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Prehospital Emergency Care

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https://www.readbyqxmd.com/read/29140748/paramedic-initiated-home-care-referrals-and-use-of-home-care-and-emergency-medical-services
#1
Amol A Verma, John Klich, Adam Thurston, Jordan Scantlebury, Alex Kiss, Gayle Seddon, Samir K Sinha
OBJECTIVE: We examined the association between paramedic-initiated home care referrals and utilization of home care, 9-1-1, and Emergency Department (ED) services. METHODS: This was a retrospective cohort study of individuals who received a paramedic-initiated home care referral after a 9-1-1 call between January 1, 2011 and December 31, 2012 in Toronto, Ontario, Canada. Home care, 9-1-1, and ED utilization were compared in the 6 months before and after home care referral...
November 15, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29023218/out-of-hospital-pediatric-patient-safety-events-results-of-the-csi-chart-review
#2
Garth Meckler, Matthew Hansen, William Lambert, Kerth O'Brien, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. METHODS: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29023172/basic-and-advanced-ems-providers-are-equally-effective-in-naloxone-administration-for-opioid-overdose-in-northern-new-england
#3
Nazey Gulec, Joseph Lahey, James C Suozzi, Matthew Sholl, Charles D MacLean, Daniel L Wolfson
OBJECTIVE: Overdose mortality from illicit and prescription opioids has reached epidemic proportions in the United States, especially in rural areas. Naloxone is a safe and effective agent that has been shown to successfully reverse the effects of opioid overdose in the prehospital setting. The National EMS Scope of Practice Model currently only recommends advanced life support (ALS) providers to administer naloxone; however, some individual states have expanded this scope of practice to include intranasal (IN) administration of naloxone by basic life support (BLS) providers, including the Northern New England states...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29023167/state-regulation-of-community-paramedicine-programs-a-national-analysis
#4
Melody Glenn, Olivia Zoph, Kim Weidenaar, Leila Barraza, Warren Greco, Kylie Jenkins, Pooja Paode, Jonathan Fisher
BACKGROUND: Community Paramedicine (CP) is a rapidly evolving field within prehospital care where paramedics step outside of their traditional roles of treating acute conditions to provide elements of primary and preventive care. It is unclear if current state oversight regarding the scope of practice (SOP) for paramedics provides clear guidance on the novel functions provided and skills performed by CP programs. OBJECTIVE: To determine the process and authority, as currently defined by state laws and regulations in the United States, to expand paramedic SOP in order to perform CP roles and to assess state EMS agencies' interpretation of paramedic SOP as it applies to CP...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29023166/prehospital-stroke-assessment-for-large-vessel-occlusions-a-systematic-review
#5
William Krebs, Travis P Sharkey-Toppen, Fern Cheek, Eric Cortez, Ashley Larrimore, David Keseg, Ashish R Panchal
BACKGROUND AND OBJECTIVE: Stroke is the leading cause of disability in the United States and new evidence shows interventional procedures provide better outcomes for large vessel occlusions (LVO). We performed a systematic review of the literature on prehospital stroke scales used to identify LVOs comparing the scales with analysis of the sensitivity, specificity, and predictive values. The goal was to determine if emergency medical services (EMS) are able to accurately identify LVO in the field...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28980864/abstracts-for-the-2018-naemsp-scientific-assembly
#6
(no author information available yet)
No abstract text is available yet for this article.
October 5, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28980844/abstracts-for-the-2018-naemsp-annual-meeting-innovations-in-ems-education
#7
(no author information available yet)
No abstract text is available yet for this article.
October 5, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28956680/scene-safety-and-force-protection-in-the-era-of-ultra-potent-opioids
#8
Michael J Lynch, Joe Suyama, Francis X Guyette
Ultra-potent opioids (fentanyl, carfentanil) are now widely available and fueling an epidemic of overdose. First responders are increasingly exposed to these potent narcotics necessitating guidance for scene safety and force protection from medical directors. Reports in lay media have sensationalized accounts of exposure and harm that may lead providers to fear providing care to patients suspected of opioid overdose. The likelihood of prehospital providers suffering ill effects from opioid exposure during routine emergency medical services (EMS) operations is extremely low...
September 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28956669/prehospital-pain-management-disparity-by-age-and-race
#9
Hilary A Hewes, Mengtao Dai, N Clay Mann, Tanya Baca, Peter Taillac
IMPORTANCE: Historically, pain management in the prehospital setting, specifically pediatric pain management, has been inadequate despite many EMS (emergency medical services) transports related to traumatic injury with pain noted as a symptom. The National Emergency Services Information System (NEMSIS) database offers the largest national repository of prehospital data, and can be used to assess current patterns of EMS pain management across the country. OBJECTIVES: To analyze prehospital management of pain using NEMSIS data, and to assess if variables such as patient age and/or race/ethnicity are associated with disparity in pain treatment...
September 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28952823/neurological-favorable-outcomes-associated-with-ems-compliance-and-on-scene-resuscitation-time-protocol
#10
Tae Han Kim, Eui Jung Lee, Sang Do Shin, Young Sun Ro, Yu Jin Kim, Ki Ok Ahn, Kyoung Jun Song, Ki Jeong Hong, Kyung Won Lee
PURPOSE: Korean national emergency care protocol for EMS providers recommends a minimum of 5 minutes of on-scene resuscitation before transport to hospital in cases of Out-of-Hospital Cardiac Arrest (OHCA). We compared survival outcome of OHCA patients according to scene time interval (STI)-protocol compliance of EMS. METHODS: EMS treated adult OHCAs with presumed cardiac etiology during a two-year period were analyzed. Non-compliance was defined as hospital transport with STI less than 6 minutes without return of spontaneous circulation (ROSC) on scene...
September 27, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28952816/multi-patient-rabies-exposure-on-a-colorado-river-rafting-expedition-urgent-vs-emergent-transport-decision-making-in-an-austere-setting
#11
Emily A Pearce, Aaron N Farney, Laura Banks, Andrew J Harrell
We present a case of rabies exposure on a private river rafting trip on Grand Canyon National Park's Colorado River. Five individuals were exposed to an erratically acting bat; one of the individuals sustained a direct bite to the upper lip while sleeping. This case illustrates the challenges of austere medical care and evacuation in remote conditions while highlighting the importance of risk mitigation considerations in all austere situations.
September 27, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28910212/feasibility-of-paramedic-performed-prehospital-lung-ultrasound-in-medical-patients-with-respiratory-distress
#12
Torben K Becker, Christian Martin-Gill, Clifton W Callaway, Francis X Guyette, Christopher Schott
OBJECTIVE: Prehospital ultrasound is not yet widely implemented. Most studies report on convenience samples and trauma patients, often by prehospital physicians or critical care clinicians. We assessed the feasibility of paramedic performed prehospital lung ultrasound in medical patients with respiratory distress. METHODS: Paramedics at 2 ambulance stations in the city of Pittsburgh, Pennsylvania, USA underwent a 2-hour training session in prehospital lung ultrasound using the SonoSite iViz, a handheld ultrasound device...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28910207/challenges-of-using-probabilistic-linkage-methodology-to-characterize-post-cardiac-arrest-care-in-michigan
#13
Robert Swor, Lihua Qu, Kevin Putman, Kelly N Sawyer, Robert Domeier, Jennifer Fowler, William Fales
BACKGROUND: To improve survival of patients resuscitated from out of hospital cardiac arrest (OCHA), data is needed to assess and improve inpatient post-resuscitation care. Our objective was to apply probabilistic linkage methodology to link EMS and inpatient databases and evaluate whether it may be used to describe post-arrest care in Michigan. METHODS: We performed a retrospective study to describe post-cardiac arrest care in adult OHCA patients who were transported to Michigan hospitals from July 1, 2010, to June 30, 2013...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28910187/sternal-route-more-effective-than-tibial-route-for-intraosseous-amiodarone-administration-in-a-swine-model-of-ventricular-fibrillation
#14
James M Burgert, Andre Martinez, Mara O'Sullivan, Dawn Blouin, Audrey Long, Arthur D Johnson
OBJECTIVE: The pharmacokinetics of IO administered lipid soluble amiodarone during ventricular fibrillation (VF) with ongoing CPR are unknown. This study measured mean plasma concentration over 5 minutes, maximum plasma concentration (Cmax), and time to maximum concentration (Tmax) of amiodarone administered by the sternal IO (SIO), tibial IO (TIO), and IV routes in a swine model of VF with ongoing CPR. METHODS: Twenty-one Yorkshire-cross swine were randomly assigned to three groups: SIO, TIO, and IV...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28862480/national-characteristics-of-emergency-medical-services-responses-for-older-adults-in-the-united-states
#15
Hieu V Duong, Lauren Nicholas Herrera, Justin Xavier Moore, John Donnelly, Karen E Jacobson, Jestin N Carlson, N Clay Mann, Henry E Wang
OBJECTIVE: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. METHODS: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses...
September 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28857647/ems-dispatches-during-hurricanes-irene-and-sandy-in-new-jersey
#16
Joshua Bucher, Jonathan McCoy, Colleen Donovan, Snehal Patel, Pamela Ohman-Strickland, Asa Dewan
BACKGROUND: Hurricanes Irene and Sandy heavily impacted New Jersey. Investigating EMS dispatch trends during these storms may allow us to prepare for future disasters. OBJECTIVES: Our objectives to characterize the types of EMS dispatches immediately before, during, and after landfall compared to a control period. METHODS: This retrospective study was conducted at a large EMS dispatch center that provides first responders, Basic Life Support (BLS), Advanced Life Support (ALS), and critical care transport services to an area with approximately 20 receiving hospitals including a Level I Trauma Center...
August 31, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28857641/safety-events-in-high-risk-prehospital-neonatal-calls
#17
Rebecca Duby, Matt Hansen, Garth Meckler, Barbara Skarica, William Lambert, Jeanne-Marie Guise
OBJECTIVE: The objective of this study was to quantify and characterize patient safety events during high-risk neonatal transports in the prehospital setting. METHOD: We conducted a retrospective chart review of all "lights and sirens" ambulance transports of neonates ≤30 days old over a four-year period in a metropolitan area. Each case was independently reviewed for potential patient safety events that may have occurred in clinical assessment and decision making, resuscitation, airway management, fluid or medication administration, procedures performed, and/or equipment used...
August 31, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28841360/prehospital-end-tidal-carbon-dioxide-predicts-mortality-in-trauma-patients
#18
Kelsey Childress, Kelly Arnold, Christopher Hunter, George Ralls, Linda Papa, Salvatore Silvestri
BACKGROUND: End-tidal carbon dioxide (EtCO2) measurement has been shown to have prognostic value in acute trauma. OBJECTIVE: Evaluate the association of prehospital EtCO2 and in-hospital mortality in trauma patients and to assess its prognostic value when compared to traditional vital signs. METHODS: Retrospective, cross-sectional study of patients transported by a single EMS agency to a level one trauma center. We evaluated initial out-of-hospital vital signs documented by EMS personnel including EtCO2, respiratory rate (RR), systolic BP (SBP), diastolic BP (DBP), pulse (P), and oxygen saturation (O2) and hospital data...
August 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28841102/association-of-burnout-with-workforce-reducing-factors-among-ems-professionals
#19
Remle P Crowe, Julie K Bower, Rebecca E Cash, Ashish R Panchal, Severo A Rodriguez, Susan E Olivo-Marston
OBJECTIVES: Emergency medical services (EMS) professionals often work long hours at multiple jobs and endure frequent exposure to traumatic events. The stressors inherent to the prehospital setting may increase the likelihood of experiencing burnout and lead providers to exit the profession, representing a serious workforce and public health concern. Our objectives were to estimate the prevalence of burnout, identify characteristics associated with experiencing burnout, and quantify its relationship with factors that negatively impact EMS workforce stability, namely sickness absence and turnover intentions...
August 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28841085/observational-multicenter-study-of-a-direct-to-ct-protocol-for-ems-transported-patients-with-suspected-stroke
#20
David C Cone, Craig Cooley, Jeffrey Ferguson, Andrew J Harrell, Jeffrey H Luk, Christian Martin-Gill, Sean W Marquis, Scott Pasichow
OBJECTIVE: In an effort to decrease door-to-needle times for patients with acute ischemic stroke, some hospitals have begun taking stable EMS patients with suspected stroke directly from the ambulance to the CT scanner, then to an emergency department (ED) bed for evaluation. Minimal data exist regarding the potential for time savings with such a protocol. The study hypothesis was that a direct-to-CT protocol would be associated with decreases in both door-to-CT-ordered and door-to-needle times...
August 25, 2017: Prehospital Emergency Care
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