No abstract

The Defence Medical Services aims to provide gold standard care to ill and injured personnel in the deployed environment and its prehospital emergency care (PHEC) systems have been proven to save lives. The authors have set out to demonstrate, using existing literature, consensus and doctrine that the NHS Skills for Health framework can be reflected in military prehospital care and provides an existing model for defining the levels of care our providers can offer. In addition, we have demonstrated how these levels of care support the Operational Patient Care Pathway and add to the body of evidence for the use of specialist PHEC teams to allow the right patient to be transported on the right platform, with the right medical team, to the right place. These formalised levels allow military planners to consider the scope of practice, amount of training and appropriate equipment required to support deployed operations.

Introduction Inhaled methoxyflurane is an analgesic used for the emergency relief of moderate to severe pain in conscious adult patients with trauma and associated pain that is increasingly being used in hospital emergency departments to provide rapid analgesia. It is widely accepted that effective pain relief can facilitate patient care and flow through the emergency department (ED). The main aim of this evaluation was to assess the impact of inhaled methoxyflurane on patient length of stay (LOS) in the ED compared with standard care. Methods Adult patients with moderate to severe trauma pain and Glasgow coma score of 15 were included in the evaluation. Evaluation forms were completed for 79 patients who received methoxyflurane and were matched with 80 patients who received standard care. Results Overall the mean time spent in the ED was reduced by 71 min in those patients who were administered methoxyflurane compared with patients who received standard care. Furthermore, analysis of LOS by injury type demonstrated a reduction in ED LOS by 183 min for patients with shoulder dislocation who were treated with methoxyflurane compared with patients who received standard care. There was no reduction in ED LOS for patients with lower limb, hip or pelvic injuries between the two treatment groups. Conclusion Use of methoxyflurane in adult patients with trauma pain significantly reduced the ED LOS and may potentially improve patient flow through the ED.