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Prehospital and Disaster Medicine

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https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#1
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
May 6, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29708085/weekly-checks-improve-real-time-prehospital-ecg-transmission-in-suspected-stemi
#2
Nicole T D'Arcy, Nichole Bosson, Amy H Kaji, Quang T Bui, William J French, Joseph L Thomas, Yvonne Elizarraraz, Natalia Gonzalez, Jose Garcia, James T Niemann
IntroductionField identification of ST-elevation myocardial infarction (STEMI) and advanced hospital notification decreases first-medical-contact-to-balloon (FMC2B) time. A recent study in this system found that electrocardiogram (ECG) transmission following a STEMI alert was frequently unsuccessful.HypothesisInstituting weekly test ECG transmissions from paramedic units to the hospital would increase successful transmission of ECGs and decrease FMC2B and door-to-balloon (D2B) times. METHODS: This was a natural experiment of consecutive patients with field-identified STEMI transported to a single percutaneous coronary intervention (PCI)-capable hospital in a regional STEMI system before and after implementation of scheduled test ECG transmissions...
April 30, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29699595/skills-and-core-competencies-of-pharmacists-in-humanitarian-assistance
#3
Hamaspyur Vardanyan, Gabriela Bittencourt Gonzalez Mosegui, Elaine Silva Miranda
BACKGROUND: Pharmacists' participation in health care within multi-disciplinary teams in Humanitarian Assistance (HA) shall be encouraged. Limited literature exists on their role in the humanitarian context. The objective of this paper is to evidence the skill-specific, comprehensive core competencies that pharmacists must demonstrate working in humanitarian interventions. METHODS: The literature search laid the groundwork for the development of interview guides and further analysis of the data...
April 27, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29697044/international-emergency-medical-teams-training-workshop-special-report
#4
Anthony Albina, Laura Archer, Marlène Boivin, Hilarie Cranmer, Kirsten Johnson, Gautham Krishnaraj, Anali Maneshi, Lisa Oddy, Lynda Redwood-Campbell, Rebecca Russell
The World Health Organization's (WHO; Geneva, Switzerland) Emergency Medical Team (EMT) Initiative created guidelines which define the basic procedures to be followed by personnel and teams, as well as the critical points to discuss before deploying a field hospital. However, to date, there is no formal standardized training program established for EMTs before deployment. Recognizing that the World Association of Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) Congress brings together a diverse group of key stakeholders, a pre-Congress workshop was organized to seek out collective expertise and to identify key EMT training competencies for the future development of training programs and protocols...
April 26, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29697042/dispatcher-cpr-instructions-across-the-age-continuum
#5
Kristi L Weinmeister, E Brooke Lerner, Clare E Guse, Khalid A Ateyyah, Ronald G Pirrallo
BACKGROUND: Survival rates following out-of-hospital cardiac arrest (OHCA) increase two to three times when cardiopulmonary resuscitation (CPR) is started by bystanders, as compared to starting CPR when Emergency Medical Services (EMS) arrives. Municipalities that have implemented dispatcher-assisted bystander CPR programs have seen increased rates of bystander CPR. Cardiopulmonary resuscitation instructions are given for victims of all ages, but it is unknown if offering instructions results in similar rates of EMS-documented bystander CPR across the age continuum in these municipalities...
April 26, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29692279/analysis-of-medical-responses-in-mass-gatherings-the-commemoration-ceremonies-for-the-100th-anniversary-of-the-battle-of-gallipoli
#6
Hüseyin Koçak, Cüneyt Çalışkan, Mehmet Şerafettin Sönmezler, Kenan Eliuz, Fatih Küçükdurmaz
IntroductionMass crowds outside the routine population create a burden of disease on Emergency Medical Services (EMS). The need for EMS in various mass-crowd events may vary. It is especially important to determine the EMS requirement that emerges during the historic commemoration ceremonies in Çanakkale (Turkey).Hypothesis/ProblemThis study aims to determine the unique challenges in the planning of EMS responses provided for people from various countries at the commemoration ceremony for a 100-year-old war and to identify the medical provision of those services...
April 25, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29681244/orthopedic-knowledge-and-need-in-the-provincial-philippines-pilot-study-of-a-population-based-survey
#7
Christopher S Courtney, Thomas D Kirsch
IntroductionInterventions to reduce disability from acute orthopedic injuries require a primary assessment of knowledge and need. There are no previous studies to assess this need in the remote provincial islands of the Philippines, an area recurrently affected by natural disaster.ProblemA preliminary assessment of orthopedic knowledge and need was performed to be expanded for regional or national implementation. METHODS: Two independent surveys were conducted of households and mid-level providers who represent the first contact of care...
April 23, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669616/comparison-of-thermal-manikin-modeling-and-human-subjects-response-during-use-of-cooling-devices-under-personal-protective-ensembles-in-the-heat
#8
Tyler Quinn, Jung-Hyun Kim, Yongsuk Seo, Aitor Coca
IntroductionPersonal protective equipment (PPE) recommended for use in West Africa during the Ebola outbreak increased risk for heat illness, and countermeasures addressing this issue would be valuable.Hypothesis/ProblemThe purpose of this study was to examine the physiological impact and heat perception of four different personal cooling devices (PCDs) under impermeable PPE during low-intensity exercise in a hot and humid environment using thermal manikin modeling and human testing. METHODS: Six healthy male subjects walked on a treadmill in a hot/humid environment (32°C/92% relative humidity [RH]) at three metabolic equivalents (METs) for 60 minutes wearing PPE recommended for use in West Africa and one of four different personal cooling devices (PCDs; PCD1, PCD2, PCD3, and PCD4) or no PCD for control (CON)...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669612/prehospital-blood-product-administration-opportunities-in-ground-transport-als-ems-a-descriptive-study
#9
Felicia M Mix, Martin D Zielinski, Lucas A Myers, Kathy S Berns, Anurahda Luke, James R Stubbs, Scott P Zietlow, Donald H Jenkins, Matthew D Sztajnkrycer
IntroductionHemorrhage remains the major cause of preventable death after trauma. Recent data suggest that earlier blood product administration may improve outcomes. The purpose of this study was to determine whether opportunities exist for blood product transfusion by ground Emergency Medical Services (EMS). METHODS: This was a single EMS agency retrospective study of ground and helicopter responses from January 1, 2011 through December 31, 2015 for adult trauma patients transported from the scene of injury who met predetermined hemodynamic (HD) parameters for potential transfusion (heart rate [HR]≥120 and/or systolic blood pressure [SBP]≤90)...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669611/needle-thoracostomy-does-changing-needle-length-and-location-change-patient-outcome
#10
Lori A Weichenthal, Scott Owen, Geoffory Stroh, John Ramos
BACKGROUND: Needle thoracostomy (NT) is a common prehospital intervention for patients in extremis or cardiac arrest due to trauma. The purpose of this study is to compare outcomes, efficacy, and complications after a change in policy related to NT in a four-county Emergency Medical Services (EMS) system with a catchment area of greater than 1.6 million people. METHODS: This is a before and after observational study of all patients who had NT performed in the Central California (USA) EMS system...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669608/assessment-of-behavioral-health-concerns-in-the-community-affected-by-the-flint-water-crisis-michigan-usa-2016
#11
Gamola Z Fortenberry, Patricia Reynolds, Sherry L Burrer, Vicki Johnson-Lawrence, Alice Wang, Amy Schnall, Price Pullins, Stephanie Kieszak, Tesfaye Bayleyegn, Amy Wolkin
OBJECTIVES: The Flint Community Resilience Group (Flint, Michigan USA) and the Centers for Disease Control and Prevention (CDC; Atlanta, Georgia USA) assessed behavioral health concerns among community members to determine the impact of lead contamination of the Flint, Michigan water supply. METHODS: A Community Assessment for Public Health Emergency Response (CASPER) was conducted from May 17 through May 19, 2016 using a multi-stage cluster sampling design to select households and individuals to interview...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29667566/us-emergency-medical-services-fellows
#12
Brian Clemency, Christian Martin-Gill, Nicole Rall, Dipesh Patel, Jeffery Myers
IntroductionThe 2015-2016 academic year was the fourth year since the Accreditation Council for Graduate Medical Education (ACGME; Chicago, Illinois USA) accredited Emergency Medical Services (EMS) fellowships, and the first year an in-training examination was given. Soon, ACGME-accredited fellowship education will be the sole path to EMS board certification when the practice pathway closes after 2019. This project aimed to describe the current class of EMS fellows at ACGME-accredited programs and their current educational opportunities to better understand current and future needs in EMS fellowship education...
April 18, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29661267/comparison-of-electronic-versus-manual-mass-casualty-incident-triage
#13
Claudie Bolduc, Nisreen Maghraby, Patrick Fok, The Minh Luong, Valerie Homier
IntroductionMass-casualty incidents (MCIs) easily overwhelm a health care facility's human and material resources through the extraordinary influx of casualties. Efficient and accurate triage of incoming casualties is a critical step in the hospital disaster response.Hypothesis/ProblemTraditionally, triage during MCIs has been manually performed using paper cards. This study investigated the use of electronic Simple Triage and Rapid Treatment (START) triage as compared to the manual method. METHODS: This observational, crossover study was performed during a live MCI simulation at an urban, Canadian, Level 1 trauma center on May 26, 2016...
April 17, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29560850/regional-birth-outcomes-after-the-2011-great-east-japan-earthquake-and-tsunami-in-miyagi-prefecture
#14
Junichi Sugawara, Noriyuki Iwama, Tetsuro Hoshiai, Hideki Tokunaga, Hidekazu Nishigori, Hirohito Metoki, Kunihiro Okamura, Nobuo Yaegashi
OBJECTIVES: This study was aimed to analyze post-disaster birth outcomes in coastal and inland regions of Miyagi Prefecture, Japan. METHODS: Primary data sets were compiled from birth records of obstetric facilities and 12,808 patients were analyzed for baseline birth outcomes by region. Regional risk analysis of the low-birth-weight rate and premature birth rate were conducted using multi-level logistic regression analysis. RESULTS: From overall baseline birth outcomes, a preterm birth rate was 4...
March 21, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29534767/effective-international-medical-disaster-relief-a-qualitative-descriptive-study
#15
Nicolette Broby, Jane H Lassetter, Mary Williams, Blaine A Winters
Purpose The aim of this study was to assist organizations seeking to develop or improve their medical disaster relief effort by identifying fundamental elements and processes that permeate high-quality, international, medical disaster relief organizations and the teams they deploy. METHODS: A qualitative descriptive design was used. Data were gathered from interviews with key personnel at five international medical response organizations, as well as during field observations conducted at multiple sites in Jordan and Greece, including three refugee camps...
March 14, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29589575/likert-data
#16
Samuel J Stratton
No abstract text is available yet for this article.
April 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29560844/an-effective-risk-minimization-strategy-applied-to-an-outdoor-music-festival-a-multi-agency-approach
#17
Matt Luther, Fergus Gardiner, Shane Lenson, David Caldicott, Ryan Harris, Ryan Sabet, Mark Malloy, Jo Perkins
Specific Event Identifiers a. Event type: Outdoor music festival. b. Event onset date: December 3, 2016. c. Location of event: Regatta Point, Commonwealth Park. d. Geographical coordinates: Canberra, Australian Capital Territory (ACT), Australia (-35.289002, 149.131957, 600m). e. Dates and times of observation in latitude, longitude, and elevation: December 3, 2016, 11:00-23:00. f. Response type: Event medical support. Abstract Introduction Young adult patrons are vulnerable to risk-taking behavior, including drug taking, at outdoor music festivals...
April 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29530105/a-descriptive-analysis-of-care-provided-by-law-enforcement-prior-to-ems-arrival-in-the-united-states
#18
Aaron B Klassen, S Brent Core, Christine M Lohse, Matthew D Sztajnkrycer
Study Objectives Law enforcement is increasingly viewed as a key component in the out-of-hospital chain of survival, with expanded roles in cardiac arrest, narcotic overdose, and traumatic bleeding. Little is known about the nature of care provided by law enforcement prior to the arrival of Emergency Medical Services (EMS) assets. The purpose of the current study was to perform a descriptive analysis of events reported to a national EMS database. METHODS: This study was a descriptive analysis of the 2014 National Emergency Medical Services Information System (NEMSIS) public release research data set, containing EMS emergency response data from 41 states...
April 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29514727/a-new-triage-support-tool-in-case-of-explosion
#19
Olivier Yavari-Sartakhti, Frédérique Briche, Daniel Jost, Nicolas Michaud, Michel Bignand, Jean-Pierre Tourtier
Deafness frequently observed in explosion victims, currently following terrorist attack, is a barrier to communication between victims and first responders. This may result in a delay in the initial triage and evacuation. In such situations, Paris Fire Brigade (Paris, France) proposes the use of assistance cards to help conscious, but deafened patients at the site of an attack where there may be numerous victims. Yavari-Sartakhti O , Briche F , Jost D , Michaud N , Bignand M , Tourtier JP . A new triage support tool in case of explosion...
April 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29514720/the-association-between-cardiopulmonary-resuscitation-in-out-of-hospital-settings-and-chest-injuries-a-retrospective-observational-study
#20
Wataru Takayama, Hazuki Koguchi, Akira Endo, Yasuhiro Otomo
OBJECTIVES: The aim of this study was to assess the risk of cardiopulmonary resuscitation (CPR) performed in out-of-hospital settings for chest injuries in patients with out-of-hospital cardiac arrest (OHCA). METHODS: This retrospective, observational study was conducted in an emergency critical care medical center in Japan. Non-traumatic OHCA patients transferred to the hospital from April 2013 through August 2016 were analyzed. The outcome was defined by chest injuries related to CPR, which is composite of rib fractures, sternal fractures, and pneumothoraces...
April 2018: Prehospital and Disaster Medicine
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