Prehospital personnel operate in environments with a significant risk of on-duty traffic accidents. We investigated the prevalence and characteristics of on-duty ambulance traffic accidents and explored how prehospital personnel perceive and experience accidents involving occupational injury.

In non-compressible blunt pelvic trauma with hemodynamic instability there are few options to ensure bleeding control in the prehospital setting or the emergency bay. These include insertion of a balloon into the descending aorta to achieve occlusion and loss of blood flow distal to the device known as resuscitative endovascular balloon occlusion of the aorta (REBOA). An alternative is the use of an external abdominal aortic and junctional tourniquet (AAJT) which is inflated to produce compression of the aorta.

Minimising time from injury to hospital admission is considered a key factor in trauma. Trauma care is often centralised to hospitals, which, because of their urban location, make treatment more accessible to patients in densely populated areas. If prehospital time increases with declining population density, an effect on mortality could hence be present. The primary aim of this study was to describe prehospital time intervals across population density groups. A secondary objective was to compare the 30-day mortality rates in these population groups.

Acute pain accounts for 60-90% of presentations to the emergency department (ED), with 20-40% of patients reporting severe pain. Current management practices, including simple analgesics, opiates and anti-inflammatory drugs, are often inadequate or slow to reach peak effect, necessitating the exploration of alternative analgesics. Ketamine, acting primarily through N-methyl-D-aspartate (NMDA) receptor antagonism, presents a promising alternative due to its rapid onset. However, its nebulised form remains underutilised in clinical practice.

A high Hypothermia Outcome Prediction after Extracorporeal Life Support (HOPE) score may indicate favourable neurological outcomes in hypothermic cardiac arrest, even among elderly adults. Although the score does not account for life-threatening complications arising during hospitalisation, outcomes may nevertheless align with its favourable estimates.

In 2022 the Faculty of Pre-hospital Care (FPHC) report on "Valuing Staff, Valuing Patients" was published, outlining the need to "seek out and remedy secondary stressors", such as training burdens or financial costs. Since that original publication, COVID-19 and the increased demand for healthcare have presented additional challenges, and staff wellbeing remains an increasing concern. The aim of the FPHC Wellbeing Group was to develop a FPHC Wellbeing Charter, to put the recommendations of the report into practice in a document that outlines achievable measures for all pre-hospital organisations to improve their staff and volunteers' wellbeing.

Extremity vascular injuries are among the most challenging problems in military surgery. They are frequently accompanied by extensive soft tissue loss and heavy contamination, which increases the risk of infection and limb loss. Although negative pressure wound therapy (NPWT) is widely used in civilian practice, its role in combat vascular injuries remains unclear. The war in Ukraine provided an opportunity to evaluate NPWT as part of staged surgical care under modern battlefield conditions.

Advanced airway management in the prehospital environment is a technically demanding and high-stakes procedure requiring effective team collaboration. While operator skill is often emphasized, few studies have examined whether an airway assistant's professional background influences intubation outcomes. This subgroup analysis of prehospital advanced airway management data aimed to evaluate whether the airway assistant profession affects first-pass success and complication rates during prehospital drug-assisted endotracheal intubation performed by anaesthesiologist-staffed Scandinavian helicopter emergency medical services.

Ongoing changes in the hospital landscape, combined with evolving patient transfer modalities, are reshaping acute care pathways. This study analyzed the medical needs of transferred stroke patients and assessed the potential time advantage of helicopter transport in this shifting context.

Models for the optimal location of ambulance bases typically focus on response time, but for some patients (e.g., trauma), the total pre-hospital time may matter more. Iceland's geography and population distribution imply that fixed-wing air ambulances are an important mode for transporting emergency patients to one of the small number of hospitals with capabilities to treat patients with time-sensitive conditions. Helicopter ambulances have the potential to improve service for incidents that occur far from the closest airport.

Blood component administration for major traumatic haemorrhage is established clinical practice in pre-hospital emergency medicine. However, transfusion practices for non-traumatic haemorrhage lack specific guidance. We analysed historical data on non-traumatic major haemorrhage to describe the incidence and current blood product administration practices.

Tranexamic acid is an established drug in the treatment of bleeding trauma patients. Concerns have been raised over possible complications of tranexamic acid regarding thromboembolic events as serious complications during the treatment of severely injured patients.

Severe thoracic trauma in children is rare and often underestimated. While standardized protocols exist, the rarity of polytrauma in children may lead to uncertainties in their application. Thus, we aim to characterize severely injured children with significant thoracic trauma and identify age-dependent differences in prehospital and early clinical management.

Recent studies have increasingly investigated the efficacy and safety of ketamine for the management of acute pain in emergency settings and compared it with standard treatments, such as morphine; however, the results remain inconsistent. This updated meta-analysis aimed to investigate the efficacy of low-dose ketamine compared to morphine on the severity of acute pain in emergency situations.

To identify factors associated with the mission outcome (transport completed vs. not transported) of air medical transport (AMT), with particular attention to environmental and operational constraints such as haze-related air pollution.

The transfusion of red blood cell (RBC) concentrates represents an emerging approach in paediatric trauma management, even in the prehospital period. Nevertheless, distinctive parameters for predicting the need for transfusion in children are still lacking. This study aimed to identify indicators for early in-hospital RBC transfusions that are primarily accessible either in the prehospital or in the early in-hospital setting in a large paediatric trauma cohort.

Accurate early identification of bleeding trauma patients remains challenging. Several clinical prediction tools-including the Assessment of Blood Consumption (ABC) score, Trauma-Associated Severe Hemorrhage (TASH) score, and shock index (SI)-have been developed to guide transfusion decisions, but their performance across clinically meaningful outcomes remains uncertain.

The role of thrombolysis in out-of-hospital cardiac arrest (OHCA) remains uncertain, with limited evidence of benefit. This study evaluated whether prehospital administration of Tenecteplase improves outcomes in patients with presumed thromboembolic OHCA.