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https://www.readbyqxmd.com/read/28417645/the-early-chain-of-care-and-risk-of-death-in-acute-stroke-in-relation-to-the-priority-given-at-the-dispatch-centre-a-multicentre-observational-study
#1
Birgitta Wireklint Sundström, Magnus Andersson Hagiwara, Peter Brink, Johan Herlitz, Per Olof Hansson
BACKGROUND: The early chain of care is critical for stroke patients. The most important part is the so-called 'system delay' i.e. the delay time from call to the emergency medical services until a diagnosis is established (computer tomography). AIM: The purpose of this study was to relate the initial priority level given by the dispatch centre to the early chain of care in acute stroke and to short-term and long-term mortality. METHODS: All patients hospitalised with the first and the final diagnosis of acute stroke, 15 December 2010-15 April 2011, were recruited across nine hospitals, each hospital with a stroke care unit...
April 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28414165/recognising-out-of-hospital-cardiac-arrest-during-emergency-calls-increases-bystander-cardiopulmonary-resuscitation-and-survival
#2
Søren Viereck, Thea Palsgaard Møller, Annette Kjær Ersbøll, Josefine Stokholm Bækgaard, Andreas Claesson, Jacob Hollenberg, Fredrik Folke, Freddy K Lippert
BACKGROUND: Initiation of early bystander cardiopulmonary resuscitation (CPR) depends on bystanders' or medical dispatchers' recognition of out-of-hospital cardiac arrest (OHCA). The primary aim of our study was to investigate if OHCA recognition during the emergency call was associated with bystander CPR, return of spontaneous circulation (ROSC), and 30-day survival. Our secondary aim was to identify patient-, setting-, and dispatcher-related predictors of OHCA recognition. METHODS: We performed an observational study of all OHCA patients' emergency calls in the Capital Region of Denmark from 01/01/2013-31/12/2013...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28409655/9-1-1-triage-of-non-traumatic-chest-pain-association-with-hospital-diagnosis
#3
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/28385640/bystander-capability-to-activate-speaker-function-for-continuous-dispatcher-assisted-cpr-in-case-of-suspected-cardiac-arrest
#4
Alvilda T Steensberg, Mette M Eriksen, Lars B Andersen, Ole M Hendriksen, Heinrich D Larsen, Gunnar H Laier, Thomas Thougaard
BACKGROUND: The European Resuscitation Council Guidelines 2015 recommend bystanders to activate their mobile phone speaker function, if possible, in case of suspected cardiac arrest. This is to facilitate continuous dialogue with the dispatcher including (if required) cardiopulmonary resuscitation instructions. The aim of this study was to measure the bystander capability to activate speaker function in case of suspected cardiac arrest. METHOD: In 87days, a systematic prospective registration of bystander capability to activate the speaker function, when cardiac arrest was suspected, was performed...
April 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/28374471/a-high-proportion-of-prehospital-emergency-patients-are-not-transported-by-ambulance-a-retrospective-cohort-study-in-northern-finland
#5
M Hoikka, T Silfvast, T I Ala-Kokko
BACKGROUND: The number of missions in the emergency medical services (EMS) has increased considerably in recent years. People are requesting ambulance for even minor illnesses and non-medical problems, which is placing financial and resource burdens on the EMS. The aim of this study was to determine the rate of non-transportation missions in Northern Finland and the reasons for these missions. METHODS: All ambulance missions in two hospital districts in Northern Finland during the 6-month period of January 1 through June 30, 2014, were retrospectively evaluated from the EMS charts to identify missions in which the patients were not transported by the EMS...
May 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28347554/long-term-mortality-of-emergency-medical-services-patients
#6
Morten T Bøtker, Christian J Terkelsen, Jan N Sørensen, Søren B Jepsen, Søren P Johnsen, Erika F Christensen, Mikkel S Andersen
STUDY OBJECTIVE: Emergency medical services (EMS) provides out-of-hospital care to patients with life-threatening conditions, but the long-term outcomes of EMS patients are unknown. We seek to determine the long-term mortality of EMS patients in Denmark. METHODS: We analyzed linked EMS, hospital, and vital status data from 3 of 5 geographic regions in Denmark. We included events from July 1, 2011, to December 31, 2012. We classified EMS events according to primary dispatch category (unconsciousness/cardiac arrest, accidents/trauma, chest pain, dyspnea, neurologic symptoms, and other EMS patients)...
March 25, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28317095/evaluating-helicopter-emergency-medical-missions-a-reliability-study-of-the-hems-benefit-and-naca-scores
#7
L Raatiniemi, J Liisanantti, M Tommila, S Moilanen, P Ohtonen, M Martikainen, V Voipio, J Reitala, T Iirola
BACKGROUND: The benefits of the Helicopter Emergency Medical Service (HEMS) and dispatch accuracy are continuously debated, and a widely accepted score to measure the benefits of the mission is lacking. The HEMS Benefit Score (HBS) has been used in Finnish helicopter emergency medical services, but studies are lacking. The National Advisory Committee for Aeronautics (NACA) score is widely used to measure the severity of illness or injury in the pre-hospital setting, but it has many critics due to its subjectivity...
May 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28315728/can-ambulance-telephone-triage-using-nhs-pathways-accurately-identify-paediatric-cardiac-arrest
#8
Charles D Deakin, Simon England, Debbie Diffey, Ian Maconochie
BACKGROUND: Most out-of-hospital paediatric cardiac arrests (CA) are not identified until a call is made to the emergency medical services. Accurate identification increases overall survival by enabling immediate ambulance dispatch and delivery of bystander CPR. European ambulance services use a variety of didactic telephone scripts to interrogate the caller and rapidly identify paediatric CA. The performance of these scripts has not been reported. This study aims to evaluate the diagnostic accuracy of the NHS Pathways as a telephone triage tool to identify patients less than 16 years age in cardiac arrest...
March 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28297003/bystander-defibrillation-for-out-of-hospital-cardiac-arrest-in-public-vs-residential-locations
#9
Steen Møller Hansen, Carolina Malta Hansen, Fredrik Folke, Shahzleen Rajan, Kristian Kragholm, Linda Ejlskov, Gunnar Gislason, Lars Køber, Thomas A Gerds, Søren Hjortshøj, Freddy Lippert, Christian Torp-Pedersen, Mads Wissenberg
Importance: Bystander-delivered defibrillation (hereinafter referred to as bystander defibrillation) of patients with out-of-hospital cardiac arrests (OHCAs) remains limited despite the widespread dissemination of automated external defibrillators (AEDs). Objective: To examine calendar changes in bystander defibrillation and subsequent survival according to a public or a residential location of the cardiac arrest after nationwide initiatives in Denmark to facilitate bystander-mediated resuscitative efforts, including bystander defibrillation...
March 15, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28291494/military-emergency-medical-service-system-assessment-application-of-the-national-park-service-needs-assessment-and-program-audit-to-objectively-evaluate-the-military-ems-system-of-okinawa-japan
#10
Elliot M Ross, Stephen A Harper, Cord Cunningham, Benjamin D Walrath, Gerard DeMers, Chetan U Kharod
INTRODUCTION: As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). METHODS: A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28285797/opening-a-new-front-in-the-fight-against-sudden-cardiac-death-is-it-time-for-near-term-prevention
#11
Nicole Karam, Eloi Marijon, Xavier Jouven
INTRODUCTION: Sudden cardiac death (SCD) is a major issue of public health. Despite tremendous investments in prevention and resuscitation, SCD mortality remains high. We aimed on assessing the feasibility of developing near-term prevention as a novel approach for decreasing SCD burden. METHODS AND RESULTS: We previously showed that half of SCD victims presented warning symptoms during the month before SCD, with symptoms recurrence in 93% within 24 h preceding SCD...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28270170/effect-and-accuracy-of-emergency-dispatch-telephone-guidance-to-bystanders-in-trauma-post-hoc-analysis-of-a-prospective-observational-study
#12
Håkon Kvåle Bakke, Tine Steinvik, Håkon Ruud, Torben Wisborg
BACKGROUND: Emergency medical communication centres (EMCCs) dispatch and allocate ambulance resources, and provide first-aid guidance to on-scene bystanders. We aimed to 1) evaluate whether dispatcher guidance improved bystander first aid in trauma, and 2) to evaluate whether dispatchers and on-scene emergency medical services (EMS) crews identified the same first aid measures as indicated. METHODS: For 18 months, the crew on the first EMS crew responding to trauma calls used a standard form to assess bystander first aid...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28253479/systematic-review-of-the-effectiveness-of-prehospital-critical-care-following-out-of-hospital-cardiac-arrest
#13
REVIEW
Johannes von Vopelius-Feldt, Janet Brandling, Jonathan Benger
BACKGROUND: Improving survival after out-of-hospital cardiac arrest (OHCA) is a priority for modern emergency medical services (EMS) and prehospital research. Advanced life support (ALS) is now the standard of care in most EMS. In some EMS, prehospital critical care providers are also dispatched to attend OHCA. This systematic review presents the evidence for prehospital critical care for OHCA, when compared to standard ALS care. METHODS: We searched the following electronic databases: PubMed, EmBASE, CINAHL Plus and AMED (via EBSCO), Cochrane Database of Systematic Reviews, DARE, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, NIHR Health Technology Assessment Database, Google Scholar and ClinicalTrials...
February 27, 2017: Resuscitation
https://www.readbyqxmd.com/read/28249588/the-difficult-medical-emergency-call-a-register-based-study-of-predictors-and-outcomes
#14
Thea Palsgaard Møller, Thora Majlund Kjærulff, Søren Viereck, Doris Østergaard, Fredrik Folke, Annette Kjær Ersbøll, Freddy K Lippert
BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data...
March 1, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28238537/defibrillation-before-ems-arrival-in-western-sweden
#15
A Claesson, J Herlitz, L Svensson, L Ottosson, L Bergfeldt, J Engdahl, C Ericson, P Sandén, C Axelsson, A Bremer
BACKGROUND: Bystanders play a vital role in public access defibrillation (PAD) in out-of-hospital cardiac arrest (OHCA). Dual dispatch of first responders (FR) alongside emergency medical services (EMS) can reduce time to first defibrillation. The aim of this study was to describe the use of automated external defibrillators (AEDs) in OHCAs before EMS arrival. METHODS: All OHCA cases with a shockable rhythm in which an AED was used prior to the arrival of EMS between 2008 and 2015 in western Sweden were eligible for inclusion...
February 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28237735/emergency-medical-dispatch-priority-in-chest-pain-patients-due-to-life-threatening-conditions-a-cohort-study-examining-circadian-variations-and-impact-of-the-education
#16
Araz Rawshani, Nina Rawshani, Carita Gelang, Jan-Otto Andersson, Anna Larsson, Angela Bång, Johan Herlitz, Martin Gellerstedt
BACKGROUND AND AIMS: We examined the accuracy in assessments of emergency dispatchers according to their education and time of the day. We examined this in chest pain patients who were diagnosed with a potentially life-threatening condition (LTC) or died within 30days. METHODS: Among 2205 persons, 482 died, 1631 experienced an acute coronary syndrome (ACS), 1914 had a LTC. Multivariable logistic regression was used to study how time of the call and the dispatcher's education were associated with the risk of missing to give priority 1 (the highest)...
February 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28236428/targeted-simulation-and-education-to-improve-cardiac-arrest-recognition-and-telephone-assisted-cpr-in-an-emergency-medical-communication-centre
#17
Camilla Hardeland, Christiane Skåre, Jo Kramer-Johansen, Tonje S Birkenes, Helge Myklebust, Andreas E Hansen, Kjetil Sunde, Theresa M Olasveengen
AIM: Recognition of cardiac arrest and prompt activation time by emergency medical dispatch are key process measures that have been associated with improved survival after out-of-hospital cardiac arrest (OHCA). The aim of this study is to improve recognition of OHCA and time to initiation of telephone assisted chest compressions in an emergency medical communication centre (EMCC). METHODS: A prospective, interventional study implementing targeted interventions in an EMCC...
February 21, 2017: Resuscitation
https://www.readbyqxmd.com/read/28235958/prehospital-emergency-care-in-childhood-arterial-ischemic-stroke
#18
Belinda Stojanovski, Paul T Monagle, Ian Mosley, Leonid Churilov, Fiona Newall, Grant Hocking, Mark T Mackay
BACKGROUND AND PURPOSE: Immediately calling an ambulance is the key factor in reducing time to hospital presentation for adult stroke. Little is known about prehospital care in childhood arterial ischemic stroke (AIS). We aimed to determine emergency medical services call-taker and paramedic diagnostic sensitivity and to describe timelines of care in childhood AIS. METHODS: This is a retrospective study of ambulance-transported children aged <18 years with first radiologically confirmed AIS, from 2008 to 2015...
February 24, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28202420/out-of-hospital-cardiac-arrest-ohca-attended-by-mobile-emergency-teams-with-a-physician-on-board-results-of-the-spanish-ohca-registry-oshcar
#19
Fernando Rosell-Ortiz, Xavier Escalada-Roig, Patricia Fernández Del Valle, Luis Sánchez-Santos, José M Navalpotro-Pascual, Alfredo Echarri-Sucunza, José M Adsuar-Quesada, Isabel Ceniceros-Rozalén, José I Ruiz-Azpiazu, Karlos Ibarguren-Olalde, Nuria López-Cabeza, María V Mier-Ruiz, Enrique Martín-Sánchez, Marta Martínez Del Valle, Guadalupe Inza-Muñoz, Juan A Cordero Torres, María J García-Ochoa, José A Cortés-Ramas, Raúl Canabal-Berlanga, Rafael Zoyo López-Navarro, Juan B López-Messa, Javier García Del Águila, Daniel Alonso-Moreno, Carmen Pozo-Pérez, José Bravo-Castello, Natividad Ramos-García, Ignacio Gómez-Larrosa, Francisco J Mellado-Vergel
Most survival outcomes in out-of-hospital cardiac arrest (OHCA) are provided by emergency medical services (EMS) without a doctor on board. Our objective was to determine such outcomes in a whole country with public physician-led EMS. METHODS: We analyzed data from a nationwide prospective registry of OHCA cases attended by 19 public EMS in Spain, covering the period from 1-October 2013 to 30-October 2014. RESULTS: Advanced life support (ALS) was initiated in 9347 cases (incidence 18...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/28147415/improving-survival-after-cardiac-arrest
#20
Conrad Arnfinn Bjørshol, Eldar Søreide
Each year, approximately half a million people suffer out-of-hospital cardiac arrest (CA) in Europe: The majority die. Survival after CA varies greatly between regions and countries. The authors give an overview of the important elements necessary to promote improved survival after CA as a function of the chain of survival and formula for survival concepts. The chain of survival incorporates bystanders (who identify warning symptoms, call the emergency dispatch center, initiate cardiopulmonary resuscitation [CPR]), dispatchers (who identify CA, and instruct and reassure the caller), first responders (who provide high-quality CPR, early defibrillation), paramedics and other prehospital care providers (who continue high-quality CPR, and provide timely defibrillation and advanced life support, transport to CA center), and hospitals (targeted temperature management, percutaneous coronary intervention, delayed prognostication)...
February 2017: Seminars in Neurology
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