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preventable prehospital death

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https://www.readbyqxmd.com/read/27849133/do-heroin-overdose-patients-require-observation-after-receiving-naloxone
#1
Michael W Willman, David B Liss, Evan S Schwarz, Michael E Mullins
CONTEXT: Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses...
November 16, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27779578/does-small-volume-resuscitation-with-crystalloids-or-colloids-influence-hemostasis-and-survival-of-rabbits-subjected-to-lethal-uncontrolled-hemorrhage
#2
Bijan S Kheirabadi, Nahir Miranda, Irasema B Terrazas, Mary D Gonzales, Rose C Grimm, Michael A Dubick
INTRODUCTION: Prehospital, small-volume resuscitation of combat casualties with a synthetic colloid [6% hydroxyethyl starch (HES) 670/0.75] has been recommended when blood or blood components are unavailable. We studied hemostatic effects of a newer synthetic colloid (6% HES 130/0.4,) compared to either a natural colloid (albumin) or to crystalloids in an uncontrolled hemorrhage model. METHODS: Spontaneously breathing NZW rabbits (3.4±0.1 kg) were anesthetized, instrumented and subjected to a splenic injury with uncontrolled bleeding...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27756343/the-recapta-study-a-prospective-out-of-hospital-cardiac-arrest-registry-including-multiple-sources-of-surveillance-for-the-study-of-sudden-cardiac-death-in-the-mediterranean-area
#3
Youcef Azeli, Eneko Barbería, María Jiménez-Herrera, Gil Bonet, Eva Valero-Mora, Alfonso Lopez-Gomariz, Isaac Lucas-Guarque, Alex Guillen-Lopez, Carlos Alonso-Villaverde, Inés Landín, Pilar Torralba, Ali Jammoul, Jordi Bladé-Creixenti, Christer Axelsson, Alfredo Bardají
BACKGROUND: Cardiovascular diseases are one of the leading causes of death in the industrialized world. Sudden cardiac death is very often the first manifestation of the disease and it occurs in the prehospital setting. The determination of the sudden cardiac death phenotype is challenging. It requires prospective studies in the community including multiple sources of case ascertainment that help to identify the cause and circumstances of death. The aim of the Clinical and Pathological Registry of Tarragona (ReCaPTa) is to study incidence and etiology of Sudden Cardiac Death in the Tarragona region (Catalonia, Spain)...
October 19, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27741992/treatment-of-acute-ischemic-stroke
#4
Matthew S Siket
Although stroke declined from the third to fifth most common cause of death in the United States, the annual incidence and overall prevalence continue to increase. Since the available US Food and Drug Administration-approved treatment options are time dependent, improving early stroke care may have more of a public health impact than any other phase of care. Timely and efficient stroke treatment should be a priority for emergency department and prehospital providers. This article discusses currently available and emerging treatment options in acute ischemic stroke focusing on the preservation of salvageable brain tissue, minimizing complications, and secondary prevention...
November 2016: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27692683/the-effect-of-combined-out-of-hospital-hypotension-and-hypoxia-on-mortality-in-major-traumatic-brain-injury
#5
Daniel W Spaite, Chengcheng Hu, Bentley J Bobrow, Vatsal Chikani, Bruce Barnhart, Joshua B Gaither, Kurt R Denninghoff, P David Adelson, Samuel M Keim, Chad Viscusi, Terry Mullins, Duane Sherrill
STUDY OBJECTIVE: Survival is significantly reduced by either hypotension or hypoxia during the out-of-hospital management of major traumatic brain injury. However, only a handful of small studies have investigated the influence of the combination of both hypotension and hypoxia occurring together. In patients with major traumatic brain injury, we evaluate the associations between mortality and out-of-hospital hypotension and hypoxia separately and in combination. METHODS: All moderate or severe traumatic brain injury cases in the preimplementation cohort of the Excellence in Prehospital Injury Care study (a statewide, before/after, controlled study of the effect of implementing the out-of-hospital traumatic brain injury treatment guidelines) from January 1, 2007, to March 31, 2014, were evaluated (exclusions: <10 years, out-of-hospital oxygen saturation ≤10%, and out-of-hospital systolic blood pressure <40 or >200 mm Hg)...
September 27, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27338530/prehospital-care-training-in-a-rapidly-developing-economy-a-multi-institutional-study
#6
Dinesh Vyas, Michael Hollis, Rohit Abraham, Neeti Rustagi, Siddharth Chandra, Ajai Malhotra, Vikas Rajpurohit, Harshada Purohit, Ranabir Pal
BACKGROUND: The trauma pandemic is one of the leading causes of death worldwide but especially in rapidly developing economies. Perhaps, a common cause of trauma-related mortality in these settings comes from the rapid expansion of motor vehicle ownership without the corresponding expansion of national prehospital training in developed countries. The resulting road traffic injuries often never make it to the hospital in time for effective treatment, resulting in preventable disability and death...
June 1, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27218055/overview-of-agents-used-for-emergency-hemostasis
#7
REVIEW
Hadi Khoshmohabat, Shahram Paydar, Hossein Mohammad Kazemi, Behnam Dalfardi
CONTEXT: In today's modern world, despite the multiple advances made in the field of medicine, hemorrhagic shock is still the main cause of battlefield mortality and the second most prevalent cause of mortality in civilian trauma. Hemostatic agents can play a key role in establishing hemostasis in prehospital situations and preventing hemorrhage-associated death. In this respect, this article aims to review different aspects of known hemostatic agents. EVIDENCE ACQUISITION: A comprehensive search of the academic scientific databases for relevant keywords was conducted; relevant articles were compiled and assessed...
February 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27170115/characteristics-and-outcomes-of-emergency-patients-with-self-inflicted-injuries-a-report-from-ambulance-records-in-osaka-city-japan
#8
Tasuku Matsuyama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Takashi Kawamura, Taku Iwami, Bon Ohta
BACKGROUND: Few studies have evaluated the actual situations of emergency patients with self-inflicted injuries treated by emergency-medical-service (EMS) personnel. METHODS: This study retrospectively reviewed population-based ambulance records in Osaka City, Japan, between January 2010 and December 2012, and enrolled emergency patients who suffered from self-inflicted injuries such as poisoning by drugs or gas, cutting/piercing skin, jumping from heights, hanging, and drowning...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27100757/surgical-adjuncts-to-noncompressible-torso-hemorrhage-as-tools-for-patient-blood-management
#9
Joseph F Rappold, Grant V Bochicchio
Despite the tremendous advances and successes in the care of combat casualties over the past 15 years of war, noncompressible torso hemorrhage (NCTH) remains the most likely source of potentially preventable death (approx. 25%) on the battlefield. This is also likely true for civilian victims of blunt and penetrating trauma. Various devices and therapeutic interventions have been, and are being, developed in an attempt to reduce morbidity and mortality for patients with NCTH. Examples include the use of prehospital blood and blood products, tranexamic acid, specially designed tourniquets for junctional hemorrhage control, retrograde endovascular balloon occlusion of the aorta, intracavity foam, expandable hemostatic sponges, and intravascular nanoparticles to suspended animation...
April 2016: Transfusion
https://www.readbyqxmd.com/read/26844807/a-call-for-consensus-on-methodology-and-terminology-to-improve-comparability-in-the-study-of-preventable-prehospital-trauma-deaths-a-systematic-literature-review
#10
Govind J Oliver, Darren P Walter
OBJECTIVES: The study of preventable deaths is essential to trauma research for measuring service quality and highlighting avenues for improving care and as a performance indicator. However, variations in the terminology and methodology of studies on preventable prehospital trauma death limit the comparability and wider application of data. The objective of this study was to describe the heterogeneity in terminology and methodology. METHODS: We performed a systematic literature review and report this using the PRISMA guidelines...
April 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26830121/prehospital-use-of-hemostatic-dressings-in-emergency-medical-services-in-the-netherlands-a-prospective-study-of-66-cases
#11
Ruben Te Grotenhuis, Pierre M van Grunsven, Wim M J M Heutz, Edward C T H Tan
BACKGROUND: Uncontrolled haemorrhage is the leading cause of potentially preventable death in both civilian and military trauma patients. Animal studies and several case series have shown that hemostatic dressings reduce haemorrhage and might improve survival. One of these products is HemCon ChitoGauze(®). The objective of this study was to determine the effectiveness and safety of ChitoGauze in achieving hemostasis in massive traumatic bleeding in civilian emergency medical services...
May 2016: Injury
https://www.readbyqxmd.com/read/26808030/aspirin-as-added-prophylaxis-for-deep-vein-thrombosis-in-trauma-a-retrospective-case-control-study
#12
Jason B Brill, Richard Y Calvo, James D Wallace, Paul R Lewis, Vishal Bansal, Michael J Sise, Steven R Shackford
BACKGROUND: Current prophylaxis does not completely prevent deep vein thrombosis (DVT) in trauma patients. Recent data suggest that platelets may be a major contributor to hypercoagulability after trauma, indicating a potential role for antiplatelet medications in prophylaxis for DVT. We sought to determine if preinjury aspirin use was associated with a reduced incidence of lower extremity DVT in trauma patients. METHODS: Using a retrospective case-control design, we matched 110 cases of posttrauma lower extremity DVT one-to-one with controls using seven covariates: age, admission date, probability of death, number of DVT risk factors, sex, mechanism of injury, and presence of head injury...
April 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26779395/hip-hop-stroke-study-protocol-for-a-randomized-controlled-trial-to-address-stroke-literacy
#13
Olajide Williams, Ellyn Leighton-Herrmann, Alexandra DeSorbo, Mindy Hecht, Monique Hedmann, Saima Huq, William Gerin, Vernon Chinchilli, Gbenga Ogedegbe, James Noble
OBJECTIVE: Stroke is the fifth leading cause of death and the leading cause of serious long-term adult disability in the US. Acute stroke treatments with intravenous thrombolysis and endovascular therapy are proven to reduce disability, however a critical limitation on their effectiveness is the narrow time window for administration, which is 4.5 hours and 6 hours respectively from the onset of symptoms. Our overarching goal is to reduce pre-hospital delays to acute stroke treatments in economically disadvantaged minority communities where the greatest delays exist, using Hip Hop Stroke...
October 2015: Journal of Clinical Trials
https://www.readbyqxmd.com/read/26716998/mortality-in-spanish-pediatric-emergency-departments-a-5-year-multicenter-survey
#14
Edurne Lopez, June Udaondo, Mikel Olabarri, Lorea Martinez-Indart, Javier Benito, Santiago Mintegi
BACKGROUND: Analysis of the causes of death in children in the pediatric emergency department (ED) may aid the development of management and prevention practices. OBJECTIVE: To identify the causes of death in Spanish pediatric EDs and to analyze the management of these children in the prehospital and hospital settings. METHODS: This was a retrospective descriptive multicenter survey including all patients whose death was certified in 18 Spanish pediatric EDs between 2008 and 2013...
December 29, 2015: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/26633663/needle-thoracotomy-in-trauma
#15
Misgav Rottenstreich, Shmuel Fay, Sami Gendler, Yoram Klein, Marc Arkovitz, Amihai Rottenstreich
Tension pneumothorax is one of the leading causes of preventable death in trauma patients. Needle thoracotomy (NT) is the currently accepted first-line intervention but has not been well validated. In this review, we have critically discussed the evidence for NT procedure, re-examined the recommendations by the Advanced Trauma Life Support organization and investigated the safest and most effective way of NT. The current evidence to support the use of NT is limited. However, when used, it should be applied in the 2nd intercostal space at midclavicular line using a catheter length of at least 4...
December 2015: Military Medicine
https://www.readbyqxmd.com/read/26610762/where-children-and-adolescents-drown-in-queensland-a-population-based-study
#16
Belinda A Wallis, Kerrianne Watt, Richard C Franklin, James W Nixon, Roy M Kimble
OBJECTIVE: This retrospective population-based study examined drowning location by the site of immersion for both fatal and non-fatal drowning events in Queensland. Drowning location is not routinely collected, and this study used data linkage to identify drowning sites. The resulting enhanced quality data quantify drowning incidence for specific locations by geographic region, age group and by severity for the first time. DESIGN: Linked data were accessed from the continuum of care (prehospital, emergency, hospital admission and death data) on fatal and non-fatal drowning episodes in children aged 0-19 years in Queensland for the years 2002-2008 inclusive...
November 26, 2015: BMJ Open
https://www.readbyqxmd.com/read/26563786/hydrogen-sulfide-intoxication
#17
Tee L Guidotti
Hydrogen sulfide (H2S) is a hazard primarily in the oil and gas industry, agriculture, sewage and animal waste handling, construction (asphalt operations and disturbing marshy terrain), and other settings where organic material decomposes under reducing conditions, and in geothermal operations. It is an insoluble gas, heavier than air, with a very low odor threshold and high toxicity, driven by concentration more than duration of exposure. Toxicity presents in a unique, reliable, and characteristic toxidrome consisting, in ascending order of exposure, of mucosal irritation, especially of the eye ("gas eye"), olfactory paralysis (not to be confused with olfactory fatigue), sudden but reversible loss of consciousness ("knockdown"), pulmonary edema (with an unusually favorable prognosis), and death (probably with apnea contributing)...
2015: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/26542464/should-we-still-use-motor-vehicle-intrusion-as-a-sole-triage-criterion-for-the-use-of-trauma-center-resources
#18
Kazuhide Matsushima, Konstantinos Chouliaras, William Koenig, Christy Preston, Deidre Gorospe, Demetrios Demetriades
BACKGROUND: Motor vehicle intrusion (MVI) is one of the field triage criteria recommended by the American College of Surgeons Committee of Trauma (ACS-COT) and Centers for Disease Control and Prevention (CDC). However, the evidence supporting its validity is scarce. The purpose of this study was to evaluate the validity of this criterion and assess its impact on overtriage or undertriage. PATIENTS AND METHODS: This was a retrospective study based on the Los Angeles County Trauma and Emergency Medicine Information System (TEMIS) Trauma database...
January 2016: Injury
https://www.readbyqxmd.com/read/26539007/epidemiology-and-regional-distribution-of-pediatric-unintentional-emergency-injury-in-korea-from-2010-to-2011
#19
Jin Hee Jung, Do Kyun Kim, Hye Young Jang, Young Ho Kwak
Injury is a leading cause of death and disability in children and adolescents worldwide. The purpose of the current study was to investigate the epidemiologic characteristics of the pediatric unintentional injuries presenting to the Korean emergency department (ED). We included unintentional injuries in patients aged < 20 yr. Data collected from January 2010 to December 2011 was extracted from the National Emergency Department Information System (NEDIS) of Korea. The NEDIS data included information on patient's age and gender, geographic location of the ED visits, mechanism of injuries; and clinical outcomes...
November 2015: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/26449600/time-since-injury-is-the-major-factor-in-preventing-tranexamic-acid-use-in-the-trauma-setting-an-observational-cohort-study-from-a-major-trauma-centre-in-a-middle-income-country
#20
Ben Thurston, Sharfuddin Chowdhury, Sorin Edu, Andrew J Nicol, Pradeep Harkison Navsaria
BACKGROUND: Haemorrhage is responsible for about a third of in-hospital trauma deaths. The CRASH-2 trial demonstrated that early administration of tranexamic acid, ideally within 3 hours, can reduce mortality from trauma-associated bleeding by up to 32%. OBJECTIVE: To explore whether, in our trauma network in a middle-income country, patients arrived at hospital soon enough after injury for tranexamic acid administration to be effective and safe. METHODS: A prospective cohort study of 50 consecutive patients admitted to our trauma unit was undertaken...
March 2015: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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