Pic1 London EMS

Surgery in the streets of London: Lessons Learned on Essential Procedures

The London Helicopter Emergency Medical Service (London HEMS), also known as London’s Air Ambulance (LAA), is a physician-based urban trauma service that provides advanced prehospital care twenty-four hours per day. It is unique in that it brings the resuscitation bay to the field and can perform cutting-edge life-saving procedures in the prehospital environment. Some of these procedures include advanced peripheral line placement, thoracostomy, resuscitative thoracotomy, surgical cricothryroidotomy, ultrasound evaluation, fracture reduction, rapid sequence intubation, and transfusion of blood products. This article reviews a few of these procedures and discusses the unique aspect of London’s EMS system.


R.E.B.E.L. EM – Xanthochromia Detection: Visual Inspection vs. Spectrophotometry

An LP gives providers the ability to perform CSF analysis for red blood cells and detect xanthochromia by visual inspection or spectrophotometry. In most of the world, including the United States, the predominant approach to identifying xanthochromia is visual detection. However, this technique is subjective and considered unreliable by many. Spectrophotometry is a more objective test but, has lower specificity, carries a higher cost and is unavailable in the majority of hospitals.

Emergency Medicine Education