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https://www.readbyqxmd.com/read/29452732/efficacy-of-pre-hospital-rapid-sequence-intubation-in-paediatric-traumatic-brain-injury-a-9-year-observational-study
#1
Stefan Heschl, Ben Meadley, Emily Andrew, Warwick Butt, Stephen Bernard, Karen Smith
INTRODUCTION: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29423822/barriers-to-the-medication-error-reporting-process-within-the-irish-national-ambulance-service-a-focus-group-study
#2
Eamonn Byrne, Gerard Bury
BACKGROUND: Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring...
February 8, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29364730/improving-prehospital-protocol-adherence-using-bundled-educational-interventions
#3
Megan C Marino, Daniel G Ostermayer, Juan A Mondragon, Elizabeth A Camp, Elizabeth M Keating, Louis B Fornage, Charles A Brown, Manish I Shah
BACKGROUND: Seizures and anaphylaxis are life-threatening conditions that require immediate treatment in the prehospital setting. There is variation in treatment of pediatric prehospital patients for both anaphylaxis and seizures. This educational study was done to improve compliance with pediatric prehospital protocols, educate prehospital providers and decrease variation in care. OBJECTIVE: To improve the quality of care for children with seizures and anaphylaxis in the prehospital setting using a bundled, multifaceted educational intervention...
January 24, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29319741/verbal-abuse-and-mobbing-in-pre-hospital-care-services-in-chile
#4
Varinia Rodríguez Campo, Tatiana Paravic Klijn
OBJECTIVE: to determine the perception of verbal abuse and mobbing and the associated factors of paramedic technicians (nursing assistants) and professionals (nurses, midwives, kinesiologists) in the pre-hospital care areas of three regions in the south of Chile. METHODS: descriptive and correlational study was performed within the professional community and a two-stage sample of the paramedic technician population in three regions. The questionnaire "workplace violence in the health sector" (spanish version) was applied after signing the informed consent...
January 8, 2018: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#5
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patient patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29301973/association-between-hyperacute-stage-blood-pressure-variability-and-outcome-in-patients-with-spontaneous-intracerebral-hemorrhage
#6
Pil-Wook Chung, Joon-Tae Kim, Nerses Sanossian, Sidney Starkmann, Scott Hamilton, Jeffrey Gornbein, Robin Conwit, Marc Eckstein, Frank Pratt, Sam Stratton, David S Liebeskind, Jeffrey L Saver
BACKGROUND AND PURPOSE: Increased blood pressure (BP) variability, in addition to high BP, may contribute to adverse outcome in intracerebral hemorrhage. However, degree and association with outcome of BP variability (BPV) in the hyperacute period, 15 minutes to 5 hours after onset, have not been delineated. METHODS: Among consecutive patients with intracerebral hemorrhage enrolled in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium), BPs were recorded by paramedics in the field and during the first 24 hours of hospital course...
January 4, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29237604/stormy-weather-a-retrospective-analysis-of-demand-for-emergency-medical-services-during-epidemic-thunderstorm-asthma
#7
Emily Andrew, Ziad Nehme, Stephen Bernard, Michael J Abramson, Ed Newbigin, Ben Piper, Justin Dunlop, Paul Holman, Karen Smith
OBJECTIVES: To describe the demand for emergency medical assistance during the largest outbreak of thunderstorm asthma reported globally, which occurred on 21 November 2016. DESIGN: A time series analysis was conducted of emergency medical service caseload between 1 January 2015 and 31 December 2016. Demand during the thunderstorm asthma event was compared to historical trends for the overall population and across specific subgroups. SETTING: Victoria, Australia...
December 13, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28904070/antiarrhythmic-drugs-for-nonshockable-turned-shockable-out-of-hospital-cardiac-arrest-the-alps-study-amiodarone-lidocaine-or-placebo
#8
RANDOMIZED CONTROLLED TRIAL
Peter J Kudenchuk, Brian G Leroux, Mohamud Daya, Thomas Rea, Christian Vaillancourt, Laurie J Morrison, Clifton W Callaway, James Christenson, Joseph P Ornato, James V Dunford, Lynn Wittwer, Myron L Weisfeldt, Tom P Aufderheide, Gary M Vilke, Ahamed H Idris, Ian G Stiell, M Riccardo Colella, Tami Kayea, Debra Egan, Patrice Desvigne-Nickens, Pamela Gray, Randal Gray, Ron Straight, Paul Dorian
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) commonly presents with nonshockable rhythms (asystole and pulseless electric activity). It is unknown whether antiarrhythmic drugs are safe and effective when nonshockable rhythms evolve to shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia [VF/VT]) during resuscitation. METHODS: Adults with nontraumatic OHCA, vascular access, and VF/VT anytime after ≥1 shock(s) were prospectively randomized, double-blind, to receive amiodarone, lidocaine, or placebo by paramedics...
November 28, 2017: Circulation
https://www.readbyqxmd.com/read/28810931/a-comprehensive-regional-clinical-and-educational-ecpr-protocol-decreases-time-to-ecmo-in-patients-with-refractory-out-of-hospital-cardiac-arrest
#9
Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
OBJECTIVE: Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). METHODS: In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital...
November 2017: CJEM
https://www.readbyqxmd.com/read/28782875/comparison-of-trauma-care-systems-in-asian-countries-a-systematic-literature-review
#10
Se Jin Choi, Moon Young Oh, Na Rae Kim, Yoo Joong Jung, Young Sun Ro, Sang Do Shin
OBJECTIVE: The study aims to compare the trauma care systems in Asian countries. METHODS: Asian countries were categorised into three groups; 'lower middle-income country', 'upper middle-income country' and 'high-income country'. The Medline/PubMed database was searched for articles published from January 2005 to December 2014 using relevant key words. Articles were excluded if they examined a specific injury mechanism, referred to a specific age group, and/or did not have full text available...
August 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28771639/utilisation-of-prehospital-emergency-medical-services-for-hyperglycaemia-a-community-based-observational-study
#11
Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Arul Earnest, Karen Smith, Georgia Soldatos, Helena Teede, Sophia Zoungas
AIMS: This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport. MATERIALS AND METHODS: A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/28669391/rates-of-serum-level-determinations-of-antiepileptic-drugs-in-accord-with-guidelines-a-clinical-study-at-a-tertiary-center
#12
REVIEW
A Hanin, R Tubiana, M Bedouet, A Gales, N Zahr, A Liou, S Dupont
OBJECTIVE: To compare our rates of appropriate therapeutic drug monitoring (TDM) with those defined in the French guidelines for measuring drug levels of antiepileptic drugs (AEDs) during the pre- and post-medical/pharmaceutical interventional periods. METHODS: This study was prospectively carried out at a tertiary center (epilepsy unit of the Pitié-Salpêtrière Hospital in Paris) between 2013 and 2016 over three time periods. Criteria for appropriateness were those stated in the current French guidelines...
June 29, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28553450/calf-compartment-syndrome-associated-with-the-use-of-an-intra-osseous-line-in-an-adult-patient-a-case-report
#13
R Malhotra, W L Chua, G O'Neill
We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement...
November 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28483276/effectiveness-of-finger-marker-for-maintaining-the-correct-compression-point-during-paediatric-resuscitation-a-simulation-study
#14
Jae Yun Jung, Young Ho Kwak, Hyuksool Kwon, Yoo Jin Choi, Do Kyun Kim, Hee Chan Kim, Jung Chan Lee, Ji Heum Park, Hyungsoo Lim
OBJECTIVE: High-quality cardiopulmonary resuscitation is a significant factor for increasing the survival rate of paediatric patients. This study is to investigate the effectiveness of finger-marker stickers for maintaining the correct compression point during simulated infant cardiopulmonary resuscitation (CPR). METHODS: This crossover simulation study was conducted with 40 emergency physicians and paramedics at emergency departments of 2 tertiary hospitals. We used a remodeled infant CPR manikin developed to measure CPR quality indicators...
September 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28457576/effect-of-concentrated-psychiatric-education-on-perceived-competence-to-care-for-behavioral-health-patients
#15
Elizabeth J Winokur, Jeannine Loucks, Dana N Rutledge
CONTRIBUTION TO EMERGENCY NURSING PRACTICE: ABSTRACT INTRODUCTION: Increasing numbers of behavioral patients are presenting to emergency departments, where competency of staff to care for this group is unknown. METHODS: This pre-post study measured the effects of a 7-hour conference on perceived competency of nurses and allied health professionals to care for behavioral health (BH) patients, as measured by the 23-item Behavioral Health Care Competency (BHCC) survey...
September 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28344362/positive-serum-ethanol-concentration-on-admission-to-hospital-as-the-factor-predictive-of-treatment-outcome-in-acute-methanol-poisoning
#16
Sergey Zakharov, Olga Nurieva, Katerina Kotikova, Jaromir Belacek, Tomas Navratil, Daniela Pelclova
ABSTRACT: Mass methanol poisonings present a serious problem for health systems worldwide, with poor outcome associated with delayed treatment. Positive pre-hospital serum ethanol concentration may have predictive value as the prognostic factor of the treatment outcome. We studied the effect of positive serum ethanol level on admission to hospital on survival in patients treated during the Czech methanol outbreak during 2012-2014. Cross-sectional cohort study was performed in 100 hospitalized patients with confirmed methanol poisoning...
2017: Monatshefte Für Chemie
https://www.readbyqxmd.com/read/28326162/trauma-informed-care-for-children-in-the-ambulance-international-survey-among-pre-hospital-providers
#17
Eva Alisic, Mark P Tyler, Melita J Giummarra, Rahim Kassam-Adams, Juul Gouweloos, Markus A Landolt, Nancy Kassam-Adams
Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28314465/data-capture-and-communication-during-transfers-to-definitive-care-in-an-inclusive-trauma-system
#18
Nori L Bradley, Naisan Garraway, Nathaniel Bell, Nasira Lakha, S Morad Hameed
INTRODUCTION: Background trauma survivors in rural areas transferred to urban centers have higher mortality than trauma patients admitted directly to urban centers. Transfer data in trauma registries is important for injury control. Prehospital and early physiologic data may reflect processes of pre-hospital care. British Columbia currently has no standardized process for trauma patient data transfer. PATIENTS AND METHODS: We performed a retrospective data analysis for major trauma patients (ISS>15) transferred to a Level I trauma center over a 1year period (n=243)...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/28196949/referral-pathways-for-patients-with-tia-avoiding-hospital-admission-a-scoping-review
#19
Bridie Angela Evans, Khalid Ali, Jenna Bulger, Gary A Ford, Matthew Jones, Chris Moore, Alison Porter, Alan David Pryce, Tom Quinn, Anne C Seagrove, Helen Snooks, Shirley Whitman, Nigel Rees
OBJECTIVE: To identify the features and effects of a pathway for emergency assessment and referral of patients with suspected transient ischaemic attack (TIA) in order to avoid admission to hospital. DESIGN: Scoping review. DATA SOURCES: PubMed, CINAHL Web of Science, Scopus. STUDY SELECTION: Reports of primary research on referral of patients with suspected TIA directly to specialist outpatient services. DATA EXTRACTION: We screened studies for eligibility and extracted data from relevant studies...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28169135/case-study-and-case-based-research-in-emergency-nursing-and-care-theoretical-foundations-and-practical-application-in-paramedic-pre-hospital-clinical-judgment-and-decision-making-of-patients-with-mental-illness
#20
Ramon Z Shaban, Julie Considine, Margaret Fry, Kate Curtis
Generating knowledge through quality research is fundamental to the advancement of professional practice in emergency nursing and care. There are multiple paradigms, designs and methods available to researchers to respond to challenges in clinical practice. Systematic reviews, randomised control trials and other forms of experimental research are deemed the gold standard of evidence, but there are comparatively few such trials in emergency care. In some instances it is not possible or appropriate to undertake experimental research...
February 2017: Australasian Emergency Nursing Journal: AENJ
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