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"Medical Emergency Response Team"

Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
January 6, 2017: Journal of the Royal Army Medical Corps
G Bott, J Barnard, K Prior
Operation GRITROCK saw the first operational deployment of the Maritime In Transit Care team from the Role 2 (Enhanced) (R2(E)) Medical Treatment Facility, which is able to provide Damage Control Surgery and the limited holding of patients, situated on board RFA ARGUS. Whilst the Medical Emergency Response Team demonstrated the capability of advanced military Pre-Hospital Emergency Care (PHEC) on Op HERRICK, the need to provide a similar high level of care on contingency operations was recognised. Op GRITROCK allowed for the continued exploration of a maritime capability from an established R2(E) platform whilst providing medical evacuation capability for a significant population at risk distributed over a large Joint Operation Area...
2015: Journal of the Royal Naval Medical Service
Christopher James Taylor
BACKGROUND: Public address announcements are an effective way of alerting staff on cruise ships to life -threatening medical emergencies on-board, but should only be used when truly necessary. An audit to investigate the outcome following this method of activating the medical emergency response team (MERT) suggested system flaws. A new elementary first aid training programme for the crew was then developed, emphasising patient assessment and the correct determination of appropriate levels of response...
2015: International Maritime Health
J F Dyett, M S Moser, A E Tobin
The objective of this study is to describe the population of patients receiving emergency airway management outside operating theatres at our institution, a tertiary referral centre in Melbourne. A registry of all patients receiving emergency airway management in the emergency department, ICU and on the wards as part of Medical Emergency Response teams' care, was prospectively collected. There were 128 adults and one paediatric patient requiring emergency airway management recruited to the study. Data for analysis included patient demographics, pre-oxygenation and apnoeic oxygenation, staff, drugs, details of laryngoscopic attempts, adjuncts, airway manoeuvres, complications sustained and method of confirmation of endotracheal tube placement...
September 2015: Anaesthesia and Intensive Care
Lawrence N Petz, Stuart Tyner, Ed Barnard, Alicia Ervin, Alex Mora, John Clifford, Marcie Fowler, Vikhyat S Bebarta
BACKGROUND: Combat injuries result in acute, severe pain. Early use of analgesia after injury is known to be beneficial. Studies on prehospital analgesia in combat are limited and no prospectively designed study has reported the use of analgesics in the prehospital and en route care setting. Our objective was to describe the current use of prehospital analgesia in the combat setting. METHODS: This prospectively designed, multicenter, observational, prehospital combat study was undertaken at medical treatment facilities (MTF) in Afghanistan between October 2012 and September 2013...
March 2015: Military Medicine
David J O'Reilly, Jonathan J Morrison, Jan O Jansen, Amy N Apodaca, Todd E Rasmussen, Mark J Midwinter
BACKGROUND: The value of prehospital blood transfusion (PHBTx) in the management of severe trauma has not been established. This study aimed to evaluate the effect of PHBTx on mortality in combat casualties. METHODS: This is a retrospective cohort study of casualties admitted to the field hospital at Camp Bastion, Afghanistan, by the Medical Emergency Response Team from May 2006 to March 2011. Participants were divided into two consecutive cohorts by the introduction of PHBTx...
September 2014: Journal of Trauma and Acute Care Surgery
E B G Barnard, R J Moy, A D Kehoe, V S Bebarta, J E Smith
BACKGROUND: Intraosseous (IO) drug infusion has been reported to have similar pharmacokinetics to intravenous (IV) infusion. In military and civilian trauma, the IO route is often used to obtain rapid and reliable parenteral access for drug administration. Only a few case reports have described the use of IO infusion to administer drugs for rapid sequence induction of anaesthesia (RSI). OBJECTIVE: We aimed to assess the feasibility of the administration of RSI drugs via an IO catheter in a prospective observational study...
June 2015: Emergency Medicine Journal: EMJ
Martin S Tindel, Joseph M Darby, Richard L Simmons
OBJECTIVE: The aim of this study was to determine the underlying characteristics of inpatients sustaining crisis events in the radiology department (RD). METHODS: This is a retrospective case series undertaken in a 715-bed university-based tertiary care referral center in the United States, with a well-established medical emergency response team (MET). Adult hospitalized inpatients sustaining crisis events in the radiology suites of the University of Pittsburgh Medical Center from November 1, 2008, to October 31, 2010, were reviewed...
June 2014: Journal of Patient Safety
Matthew Aboudara, P F Mahoney, B Hicks, D Cuadrado
BACKGROUND: Primary blast lung injury (PBLI) is defined as lung contusion from barotrauma following an explosive mechanism of injury (MOI). Military data have focused on PBLI characteristics following evacuation from the combat theatre; less is known about its immediate management and epidemiology in the deployed setting. We conducted a quality improvement project to describe the prevalence, clinical characteristics, management strategies and evacuation techniques for PBLI patients prior to evacuation...
June 2014: Journal of the Royal Army Medical Corps
Amy Apodaca, Chris M Olson, Jeffrey Bailey, Frank Butler, Brian J Eastridge, Eric Kuncir
BACKGROUND: The following three helicopter-based medical evacuation platforms operate in Southern Afghanistan: the US Army emergency medical technician (basic)-led DUSTOFF, US Air Force paramedic-led PEDRO, and UK physician-led medical emergency response team (MERT). Nearly 90% of battlefield deaths occur in the prehospital phase, comparative outcomes for these en route care platforms are unknown. The objective of this investigation was to characterize the nature of injuries in patients transported by three evacuation platforms...
August 2013: Journal of Trauma and Acute Care Surgery
Amy N Apodaca, Jonathan J Morrison, Mary Ann Spott, John J Lira, Jeffery Bailey, Brian J Eastridge, Robert L Mabry
Three Forward Aeromedical Evacuation platforms operate in Southern Afghanistan: UK Medical Emergency Response Team (MERT), US Air Force Expeditionary Rescue Squadron (PEDRO), and US Army Medical Evacuation Squadrons (DUSTOFF), each with a different clinical capability. Recent evidence suggests that retrieval by a platform with a greater clinical capability (MERT) is associated with improved mortality in critical patients when compared with platforms with less clinical capability (PEDRO and DUSTOFF). It is unclear whether this is due to en route resuscitation or the dispatch procedure...
July 2013: Shock
Darryl A Newman
This article examines the non clinical skills and training required for effective maritime pre-hospital emergency care provision within a Role Two Afloat facility, allowing for a Primary Retrieval Team to be deployed in support of boarding operations. The provision of pre-hospital emergency care and sending a retrieval team forward has been trialled in various forms. In 2010 and 2011 a R2A team was deployed aboard RFA FORT VICTORIA. This included a Primary Retrieval Team consisting of an Emergency Nurse Specialist, a Medical Assistant which can be enhanced when required by an Emergency Care or Anaesthetic Consultant...
2012: Journal of the Royal Naval Medical Service
H O Jørgensen, K Heier-Madsen, J E Stokkebye
In 2002 - 2009 Danish forces suffered a mortality rate of 0.09% in Iraq and 0.38% in Afghanistan, and a morbidity rate of 0.30% in Iraq and 1.01% in Afghanistan, as a result of weapons effects. In Afghanistan the survival rate is 97.0% for Danish wounded who were alive on arrival at UK R3 Hospital. British data from Afghanistan are compared to the Danish figures and there is no significant difference. We found an increase in injuries and deaths caused by mines/IEDs from 33% in 2006 to 72.7% in 2009 of all weapon effects causes...
March 2012: Journal of the Royal Army Medical Corps
E J Hulse, G O R Thomas
Timely and appropriate access to the vascular circulation is critical in the management of 21st century battlefield trauma. It allows the administration of emergency drugs, analgesics and rapid replacement of blood volume. Methods used to gain access can include; the cannulation of peripheral and central veins, venous cut-down and intraosseus devices. This article reviews the current literature on the benefits and complications of each vascular access method. We conclude that intraosseus devices are best for quick access to the circulation, with central venous access via the subclavian route for large volume resuscitation and low complication rates...
December 2010: Journal of the Royal Army Medical Corps
S J Mercer, C Whittle, B Siggers, R S Frazer
Simulation in healthcare has come a long way since it's beginnings in the 1960s. Not only has the sophistication of simulator design increased, but the educational concepts of simulation have become much clearer. One particularly important area is that of non-technical skills (NTS) which has been developed from similar concepts in the aviation and nuclear industries. NTS models have been developed for anaesthetists and more recently for surgeons too. This has clear value for surgical team working and the recently developed Military Operational Surgical Training (MOST) course uses simulation and NTS to improve such team working...
December 2010: Journal of the Royal Army Medical Corps
A G Haldane
OBJECTIVES: To determine the number of medical emergency response team (MERT) patients undergoing advanced airway management in the peri-evacuation phase and to determine the indications for airway interventions undertaken in flight. METHODS: This was a retrospective study. Data was collected from patient report and mission debrief forms completed after each MERT mission during Operation HERRICK 10 (April-October 2009). All patients that received advanced airway interventions before or during evacuation were identified...
September 2010: Journal of the Royal Army Medical Corps
Philip Calderbank, Tom Woolley, Stuart Mercer, Jason Schrager, Mike Kazel, Stephen Bree, Douglas M Bowley
BACKGROUND: In a military setting, pre-hospital times may be extended due to geographical or operational issues. Helicopter casevac enables patients to be transported expediently across all terrains. The skill-mix of the pre-hospital team can vary. AIM: To quantify the doctors' contribution to the Medical Emergency Response Team-Enhanced (MERT-E). METHODS: A prospective log of missions recorded urgency category, patient nationality, mechanism of injury, medical interventions and whether, in the crew's opinion, the presence of the doctor made a positive contribution...
October 2011: Emergency Medicine Journal: EMJ
Linda Kirschenbaum, Susannah Kurtz, Mark Astiz
BACKGROUND: There is a focus on integrating quality improvement with medical education and advancement of the American College of Graduate Medical Education (ACGME) core competencies. OBJECTIVE: To determine if audits of patients with unexpected admission to the medical intensive care unit using a self-assessment tool and a focused Morbidity and Mortality (M&M) conference improves patient care. DESIGN: Charts from patients transferred from the general medical floor (GMF) to the medical intensive care unit (ICU) were reviewed by a multidisciplinary team...
October 2010: Journal of General Internal Medicine
N R M Tai, A Brooks, M Midwinter, J C Clasper, P J Parker
There are no published studies directly addressing the issue of what is an acceptable timeline from point of wounding to surgical intervention within the military context. The proximal threshold has previously been determined by personal opinion, tactical, logistic and practical imperatives rather than by clinical demands. The aim of this paper is to review all relevant military and civilian studies where timelines have been quoted and to reach a number of unambiguous consensus statements to state the perceived ideal upper limits from point of wounding to holistic and realistic surgical care in modern war...
December 2009: Journal of the Royal Army Medical Corps
Mary Ann Peberdy, Cathy M Boze, Joseph P Ornato
Health care facilities should reassess their resuscitation team response strategies in light of the shift in care from inpatient to outpatient facilities. This article discusses a strategy for assessing a health care facility's resuscitation needs globally, including a detailed analysis of the physical layout, population requiring coverage, personnel, and equipment. Resuscitation system design is reviewed, with particular emphasis on training, equipment, process variables, administration, cost, and quality improvement...
December 2002: Critical Pathways in Cardiology
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