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Needle Thoracostomy
Air Care Orientation Curriculum, Prehospital Medicine Jeffery Hill, MD M.Ed Air Care Orientation Curriculum, Prehospital Medicine Jeffery Hill, MD M.Ed

Needle Thoracostomy

There has been much digital ink spilled over the topic of needle thoracostomy (check below for some additional reading) with most of the hub bub surrounding the proper location to place the needle.  We’re not going to completely rehash that which has already been said, but instead focus on distilling the highlights and turning our attention to a video showing how to perform what is ultimately a potentially life saving procedure.  We won’t go much into finger thoracostomy as we will cover that procedure in a future blog post. So I heard that you’re setting yourself up for failure if you choose the 2nd ICS MCL to decompress the chest?

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Who Gets a Pelvic Binder? Lessons from the #HEMS #FOAMed World
Air Care Orientation Curriculum, Prehospital Medicine Jeffery Hill, MD M.Ed Air Care Orientation Curriculum, Prehospital Medicine Jeffery Hill, MD M.Ed

Who Gets a Pelvic Binder? Lessons from the #HEMS #FOAMed World

In our most recent post in the Air Care & Mobile Care Online Flight Physician Orientation, we talked about pelvic binding devices.  As we noted, there's generally a paucity of evidence for or against the use of a pelvic binding device in blunt trauma patients.  There are no hard and fast indications for the use of these devices.  Whenever there is a lack of evidence for a particular treatment, we find ourselves looking to experts in the field for their experience and practice patterns.  To that end, I asked some of of the #HEMS #FOAMed community to weigh in on the question and tell us their practice pattern

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Application of Pelvic Binders
Air Care Orientation Curriculum, Prehospital Medicine, Procedural Education Jeffery Hill, MD M.Ed Air Care Orientation Curriculum, Prehospital Medicine, Procedural Education Jeffery Hill, MD M.Ed

Application of Pelvic Binders

As we mentioned in the podcast that accompanied our most recent post, an injury that is critical to identify in blunt trauma yet easy to miss or forget is pelvic fractures and pelvic trauma.  Significant injuries occurring to the pelvic ring usually involved high mechanisms of injury such as high speed MVCs, motorcycle crashes, pedestrian struck, and falls from significant height.  Pelvic fractures can be associated with a significant amount of bleeding, hypotension, and increased mortality.  Mortality for all trauma patients with pelvic trauma ranges from 5-30%.  If there is associated hypotension, mortality rises to 10-42%

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