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Ems performance improvement

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https://www.readbyqxmd.com/read/29136270/60-seconds-to-survival-a-pilot-study-of-a-disaster-triage-video-game-for-prehospital-providers
#1
Mark X Cicero, Travis Whitfill, Kevin Munjal, Manu Madhok, Maria Carmen G Diaz, Daniel J Scherzer, Barbara M Walsh, Angela Bowen, Michael Redlener, Scott A Goldberg, Nadine Symons, James Burkett, Joseph C Santos, David Kessler, Ryan N Barnicle, Geno Paesano, Marc A Auerbach
INTRODUCTION: Disaster triage training for emergency medical service (EMS) providers is not standardized. Simulation training is costly and time-consuming. In contrast, educational video games enable low-cost and more time-efficient standardized training. We hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. METHODS: Participants recorded their demographics and highest EMS training level and were randomized to play 60S (intervention) or serve as controls...
April 2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/29132482/effectiveness-of-functional-electrical-stimulation-fes-versus-conventional-electrical-stimulation-in-gait-rehabilitation-of-patients-with-stroke
#2
Freeha Sharif, Samina Ghulam, Arshad Nawaz Malik, Quratulain Saeed
OBJECTIVE: To compare the effectiveness of functional electrical stimulation (FES) versus conventional electrical stimulation in gait rehabilitation of patients with stroke for finding the most appropriate problem-oriented treatment for foot drop patients in a shorter time period. STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, from July to December 2016...
November 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29123877/performance-review-of-regional-emergency-medical-service-pre-arrival-cardiopulmonary-resuscitation-with-or-without-dispatcher-instruction-a-population-based-observational-study
#3
Hidetada Fukushima, Yasuyuki Kawai, Hideki Asai, Tadahiko Seki, Kazunobu Norimoto, Yasuyuki Urisono, Kazuo Okuchi
Background: To investigate variations in emergency medical service (EMS) pre-arrival cardiopulmonary resuscitation (CPR), including both bystander CPR without dispatch assistance and dispatch-assisted CPR (DACPR). Methods: We carried out an observational study by implementing EMS pre-arrival CPR reports in three fire agencies. We included adult, non-traumatic, and non-EMS witnessed out-of-hospital cardiac arrests. This reporting system comprised the dispatch instruction process and bystander CPR quality based on evaluations by EMS crews who arrived on the scene...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29065643/experimental-simulation-based-performance-evaluation-of-an-sms-based-emergency-geolocation-notification-system
#4
Isibor Osebor, Sanjay Misra, Nicholas Omoregbe, Adewole Adewumi, Luis Fernandez-Sanz
In an emergency, a prompt response can save the lives of victims. This statement generates an imperative issue in emergency medical services (EMS). Designing a system that brings simplicity in locating emergency scenes is a step towards improving response time. This paper therefore implemented and evaluated the performance of an SMS-based emergency geolocation notification system with emphasis on its SMS delivery time and the system's geolocation and dispatch time. Using the RAS metrics recommended by IEEE for evaluation, the designed system was found to be efficient and effective as its reliability stood within 62...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29048208/an-innovative-technique-of-transurethral-seminal-vesiculoscopy-with-ultrasonic-lithotripter-for-severe-persistent-hematospermia
#5
Wei Zhang, Guang'an Xiao, Shenfei Qin, Amanda B Reed-Maldonado, Jian Xu, Guanghua Chen, Lei Wang, Tie Zhou
BACKGROUND AND PURPOSE: Transurethral seminal vesiculoscopy (TSV) provides an efficient approach to diagnose and treat the hematospermia but still need further improvement in manipulation and corresponding instruments. In this study, we develop an innovative technique with ultrasonic lithotripter (EMS) to treat severe, persistent hematospermia. PATIENTS AND METHODS: Data of patients who underwent TSV with or without ultrasonic lithotripter between May 2012 and December 2015 was reviewed...
October 19, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29033601/urine-metabolic-ratio-of-omeprazole-in-relation-to-cyp2c19-polymorphisms-in-russian-peptic-ulcer-patients
#6
Natalia P Denisenko, Dmitriy A Sychev, Zhanna M Sizova, Valeriy V Smirnov, Kristina A Ryzhikova, Zhannet A Sozaeva, Elena A Grishina
BACKGROUND: CYP2C19 is known to be the main enzyme of biotransformation of proton pump inhibitors (PPIs), whereas the CYP2C19 gene is highly polymorphic. Genotyping and phenotyping together represent more reliable data about patient's CYP2C19 activity. PURPOSE: The aim of the study was to investigate the applicability of urine metabolic ratio of omeprazole for CYP2C19 phenotyping in Russian peptic ulcer patients with different CYP2C19 genotypes. PATIENTS AND METHODS: A total of 59 patients (19 men and 40 women) aged 18-91 years (mean age 53...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/29030647/the-diagnostic-reliability-of-the-quantitative-pivot-shift-evaluation-using-an-electromagnetic-measurement-system-for-anterior-cruciate-ligament-deficiency-was-superior-to-those-of-the-accelerometer-and-ipad-image-analysis
#7
Toshikazu Tanaka, Yuichi Hoshino, Nobuaki Miyaji, Kazuyuki Ibaragi, Kyohei Nishida, Yuichiro Nishizawa, Daisuke Araki, Noriyuki Kanzaki, Takehiko Matsushita, Ryosuke Kuroda
PURPOSE: Several non-invasive devices have been developed to obtain quantitative assessment of the pivot-shift test in clinical setting using similar but diverse measurement parameters. However, the clinical usability of those measurements has yet to be closely investigated and compared. The purpose of this study was to compare the diagnostic accuracy of three non-invasive measurement devices for the pivot-shift test. METHODS: Thirty patients with unilateral anterior cruciate ligament (ACL) injury were enrolled...
October 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28939711/multistate-5-year-initiative-to-improve-care-for-out-of-hospital-cardiac-arrest-primary-results-from-the-heartrescue-project
#8
Sean van Diepen, Saket Girotra, Benjamin S Abella, Lance B Becker, Bentley J Bobrow, Paul S Chan, Carol Fahrenbruch, Christopher B Granger, James G Jollis, Bryan McNally, Lindsay White, Demetris Yannopoulos, Thomas D Rea
BACKGROUND: The HeartRescue Project is a multistate public health initiative focused on establishing statewide out-of-hospital cardiac arrest (OHCA) systems of care to improve case capture and OHCA care in the community, by emergency medical services (EMS), and at hospital level. METHODS AND RESULTS: From 2011 to 2015 in the 5 original HeartRescue states, all adults with EMS-treated OHCA due to a presumed cardiac cause were included. In an adult population of 32...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28910472/a-descriptive-analysis-of-occupational-fatalities-due-to-felonious-assault-among-u-s-law-enforcement-officers-during-tactical-incidents-1996-2014
#9
Moriah S Thompson, Tyler M Hartman, Matthew D Sztajnkrycer
INTRODUCTION: Little is known about occupational fatalities among tactical officers. A greater understanding of such injuries is needed to improve officer safety. The purpose of this study was to provide a descriptive analysis of line-of-duty deaths secondary to felonious assault during tactical incidents. METHODS: Retrospective analysis was performed of open-source de-identified Federal Bureau of Investigation Uniform Crime Reporting Law Enforcement Officers Killed and Assaulted (LEOKA) data inclusive of the years 1996-2014...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910207/challenges-of-using-probabilistic-linkage-methodology-to-characterize-post-cardiac-arrest-care-in-michigan
#10
Robert Swor, Lihua Qu, Kevin Putman, Kelly N Sawyer, Robert Domeier, Jennifer Fowler, William Fales
BACKGROUND: To improve survival of patients resuscitated from out of hospital cardiac arrest (OCHA), data is needed to assess and improve inpatient post-resuscitation care. Our objective was to apply probabilistic linkage methodology to link EMS and inpatient databases and evaluate whether it may be used to describe post-arrest care in Michigan. METHODS: We performed a retrospective study to describe post-cardiac arrest care in adult OHCA patients who were transported to Michigan hospitals from July 1, 2010, to June 30, 2013...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28900873/numerical-analysis-of-intracochlear-mechanical-auditory-stimulation-using-piezoelectric-bending-actuators
#11
Daniel Schurzig, Sebastian Schwarzendahl, Jörg Wallaschek, Wouter J van Drunen, Thomas S Rau, Thomas Lenarz, Omid Majdani
Cochlear implantation can restore a certain degree of auditory impression of patients suffering from profound hearing loss or deafness. Furthermore, studies have shown that in case of residual hearing, patients benefit from the use of a hearing aid in addition to the cochlear implant. The presented studies aim at the improvement of this electromechanical stimulation (EMS) approach by substituting the external hearing aid by an internal stimulus provided by miniaturized piezoelectric actuators. Finite element analyses are performed in order to derive fundamental guidelines for the actuator layout aiming at maximal mechanical stimuli...
September 13, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28887248/positive-impact-of-an-aortic-center-designation
#12
Adam Tanious, Mathew Wooster, Marcelo Giarelli, Paul A Armstrong, Brad Johnson, Karl A Illig, Bruce Zwiebel, Lawrence S Grundy, Robert Hooker, Christiano Caldeira, Martin A Back, Murray L Shames
BACKGROUND: In January 2015, we created a multidisciplinary Aortic Center with the collaboration of Vascular Surgery, Cardiac Surgery, Interventional Radiology, Anesthesia and Hospital Administration. We report the initial success of creating a Comprehensive Aortic Center. METHODS: All aortic procedures performed from January 1, 2015 until December 31, 2016 were entered into a prospectively collected database and compared with available data for 2014. Primary outcomes included the number of all aortic related procedures, transfer acceptance rate, transfer time, and proportion of elective/emergent referrals...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28870382/simulation-based-decision-support-framework-for-dynamic-ambulance-redeployment-in-singapore
#13
Sean Shao Wei Lam, Clarence Boon Liang Ng, Francis Ngoc Hoang Long Nguyen, Yih Yng Ng, Marcus Eng Hock Ong
OBJECTIVE: Dynamic ambulance redeployment policies tend to introduce much more flexibilities in improving ambulance resource allocation by capitalizing on the definite geospatial-temporal variations in ambulance demand patterns over the time-of-the-day and day-of-the-week effects. A novel modelling framework based on the Approximate Dynamic Programming (ADP) approach leveraging on a Discrete Events Simulation (DES) model for dynamic ambulance redeployment in Singapore is proposed in this paper...
October 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28864072/improvements-in-the-quality-of-advanced-life-support-and-patient-outcome-after-implementation-of-a-standardized-real-life-post-resuscitation-feedback-system
#14
Pia Hubner, Elisabeth Lobmeyr, Christian Wallmüller, Michael Poppe, Philip Datler, Markus Keferböck, Sebastian Zeiner, Alexander Nürnberger, Andreas Zajicek, Anton Laggner, Fritz Sterz, Patrick Sulzgruber
BACKGROUND: Educational aspects in the training of advanced life support (ALS) represent a key role in critical care management of patients with out-of-hospital cardiac arrest (OHCA) and received special attention in guidelines of various international societies. While a positive association of feedback on ALS performance in training conditions is well established, data on the impact of a real-life post-resuscitation feedback on both ALS quality and outcome remain scarce and inconclusive...
November 2017: Resuscitation
https://www.readbyqxmd.com/read/28860011/the-relationship-between-chronic-health-conditions-and-outcome-following-out-of-hospital-ventricular-fibrillation-cardiac-arrest
#15
Florence Dumas, Jennifer Blackwood, Lindsay White, Carol Fahrenbruch, Xavier Jouven, Alain Cariou, Thomas Rea
INTRODUCTION: The cumulative burden of chronic health conditions could contribute to out-of-hospital cardiac arrest (OHCA) physiology and response to attempted resuscitation. Yet little is known about how chronic health conditions influence prognosis. We evaluated the relationship between cumulative comorbidity and outcome following ventricular fibrillation OHCA using 3 different scales. METHODS: We performed a cohort investigation of persons >=18years who suffered non-traumatic OHCA and presented with ventricular fibrillation between January 1, 2007 and December 31, 2013 in a metropolitan emergency medical service (EMS) system...
November 2017: Resuscitation
https://www.readbyqxmd.com/read/28851659/improving-trend-in-ventricular-fibrillation-pulseless-ventricular-tachycardia-out-of-hospital-cardiac-arrest-in-rochester-minnesota-a-26-year-observational-study-from-1991-to-2016
#16
Masashi Okubo, Elizabeth J Atkinson, Erik P Hess, Roger D White
BACKGROUND: Mortality from out-of-hospital cardiac arrest (OHCA) is characterized by substantial regional variation. The Institute of Medicine (IOM) recently recommended enhancing the capabilities of EMS systems to improve outcome. In this study, we analyzed the trend in outcome from ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) OHCA in Rochester, MN. Survival from these forms of arrest is commonly employed as a benchmark of Emergency Medical Services (EMS) system performance...
November 2017: Resuscitation
https://www.readbyqxmd.com/read/28827263/effect-of-national-implementation-of-utstein-recommendation-from-the-global-resuscitation-alliance-on-ten-steps-to-improve-outcomes-from-out-of-hospital-cardiac-arrest-a-ten-year-observational-study-in-korea
#17
Young Taek Kim, Sang Do Shin, Sung Ok Hong, Ki Ok Ahn, Young Sun Ro, Kyoung Jun Song, Ki Jeong Hong
OBJECTIVES: The Utstein ten-step implementation strategy (UTIS) proposed by the Global Resuscitation Alliance, a bundle of community cardiopulmonary resuscitation (CPR) programs to improve outcomes after out-of-hospital cardiac arrests (OHCAs), has been developed. However, it is not documented whether UTIS programs are associated with better outcomes or not. The study aimed to test the association between the UTIS programme and better outcomes after OHCA. METHODS: The study was a before- and after-intervention study...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28744180/mutant-selection-in-the-self-incompatible-plant-radish-raphanus-sativus-l-var-sativus-using-two-step-tilling
#18
Kaori Kohzuma, Motoko Chiba, Soichiro Nagano, Toyoaki Anai, Miki U Ueda, Riichi Oguchi, Kazumasa Shirai, Kousuke Hanada, Kouki Hikosaka, Nobuharu Fujii
Radish (Raphanus sativus L. var. sativus), a widely cultivated root vegetable crop, possesses a large sink organ (the root), implying that photosynthetic activity in radish can be enhanced by altering both the source and sink capacity of the plant. However, since radish is a self-incompatible plant, improved mutation-breeding strategies are needed for this crop. TILLING (Targeting Induced Local Lesions IN Genomes) is a powerful method used for reverse genetics. In this study, we developed a new TILLING strategy involving a two-step mutant selection process for mutagenized radish plants: the first selection is performed to identify a BC1M1 line, that is, progenies of M1 plants crossed with wild-type, and the second step is performed to identify BC1M1 individuals with mutations...
June 2017: Breeding Science
https://www.readbyqxmd.com/read/28723789/measuring-the-impact-of-emergency-medical-services-ems-on-out-of-hospital-cardiac-arrest-survival-in-a-developing-country-a-key-metric-for-ems-systems-performance
#19
Mazen El Sayed, Reem Al Assad, Yasmin Abi Aad, Nour Gharios, Marwan M Refaat, Hani Tamim
Out-of-hospital cardiac arrest (OHCA) can be used to evaluate the overall performance of the emergency medical services' (EMS) system. This study assessed the impact of EMS on OHCA survival rates in a setting where the prehospital system is underdeveloped.A retrospective chart review was carried out over a 5-year period of all adult OHCA patients admitted to the emergency department (ED) of a tertiary care center in Lebanon.A total of 271 patients with OHCA (179 [66.1%] men, mean age of 69.9 [standard deviation = 15...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28712685/emergency-medical-services-perspectives-on-identifying-and-reporting-victims-of-elder-abuse-neglect-and-self-neglect
#20
Tony Rosen, Cynthia Lien, Michael E Stern, Elizabeth M Bloemen, Regina Mysliwiec, Thomas J McCarthy, Sunday Clark, Mary R Mulcare, Daniel S Ribaudo, Mark S Lachs, Karl Pillemer, Neal E Flomenbaum
BACKGROUND: Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. OBJECTIVE: To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment...
October 2017: Journal of Emergency Medicine
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