Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries

Abstract Early haemorrhage control and minimizing the time to definitive care have long been the cornerstones of therapy for patients exsanguinating from non-compressible haemorrhage (NCH) after penetrating injuries, as only basic treatment could be provided on scene. However, more recently, advance...

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Main Authors: E. ter Avest, L. Carenzo, R. A. Lendrum, M. D. Christian, R. M. Lyon, C. Coniglio, M. Rehn, D. J. Lockey, Z. B. Perkins
Format: Article
Language:English
Published: BMC 2022-06-01
Series:Critical Care
Subjects:
Online Access:https://doi.org/10.1186/s13054-022-04052-7
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author E. ter Avest
L. Carenzo
R. A. Lendrum
M. D. Christian
R. M. Lyon
C. Coniglio
M. Rehn
D. J. Lockey
Z. B. Perkins
author_facet E. ter Avest
L. Carenzo
R. A. Lendrum
M. D. Christian
R. M. Lyon
C. Coniglio
M. Rehn
D. J. Lockey
Z. B. Perkins
author_sort E. ter Avest
collection DOAJ
description Abstract Early haemorrhage control and minimizing the time to definitive care have long been the cornerstones of therapy for patients exsanguinating from non-compressible haemorrhage (NCH) after penetrating injuries, as only basic treatment could be provided on scene. However, more recently, advanced on-scene treatments such as the transfusion of blood products, resuscitative thoracotomy (RT) and resuscitative endovascular balloon occlusion of the aorta (REBOA) have become available in a small number of pre-hospital critical care teams. Although these advanced techniques are included in the current traumatic cardiac arrest algorithm of the European Resuscitation Council (ERC), published in 2021, clear guidance on the practical application of these techniques in the pre-hospital setting is scarce. This paper provides a scoping review on how these advanced techniques can be incorporated into practice for the resuscitation of patients exsanguinating from NCH after penetrating injuries, based on available literature and the collective experience of several helicopter emergency medical services (HEMS) across Europe who have introduced these advanced resuscitation interventions into routine practice. Graphical Abstract
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spelling doaj.art-80ee7602f8ad45fa8fdb0603510b78df2022-12-22T00:30:31ZengBMCCritical Care1364-85352022-06-0126111110.1186/s13054-022-04052-7Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuriesE. ter Avest0L. Carenzo1R. A. Lendrum2M. D. Christian3R. M. Lyon4C. Coniglio5M. Rehn6D. J. Lockey7Z. B. Perkins8London’s Air Ambulance and Bart’s Health NHS Trust, Royal London HospitalLondon’s Air Ambulance and Bart’s Health NHS Trust, Royal London HospitalLondon’s Air Ambulance and Bart’s Health NHS Trust, Royal London HospitalLondon’s Air Ambulance and Bart’s Health NHS Trust, Royal London HospitalAir Ambulance Kent Surrey and SussexDepartment of Anesthesia, Intensive Care and Pre-Hospital Emergency Medical Services, Maggiore Hospital Carlo Alberto PizzardiThe Norwegian Air Ambulance FoundationLondon’s Air Ambulance and Bart’s Health NHS Trust, Royal London HospitalLondon’s Air Ambulance and Bart’s Health NHS Trust, Royal London HospitalAbstract Early haemorrhage control and minimizing the time to definitive care have long been the cornerstones of therapy for patients exsanguinating from non-compressible haemorrhage (NCH) after penetrating injuries, as only basic treatment could be provided on scene. However, more recently, advanced on-scene treatments such as the transfusion of blood products, resuscitative thoracotomy (RT) and resuscitative endovascular balloon occlusion of the aorta (REBOA) have become available in a small number of pre-hospital critical care teams. Although these advanced techniques are included in the current traumatic cardiac arrest algorithm of the European Resuscitation Council (ERC), published in 2021, clear guidance on the practical application of these techniques in the pre-hospital setting is scarce. This paper provides a scoping review on how these advanced techniques can be incorporated into practice for the resuscitation of patients exsanguinating from NCH after penetrating injuries, based on available literature and the collective experience of several helicopter emergency medical services (HEMS) across Europe who have introduced these advanced resuscitation interventions into routine practice. Graphical Abstracthttps://doi.org/10.1186/s13054-022-04052-7Penetrating injuriesPre-hospitalHelicopter emergency medical services (HEMS)Interventions
spellingShingle E. ter Avest
L. Carenzo
R. A. Lendrum
M. D. Christian
R. M. Lyon
C. Coniglio
M. Rehn
D. J. Lockey
Z. B. Perkins
Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries
Critical Care
Penetrating injuries
Pre-hospital
Helicopter emergency medical services (HEMS)
Interventions
title Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries
title_full Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries
title_fullStr Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries
title_full_unstemmed Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries
title_short Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries
title_sort advanced interventions in the pre hospital resuscitation of patients with non compressible haemorrhage after penetrating injuries
topic Penetrating injuries
Pre-hospital
Helicopter emergency medical services (HEMS)
Interventions
url https://doi.org/10.1186/s13054-022-04052-7
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