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https://www.readbyqxmd.com/read/26753808/the-head-injury-transportation-straight-to-neurosurgery-hits-ns-randomised-trial-a-feasibility-study
#1
RANDOMIZED CONTROLLED TRIAL
Fiona Lecky, Wanda Russell, Gordon Fuller, Graham McClelland, Elspeth Pennington, Steve Goodacre, Kyee Han, Andrew Curran, Damien Holliman, Jennifer Freeman, Nathan Chapman, Matt Stevenson, Sonia Byers, Suzanne Mason, Hugh Potter, Tim Coats, Kevin Mackway-Jones, Mary Peters, Jane Shewan, Mark Strong
BACKGROUND: Reconfiguration of trauma services, with direct transport of traumatic brain injury (TBI) patients to neuroscience centres (NCs), bypassing non-specialist acute hospitals (NSAHs), could potentially improve outcomes. However, delays in stabilisation of airway, breathing and circulation (ABC) and the difficulties in reliably identifying TBI at scene may make this practice deleterious compared with selective secondary transfer from nearest NSAH to NC. National Institute for Health and Care Excellence guidance and systematic reviews suggested equipoise and poor-quality evidence - with regard to 'early neurosurgery' in this cohort - which we sought to address...
January 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/26066019/air-ambulance-and-hospital-services-for-critically-ill-and-injured-in-greenland-iceland-and-the-faroe-islands-how-can-we-improve
#2
Björn Gunnarsson, Niels S Kieler Jensen, Tummas I Garði, Helga Harðardóttir, Lilja Stefánsdóttir, María Heimisdóttir
The Nordic Atlantic Cooperation (NORA) is an intergovernmental organization under the auspices of the Nordic Council of Ministers. The NORA region comprises Greenland, Iceland, Faroe Islands and western coastal areas of Norway. Historical, cultural and institutional links bind these nations together in multiple ways, and regional co-operation has in recent years become a focus of interest. This commentary addresses air medical services (AMSs) and available advanced hospital services in the 3 smallest NORA countries challenged sparse populations, hereafter referred to as the region...
2015: International Journal of Circumpolar Health
https://www.readbyqxmd.com/read/25573067/the-challenges-of-conducting-prehospital-research-successes-and-lessons-learnt-from-the-head-injury-transportation-straight-to-neurosurgery-hits-ns-trial
#3
Graham McClelland, Elspeth Pennington, Sonia Byers, Wanda Russell, Fiona Lecky
Head Injury Transportation Straight to Neurosurgery was a cluster randomised trial studying suspected severe head injury treatment pathways conducted in the North East Ambulance Service NHS Foundation Trust and North West Ambulance Service NHS Trust between January 2012 and March 2013. This was the world's first large scale trial of any trauma bypass and was conducted as a feasibility study. This short report will describe some of the lessons learnt during this ground breaking and complex trial.
August 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25467566/mechanical-versus-manual-chest-compression-for-out-of-hospital-cardiac-arrest-paramedic-a-pragmatic-cluster-randomised-controlled-trial
#4
RANDOMIZED CONTROLLED TRIAL
Gavin D Perkins, Ranjit Lall, Tom Quinn, Charles D Deakin, Matthew W Cooke, Jessica Horton, Sarah E Lamb, Anne-Marie Slowther, Malcolm Woollard, Andy Carson, Mike Smyth, Richard Whitfield, Amanda Williams, Helen Pocock, John J M Black, John Wright, Kyee Han, Simon Gates
BACKGROUND: Mechanical chest compression devices have the potential to help maintain high-quality cardiopulmonary resuscitation (CPR), but despite their increasing use, little evidence exists for their effectiveness. We aimed to study whether the introduction of LUCAS-2 mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest. METHODS: The pre-hospital randomised assessment of a mechanical compression device in cardiac arrest (PARAMEDIC) trial was a pragmatic, cluster-randomised open-label trial including adults with non-traumatic, out-of-hospital cardiac arrest from four UK Ambulance Services (West Midlands, North East England, Wales, South Central)...
March 14, 2015: Lancet
https://www.readbyqxmd.com/read/22729146/-is-he-awake-dialogues-between-callers-and-call-handlers-about-consciousness-during-emergency-calls-for-suspected-acute-stroke
#5
Josephine M E Gibson, Mike Bullock, Gary A Ford, Stephanie P Jones, Michael J Leathley, Joanna J McAdam, Tom Quinn, Caroline L Watkins
BACKGROUND: Altered consciousness is an important symptom of acute stroke but assessment may be challenging when cognitive or language deficits are present. Callers are routinely questioned about conscious level by emergency medical services (EMS) call handlers for any presenting problem. OBJECTIVE: This study aimed to identify and compare how patients' conscious level was questioned, described and interpreted by callers and call handlers during acute stroke calls...
May 2013: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/21999815/spatial-analysis-of-ambulance-response-times-related-to-prehospital-cardiac-arrests-in-the-city-state-of-singapore
#6
COMPARATIVE STUDY
Arul Earnest, Marcus Eng Hock Ong, Nur Shahidah, Wen Min Ng, Chuanyang Foo, David John Nott
OBJECTIVES: The main objective of this study was to establish the spatial variation in ambulance response times for out-of-hospital cardiac arrests (OHCAs) in the city-state of Singapore. The secondary objective involved studying the relationships between various covariates, such as traffic condition and time and day of collapse, and ambulance response times. METHODS: The study design was observational and ecological in nature. Data on OHCAs were collected from a nationally representative database for the period October 2001 to October 2004...
April 2012: Prehospital Emergency Care
https://www.readbyqxmd.com/read/20189286/prevalence-outcome-and-pre-hospital-management-of-anaphylaxis-by-first-aiders-and-paramedical-ambulance-staff-in-manchester-uk
#7
Jennifer A Capps, Vibha Sharma, Peter D Arkwright
BACKGROUND: Anaphylaxis is of increasing prevalence and concern in Western communities. Ambulance services are often called to deal with these emergencies. There are few published studies that examine the demand and management of allergic reactions by emergency services. The aim of this study was to investigate the frequency, severity and outcome of calls, as well as whether intramuscular adrenaline was required for successful management of allergic reactions by paramedics and first aiders...
June 2010: Resuscitation
https://www.readbyqxmd.com/read/20084394/cancellations-of-helicopter-transported-mobile-medical-team-dispatches-in-the-netherlands
#8
Georgios F Giannakopoulos, Wouter D Lubbers, Herman M T Christiaans, Pieternel van Exter, Piet Bet, Paul J C Hugen, Gerard Innemee, Edo Schubert, Elly S M de Lange-Klerk, J Carel Goslings, Gerrolt N Jukema
BACKGROUND: The trauma centre of the Trauma Center Region North-West Netherlands (TRNWN) has consensus criteria for Mobile Medical Team (MMT) scene dispatch. The MMT can be dispatched by the EMS-dispatch centre or by the on-scene ambulance crew and is transported by helicopter or ground transport. Although much attention has been paid to improve the dispatch criteria, the MMT is often cancelled after being dispatched. The aim of this study was to assess the cancellation rate and the noncompliant dispatches of our MMT and to identify factors associated with this form of primary overtriage...
August 2010: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/19202817/collaborative-training-with-ambulance-service-nhs-trusts
#9
R J McBroom
Creating opportunities for pre-hospital emergency care Army medical staff to maintain their clinical and medical management skills whilst in barracks has always been a challenge for Commanding Officers. In the past there have been informal relationships between some units and Ambulance Trusts; however, these have usually faltered and been seen as unsustainable. Memoranda of Understanding (MoU) between 5 General Support Medical Regiment and the North West and Yorkshire Ambulance Service NHS Trusts, using the Ministry of Defence/Department of Health Concordat as a backdrop, has hopefully created a more formal training relationship which will produce a sustainable collaboration to create training opportunities for both parties...
September 2008: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/17540690/the-obstacles-to-maximising-the-impact-of-public-access-defibrillation-an-assessment-of-the-dispatch-mechanism-for-out-of-hospital-cardiac-arrest
#10
K J Cairns, A J Hamilton, A H Marshall, M J Moore, A A J Adgey, F Kee
OBJECTIVES: To determine the diagnostic accuracy of advanced medical priority dispatch system (AMPDS) software used to dispatch public access defibrillation first responders to out-of-hospital cardiac arrests (OHCA). DESIGN: All true OHCA events in North and West Belfast in 2004 were prospectively collated. This was achieved by a comprehensive search of all manually completed Patient Report Forms compiled by paramedics, together with autopsy reports, death certificates and medical records...
March 2008: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/16977789/-prova-e-trasporta-project-results-of-tele-transmission-of-the-electrocardiogram-from-community-hospitals-and-emergency-service-ambulances-in-the-management-of-st-elevation-acute-coronary-syndromes
#11
Alberto Limido, Claudio Mare, Stefano Giani, Francesco Perlasca, Massimo Bianchi, Sergio Ghiringhelli, Battistina Castiglioni, Paolo Cattaneo, Paolo Marchetti, Ylenia Bertelli, Laura Zoli, Sabrina Pappa, Daniela Guzzetti, Jorge Antonio Salerno-Uriarte
BACKGROUND: Availability of a telematic system of electrocardiogram (ECG) transmission may improve the management of ST-elevation myocardial infarction (STEMI), by reducing time to treatment. The aim of this study was to show the effectiveness of telephone transmission of ECG in improving quality of care for patients with acute STEMI. METHODS: Since January 1, 2003, we activated a management program of STEMI in healthcare district of Varese, located in the North-West of Lombardy (Italy), comprising one fourth-level hospital, equipped with a cath lab on call 24/24 h for primary angioplasty since 1993 and cardiac surgery, and 2 community hospitals, placed in a mountain area approximately 30 km far from Varese...
July 2006: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/14734395/ambulance-emergency-services-for-patients-with-coronary-heart-disease-in-lancashire-achieving-standards-and-improving-performance
#12
B Stoykova, R Dowie, P Bastow, K V Rowsell, R P F Gregory
OBJECTIVES: To examine the performance of a rural ambulance trust during two time periods, 1996/97 and 2001, with respect to achieving standards for ambulance journey times and delivery of clinical care for patients with suspected acute myocardial infarction (AMI). METHODS: Audit datasets on two cohorts of patients with chest pain and suspected AMI were assembled by the Lancashire Ambulance Service NHS Trust in north west England: 3706 patients during 1996/97 and 3423 in 2001...
January 2004: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/14508702/-comparison-of-the-emergency-medical-services-systems-of-birmingham-and-bonn-process-efficacy-and-cost-effectiveness
#13
COMPARATIVE STUDY
M Fischer, H Krep, D Wierich, U Heister, A Hoeft, S Edwards, L G Castrillo-Riesgo, T Krafft
OBJECTIVE: Due to rising health care costs there is a need to verify that the treatment by Emergency Medical Services (EMS) systems is efficient and cost effective. The integration of emergency physicians is inherent part of out-of-hospital emergency care and regulated by law in Germany but not in England and the United States of America. Aim of this study therefore was to conduct a cost performance analysis by evaluating the underlying structure, the costs incurred and the achieved performance in two EMS systems with paramedics or emergency physicians on scene...
October 2003: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/11696486/emergency-oxygen-therapy-for-the-breathless-patient-guidelines-prepared-by-north-west-oxygen-group
#14
R Murphy, K Mackway-Jones, I Sammy, P Driscoll, A Gray, R O'Driscoll, J O'Reilly, R Niven, A Bentley, G Brear, R Kishen
No abstract text is available yet for this article.
November 2001: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/11325360/triaging-patients-with-serious-head-injury-results-of-a-simulation-evaluating-strategies-to-bypass-hospitals-without-neurosurgical-facilities
#15
M D Stevenson, P A Oakley, S M Beard, A Brennan, A L Cook
OBJECTIVES: to inform the debate on whether seriously head-injured adult patients should be transported directly to the regional neurosurgical unit or indirectly after evaluation and stabilisation at the nearest hospital. DESIGN: a simulation model was constructed to compare triage strategies and to identify those that predicted the maximum survivors. In each strategy, an estimate of the patient's condition in the field was used to determine the receiving hospital...
May 2001: Injury
https://www.readbyqxmd.com/read/11005405/the-capability-of-accident-and-emergency-departments-to-safely-decontaminate-victims-of-chemical-incidents
#16
P Horby, V Murray, A Cummins, K Mackway-Jones, R Euripidou
OBJECTIVES: To evaluate the capability of accident and emergency (A&E) departments in six health regions of England to safely decontaminate casualties exposed to hazardous chemicals. METHODS: In January 1999 a postal questionnaire was sent to the clinical director of all A&E departments in Trent, North and South Thames, South and West, North West and, Anglia and Oxford Health Regions. The questionnaire inquired about characteristics of the department, decontamination facilities and equipment, and staff training...
September 2000: Journal of Accident & Emergency Medicine
https://www.readbyqxmd.com/read/10858679/a-strategy-for-vascular-services-testing-the-600-000-population-model
#17
S Arora, J Wolfe, R Maheswaran, A Grossinho, S Darke, J Colin, S Hargreaves
BACKGROUND: Vascular services' delivery has been criticised, and re-organisation based on a 600,000 population model suggested. We assessed the feasibility of this model in three geographically disparate English regions. METHODS: Surgical arterial activity by Trust was analyzed using 1994/95 data from Hospital Episode Statistics. A postal survey of acute Trusts was used to assess vascular facilities and personnel. Distances between hospitals and enumeration districts were mapped using a Geographical Information System...
May 2000: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/9402777/effectiveness-of-a-regional-trauma-system-in-reducing-mortality-from-major-trauma-before-and-after-study
#18
J Nicholl, J Turner
OBJECTIVE: To assess the effect of the development of an experimental trauma centre and regional trauma system on the survival of patients with major trauma. DESIGN: Controlled before and after study examining outcomes between 1990 and 1993, spanning the introduction of the system in 1991-2. SETTING: Trauma centre in North Staffordshire Royal Infirmary and five associated district general hospitals in the North West Midlands regional trauma system, and two control regions in Lancashire and Humberside...
November 22, 1997: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/8010918/a-survey-of-rural-road-fatalities
#19
D G Papadimitriou, M N Mathur, D A Hill
This study is a retrospective case series analysis of all 82 road deaths occurring in the Orana Area Health Service (OAHS) over the 2 year period 1989-90. The OAHS services a population of 112,800 in an area of 199,077 km2 in north-west New South Wales. The aim of the study was to document timing, place and cause of deaths, severity of injuries, pre-hospital management of victims, and a TRISS analysis of outcome. This was done using ambulance, hospital, police and autopsy reports. Seventy-two (88%) of the victims were motor vehicle occupants, five (6%) were motorcyclists and four (5%) were pedestrians...
July 1994: Australian and New Zealand Journal of Surgery
https://www.readbyqxmd.com/read/476405/regional-organisation-of-neonatal-intensive-care-in-the-north-west
#20
M L Chiswick, P Davies, R Bate, E Dryburgh, D Gordon-Nesbitt
From January 1976 to July 1978, 234 ill neonates were transported to the regional neonatal intensive care unit (ICU) of St Mary's Hospital, Manchester, from 26 maternity hospitals three to 120 miles (4.8-193.1 km) away. Ninety per cent were transferred from 15 hospitals within a 30-mile (48.3 km) radius of the ICU. Most referring hospitals had more than 2000 births a year and offered good nursing supervision of high-risk neonates in conventional special care baby units (SCBUs). In 200 of the 234 babies respiratory symptoms precipitated referral, hyaline membrane disease being the most common final diagnosis...
July 28, 1979: British Medical Journal (1857-1980)
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