Highlights in this issue

Prehospital considerations In this issue of EMJ, several important subjects relevant to prehospital care are considered. Firstly, Kate Cantwell and colleagues from Victoria, Australia review the literature relating to the temporal demands on the ambulance service. They argue that whilst there are temporal patterns on ambulance demand, these do not necessarily match hospital demand, so need to be considered separately. Later in the issue, the (traditionally contentious) topic of prehospital tracheal intubation for trauma patients receives some attention. Christopher Evans and colleagues provide data from Ontario, from which they conclude that paramedic non-drug assisted tracheal intubation or attempted tracheal intubation for trauma was associated with a heightened risk of mortality. Interestingly, during the study period, the annual rates of prehospital tracheal intubation declined significantly. In amongst all of the quantitative studies, there is also a qualitative study focussing upon the experiences of patients who had accessed the ambulance service for acute myocardial infarction or stroke. Fiona Togher and colleagues conducted 33 semi-structured interviews with patients and staff. These provide some interesting insights into the thoughts and feelings of some patients at their most vulnerable moments.