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Prehospital Emergency Care

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https://www.readbyqxmd.com/read/29775117/intravenous-low-dose-ketamine-provides-greater-pain-control-compared-to-fentanyl-in-a-civilian-prehospital-trauma-system-a-propensity-matched-analysis
#1
E Stein Bronsky, Catherine Koola, Alessandro Orlando, Diane Redmond, Cecile D'Huyvetter, Heather Sieracki, Allen Tanner, Ray Fowler, Charles Mains, David Bar-Or
OBJECTIVE: A few studies report comparable analgesic efficacy between low-dose ketamine and opioids such as morphine or fentanyl; however, limited research has explored the safety and effectiveness of intravenous low-dose ketamine as a primary analgesic in a civilian prehospital setting. The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016...
May 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29768077/strategy-to-address-private-location-cardiac-arrest-a-public-safety-survey
#2
Jennifer Blackwood, Mickey Eisenberg, Dawn Jorgenson, James Nania, Bryan Howard, Bryan Collins, Peter Connell, Tim Day, Cody Rohrbach, Thomas Rea
OBJECTIVE: Most cardiac arrests occur in the private setting where response is often delayed and outcomes are poor. We surveyed public safety personnel to determine if they would volunteer to respond into private locations and/or be equipped with a personal automated external defibrillator (AED) as part of a vetted responder program that would use smart geospatial technology. METHODS: We conducted an anonymized survey among personnel from fire-based emergency medical services (EMS) and search and rescue organizations from Washington State...
May 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29723076/feasibility-of-bystander-administration-of-public-access-naloxone-for-opioid-overdose
#3
Scott A Goldberg, Daniel A Dworkis, Vincent T Liao, Andrew J Eyre, Jack Albert, Meghan M Fawcett, Conor M Narovec, James DiClemente, Scott G Weiner
OBJECTIVE: Pre-stationing naloxone, a competitive antagonist that can reverse the effects of opioid overdose, in public spaces may expedite antidote delivery. Our study aimed to determine the feasibility of bystander-assisted overdose treatment using pre-stationed naloxone. METHODS: Convenience sample of bystanders in Cambridge, Massachusetts in April 2017. Subjects assisted a simulated patient described as unconscious. Subjects interacted with simulated EMS dispatch to locate a nearby box, unlock it, and administer naloxone...
May 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29714527/comparison-of-the-force-required-for-dislodgement-between-secured-and-unsecured-airways
#4
Curtis Davenport, Christian Martin-Gill, Henry E Wang, James Mayrose, Jestin N Carlson
INTRODUCTION: Airway device placement and maintenance are of utmost importance when managing critically ill patients. The best method to secure airway devices is currently unknown. STUDY OBJECTIVE: We sought to determine the force required to dislodge 4 types of airways with and without airway securing devices. METHODS: We performed a prospective study using 4 commonly used airway devices (endotracheal tube [ETT], laryngeal mask airway [LMA], King laryngeal tube [King], and iGel) performed on 5 different mannequin models...
May 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29714510/does-non-targeted-community-cpr-training-increase-bystander-cpr-frequency
#5
Amy Uber, Richard C Sadler, Todd Chassee, Joshua C Reynolds
OBJECTIVE: Only 37% of out-of-hospital cardiac arrests (OHCA) receive bystander Cardiopulmonary resuscitation (CPR) in Kent County, MI. In May 2014, prehospital providers offered one-time, point-of-contact compression-only CPR training to 2,253 passersby at 7 public locations in Grand Rapids, Michigan. To assess the impact of this intervention, we compared bystander CPR frequency and clinical outcomes in regions surrounding training sites before and after the intervention, adjusting for prehospital covariates...
May 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29693490/fatal-wounding-pattern-and-causes-of-potentially-preventable-death-following-the-pulse-night-club-shooting-event
#6
E Reed Smith, Geoff Shapiro, Babak Sarani
BACKGROUND: Mortality following shooting is related to time to provision of initial and definitive care. An understanding of the wounding pattern, opportunities for rescue, and incidence of possibly preventable death is needed to achieve the goal of zero preventable deaths following trauma. METHODS: A retrospective study of autopsy reports for all victims involved in the Pulse Nightclub Shooting was performed. The site of injury, probable site of fatal injury, and presence of potentially survivable injury (defined as survival if prehospital care is provided within 10 minutes and trauma center care within 60 minutes of injury) was determined independently by each author...
April 25, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29671664/burden-of-emergency-medical-services-usage-by-dialysis-patients
#7
John Bartolacci, Judah Goldstein, Bryce Kiberd, Janel Swain, Amanda Vinson, David Clark, Karthik K Tennankore
BACKGROUND: Patients receiving chronic dialysis often require emergent and inpatient care; however, only a minimal amount is known about their out-of-hospital/inter-hospital use of Emergency Medical Services (EMS). The purpose of this study was to describe the utilization of EMS in a cohort of dialysis patients. METHODS: We analyzed a cohort of adult (≥18 years) chronic dialysis patients within the Nova Scotia Health Authority Central Zone Renal Program who initiated chronic dialysis between January 1, 2009 and June 30, 2013 (last follow up July 1, 2015)...
April 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29648909/diabetes-related-emergency-medical-service-activations-in-23-states-united-states-2015
#8
Stephen R Benoit, Henry S Kahn, Andrew I Geller, Daniel S Budnitz, N Clay Mann, Mengtao Dai, Edward W Gregg, Linda S Geiss
OBJECTIVE: The use of emergency medical services (EMS) for diabetes-related events is believed to be substantial but has not been quantified nationally despite the diverse acute complications associated with diabetes. We describe diabetes-related EMS activations in 2015 among people of all ages from 23 U.S. states. METHODS: We used data from 23 states that reported ≥95% of their EMS activations to the U.S. National Emergency Medical Services Information System (NEMSIS) in 2015...
April 12, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29624088/intrastate-variation-in-treatment-and-outcomes-of-out-of-hospital-cardiac-arrest
#9
Ryan A Coute, Theresa A Shields, James A Cranford, Sardar Ansari, Mahshid Abir, M Hakam Tiba, Robert Dunne, Brian O'Neil, Robert Swor, Robert W Neumar
OBJECTIVE: Our objective was to analyze and compare out-of-hospital cardiac arrest (OHCA) system of care performance and outcomes at the Medical Control Authority (MCA) level in the state of Michigan. We hypothesized that clinically and statistically significant variations in treatment and outcomes of OHCA exists within a single U.S. state. METHODS: We performed a retrospective, observational study of all non-traumatic EMS-treated OHCA from the state of Michigan CARES registry for 2014-2015...
April 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29617208/analysis-of-prehospital-scene-times-and-interventions-on-mortality-outcomes-in-a-national-cohort-of-penetrating-and-blunt-trauma-patients
#10
Octavia S Ruelas, Craig F Tschautscher, Christine M Lohse, Matthew D Sztajnkrycer
BACKGROUND: Recent studies have suggested improved outcomes in victims of penetrating trauma managed with shorter prehospital times and limited interventions. The purpose of the current study was to perform an outcome analysis of patients transported following penetrating and blunt traumatic injuries. METHODS: We performed a descriptive retrospective analysis of the 2014 National Emergency Medical Services Information System (NEMSIS) public release research data set for patients presenting after acute traumatic injury...
April 4, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29596009/decreased-time-from-9-1-1-call-to-pci-among-patients-experiencing-stemi-results-in-a-decreased-one-year-mortality
#11
Jonathan R Studnek, Allison Infinger, Hadley Wilson, Gary Niess, Patrick Jackson, Doug Swanson
BACKGROUND: The impact on mortality due to prompt recognition of ST-segment Elevation Myocardial Infarction (STEMI) patients by EMS has not been well described. The objective of this study was to describe the association between the time interval, 9-1-1 call to percutaneous intervention (PCI), and mortality at one year. METHODS: This retrospective analysis included patients that were transported by EMS as a "code STEMI" and underwent PCI.  Total time from 9-1-1 call to PCI was calculated for each patient and was the independent variable of interest...
March 29, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29596006/accuracy-of-prehospital-identification-of-stroke-in-a-large-stroke-belt-municipality
#12
Nee-Kofi Mould-Millman, Halea Meese, Ibthial Alattas, Moges Ido, Iasson Yi, Tolulope Oyewumi, Michael Colman, Michael Frankel, Arthur Yancey
OBJECTIVE: Strokes are a leading cause of morbidity and mortality in the United States, especially in the "stroke belt" of the southeast. Up to 65% of stroke patients access care by calling 9-1-1. The primary objective of this study is to measure the accuracy of emergency medical dispatchers (EMD) and paramedics, in the prehospital identification of stroke. METHODS: The study was based at Grady Emergency Medical Services, which is Atlanta, Georgia's public emergency medical services (EMS) provider...
March 29, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29595357/defining-quality-in-ems
#13
(no author information available yet)
No abstract text is available yet for this article.
March 29, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29565717/determinants-of-pediatric-ems-utilization-in-children-with-high-acuity-conditions
#14
Casandra Quiñones, Manish I Shah, Andrea T Cruz, Jeanine M Graf, Juan A Mondragon, Elizabeth A Camp, Pooja Reddy, Esther M Sampayo
BACKGROUND: Underutilization of emergency medical services (EMS) for children with high-acuity conditions is poorly understood. Our objective was to identify differences in demographic factors and describe caregivers' knowledge, beliefs, and attitudes regarding EMS utilization for children with high-acuity conditions. DESIGN/METHODS: This was a mixed-methods study of children with high acuity conditions, defined as requiring immediate medical or surgical intervention and intensive care admission, over a one year period...
March 22, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29558224/a-prospective-before-and-after-study-of-droperidol-for-prehospital-acute-behavioral-disturbance
#15
Colin B Page, Lachlan E Parker, Stephen J Rashford, Emma Bosley, Katherine Z Isoardi, Frances E Williamson, Geoffrey K Isbister
STUDY OBJECTIVE: Acute behavioral disturbance is a common problem for emergency medical services. We aimed to investigate the safety and effectiveness of droperidol compared to midazolam in the prehospital setting. METHODS: This was a prospective before and after study comparing droperidol to midazolam for prehospital acute behavioral disturbance, when the state ambulance service changed medications. The primary outcome was the proportion of adverse effects (airway intervention, oxygen saturation < 90%, respiratory rate < 12, systolic blood pressure < 90 mmHg, sedation assessment tool score -3 and dystonic reactions) in patients receiving sedation...
March 20, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29521551/effect-of-dial-out-prefix-change-on-9-1-1-calls-at-a-large-state-university
#16
Jane H Brice, Matthew A Psioda, Renee Johnson, Amy Oakley, Julianne M Cyr, Christopher S Cowden, Richard Uribe
BACKGROUND: Accessing the emergency medical services system via 9-1-1 operators is an effective way for patients to seek urgent health care; however, technological advances and telecommunication practices inundate the 9-1-1 and emergency services infrastructure with unintentional calls that delay response efforts to legitimate medical emergencies. OBJECTIVE: To determine whether the change in university-wide dial-out prefix from "9" to "7" reduced unnecessary calls to a 9-1-1 call center...
March 9, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29494777/prehospital-interventions-performed-on-pediatric-trauma-patients-in-iraq-and-afghanistan
#17
Steven G Schauer, Michael D April, Guyon J Hill, Jason F Naylor, Matthew A Borgman, Robert A De Lorenzo
BACKGROUND: United States (US) and coalition military medical units deployed to combat zones frequently encounter pediatric trauma patients. Pediatric patients may present unique challenges due to their anatomical and physiological characteristics and most military prehospital providers lack pediatric-specific training. A minimal amount of data exists to illuminate the prehospital care of pediatric patients in this environment. We describe the prehospital care of pediatric trauma patients in Iraq and Afghanistan...
March 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29494776/simulation-of-the-effects-of-co-locating-naloxone-with-automated-external-defibrillators
#18
Jessica E Salerno, Leonard S Weiss, David D Salcido
INTRODUCTION: Opioid-related overdoses have been steadily increasing over the past decade in the United States. Naloxone is used by first responders to revive overdose victims, but results may be improved by increasing access to and usage of naloxone by bystanders. Automated External Defibrillators (AEDs) are pervasive, recognizable, and publicly accessible. Co-locating naloxone kits with AEDs could increase public naloxone access and usage. However, the impact of co-locating naloxone kits with AEDs is not known...
March 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29494774/out-of-hospital-research-in-the-era-of-electronic-health-records
#19
Craig D Newgard, Rochelle Fu, Susan Malveau, Tom Rea, Denise E Griffiths, Eileen Bulger, Pat Klotz, Abbie Tirrell, Dana Zive
Conducting out-of-hospital research is unique and challenging and requires tracking patients across multiple phases of care, using multiple sources of patient records and multiple hospitals. The logistics and strategies used for out-of-hospital research are distinct from other forms of clinical research. The increasing use of electronic health records (EHRs) by hospitals and emergency medical services (EMS) agencies presents a large opportunity for accelerating out-of-hospital research, as well as particular challenges...
March 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29485338/dexamethasone-related-perineal-burning-in-the-prehospital-setting-a-case-series
#20
Layne Dylla, Nicole M Acquisto, Francis Manzo, Jeremy T Cushman
Dexamethasone is frequently used in the treatment of allergic reactions and airway inflammation because of its potent anti-inflammatory effects and long duration of action. As prehospital use becomes more common, it is important for providers to be aware of unique and potentially distressing associated adverse effects. We report eight cases of intravenous dexamethasone administration associated with perineal or diffuse burning sensation in female patients.
February 27, 2018: Prehospital Emergency Care
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