Poster Presentations / Resuscitation 84S (2013) S8–S98 S95

machine, to the temperature on a conventional vesical bladderthermistor and, for patients undergoing deep hypothermia, tooesophageal temperature.

Results: Using a linear model for sensor comparison the arte-rial outlet sensor showed a bias among the other sensor positionsbetween −0.54 ◦C and −1.12 ◦C. The 95% confidence interval rangedbetween 7.06 ◦C and 8.82 ◦C for the upper limit and −8.14 ◦C and−10.62 ◦C for the lower limit. Due to the hysteretic shape thecurvest were fitted into a nonlinear model. During cooling andwarming phases, a quadratic relationship could be observed amongarterial, oesophageal, vesical, and cranial temperature recordings,with coefficients of determination ranging between 0.95 and 0.98(standard errors of the estimate 0.69–1.12 ◦C).

Conclusion: We suggest that measured surrogate temperatures,e.g., from the vesical bladder, as an index of cerebral overheat-ing should be interpreted with respect to the direction-dependentbehaviour of temperatures during cooling and rewarming phases.In conclusion, with greater deviations from normothermia, the wayto interprete the classical temperature measuring sites should bedone using a new non-linear, direction dependend model.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.240

Stroke

AP215

Fibrinolytic therapy in acute isckemic stroke

Ana Araújo ∗, Nuno Catorze, Tiago Pereira, LucíliaPessoa, Maghed Abu Hazima

Centro Hospitalar Médio Tejo, Abrantes, Portugal

Introduction: The stroke is the first leading cause of death inPortugal and corresponds to a major cause of long-term disability.His incidence reaches 2 cases per 1000 persons in a year. The adventof fibrinolysis changed the natural evolution of this flail.

Methods: We designed a uncontrolled intervention study: allpatients (pts) with suspected acute stroke in the temporal windowwere referred to Intensive Care Unit staff for evaluation and com-ply to effective thrombolysis. All clinicians were advised and triagein the Emergency Department was adapted using NIHSS (NationalInstitutes of Health Stroke Scale).

Results: From 485 pts evaluated between 1st March 2009 and13th June 2013, 15.05% (73 pts) was submitted to fibrinolytic ther-apy in accordance with our protocol. Men were more prevalent(70%) and age was distributed between 29 and 85 yrs. Risk fac-tors included arterial hypertension (68.5%), dyslipidemia (19.2%),auricular fibrillation (17.8%), diabetes (16.4%), obesity (15%), activesmoking (12,3%) and coronary disease (6.8%). Multiple risk fac-tors were identified in 52% of pts. NIHSS improved after treatmentin 69.9% of cases (51 pts). In the 3–4 h 30 window, 19.1% (14 pts)received fibrinolysis and from these, 71.4% (10 pts) got benefit.Complications were aspiration pneumonia (13.6%), cerebral hem-orrhage (6.8%), death (5.4%) and non-cerebral hemorrhage (2.7%).

Conclusion: Our protocol resulted in the treatment of 15.05%of observed pts (1–11% in literature). The correct triage and earlyactivation of the chain of stroke care is fundamental. The authorsconclude all emergency physicians should be aware for early neuro-logical deficits and activate a in-hospital stroke team. More studiesshould be done to evaluate the quality of life and the real social andeconomical benefit.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.241

Trauma/Disaster Med

AP216

Model of efficiency in a combat field hospital

Kimberly Broughton, Przemek Guła ∗

Eglin AFB, FL, USA

Purpose: This study is a retrospective analysis of 198 combattrauma patient records treated in the Role II Polish Field Hospitalat Forward Operating Base (FOB) Ghazni. The purpose of this studyis to evaluate the efficiency of the trauma team as dictated by ATLSprinciples.

Methods/materials: The data was collected retrospectively uti-lizing prehospital data cards, emergency room documentation,operating room documentation, and transfer data sheets. The infor-mation was loaded into an independent database we created for thepurpose of evaluation. Given the retrospective nature of this study,all statistics are descriptive without availability of a power analysis.

Results: The mean age of the patients was 27 and mostly male(195). The injury mechanism was mostly the blast (61.6%) andGSW (38.4%). The majority (78%)of the patients were evacuated byMEDEVAC system. The mean NISS of the patients was 23.2 (range4–66). All arriving patients were triaged and treated following thecombat trauma protocols (recorded on trauma cards). 98 (49.5%)patients required life saving “amage control” surgical procedures.The mean time for critical interventions in trauma room variedbased on the procedure. Time for insertion of a chest tube was 6 min51 s, endotracheal intubation was 2 min 36 s, and resuscitative tho-racotomy was 17 min 22 s. The mean time for other damage controlsurgical treatment in the OR was 45 min 7 s. The main surgicalprocedures were chest tubes (9) Thoracotomies (6), laparotomies(10), and 69 orthopedic trauma procedures. 21 (10.6%) of patientsrequired blood products and received an average of 3.5 units RBCsand 3 units FFP. The average disposition time was 180 minutes. Theearly mortality of those who died of wounds (DOW) included 4(2.02%) patients.

Conclusions: Following the rules of trauma team organisation,preforming appropriate triage and working by trauma protocol aswell as the prehospital treatment based on Tactical Combat Casu-alty Care (TCCC) have strong impacts on reducing the combat injurymortality. The rules of combat trauma can be helpful in shorteningthe decision time in critical patients with special consideration ofearly damage control interventions.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.242

AP217

Using the FIA score to predict outcome incrashes after German rescue helicopteraccidents

Jochen Hinkelbein 1,∗, Mandy Hinkelbein 2,Wolfgang Wetsch 1, Oliver Spelten 1, ChristopherNeuhaus 3

1 Department for Anaesthesiology and Intensive CareMedicine, University Hospital of Cologne, Cologne,Germany2 Cologne, Cologne, Germany3 Department for Anaesthesiology, UniversityHospital of Heidelberg, Heidelberg, Germany

Background: In the past decades, multiple studies have exam-ined factors influencing occupant survival after aviation crashes,but only few have addressed this question for Helicopter Emer-