Thread by @WicklowRR

What is #Pre-Hospital #CriticalCare? A short 🧵:

Also referred to as Pre Hospital Emergency Medicine (PHEM), #PHEM is “that area of medical care required for seriously ill or injured patients before they reach hospital (on-scene) or during emergency transfer to hospital” 1/11

PHEM in Ireland is practiced by a small number of doctors who respond voluntarily to taskings from @AmbulanceNAS to serious illness or injury.

These doctors are supported by charities like @WicklowRR.

Other groups include: @WestCorkRR @EastCorkRR and @CRITICALcharity 2/11

PHEM doctors complement the work of @PHECC practitioners in @AmbulanceNAS @DubFireBrigade and many other emergency agencies.

PHEM doctors can provide additional interventions, medications and decision-making, or simply be the closest resource to a time critical emergency. 3/11

The national professional association for PHEM in Ireland is the Irish Society for Pre Hospital Emergency Medicine @IrlPHEM 4/11

PHEM doctors can provide specialist interventions such as pre hospital emergency anaesthesia, airway management, chest tube placement, emergency surgical procedures and blood transfusion in the pre-hospital setting, potentially saving lives. 5/11

PHEM doctors often work in challenging and remote environments and can provide critical care in remote or austere settings, improving access to emergency care in Ireland. 6/11

Among the interventions that PHEM teams can provide is Pre Hospital Emergency Anaesthesia. This involves placing the patient in a medically-induced coma to take over their breathing, e.g. in cases of severe head injury, post cardiac arrest and altered level of consciousness. 7/11

Transfusion of #blood products has the potential to be life saving in ferris cases of severe injury. @WicklowRR is the only service in Ireland to routinely carry red cell concentrate and plasma for immediate transfusion thanks to @svuh #Transfusion laboratory & @Giveblood_ie 8/11

Pre Hospital diagnosis can be facilitated by the use of Point of Care Ultrasound (#POCUS) to identify haemorrhage, collapsed lungs and cardiac injury for example. 9/11

PHEM doctors can also avoid the requirement for transport to an Emergency Department by providing care for patients at scene (e.g. minor injuries) or ruling out diagnoses of concern. This can be helpful when there are multiple patients (e.g at a Mass Casualty Incident). 10/11

PHEM doctors work closely with other agencies including @NASCriticalCare @ACorps112 @IrishCoastGuard @CFRIreland @RNLI and many others. #Teamwork 11/11