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Ems performance improvement

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
Craig D Newgard, Rongwei Fu, Eileen Bulger, Jerris R Hedges, N Clay Mann, Dagan A Wright, David P Lehrfeld, Carol Shields, Gregory Hoskins, Craig Warden, Lynn Wittwer, Jennifer N B Cook, Michael Verkest, William Conway, Stephanie Somerville, Matthew Hansen
Importance: Despite a large rural US population, there are potential differences between rural and urban regions in the processes and outcomes following trauma. Objectives: To describe and evaluate rural vs urban processes of care, injury severity, and mortality among injured patients served by 9-1-1 emergency medical services (EMS). Design, Setting, and Participants: This was a preplanned secondary analysis of a prospective cohort enrolled from January 1 through December 31, 2011, and followed up through hospitalization...
October 12, 2016: JAMA Surgery
Viktoras Silinskas, Albinas Grūnovas, Jurate Stanislovaitiene, Alfonsas Buliuolis, Eugenijus Trinkunas, Jonas Poderys
Electrical myostimulation (EMS) method is applied to improve skeletal muscle function. The aim of this study was to evaluate the efficacy of EMS applied to the sole and calf muscles on their strength and on maximal sprint performance. Each of 10 training sessions involved 10 s of stimulation and 50 s of rest for a total of 10 min. After the 10 training sessions, the maximal voluntary contraction (MVC) of right calf muscles increased by 6.0% from 830.0 ± 47.0 N to 878.0 ± 45.3 N (P < 0.05). When EMS was applied to trained athletes, their 10-m sprint performance improved by 2...
August 26, 2016: Journal of Strength and Conditioning Research
Bryan Choi, Nicholas Asselin, Catherine C Pettit, Max Dannecker, Jason T Machan, Derek L Merck, Lisa H Merck, Selim Suner, Kenneth A Williams, Gregory D Jay, Leo Kobayashi
INTRODUCTION: Effective resuscitation of out-of-hospital cardiac arrest (OHCA) patients is challenging. Alternative resuscitative approaches using electromechanical adjuncts may improve provider performance. Investigators applied simulation to study the effect of an experimental automation-assisted, goal-directed OHCA management protocol on EMS providers' resuscitation performance relative to standard protocols and equipment. METHODS: Two-provider (emergency medical technicians (EMT)-B and EMT-I/C/P) teams were randomized to control or experimental group...
August 9, 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Elliot M Ross, Theodore T Redman, Stephen A Harper, Julian G Mapp, David A Wampler, David A Miramontes
STUDY OBJECTIVES: The goal of our study is to determine if prehospital dual defibrillation (DD) is associated with better neurologically intact survival in out-of-hospital cardiac arrest. METHODS: This study is a retrospective cohort analysis of prospectively collected Quality Assurance/Quality Improvement data from a large urban fire based EMS system out-of-hospital cardiac arrest (OHCA) database between Jan 2013 and Dec 2015. Our inclusion criteria were administration of DD or at least four conventional 200J defibrillations for cases of recurrent and refractory ventricular fibrillation (VF)...
September 2016: Resuscitation
Michael E Abboud, Roger Band, Judy Jia, William Pajerowski, Guy David, Michelle Guo, C Crawford Mechem, Steven R Messé, Brendan G Carr, Michael T Mullen
OBJECTIVE: Hospital arrival via Emergency Medical Services (EMS) and EMS prenotification are associated with faster evaluation and treatment of stroke. We sought to determine the impact of diagnostic accuracy by prehospital providers on emergency department quality measures. METHODS: A retrospective study was performed of patients presenting via EMS between September 2009 and December 2012 with a discharge diagnosis of transient ischemic attack (TIA), ischemic stroke (IS), or intracerebral hemorrhage (ICH)...
May 31, 2016: Prehospital Emergency Care
Hamid Reza Khankeh, Razieh Froutan, Masoud Fallahi-Khoshknab, Fazlollah Ahmadi, Kian Norouzi
A thorough understanding of experiences of Emergency Medical Services (EMS) personnel related to the field transfer of burn victims can be used as a prerequisite of quality improvement of pre-hospital clinical care for these kinds of victims. The aim of the present study was to explore the experiences of EMS personnel during transferring burn victims. In this qualitative research, content analysis was performed to explore the experiences and perceptions of a purposeful sample of Iranian EMS personnel (n = 32)...
2016: Global Journal of Health Science
David A Pearson, R Darrell Nelson, Lisa Monk, Clark Tyson, James G Jollis, Christopher B Granger, Claire Corbett, Lee Garvey, Michael S Runyon
BACKGROUND: Team-focused CPR (TFCPR) is a choreographed approach to cardiopulmonary resuscitation (CPR) with emphasis on minimally interrupted high-quality chest compressions, early defibrillation, discourages endotracheal intubation and encourages use of the bag-valve-mask (BVM) and/or blind-insertion airway device (BIAD) with a ventilation rate of 8-10 breaths/min to minimize hyperventilation. Widespread incorporation of TFCPR in North Carolina (NC) EMS agencies began in 2011, yet its impact on outcomes is unknown...
August 2016: Resuscitation
Ming-Ju Hsieh, Sung-Chun Tang, Wen-Chu Chiang, Li-Kai Tsai, Jiann-Shing Jeng, Matthew Huei-Ming Ma
BACKGROUND: The sooner thrombolytic therapy is given to acute ischemic stroke patients, the better the outcome. Prehospital notification may shorten the time between hospital arrival and brain computed tomography (door-to-CT) and the door-to-needle (DTN) time. This study investigated the effect of prehospital notification on acute stroke care in an urban city in Taiwan. METHODS: This retrospective observational study utilized a prospectively collected dataset from patients treated at 9 hospitals and the emergency medical service (EMS) system in Taipei City from September 1, 2012 to December 31, 2014...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
D W Healy, E J LaHart, E E Peoples, E S Jewell, R J Bettendorf, S K Ramachandran
BACKGROUND: The Mallampati examination is a standard component of an airway risk assessment. Existing evidence suggests that cervical spine extension improves the predictive power of the Mallampati examination for detecting difficult laryngoscopy and tracheal intubation, but a comparative effectiveness study has not been conducted. METHODS: The extended Mallampati examination (EMS) was introduced to the standard preoperative airway assessment, in addition to the standard Modified Mallampati examination (MMP)...
May 2016: British Journal of Anaesthesia
Marc Felzen, Jörg C Brokmann, Stefan K Beckers, Michael Czaplik, Frederik Hirsch, Miriam Tamm, Rolf Rossaint, Sebastian Bergrath
INTRODUCTION: Telemedical concepts in emergency medical services (EMS) lead to improved process times and patient outcomes, but their technical performance has thus far been insufficient; nevertheless, the concept was transferred into EMS routine care in Aachen, Germany. This study evaluated the system's technical performance and compared it to a precursor system. METHODS: The telemedicine system was implemented on seven ambulances and a teleconsultation centre staffed with experienced EMS physicians was established in April 2014...
April 13, 2016: Journal of Telemedicine and Telecare
Vinod Vasudevan, Preeti Singh, Samyajit Basu
OBJECTIVE: India has been slow in implementing a central emergency medical services (EMS) system across the country. "108 services" is one of the most popular services that is functional under the public-private partnership model. Limited available literature shows that despite access to services, many traffic crash victims are transported using private vehicles. The objective of this study is to understand the effectiveness of 108 services from a traffic safety perspective. METHOD: A questionnaire survey is conducted to understand the awareness of EMS and their function...
October 2, 2016: Traffic Injury Prevention
Prajapathi Lakireddy, Peter Canning, Juyong Lee, Michael Azrin, Aseem Vashist
BACKGROUND: Adhering to core measures and consistent application of best practice guidelines in patients with acute coronary syndromes is challenging for hospitals. METHODS: A task force addressed gaps in care and adherence to guidelines, and included Emergency Medical Services (EMS) in the decision pathway. RESULTS: Previously, our institutional performance on most core metrics was in the lower tertile nationally. Task force recommendations and the recognition of EMS's role in care produced significant improvement...
February 2016: Connecticut Medicine
Tuukka Puolakka, Taneli Väyrynen, Elja-Pekka Erkkilä, Markku Kuisma
UNLABELLED: Introduction On-scene time (OST) previously has been shown to be a significant component of Emergency Medical Services' (EMS') operational delay in acute stroke. Since stroke patients are managed routinely by two-person ambulance crews, increasing the number of personnel available on the scene is a possible method to improve their performance. Hypothesis Using fire engine crews to support ambulances on the scene in acute stroke is hypothesized to be associated with a shorter OST...
June 2016: Prehospital and Disaster Medicine
Akira Funada, Yoshikazu Goto, Tetsuo Maeda, Ryota Teramoto, Kenshi Hayashi, Masakazu Yamagishi
BACKGROUND: There is sparse data regarding the survival and neurological outcome of elderly patients with out-of-hospital cardiac arrest (OHCA). METHODS AND RESULTS: OHCA patients (334,730) aged ≥75 years were analyzed using a nationwide, prospective, population-based Japanese OHCA database from 2008 to 2012. The overall 1-month survival with favorable neurological outcome (Cerebral Performance Category Scale, category 1 or 2; CPC 1-2) rate was 0.88%. During the study period, the annual 1-month CPC 1-2 rate in whole OHCA significantly improved (0...
April 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Nicolas Wirtz, Christoph Zinner, Ulrike Doermann, Heinz Kleinoeder, Joachim Mester
The aim of the present study was to investigate the effects of a multiple set squat exercise training intervention with superimposed electromyostimulation (EMS) on strength and power, sprint and jump performance. Twenty athletes from different disciplines participated and were divided into two groups: strength training (S) or strength training with superimposed EMS (S+E). Both groups completed the same training program twice a week over a six week period consisting of four sets of the 10 repetition maximum of back squats...
March 2016: Journal of Sports Science & Medicine
Brian Grunau, Frank Xavier Scheuermeyer, Dion Stub, Robert H Boone, Joseph Finkler, Sarah Pennington, Sarah Ann Carriere, Anson Cheung, Ruth MacRedmond, Jamil Bashir, Jim Christenson
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR), while resource-intensive, may improve outcomes in selected patients with refractory out-of-hospital cardiac arrest (OHCA). We sought to identify patients who fulfilled a set of ECPR criteria in order to estimate: (1) the proportion of patients with refractory cardiac arrest who may have benefited from ECPR; and (2) the outcomes achieved with conventional resuscitation. METHODS: We performed a secondary analysis from a 52-month prospective registry of consecutive adult non-traumatic OHCA cases from a single urban Canadian health region serving one million patients...
March 4, 2016: CJEM
Jonathan Lu, Akshay Bagai, Chris Buller, Asim Cheema, John Graham, Michael Kutryk, Jo-Ann Christie, Neil Fam
BACKGROUND: The implementation of regional primary percutaneous coronary intervention (PCI) programs has been critical in achieving timely intervention in patients with ST-segment elevation myocardial infarction (STEMI). However, 1 consequence has been inappropriate and false-positive cardiac catheterization laboratory (CCL) activations where either angiography is cancelled or no culprit lesion is found, respectively. METHODS: We performed a retrospective cohort study of 1,391 patients referred for primary PCI to a single academic center from November 2007 to August 2013...
March 2016: American Heart Journal
Tom Brosch, Lisa Tang, Youngjin Yoo, David Li, Anthony Traboulsee, Roger Tam
We propose a novel segmentation approach based on deep 3D convolutional encoder networks with shortcut connections and apply it to the segmentation of multiple sclerosis (MS) lesions in magnetic resonance images. Our model is a neural network that consists of two interconnected pathways, a convolutional pathway, which learns increasingly more abstract and higher-level image features, and a deconvolutional pathway, which predicts the final segmentation at the voxel level. The joint training of the feature extraction and prediction pathways allows for the automatic learning of features at different scales that are optimized for accuracy for any given combination of image types and segmentation task...
February 11, 2016: IEEE Transactions on Medical Imaging
Daniel Lane, Robbie I Ichelson, Ian R Drennan, Damon C Scales
OBJECTIVE: To identify studies describing the accuracy of prehospital sepsis identification and to summarise results of studies of prehospital management of patients with sepsis, severe sepsis or septic shock. METHODS: We conducted a systematic review to retrieve studies that evaluated the prehospital identification or treatment of patients with sepsis by emergency medical services (EMS). Two authors extracted data describing the study characteristics, incidence of sepsis among EMS-transported patients, criteria used to identify sepsis and specific treatments provided to patients with sepsis...
June 2016: Emergency Medicine Journal: EMJ
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