decide if it's willing to spend on this or divert $ to other areas. Here's a local cost analysis:
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Timing of Advanced Airway Placement after Witnessed Out-of-Hospital Cardiac Arrest: Prehospital Emergency Care: Vol 0, No ja
tandfonline.com
Background: Advanced airways (endotracheal tubes, supraglottic airways) are frequently placed by Emergency Medical Services (EMS) in patients with out-of-hospital cardiac arrest (OHCA). However, if...
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Intubation success rate in cardiac arrest should be >90% first attempt. If can’t achieve that in a particular system, use SGA. #smacc @EmICUcanada
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and if you're really unlucky some goodhearted soul sells you a "crisis manual" and before you know it, you (& your patient) is in it deeper than you can imagine..
@LeechCaroline And even if the 80 intubations is enough to achieve an acceptable succes rate; if you are that inexperienced, my guess is that you are using most of your band width just to pass the tube safely. And that of course will hamper you critical decision making. 2/
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Why ign is it so hard to get acceptance for specialist care for the sickest most acute patients? Why? #HQCC #HQPHCC #resusspecialist #resusisnotforeveryone #resusisnotacrisis
Proud of being part of this!#STAND UP FOR YOUR PATIENT! #Tailoryourservice to highest levels! Response: Best practice advice on pre-hospital emergency anaesthesia & advanced airway management|Scandinavian Journal of Trauma,Resuscitation and Emergency Med
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I (fortunately) learned that in early anaesthetics training when having urgent really sick patients in theatre and then I learned it again in ICU training many years ago and have used it ever since. #protectyourpatientsfromhypoxia
I was today years old when I learned that critically ill adult patients with hypoxemic respiratory failure (60%) who are low risk for aspiration (50% fasted>6hrs) become hypoxemic during RSI and should be mask ventilated 😉
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Listen to our hardworking researcher talking about REBOA in OHCA. @BredeJostein @edecmo
https://t.co/eyAi0o0va1
@Luftambulansen
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Norwegian HEMS clinical study with REBOA in medical cardiac arrest, to increase coronary perfusion pressure and get higher rates of ROSC. Good results, but not published or analysed yet. @BredeJostein #TBS19 #BigSick19
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