HEMS LONDON – Condition Critical 1/3

Part 1 of 3. The service is featured in the documentary “CONDITION CRITICAL” broadcast in 2000 when the service used an Aerospatiale SA-365 Dauphin helicopter with red branding sponsored by the Virgin group. In October 2000 it was replaced by a MD 902 Explorer helicopter.
Video Rating: 4 / 5

{ 25 comments }

MrOverdriver October 30, 2011 at 6:00 am

@leegt5 Correct.

SpassMacher2000 October 30, 2011 at 6:28 am

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

SpassMacher2000 October 30, 2011 at 7:03 am

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

Swissair171 October 30, 2011 at 7:34 am

@leegt5 Which is presumably why they use Halon

leegt5 October 30, 2011 at 8:00 am

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

MrFuwi October 30, 2011 at 8:21 am

Why are there always firemen at the helicopter station?

kungfucapaill October 30, 2011 at 9:18 am

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

CVBGuatemala October 30, 2011 at 9:56 am

GCS 2? minimum is 3 or am I wrong?

digitalis112 October 30, 2011 at 10:40 am

“Intercranial” eh? Between who’s crania exactly

gixertrix October 30, 2011 at 11:23 am

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.

gixertrix October 30, 2011 at 12:17 pm

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.

shabzmaya October 30, 2011 at 12:24 pm

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

mrbearbear83 October 30, 2011 at 12:45 pm

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

NickEMT October 30, 2011 at 1:18 pm

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

NickEMT October 30, 2011 at 1:50 pm

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!

NickEMT October 30, 2011 at 2:43 pm

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.

digitalis123 October 30, 2011 at 3:30 pm

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.

kingkeir12 October 30, 2011 at 3:49 pm

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

arisscott October 30, 2011 at 4:34 pm

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.

EmuFrog October 30, 2011 at 4:51 pm

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

arisscott October 30, 2011 at 5:48 pm

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

EmuFrog October 30, 2011 at 6:20 pm

Oh sorry! Slight Blonde moment there!

tom90m October 30, 2011 at 6:20 pm

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

leegt5 October 30, 2011 at 6:43 pm

Increased Intracranial pressure I beleive !!

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

EmuFrog October 30, 2011 at 6:56 pm

Increased ICP What?

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