Per P Bredmose

Oslo University Hospital · Air Ambulanse

Background Aeromedical emergency retrieval services play an important role in supporting patients with critical and often life-threatening clinical conditions. Aeromedical retrieval services help to provide fast access to definitive care for critically ill patients in under-served regions. Typically, fixed-wing aeromedical retrieval becomes the mos...

Introduction Facilitators play an essential role in simulation-based training on helicopter emergency medical services (HEMS) bases. There is scant literature about the barriers to the implementation of simulation training in HEMS. The purpose of this explorative interview study was to identify factors that the local facilitators anticipated would...

Background Continuous medical education is essential in Helicopter Emergency Medical Services (HEMS). In-situ simulation training makes it possible to train in a familiar environment. The use of a dedicated facilitator is essential; however, when an in-situ simulation training session is interrupted by a live mission, the efforts invested in the tr...

Objective Prehospital and retrieval medicine (PHRM) occurs in a complex work environment. Appropriate training is essential to ensure high standards of clinical care and logistic decision making. Before commencing the role, PHRM doctors have varying levels of experience. This narrative review article aims to describe and compare 6 internationally a...

Objective Medical simulation is used in helicopter emergency services as a tool for training the crew. Using in situ simulation, we aimed to evaluate the degree of implementation, the barriers to completing simulation training, and the crew's attitude toward this form of training. Methods This was a 1-year prospective study on simulation at all 14...

The novel coronavirus SARS-CoV2 emerged in December 2019 and is now pandemic. Initial analysis suggests that 5% of infected patients will require critical care, and that respiratory failure requiring intubation is associated with high mortality. Sick patients are geographically dispersed: most patients will remain in situ until they are in need of...

Simulation-based training of emergency teams offers a safe learning environment in which training in the management of the critically ill patient can be planned and practiced without harming the patient. We developed a concept for in situ simulation that can be carried out during on-call time. The aim of this study is to investigate the feasibility...

Objective Patients with life- or limb-threatening severe injuries pose a challenge to prehospital services. Time-critical decision making and treatment are challenging because of occasional incomplete information, limited resources, adverse environments, and a range of basic and advanced technical skills available. To prepare for these infrequent c...

Introduction Medical simulation is used in helicopter emergency services as a tool for training the crew. Using in situ simulation we aimed to evaluate the degree of implementation, factors for successful simulation and the crew’s attitude towards this form for training. Methods A one year prospective study on simulation at all Norwegian helicopter...

Abstract The European HEMS and Air ambulance Committee’s Medical working group recently published Best Practice advice on pre-hospital emergency anaesthesia and advanced airway management. We believe that this initiative is important. In our opinion however, the competence requirements recommended by the authors do not meet the standards that we sh...

Pre-hospital care (PHC) personnel can be exposed to patients with infections at any time. The recent epidemic of Ebola hemorrhagic fever has highlighted the need for guidelines (SOPs) and competence in handling patients with infectious diseases in a safe manner, for both patient and PHC crew. Low fidelity in situ simulation can be an effective tool...

Physicians in prehospital care must be proficient in critical care procedures. Procedure proficiency requires a combination of training, experience and continuous clinical exposure. Most physicians in helicopter emergency medical service (HEMS) in Norway are well-trained and experienced anaesthesiologists, but we know little about their exposure to...

Pre-hospital care (PHC) personnel can be exposed to patients with infections at any time. The recent epi- demic of Ebola hemorrhagic fever has highlighted the need for guidelines (SOPs) and competence in handling patients with infectious diseases in a safe manner, for both patient and PHC crew. Low fidelity in situ simula- tion can be an effective...

Anaesthesiologists from Oslo University Hospital have transported patients with severe oxygenation failure with inhaled nitric oxide (usually 20 ppm) from other hospitals to a tertiary care centre since 2002 in an effort to reduce the number of patients that otherwise would require transport with ongoing extracorporeal membrane oxygenation. The aim...

A large number of techniques and devices for cricothyroidotomy have been developed. In this study, the PortexTM Cricothyroidotomy Kit (PCK, Smiths Medical Ltd, Hythe, UK) was compared with the bougie assisted emergency surgical cricothyrotomy technique (BACT). Twenty air ambulance anaesthesiologists performed emergency cricothyrotomy on a cadaveric...

Preliminary data from a one year prospective survey on advanced skills performed by anesthesiologists in a Norwegian HEMS.

A case of severe facial injury is described. The pre-hospital management including pre-hospital anaesthesia and intubation and the importance of advanced anaesthetic skills in rare trauma cases is discussed. In addition the rare situation where large bone fragments are retrieved from the scene and potentially used in reconstruction is mentioned.

The checklist used for structured debrief after all scenarios.

Requirements for a "simple mannequin".

These are key-points for successfully implement and use simulationtraining in a pre-hospital care service.

We describe a system of scenario-based training using simple mannequins under realistic circumstances for the training of pre-hospital care providers. A simple intubatable mannequin or student volunteers are used together with a training version of the equipment used on a routine basis by the pre-hospital care team (doctor + paramedic).Training is...

Background: Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate th...

To describe the use of ketamine in children by a pre-hospital physician-based service. A five and a half year retrospective database review of all patients aged <16 years who were attended by London's Helicopter Emergency Medical Service and given ketamine. One hundred and sixty-four children met the inclusion criteria. The median age was 10 years...

The safe delivery of adequate analgesia and appropriate sedation is a priority in prehospital care. The use of ketamine is described for analgesia and sedation in 1030 trauma patients in a physician-led prehospital trauma service. Ketamine was mainly used in awake non-trapped patients with blunt trauma for procedural sedation and analgesia. Detaile...

In the event of major incidents, neighbouring air ambulances can be used to assist. To assess the potential benefit of this cooperation, three fictitious major incidents were described to emergency service dispatch desks to assess the availability and response times for neighbouring air ambulances. A medical infrastructure at each site could be in...

We report the successful use of the Proseal laryngeal mask airway as a rescue device in three pre-hospital cases where tracheal intubation after induction of anaesthesia had failed. The ProSeal LMA allowed ventilation and oxygenation of all three patients under difficult circumstances.

This study reports the experience gained in prehospital thrombolysis in acute myocardial infarction in a sparsely inhabited remote area of northern Norway. The study was retrospective from 1992 to 1999. The area covered was 49 000 km2, with a population of 75 000. During the study period only one out of 19 municipalities offered prehospital thrombo...

The contribution of pH to exercise-induced arterial O2 desaturation was evaluated by intravenous infusion of sodium bicarbonate (Bic, 1 M; 200-350 ml) or an equal volume of saline (Sal; 1 M) at a constant infusion rate during a "2,000-m" maximal ergometer row in five male oarsmen. Blood-gas variables were corrected to the increase in blood temperat...