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Prehospital Emergency Care

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https://www.readbyqxmd.com/read/28509603/reaching-beyond-doing-a-survey-and-a-few-interviews-the-importance-of-maintaining-rigor-validity-in-prehospital-qualitative-research
#1
K N Dainty
No abstract text is available yet for this article.
May 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28489506/prehospital-intubation-is-associated-with-favorable-outcomes-and-lower-mortality-in-protect-iii
#2
Kurt R Denninghoff, Tomas Nuño, Qi Pauls, Sharon D Yeatts, Robert Silbergleit, Yuko Y Palesch, Lisa H Merck, Geoff T Manley, David W Wright
OBJECTIVE: Traumatic brain injury (TBI) causes more than 2.5 million emergency department visits, hospitalizations, or deaths annually. Prehospital endotracheal intubation has been associated with poor outcomes in patients with TBI in several retrospective observational studies. We evaluated the relationship between prehospital intubation, functional outcomes, and mortality using high quality data on clinical practice collected prospectively during a randomized multicenter clinical trial...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28489503/does-prehospital-time-influence-clinical-outcomes-in-severe-trauma-patients-a-cross-sectional-study
#3
Jungeun Kim, Kyoung Jun Song, Sang Do Shin, Young Sun Ro, Ki Jeong Hong, James F Holmes
OBJECTIVE: Prehospital time potentially impacts clinical outcomes in severely injured trauma patients. The importance of individual components, including scene and response time, however, is controversial. Our objective was to determine the impact of prehospital times on survival in severely injured patients. METHODS: We reviewed injured trauma patients enrolled in a Korean EMS trauma registry during 2012. Severe trauma patients were defined as having either a "V" or lower in the AVPU system, a systolic blood pressure ≤90mmHg, or respiratory rate <10 or >29...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28489471/effect-of-the-2011-revisions-to-the-field-triage-guidelines-on-under-and-over-triage-rates-for-pediatric-trauma-patients
#4
E Brooke Lerner, Jeremy T Cushman, Amy L Drendel, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: In 2011, revised Field Triage Guidelines were released jointly by the Centers for Disease Control and Prevention (CDC) and the American College of Surgeons - Committee on Trauma (ACS-COT). It is unknown how the modifications will affect the number of injured children identified by EMS providers as needing transport to a trauma center. OBJECTIVE: To determine the change in under- and over-triage rates when the 2011 Field Triage Guidelines are compared to the 2006 and 1999 versions...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28481722/ems-provider-perceptions-on-termination-of-resuscitation-in-a-large-urban-ems-system
#5
Katie L Tataris, Christopher T Richards, Leslee Stein-Spencer, Stephanie Ryan, Pete Lazzara, Joseph M Weber
OBJECTIVE: Despite the value of out-of-hospital Termination of Resuscitation (TOR) and the scientific evidence in favor of this practice, TOR has not been uniformly adopted or consistently practiced in EMS systems. Previous focus group studies have identified multiple barriers to implementation of out of hospital TOR but existing literature on EMS provider perceptions is limited. We sought to identify EMS providers' perceived barriers to performing out-of-hospital TOR in a large urban EMS system...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28481669/prehospital-fluid-administration-in-trauma-patients-a-survey-of-state-protocols
#6
Sahil Dadoo, Joseph M Grover, Lukas G Keil, Kay S Hwang, Jane H Brice, Timothy F Platts-Mills
OBJECTIVE: The optimal resuscitation approach during the initial treatment of hypotensive trauma patients remains unknown, but some clinical trials have observed a survival benefit from restricting fluid administration prior to definitive hemorrhage control. We sought to characterize emergency medical services (EMS) protocols for the administration of intravenous fluids in this setting. METHODS: Publicly accessible statewide EMS protocols for the treatment of hypotensive trauma patients were included and characterized by: 1) goal of fluid administration, 2) dosing strategy, 3) maximum dose, 4) type of fluid, and 5) specific protocols for head trauma, if present...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28481656/multiple-naloxone-administrations-among-emergency-medical-service-providers-is-increasing
#7
Mark Faul, Peter Lurie, Jeremiah M Kinsman, Michael W Dailey, Charmaine Crabaugh, Scott M Sasser
BACKGROUND: Opioid overdoses are at epidemic levels in the United States. Emergency Medical Service (EMS) providers may administer naloxone to restore patient breathing and prevent respiratory arrest. There was a need for contemporary data to examine the number of naloxone administrations in an EMS encounter. METHODS: Using data from the National Emergency Medical Services Information System, we examined data from 2012-5 to determine trends in patients receiving multiple naloxone administrations (MNAs)...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28481163/body-temperature-after-ems-transport-association-with-traumatic-brain-injury-outcomes
#8
Joshua B Gaither, Vatsal Chikani, Uwe Stolz, Chad Viscusi, Kurt Denninghoff, Bruce Barnhart, Terry Mullins, Amber D Rice, Moses Mhayamaguru, Jennifer J Smith, Samuel M Keim, Bentley J Bobrow, Daniel W Spaite
INTRODUCTION: Low body temperatures following prehospital transport are associated with poor outcomes in patients with traumatic brain injury (TBI). However, a minimal amount is known about potential associations across a range of temperatures obtained immediately after prehospital transport. Furthermore, a minimal amount is known about the influence of body temperature on non-mortality outcomes. The purpose of this study was to assess the correlation between temperatures obtained immediately following prehospital transport and TBI outcomes across the entire range of temperatures...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28467148/outcomes-of-cardiac-arrest-in-residential-care-homes-for-the-elderly-in-hong-kong
#9
Kit Ling Fan, Ling Pong Leung
OBJECTIVE: Studies done in the 1990's suggested nursing home residents with cardiac arrest had minimal chance of survival and resuscitation was not recommended. More recent studies showed opposing results. In Hong Kong, the proportion of elderly living in the residential care homes for the elderly is increasing. There is no study of out-of-hospital cardiac arrest outcomes in this population. This study aimed at evaluating the prognosis of out-of-hospital cardiac arrest occurring in the residential care homes for the elderly...
May 3, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28467138/chest-compression-fraction-between-mechanical-compressions-on-a-reducible-stretcher-and-manual-compressions-on-a-standard-stretcher-during-transport-in-out-of-hospital-cardiac-arrests-the-ambulance-stretcher-innovation-of-asian-cardiopulmonary-resuscitation
#10
Tae Han Kim, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Young Sun Ro, Sung Wook Song, Chu Hyun Kim
BACKGROUND: Cardiopulmonary resuscitation (CPR) with the use of mechanical devices is recommended during ambulance transport. However, the CPR quality en route and while in transfer to the emergency department (ED) for out-of-hospital cardiac arrests (OHCAs) remains uncertain. We developed a mechanical CPR device outfitted on a reducible stretcher (M-CPR) and compared with standard manual CPR on a standard stretcher (S-CPR) to evaluate CPR quality. METHODS: Adult OHCAs transported by five ambulances in a metropolitan area with a population of 3...
May 3, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28467125/do-trauma-patients-aged-55-and-older-benefit-from-air-medical-transport
#11
Howard A Werman, Subrahmanyam Darbha, Michael Cudnik, Jeffrey Caterino
INTRODUCTION: A recent analysis of the National Sample Project demonstrated that the mortality benefits of air medical transport do not extend to patients age 55 or older. The purpose of the current investigation was to evaluate mortality benefits of air transport in adult trauma patients ≥ 55 years of age. METHODS: A retrospective analysis of all adult patients greater than age 55 years directly transported from a trauma scene to a Level I or II facility was conducted...
May 3, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28467124/building-capacity-in-healthcare-by-re-examining-clinical-services-in-paramedicine
#12
Walter Tavares, Ian Drennan, Kelly Van Diepen, Michael Abanil, Natalie Kedzierski, Chris Spearen, Norm Barrette, Mathew Mercuri
OBJECTIVES: Emergency departments (ED) continue to be overburdened, leading to crowding and elevated risk of negative clinical outcomes. Extending clinical services to paramedics may support efforts to improve ED burdens by promoting health care access and capacity during times of patient crisis. The objective of this study was to identify the clinical course and most responsible diagnosis of patients transported by paramedic services to local EDs to then evaluate impact of various augmented 9-1-1/paramedic clinical service models on the need for additional ED services...
May 3, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28463042/defining-components-of-team-leadership-and-membership-in-prehospital-emergency-medical-services
#13
Remle P Crowe, Robert L Wagoner, Severo A Rodriguez, Melissa A Bentley, David Page
BACKGROUND: Teamwork is critical for patient and provider safety in high-stakes environments, including the setting of prehospital emergency medical services (EMS). OBJECTIVE: We sought to describe the components of team leadership and team membership on a single patient call where multiple EMS providers are present. METHODS: We conducted a two-day focus group with nine subject matter experts in crew resource management (CRM) and EMS using a structured nominal group technique (NGT)...
May 2, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28459305/advanced-airway-type-and-its-association-with-chest-compression-interruptions-during-out-of-hospital-cardiac-arrest-resuscitation-attempts
#14
Angela F Jarman, Christy L Hopkins, J Nicholas Hansen, Jonathan R Brown, Christopher Burk, Scott T Youngquist
OBJECTIVE: To assess interruptions in chest compressions associated with advanced airway placement during cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrest (OHCA) victims. METHODS: The method used was observational analysis of prospectively collected clinical and defibrillator data from 339 adult OHCA victims, excluding victims with <5 minutes of CPR. Interruptions in CPR, summarized by chest compression fraction (CCF), longest pause, and the number of pauses greater than 10 seconds, were compared between patients receiving bag valve mask (BVM), supraglottic airway (SGA), endotracheal intubation (ETI) via direct laryngoscopy (DL), and ETI via video laryngoscopy (VL)...
May 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28459301/role-of-guideline-adherence-in-improving-field-triage
#15
Craig D Newgard, Rongwei Fu, E Brooke Lerner, Mohamud Daya, Jonathan Jui, Lynn Wittwer, Terri A Schmidt, Dana Zive, Eileen M Bulger, Ritu Sahni, Craig Warden, Nathan Kuppermann
OBJECTIVE: To compare the sensitivity of current field triage practices for identifying high-risk trauma patients to strict guideline adherence, including changes in triage specificity, ambulance transport patterns, and trauma center volumes. METHODS: This was a pre-planned secondary analysis of an out-of-hospital prospective cohort of injured children and adults transported by 44 EMS agencies to 28 trauma and non-trauma hospitals in 7 Northwest U.S. counties from January 1, 2011 through December 31, 2011...
May 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28426258/improvements-in-out-of-hospital-cardiac-arrest-survival-from-1998-to-2013
#16
Yutaka Yamaguchi, Jeff A Woodin, Koichiro Gibo, Dana M Zive, Mohamud R Daya
OBJECTIVES: Out-of-hospital cardiac arrest (OHCA) remains a major public health burden. Aggregate OHCA survival to hospital discharge has reportedly remained unchanged at 7.6% for almost 30 years from 1970 to 2008. We examined the trends in adult OHCA survival over a 16-year period from 1998 to 2013 within a single EMS agency. METHODS: Observational cohort study of adult OHCA patients treated by Tualatin Valley Fire & Rescue (TVF&R) from 1998 to 2013. This is an ALS first response fire agency that maintains an active Utstein style cardiac arrest registry and serves a population of approximately 450,000 in 9 incorporated cities in Oregon...
April 20, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28422541/evaluation-of-the-implementation-of-the-trauma-triage-and-destination-plan-on-the-field-triage-of-injured-patients-in-north-carolina
#17
Jane H Brice, Frances S Shofer, Christopher Cowden, E Brooke Lerner, Matthew Psioda, Meredith Arasaratanam, N Clay Mann, Antonio R Fernandez, Anna Waller, Chailee Moss, Michael Mian
OBJECTIVE: Timely triage and appropriate destination decision making for injured patients are central challenges faced by emergency medical services (EMS) systems. In 2010, North Carolina (NC) adopted a statewide Trauma Triage and Destination Plan (TTDP) based on the CDC's Field Triage Guidelines to better address these challenges. We sought to characterize the implementation of these guidelines by quantifying their effect on multiple metrics of patient care. METHODS: We employed a retrospective pre-post study design utilizing a statewide EMS medical record database...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28422540/evaluating-barriers-to-bystander-cpr-among-laypersons-before-and-after-compression-only-cpr-training
#18
Andrew J Bouland, Megan H Halliday, Angela C Comer, Matthew J Levy, Kevin G Seaman, Benjamin J Lawner
OBJECTIVE: Bystander CPR is an essential part of out-of-hospital cardiac arrest (OHCA) survival. EMS and public safety jurisdictions have embraced initiatives to teach compression-only CPR to laypersons in order to increase rates of bystander CPR. We examined barriers to bystander CPR amongst laypersons participating in community compression-only CPR training and the ability of the training to alleviate these barriers. The barriers analyzed include fear of litigation, risk of disease transmission, fear of hurting someone as a result of doing CPR when unnecessary, and fear of hurting someone as a result of doing CPR incorrectly...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28422537/morbidity-and-mortality-associated-with-prehospital-lift-assist-calls
#19
Lauren Leggatt, Kristine Van Aarsen, Melanie Columbus, Adam Dukelow, Michael Lewell, Matthew Davis, Shelley McLeod
INTRODUCTION: When an individual requires assistance with mobilization, emergency medical services (EMS) may be called. If a patient does not receive treatment on scene and is not transported to hospital, these are referred to as "Lift Assist" (LA) calls. It is possible this need for assistance represents a subtle onset of a disease process or decline in function. Without recognition or treatment, the patient may be at risk for recurrent falls, repeat EMS visits or worsening illness. OBJECTIVE: To examine the 14-day morbidity and mortality associated with LA calls and determine factors that are associated with increased risk of these outcomes...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28418753/intraosseous-pressure-monitoring-in-healthy-volunteers
#20
Joshua G Salzman, Nicholas M Loken, Sandi S Wewerka, Aaron M Burnett, Abigail E Zagar, Kent R Griffith, Peter L Bliss, Bjorn K Peterson, Christopher J Ward, Ralph J Frascone
STUDY OBJECTIVE: Invasively monitoring blood pressure through the IO device has not been thoroughly demonstrated. This study attempted to establish baseline values of IO pressure in a healthy human population. METHODS: This was a prospective, healthy volunteer, observational study. Participants had two IO devices placed (humerus and tibia), and participant IO pressures, vital signs, and pain scores were monitored for up to 60 minutes. Participants were contacted at 24-hours and 7 days post-testing to assess for adverse events...
April 18, 2017: Prehospital Emergency Care
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