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https://www.readbyqxmd.com/read/27908843/treatment-of-acute-coronary-syndrome-by-telemedically-supported-paramedics-compared-with-physician-based-treatment-a-prospective-interventional-multicenter-trial
#1
Jörg C Brokmann, Clemens Conrad, Rolf Rossaint, Sebastian Bergrath, Stefan K Beckers, Miriam Tamm, Michael Czaplik, Frederik Hirsch
BACKGROUND: Prehospital treatment of acute coronary syndrome (ACS) in German emergency medical services (EMSs) is reserved for EMS physicians due to legal issues. OBJECTIVE: The objective of this prospective, interventional, multicenter trial was to evaluate the quality of telemedically-delegated therapy and the possible complications in patients with ACS. METHODS: After approval by the ethics committee and trial registration, a one-year study phase was started in August 2012 with 5 ambulances, telemedically equipped and staffed with paramedics, in 4 German EMS districts...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27902671/prehospital-transport-for-pediatric-trauma-a-comparison-of-private-transport-and-emergency-medical-services
#2
Yea-Chyi Lin, York Tien Lee, Jasmine Xun Yi Feng, Li Wei Chiang, Shireen Anne Nah
OBJECTIVES: We describe the demographics of pediatric patients with trauma transferred using private transport (PT) versus emergency medical services (EMS) and evaluate the potential impact on their treatment and outcome. METHODS: We accessed data from our national trauma registry, a prospectively collected database. Data were extracted on all patients with trauma admitted to our institution between January 2011 and June 2013, with injury severity score (ISS) higher than 8...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27894557/reporting-helicopter-emergency-medical-services-in-major-incidents-a-delphi-study
#3
Sabina Fattah, Anne Siri Johnsen, Stephen J M Sollid, Torben Wisborg, Marius Rehn, Ákos Sóti, Anatolij Truhlář, Andreas J Krüger, Björn Gunnarsson, Dan Gryth, David Ohlén, Espen Fevang, Geir Arne Sunde, Ivo Breitenmoser, Jouni Kurola, Jouni Nurmi, Knut Fredriksen, Leif Rognås, Peter Temesvari, Søren Mikkelsen, Vidar Magnusson, Wolfgang Voelckel
OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences. This type of database presently exists for major incident reporting at www.majorincidentreporting.net. This study aimed to develop a HEMS-specific major incident template. METHODS: This Delphi study included 17 prehospital critical care physicians with current or previous HEMS experience...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27879534/physician-provided-prehospital-critical-care-effect-on-patient-physiology-dynamics-and-on-scene-time
#4
Bjørn O Reid, Marius Rehn, Oddvar Uleberg, Andreas J Krüger
INTRODUCTION: Improved physiologic status can be seen as a surrogate measure of improved outcome and a field-friendly prognostic model such as the Mainz Emergency Evaluation Score (MEES) could quantify the effect on physiological response. We aim to examine the dynamic physiological profile as measured by this score on patients managed by physician-manned helicopter emergency medical services and how this profile was related to on-scene time expenditure and critical care interventions...
November 22, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27875733/relationship-between-ambient-temperature-and-frequency-and-severity-of-cardiovascular-emergencies-a-prospective-observational-study-based-on-out-of-hospital-care-data
#5
Mario Hensel, Markus Stuhr, Daniel Geppert, Jan F Kersten, Jürgen Lorenz, Thoralf Kerner
OBJECTIVE: To test the hypothesis that more cardiovascular emergencies occur at low rather than at high temperatures under moderate climatic conditions. METHODS: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and from the local weather station were evaluated over a 5-year period. Temperature data were matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the temperature and the frequency of individual cardiovascular emergencies...
November 8, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27827326/cutting-the-prehospital-on-scene-time-of-stroke-thrombolysis-in-helsinki-a-prospective-interventional-study
#6
Tuukka Puolakka, Markku Kuisma, Sami Länkimäki, Jyrki Puolakka, Juhana Hallikainen, Kirsi Rantanen, Perttu J Lindsberg
BACKGROUND AND PURPOSE: Significant portion of the prehospital delay consists of minutes spent on the scene with the patient. We implemented a training program for the emergency medical services personnel with the aim to optimize the on-scene time (OST) and to study the impact of different elements of prehospital practice to the OST duration. METHODS: In this prospective interventional study, key operational emergency medical service performance variables were analyzed from all thrombolysis candidates transported to the Helsinki University Hospital emergency department...
November 8, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27818120/efficacy-and-safety-of-prehospital-administration-of-unfractionated-heparin-enoxaparin-or-bivalirudin-in-patients-undergoing-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-insights-from-the-orbi-registry
#7
Vincent Auffret, Guillaume Leurent, Dominique Boulmier, Marc Bedossa, Amer Zabalawi, Jean-Philippe Hacot, Isabelle Coudert, Emmanuelle Filippi, Philippe Castellant, Antoine Rialan, Gilles Rouault, Philippe Druelles, Bertrand Boulanger, Josiane Treuil, Bertrand Avez, Marielle Le Guellec, Martine Gilard, Hervé Le Breton
BACKGROUND: Despite numerous studies in recent years, the best anticoagulant option for primary percutaneous coronary intervention (PCI) remains a matter of debate. AIMS: To compare in-hospital outcomes after prehospital administration of low-dose unfractionated heparin (UFH)±glycoprotein IIb/IIIa inhibitors (GPIs), enoxaparin±GPIs, or bivalirudin in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 1720 patients (median age 62...
November 3, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27797869/long-term-prognosis-after-out-of-hospital-resuscitation-of-cardiac-arrest-in-trauma-patients-prehospital-trauma-associated-cardiac-arrest
#8
François-Xavier Duchateau, Sophie Hamada, Mathieu Raux, Matthieu Gay, Jean Mantz, Catherine Paugam Burtz, Tobias Gauss
BACKGROUND: Although prehospital cardiac arrest (CA) remains associated with poor long-term outcome, recent studies show an improvement in the survival rate after prehospital trauma associated CA (TCA). However, data on the long-term neurological outcome of TCA, particularly from physician-staffed Emergency Medical Service (EMS), are scarce, and results reported have been inconsistent. The objective of this pilot study was to evaluate the long-term outcome of patients admitted to several trauma centres after a TCA...
October 26, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27724976/prehospital-treatment-with-continuous-positive-airway-pressure-in-patients-with-acute-respiratory-failure-a-regional-observational-study
#9
Vibe Maria Laden Nielsen, Jacob Madsen, Anette Aasen, Anne Pernille Toft-Petersen, Kenneth Lübcke, Bodil Steen Rasmussen, Erika Frischknecht Christensen
BACKGROUND: Patients with acute respiratory failure are at risk of deterioration during prehospital transport. Ventilatory support with continuous positive airway pressure (CPAP) can be initiated in the prehospital setting. The objective of the study is to evaluate adherence to treatment and effectiveness of CPAP as an addition to standard care. METHODS: In North Denmark Region, patients with acute respiratory failure, whom paramedics assessed as suffering from acute cardiopulmonary oedema, acute exacerbation of chronic obstructive pulmonary disease or asthma were treated with CPAP using 100 % O2 from 1 March 2014 to 3 May 2015...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27636352/prehospital-glucose-testing-for-children-with-seizures-a-proposed-change-in-management
#10
Katherine Remick, Christopher Redgate, Daniel Ostermayer, Amy H Kaji, Marianne Gausche-Hill
OBJECTIVE: Many Emergency Medicine Services (EMS) protocols require point-of-care blood glucose testing (BGT) for any pediatric patient who presents with seizure or altered level of conscious. Few data describe the diagnostic yield of BGT when performed on all pediatric seizures regardless of presenting mental status. We analyzed a large single center dataset of pediatric patients presenting with prehospital seizures to determine the prevalence of hypoglycemic seizures and the utility of repeat BGT in the emergency department (ED)...
September 16, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27629235/ten-year-maturation-period-in-a-level-i-trauma-center-a-cohort-comparison-study
#11
A M K Harmsen, G F Giannakopoulos, M Terra, E S M de Lange de Klerk, F W Bloemers
PURPOSE: Many changes have been made to improve trauma care. Improved trauma team response and usage of a hybrid resuscitation room are examples of how this trauma center has developed. The aim was to assess how the outcome of the trauma population was influenced by the maturation. METHODS: A cohort comparison, between June 2004-July 2005 and 2014, was performed. All adult trauma patients with an Injury Severity Score (ISS) >15 were included. Variables collected were: patient demographics, mechanism of trauma, total prehospital time, pre- and inhospital trauma scores, vital signs, blood values and interventions, and physician staffed helicopter emergency medical services (P-HEMS) involvement and outcome...
September 15, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27625734/determinants-of-success-and-failure-in-prehospital-endotracheal-intubation
#12
Lucas A Myers, Charles G Gallet, Logan J Kolb, Christine M Lohse, Christopher S Russi
INTRODUCTION: This study aimed to identify factors associated with successful endotracheal intubation (ETI) by a multisite emergency medical services (EMS) agency. METHODS: We collected data from the electronic prehospital record for all ETI attempts made from January through May 2010 by paramedics and other EMS crew members at a single multistate agency. If documentation was incomplete, the study team contacted the paramedic. Paramedics use the current National Association of EMS Physicians definition of an ETI attempt (laryngoscope blade entering the mouth)...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27592723/2016-emergency-medical-services-annotated-literature-in-review
#13
REVIEW
Jose V Nable, Benjamin J Lawner, William J Brady
In the daily practice of emergency medicine, physicians constantly interact with components of emergency medical services systems. The provision of high-quality care in the prehospital setting requires emergency physicians to remain abreast of recent literature that may inform the care of patients prior to their arrival at the emergency department. This literature review will examine some recent trends in the prehospital literature. In addition, the review will highlight important areas of clinical practice which represent some of the many intersections between emergency medicine and emergency medical services such as cardiac arrest and airway management...
November 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27565859/association-between-prehospital-physician-involvement-and-survival-after-out-of-hospital-cardiac-arrest-a-danish-nationwide-observational-study
#14
Annika Hamilton, Jacob Steinmetz, Mads Wissenberg, Christian Torp-Pedersen, Freddy K Lippert, Lars Hove, Nicolai Lohse
AIM: Sudden out-of-hospital cardiac arrest (OHCA) is an important public health problem. While several interventions are known to improve survival, the impact of physician-delivered advanced cardiac life support for OHCA is unclear. We aimed to assess the association between prehospital physician involvement and 30-day survival. METHODS: Observational study including persons registered with first-time OHCA of any cause in the Danish Cardiac Arrest Registry during 2005-2012...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/27551654/barriers-to-real-time-medical-direction-via-cellular-communication-for-prehospital-emergency-care-providers-in-gujarat-india
#15
Benjamin Lindquist, Matthew C Strehlow, G V Ramana Rao, Jennifer A Newberry
BACKGROUND: Many low- and middle-income countries depend on emergency medical technicians (EMTs), nurses, midwives, and layperson community health workers with limited training to provide a majority of emergency medical, trauma, and obstetric care in the prehospital setting. To improve timely patient care and expand provider scope of practice, nations leverage cellular phones and call centers for real-time online medical direction. However, there exist several barriers to adequate communication that impact the provision of emergency care...
2016: Curēus
https://www.readbyqxmd.com/read/27536530/alcohol-use-in-the-prehospital-setting-a-diagnostic-challenge-in-patients-treated-by-a-physician-staffed-mobile-intensive-care-unit
#16
Terhi Kauppila, Janne Virta, Leena Lindgren, Ilkka Virkkunen, Antti Kämäräinen
BACKGROUND: Alcohol use among emergency patients has been studied earlier, but the data regarding alcohol use especially among critically ill and injured patients treated in the prehospital setting is scarce. The aim of this study was to evaluate the incidence of alcohol use and the characteristics of cases attended by a physician staffed mobile intensive care unit (MICU). FINDINGS: During a 2 month period, exhaled air alcohol concentration-measured as a part of routine patient examination in all adolescent and adult patients treated by the MICU-was recorded...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27505936/beyond-blood-sugar
#17
Matt Zavadsky, Desiree Partain
Because POC testing has been shown to alter prehospital care in up to 30% of its uses, it may be logical for prehospital systems to consider implementing a POC testing system. Information gleaned from the i-STAT data can be used to treat electrolyte imbalances, adjust medications and ventilator settings, and even change IV fluid use. MIH providers can also use the data from POC testing to provide important feedback to physicians about enrolled patients. All of these uses support critical clinical decision making by field EMS providers, and will perhaps even help promote the value proposition we're all striving for in our EMS delivery models...
June 2016: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/27491760/effect-of-ultrasound-training-of-physicians-working-in-the-prehospital-setting
#18
Charlotte Loumann Krogh, Jacob Steinmetz, Søren Steemann Rudolph, Rasmus Hesselfeldt, Freddy K Lippert, Peter A Berlac, Lars S Rasmussen
BACKGROUND: Advances in technology have made ultrasound (US) devices smaller and portable, hence accessible for prehospital care providers. This study aims to evaluate the effect of a four-hour, hands-on US training course for physicians working in the prehospital setting. The primary outcome measure was US performance assessed by the total score in a modified version of the Objective Structured Assessment of Ultrasound Skills scale (mOSAUS). METHODS: Prehospital physicians participated in a four-hour US course consisting of both hands-on training and e-learning including a pre- and a post-learning test...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27484298/characteristics-and-outcomes-of-blood-product-transfusion-during-critical-care-transport
#19
Jorge Mena-Munoz, Udayan Srivastava, Christian Martin-Gill, Brian Suffoletto, Clifton W Callaway, Francis X Guyette
BACKGROUND: Civilian out-of-hospital transfusions have not been adequately studied. This study seeks to characterize patients receiving out-of-hospital blood product transfusion during critical care transport. STUDY DESIGN AND METHODS: We studied patients transported by a regional critical care air-medical service who received blood products during transport. This service carries two units of uncrossmatched packed Red Blood Cells (pRBCs) on every transport in addition to blood obtained from referring facilities...
September 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27480128/prehospital-lung-ultrasound-for-the-diagnosis-of-cardiogenic-pulmonary-oedema-a-pilot-study
#20
Christian B Laursen, Anja Hänselmann, Stefan Posth, Søren Mikkelsen, Lars Videbæk, Henrik Berg
BACKGROUND: An improved prehospital diagnostic accuracy of cardiogenic pulmonary oedema could potentially improve initial treatment, triage, and outcome. A pilot study was conducted to assess the feasibility, time-use, and diagnostic accuracy of prehospital lung ultrasound (PLUS) for the diagnosis of cardiogenic pulmonary oedema. METHODS: A prospective observational study was conducted in a prehospital setting. Patients were included if the physician based prehospital mobile emergency care unit was activated and one or more of the following two were present: respiratory rate >30/min...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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