Prehospital care

The HUGE number of conflicts around the world means prehospital care  is incredibly important. I like to think of pre hospital care as C. A. C. B. C. D. E:

  • Catastrophic haemorrhage
  • Airway
  • Cervical spine control
  • Breathing
  • Circulation
  • Disability
  • Environment

So ABC, doing simple things very well. check airways, breathing and circulation. catastrophic haemorrhage now takes priority over airway but still airway obstruction is fatal. here are some of the simple things that can be done:

<C> – catastrophic haemorrhage; compression!

  • Pressure dressing
  • Haemostatic gauze
  • Tourniquet
  • THUMB! digital pressure on artery above2014-07-08 20.48.24

(elevation is useful if venous bleeding)

C – cervical spine immobilisation!

If mechanism of injury suggests spinal injury e.g. head injury, RTA assume spinal injury until proven otherwise also if:

  • unconscious
  • neck pain/ tenderness/ limited movement
  • any neurological deficit

Pelvic fracture – pelvic sling

Pelvic #s are life threatening: loss of life usually though massive amount of blood loss – hypovolaemic shock. If mechanism of injury suggests pelvic # put on pelvic sling!!!

  • RTA
  • Motorcycle collision
  • Fall from height
  • Osteoporosis pathological #

N.B. PAIN RELIEF! – give analgesia, entonox -relieve the pain, REASSURANCE – hold someone’s hand, talk to them. I would like to know what emergency and pre-hospital care is like in Nigeria or anywhere with limited resources and extreme circumstances, I think creativity will be so important. But if you know about pre-hospital care anywhere in the world let me know 🙂

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