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Prehospital Emergency Care

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https://www.readbyqxmd.com/read/28426258/improvements-in-out-of-hospital-cardiac-arrest-survival-from-1998-to-2013
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28414588/prehospital-predictors-of-traumatic-spinal-cord-injury-in-victoria-australia
#6
Alaa O Oteir, Karen Smith, Johannes Stoelwinder, James W Middleton, Shelley Cox, Lisa N Sharwood, Paul A Jennings
OBJECTIVES: To identify the predictors of traumatic spinal cord injury (TSCI) and describe the differences between confirmed and potential TSCI cases in the prehospital setting. METHODS: A retrospective cohort study including all adult patients over a six-year period (2007-12) with potential TSCI who were attended and transported by Ambulance Victoria (AV). We extracted potential TSCI cases from the AV data warehouse and linked with the Victorian State Trauma Registry to compare with final hospital diagnosis...
April 17, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28414559/evaluating-the-cost-and-utility-of-mandating-schools-to-stock-epinephrine-auto-injectors
#7
Chelsea Steffens, Benjamin Clement, William Fales, Ahel El Haj Chehade, Kevin Putman, Robert Swor
BACKGROUND: The Michigan Legislature mandated that all public schools stock epinephrine auto-injectors (EAIs). A minimal amount is known regarding the incremental value of EAIs in schools. Our primary objective was to describe the frequency of administration of epinephrine for EMS patients with acute allergic reactions in public schools. Our secondary objective was to estimate the cost of mandating public schools to stock EAIs. METHODS: We performed a retrospective cohort study of EMS cases with an impression of allergic reaction and who received epinephrine recorded in the 2014 Michigan EMS Information System (MI-EMSIS)...
April 17, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28409655/9-1-1-triage-of-non-traumatic-chest-pain-association-with-hospital-diagnosis
#8
Greg Scott, Jeff J Clawson, Isabel Gardett, Meghan Broadbent, Nathan Williams, Conrad Fivaz, Gigi Marshall, Tracey Barron, Christopher Olola
OBJECTIVE: Chest pain is one of the most common reasons people seek emergency care-and one of the most critical. In the United States, chest pain is the second most common reason for emergency department (ED) visits. A patient's primary complaint of "chest pain" may reflect a broad range of underlying causes; therefore, it is important that emergency medical service (EMS) agencies gain a thorough understanding of these cases, beginning with the initial management of chest pain in the 9-1-1 center...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28409652/modeling-to-optimize-hospital-evacuation-planning-in-ems-systems
#9
Douglas R Bish, Hussein Tarhini, Roel Amara, Richard Zoraster, Nichole Bosson, Marianne Gausche-Hill
OBJECTIVE: To develop optimal hospital evacuation plans within a large urban EMS system using a novel evacuation planning model and a realistic hospital evacuation scenario, and to illustrate the ways in which a decision support model may be useful in evacuation planning. METHODS: An optimization model was used to produce detailed evacuation plans given the number and type of patients in the evacuating hospital, resource levels (teams to move patients, vehicles, and beds at other hospitals), and evacuation rules...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28409648/assessment-of-simulated-emergency-scenarios-are-trained-observers-necessary
#10
Juliane Noveanu, Felix Amsler, Wolfgang Ummenhofer, Thomas von Wyl, Mathias Zuercher
OBJECTIVES: Simulation-based medical training is associated with superior educational outcomes and improved cost efficiency. Self- and peer-assessment may be a cost-effective and flexible alternative to expert-led assessment. We compared accuracy of self- and peer-assessment of untrained raters using basic evaluation tools to expert assessment using advanced validation tools including validated questionnaires and post hoc video-based analysis. METHODS: Twenty-eight simulated emergency airway management scenarios were observed and video-recorded for further assessment...
April 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28406350/clinical-field-supervision-of-ems-providers
#11
(no author information available yet)
No abstract text is available yet for this article.
April 13, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28339320/basic-life-support-access-to-injectable-epinephrine-across-the-united-states
#12
Ian D Brasted, Michael W Dailey
BACKGROUND:  Aggressive epinephrine administration has growing support in the treatment of anaphylaxis, a life-threatening allergic reaction. Emergency Medical Services (EMS) providers are frequently in a position to provide the first care to someone experiencing an anaphylactic reaction. Intramuscular injection of epinephrine is the definitive pharmacologic treatment for many associated symptoms. While easy to use, epinephrine autoinjectors (EAI) are prohibitively expensive, having increased in price ten-fold in ten years...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28339314/an-analysis-of-ems-and-ed-detection-of-stroke
#13
Ian Medoro, David C Cone
BACKGROUND AND PURPOSE: Studies have shown a reduction in time-to-CT and improved process measures when EMS personnel notify the ED of a "stroke alert" from the field. However, there are few data on the accuracy of these EMS stroke alerts. The goal of this study was to examine diagnostic test performance of EMS and ED stroke alerts and related process measures. METHODS: The EMS and ED records of all stroke alerts in a large tertiary ED from August 2013-January 2014 were examined and data abstracted by one trained investigator, with data accuracy confirmed by a second investigator for 15% of cases...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28339308/association-between-ems-question-bank-completion-and-passing-rates-on-the-ems-certification-examination
#14
Brian Clemency, Christian Martin-Gill, Nicole Rall, Paul May, Jeffrey Lubin, Craig Cooley, Christine Van Dillen, Salvatore Silvestri, Roberto Portela, Derek Cooney, Christian Knutsen, Juan March
INTRODUCTION: A board review question bank was created to assist candidates in their preparation for the 2015 EMS certification examination. We aimed to describe the development of this question bank and evaluate its successes in preparing candidates to obtain EMS subspecialty board certification. METHODS: An online question bank was developed by 13 subject matter experts who participated as item writers, representing eight different EMS fellowship programs. The online question bank consisted of four practice tests, with each of the tests comprised of 100 questions...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28276880/effectiveness-of-prehospital-epinephrine-administration-in-improving-long-term-outcomes-of-witnessed-out-of-hospital-cardiac-arrest-patients-with-initial-non-shockable-rhythms
#15
Jun Tomio, Shinji Nakahara, Hideto Takahashi, Masao Ichikawa, Masamichi Nishida, Naoto Morimura, Tetsuya Sakamoto
OBJECTIVE: We evaluated the association between prehospital epinephrine administration by emergency medical services (EMS) and the long-term outcomes of out-of-hospital cardiac arrest (OHCA) with initial pulseless electrical activity (PEA) or asystole. METHODS: We conducted a controlled, propensity-matched, retrospective cohort study by using Japan's nationwide OHCA registry database. We studied 110,239 bystander-witnessed OHCA patients aged 15-94 years with initial non-shockable rhythms registered between January 2008 and December 2012...
February 7, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28166435/adverse-events-during-inter-hospital-transports-on-extracorporeal-membrane-oxygenation
#16
Anders Ericsson, Björn Frenckner, L Mikael Broman
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) may be a lifesaving rescue therapy in refractory, severe respiratory, and/or circulatory failure. To provide the best cost efficiency to the population served and patient outcome, ECMO therapy should be provided by specialized high volume ECMO centers. This requires dedicated transport teams to organize and perform these complex transports. Concerning adverse events and complications during these transfers, only a minimal amount of data has been published...
February 6, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28453409/it-s-time-for-ems-to-administer-ketamine-analgesia
#17
Robert Cousins, Dustin Anderson, Frank Dehnisch, Andrew Brown, Sean McKay, Erik S Glassman
No abstract text is available yet for this article.
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28276879/clinical-credentialing-of-ems-providers
#18
(no author information available yet)
No abstract text is available yet for this article.
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28276878/patient-restraint-in-emergency-medical-services
#19
(no author information available yet)
No abstract text is available yet for this article.
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28166446/use-of-intranasal-naloxone-by-basic-life-support-providers
#20
Scott G Weiner, Patricia M Mitchell, Elizabeth S Temin, Breanne K Langlois, K Sophia Dyer
STUDY OBJECTIVES: Intranasal delivery of naloxone to reverse the effects of opioid overdose by Advanced Life Support (ALS) providers has been studied in several prehospital settings. In 2006, in response to the increase in opioid-related overdoses, a special waiver from the state allowed administration of intranasal naloxone by Basic Life Support (BLS) providers in our city. This study aimed to determine: 1) if patients who received a 2-mg dose of nasal naloxone administered by BLS required repeat dosing while in the emergency department (ED), and 2) the disposition of these patients...
May 2017: Prehospital Emergency Care
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