Bystander cardiopulmonary resuscitation (CPR) has been shown to be associated with increased rates of survival from non-traumatic out-of-hospital cardiac arrest (OHCA). GoodSAM is a platform integrated into the computer-assisted dispatch system. The software allows the telecommunicator to send a link to the caller’s smart phone. Once activated, the telecommunicator can see and hear the patient, and obtain breathing and heart rates using the camera and microphone on the caller’s phone. The telecommunicator can use the platform to identify cardiac arrest and provide real-time compression feedback. It was hypothesized that telecommunicator use of video telecommunication would be associated with increased rates of pre-arrival CPR.

This was a retrospective review of all cardiac arrest resuscitations performed from July 2021 through February 2022 in the San Antonio Fire Department (SAFD) Emergency Medical Services (EMS) system – the seventh largest city in the United States. Data source was the Office of the EMS Medical Director (OMD) Cardiac Arrest Registry. Inclusion criteria included cardiac arrests for which resuscitation was attempted. Exclusion criteria were cardiac arrest was witnessed by EMS personnel, or missing data. Dataset included: location of arrest, presumed etiology of the arrest, if dispatch CPR instructions were given; caller compliance; type of CPR performed; who witnessed the arrest; and who performed the CPR prior to EMS. Patients were dichotomized as to whether video telecommunication was used by the paramedic telecommunicator. A case was recorded as having received pre-arrival CPR if the initial CPR was performed by anyone other than the responding unit.

A total of 779 cases were included in the study. Primary outcome, in the cases where video telecommunication was utilized, 46/74 (62%) received pre-arrival CPR, versus 324/705 (46%) without the use of video telecommunication, with an overall difference of 16.2% (95% CI, 4.6% to 27.9%; P = .008). When using video telecommunication, a larger proportion of the persons performing pre-arrival CPR were family members when compared to the cases where video telecommunication was not used (35% versus 17%).

Using video telecommunication to perform paramedic clinical dispatch telemedicine was associated with an increased rate of pre-arrival CPR. Further research will be required to show outcome-related results to determine if dispatch video and audio telemedicine can be used to increase survival in patients suffering OHCA.

The dynamic nature of the prehospital environment poses a challenge for maintaining optimal storage conditions for medicines and other products. Failure to ensure adequate temperature control can impact drug efficacy, potentially compromising effective prehospital care. This study aims to monitor temperature variations in vehicles operated by a helicopter Emergency Medical Service (EMS) in the east of England to evaluate temperature variation and the potential exposure of therapeutic products to extreme temperatures.

This was a prospective observational study over a 12-month period (September 2022 through August 2023). ALTA Industrial Wireless temperature sensors were deployed across five Volvo XC90 rapid response vehicles (RRVs) and an AgustaWestland 169 (AW169) helicopter operated by Essex & Herts Air Ambulance (EHAAT). One RRV (RRV02) remained permanently outside for the period of observation. Sensors recorded at 30-minute intervals, triggering alerts if temperatures exceeded 25°C or dropped below 2°C. Ambient data were obtained from the Writtle Weather Station, via the Met Office Integrated Data Archive System (MIDAS). The study did not involve any patients and ethical board review was not required.

A total of 102,524 readings were recorded; temperatures ranged from −9°C to 46.8°C. The RRV02 recorded the lowest monthly mean (7.9°C) while the AW169 recorded the highest (24.9°C). Overall, daily maximum temperatures ranged from 17.7°C to 46.8°C, with the AW169 reaching 46.8°C in May. Daily minimum values ranged from −9°C to 19.6°C, with the RRV02 recording −9°C in December.

Temperatures inside the vehicles and aircraft frequently exceed recommended limits for environmental temperatures. Indoor RRV storage provides some protection from extreme temperatures, particularly mitigating against low temperatures. The AW169 aircraft demonstrated the poorest overall temperature control. These results can be used to guide effective storage protocols and climate control strategies to ensure the integrity of therapeutic products.

In Jishishan County, Linxia Prefecture, Gansu Province, China, the altitude ranges from 1,787 meters to 4,308 meters. At 23:59 Beijing time on December 18, 2023, a magnitude 6.2 earthquake struck Jishishan County. The objective is to report the injury characteristics and medical treatments of those injured in the earthquake.

The injury and treatment data were retrospectively collected and analyzed for earthquake-related injuries among patients admitted to the People’s Hospital of Linxia Hui Autonomous Prefecture and the Traditional Chinese Medicine Hospital of Linxia Hui Autonomous Prefecture.

A total of 166 patients were hospitalized: 142 at the People’s Hospital of Linxia Hui Autonomous Prefecture and 24 at the Traditional Chinese Medicine Hospital of Linxia Hui Autonomous Prefecture. Among the injured, 40.3% presented with a single injury. The others had multiple injuries: 28.3% had two injuries, 14.5% had three injuries, 12.1% had four injuries, 4.2% presented with five injuries, while only 0.6% were diagnosed with six injuries. Additionally, 78.9% involved fractures alone, 36.8% involved lung contusions, and 34.9% involved both fractures and lung contusions. Conservative treatment was used slightly more than surgery (54.8% versus 45.2%). Among the 75 surgical cases, internal fixation and sutures were the most common (17.4% each). In total, 53.0% of the injured were treated and discharged and 47.0% were transferred to provincial hospitals. In addition, the outcome of injured patients with differing injury conditions was different.

Fractures and multiple injuries were the primary injury types in this study. Suturing and internal fixation were the most common surgical interventions. The core findings of this study provide an important reference for regionalized prevention and treatment of rural earthquake injuries in high-altitude regions.

Triage is an essential process used to adequately allocate resources and thus increase chances of survival in case of mass-casualty incidents (MCIs). Several triage scales are currently used, but data regarding their performance remain scarce. The objective was to compare the performance of two prehospital triage algorithms (Sieve versus SwissPre) using a validated physiological simulator.

This was a web-based, randomized open-label study. A real-time evolutive simulator based on a heart-lung-brain interaction model embedding functional blocks was used to simulate the evolution of vital parameters. Participants, who were randomly allocated to either algorithm, were asked to triage 30 patients in random order. The primary outcome was the triage score (each correct decision was awarded one point). The “Immediate patients” were defined as those who would die within the first hour according to the physiological model. The secondary outcome was the duration of patient triage.

Out of 71 participants, 67 (94.4%) were included in the final analysis. The Sieve group achieved a mean score of 17.1 out of 30 (95%CI, 16.3 to 17.8). The SwissPre group scored 15.5 out of 30 (95%CI, 14.5 to 16.5). The mean difference between groups was 1.6 points (95%CI, 0.4 to 2.8; P = .011) in favor of the Sieve algorithm. Triage duration did not differ significantly between the Sieve (mean 43 minutes, SD = 10) and SwissPre (mean 46 minutes, SD = 23) groups, with a mean difference of three minutes (95%CI, −12 to 6; P = .507).

The simpler Sieve algorithm may slightly outperform the more complex SwissPre in accurately categorizing critically injured patients who would likely die within 60 minutes if left untreated. No significant difference was observed in triage speed. However, these exploratory findings should be interpreted cautiously, considering the mean difference was modest and the controlled simulated setting, limiting generalizability.

Echocardiography is the preferred method for the visual assessment of bubble load in divers. This study evaluates the feasibility of a microteaching program for training combat medics to perform ultrasound measurements using echocardiography for self-monitoring decompression stress on the waterside.

A microteaching was provided to combat medics of the Netherlands Armed Forces. Participants used a handheld ultrasound device connected to a tablet. After two minutes practice time, medics performed and recorded videos on randomly assigned partners while being assessed by an anesthesiologist. Three outcomes were measured: (1) observer-assessed performance adapted from Objective Structured Assessment of Technical Skills (OSATS); (2) self-perceived procedure experience; and (3) video recording quality on a five-point scale.

All 21 combat medics completed the microteaching program. Three out of 21 video recordings were lost due to technical issues. All participants successfully obtained at least a partial cardiac view (median time: 61 seconds). Performance scores indicated near-competence across preparation, time-motion, and procedural flow. Image quality ratings by two reviewers showed near-perfect intra-rater agreement (κ = 0.904 and κ = 0.960) but substantial inter-rater variability (κ = 0.671); the assessor’s median scores were 2.75 and 3.0 out of 5.0, respectively. Most recordings received average scores of 3.0 or higher.

This study demonstrates that combat medics, following a brief microteaching session, were able to acquire cardiac ultrasound images partially suitable for assessing vascular gas emboli (VGE). These findings support microteaching as a feasible first step in echocardiography training for combat medics in austere environments.