title: Review of therapeutic agents employed by an Australian aeromedical prehospital and retrieval service.
abstract: OBJECTIVE
  There is little current evidence regarding which therapeutic agents are actually used within existing aeromedical services. The Greater Sydney Area Helicopter Emergency Medical Service operates a large, physician-staffed, multimodal, prehospital and interhospital retrieval service. The aim of the present study was to identify the range and frequency of drug, fluid and blood product use within our service.
  
  
  METHODS
  This was a retrospective cross-sectional study. Case sheets relating to a 12 month period were inspected to identify the therapeutic agents used by retrieval teams during each mission. Corresponding case notes, demographic data (age, sex) and case data (prehospital vs interhospital, trauma vs medical) were extracted from an electronic database.
  
  
  RESULTS
  Of 2566 missions, 848 were prehospital, 1662 interhospital and 56 mixed. Prehospital missions were associated with fewer agents per case (median, 2 vs 3) and a narrower range of agents overall (45 vs 117) compared to interhospital missions. In both mission types, the most frequently used agents included morphine, fentanyl, Hartmann's solution, ketamine, rocuronium, ondansetron and midazolam. Noradrenaline, propofol and metaraminol were used frequently in interhospital missions only. A number of stocked and unstocked agents were used less commonly, or not at all, over the study period.
  
  
  CONCLUSIONS
  The results of the present study form a practical guide to aid prehospital and retrieval services in establishing or reviewing their medical agent formularies. Key practice points illuminated by the data provide insights into current practice in critical care. There remains a clear need for similar studies from other services worldwide.
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Marcus D
authors.initials: MD
authors.lastname: Hayward
authors.affiliation: University of Aberdeen, Aberdeen, UK.|Emergency Department, Raigmore Hospital, Inverness, UK.
authors.forename: Luke
authors.initials: L
authors.lastname: Regan
authors.affiliation: Emergency Department, Redcliffe Hospital, Brisbane, Queensland, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Glasheen
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Greater Sydney Area Helicopter Emergency Medical Service, Ambulance Service of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Burns
mesh_terms: D017732:Air Ambulances; D001315:Australia; D003430:Cross-Sectional Studies; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D004364:Pharmaceutical Preparations
keywords: air ambulances; ambulances; emergency medicine; pharmaceutical preparations; transportation of patients