The article is a great read and makes many valid points. However I have read many articles on this in my country as well and it is used I beleive to suppress the advancement of pre-hospital care by missing some very valid points. For example pre-hospital providers witness much pain, N/V seizure activity, drug overdoses, hypoglycemia and the like and in may cases are ill equipped to manage these presentation effectively. I am interested in and never read an article that addressed these issues. I believe BLS providers can be trained to administer such drugs as fentynal, morphine, benedryal, gravol or phenergen, narcan, EPI in Cardiac Arrest. To this end if BLS providers were trained in the above it would save many a dollar in training and the high cost to run a high performance ALS system. I would suggest at least in Canada there is not much movement towards up training BLS prociders to administer simple meds for simple on going everday medical problems in the pre-hospital environment, A thought. Thank YOu
Competing interests
None declared
There is a Role of Pre-hospital Advance Life Support in Military Trauma Care
kithsiri senanayake, Rajarata University of Sri Lanka
6 January 2011
It is well proven that there is no benefit of pre-hospital advance life support for the out hospital cardiac arrest by a multicenter randomised control trial that included 5638 patients (1).
However our experience in the military trauma is that the pre-hospital advance life support saves the lives significantly in trauma setting. Sri Lanka successfully eradicated the terrorism by a military mission recently and we experienced as medical personal involving the management of military trauma. In the front line of the battle field injured are rescued, canulated and resuscitated. Needy patients were incubated and CPR given before the hospital. Main priorities were arrest of bleeding, fluid resuscitation and air way management especially intercostal tube insertion. If we were given only the BLS before hospital we would have lost many lives.
References 1. Stiell IG, George A, Brian F, et al. Advanced Cardiac Life support in Out-of-Hospital Cardiac Arrest. N Engl J Med 2004; 351:647-656
Competing interests
The author declares that there are no competing interests
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Observation on Article
1 December 2010
The article is a great read and makes many valid points. However I have read many articles on this in my country as well and it is used I beleive to suppress the advancement of pre-hospital care by missing some very valid points. For example pre-hospital providers witness much pain, N/V seizure activity, drug overdoses, hypoglycemia and the like and in may cases are ill equipped to manage these presentation effectively. I am interested in and never read an article that addressed these issues. I believe BLS providers can be trained to administer such drugs as fentynal, morphine, benedryal, gravol or phenergen, narcan, EPI in Cardiac Arrest. To this end if BLS providers were trained in the above it would save many a dollar in training and the high cost to run a high performance ALS system. I would suggest at least in Canada there is not much movement towards up training BLS prociders to administer simple meds for simple on going everday medical problems in the pre-hospital environment, A thought. Thank YOu
Competing interests
None declared
There is a Role of Pre-hospital Advance Life Support in Military Trauma Care
6 January 2011
It is well proven that there is no benefit of pre-hospital advance life support for the out hospital cardiac arrest by a multicenter randomised control trial that included 5638 patients (1).
However our experience in the military trauma is that the pre-hospital advance life support saves the lives significantly in trauma setting. Sri Lanka successfully eradicated the terrorism by a military mission recently and we experienced as medical personal involving the management of military trauma. In the front line of the battle field injured are rescued, canulated and resuscitated. Needy patients were incubated and CPR given before the hospital. Main priorities were arrest of bleeding, fluid resuscitation and air way management especially intercostal tube insertion. If we were given only the BLS before hospital we would have lost many lives.
References
1. Stiell IG, George A, Brian F, et al. Advanced Cardiac Life support in Out-of-Hospital Cardiac Arrest. N Engl J Med 2004; 351:647-656
Competing interests
The author declares that there are no competing interests