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Prehospital AND intubation

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https://www.readbyqxmd.com/read/29351503/prehospital-intubation-further-confounders-in-trial-results
#1
Iqbal Sayeed, Fahim Atif, Claudia Espinosa-Garcia, Bushra Wali, Nefize Turan, Seema Yousuf, Donald G Stein
No abstract text is available yet for this article.
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29351501/pediatric-anaphylaxis-in-the-prehospital-setting-incidence-characteristics-and-management
#2
Emily Andrew, Ziad Nehme, Stephen Bernard, Karen Smith
OBJECTIVE: Although hospital presentations for pediatric anaphylaxis have been described in the literature, a minimal amount is known regarding the incidence, characteristics, and management of pediatric anaphylaxis presenting to emergency medical services (EMS). METHODS: We performed a retrospective observational study of pediatrics (≤16 years) presenting to EMS in Victoria, Australia. Patients with suspected anaphylaxis were included if they were treated with epinephrine before or after EMS arrival...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29338483/reply-to-prehospital-intubation-further-confounders-in-trial-results
#3
Tomas Nuño, Kurt R Denninghoff, Qi Pauls, Sharon D Yeatts, Robert Silbergleit, Yuko Y Palesch, Lisa H Merck, Geoff Manley, David W Wright
No abstract text is available yet for this article.
January 17, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29297718/evaluation-of-physiologic-alterations-during-prehospital-paramedic-performed-rapid-sequence-intubation
#4
Robert G Walker, Lynn J White, Geneva N Whitmore, Alexander Esibov, Michael K Levy, Gregory C Cover, Joel D Edminster, James M Nania
OBJECTIVE: Physiologic alterations during rapid sequence intubation (RSI) have been studied in several emergency airway management settings, but few data exist to describe physiologic alterations during prehospital RSI performed by ground-based paramedics. To address this evidence gap and provide guidance for future quality improvement initiatives in our EMS system, we collected electronic monitoring data to evaluate peri-intubation vital signs changes occurring during prehospital RSI...
January 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29258783/air-versus-ground-transportation-in-isolated-severe-head-trauma-a-national-trauma-data-bank-study
#5
Alberto Aiolfi, Elizabeth Benjamin, Gustavo Recinos, Alejandro De Leon Castro, Kenji Inaba, Demetrios Demetriades
BACKGROUND: The effect of prehospital helicopter emergency medical services (HEMS) on mortality has been analyzed previously in polytrauma patients with discordant results. OBJECTIVE: Our aim was to compare outcomes in patients with isolated severe blunt traumatic brain injuries (TBIs) transported by HEMS or ground emergency medical services (GEMS). METHODS: We conducted a National Trauma Data Bank study (2007-2014). All adult patients (≥16 years old) who sustained an isolated severe blunt TBI and were transported by HEMS or GEMS were included in the study...
December 16, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29239965/videolaryngoscopy-for-physician-based-prehospital-emergency-intubation-a-prospective-randomized-multicenter-comparison-of-different-blade-types-using-a-p-advance-c-mac-system-and-kingvision
#6
Erol Cavus, Sebastian Janssen, Florian Reifferscheid, Amke Caliebe, Andreas Callies, Martin von der Heyden, Peer G Knacke, Volker Doerges
BACKGROUND: Videolaryngoscopy is a valuable technique for endotracheal intubation. When used in the perioperative period, different videolaryngoscopes vary both in terms of technical use and intubation success rates. However, in the prehospital environment, the relative performance of different videolaryngoscopic systems is less well studied. METHODS: We conducted this prospective, randomized, multicenter study at 4 German prehospital emergency medicine centers...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29229538/association-of-prehospital-intubation-with-decreased-survival-among-pediatric-trauma-patients-in-iraq-and-afghanistan
#7
Steven G Schauer, Jason F Naylor, Guyon J Hill, Allyson A Arana, Jamie L Roper, Michael D April
INTRODUCTION: Airway compromise is the second leading cause of preventable death on the battlefield among US military casualties. Airway management is an important component of pediatric trauma care. Yet, intubation is a challenging skill with which many prehospital providers have limited pediatric experience. We compare mortality among pediatric trauma patients undergoing intubation in the prehospital setting versus a fixed-facility emergency department. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric encounters in Iraq and Afghanistan from January 2007 to January 2016...
December 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29178953/video-laryngoscopy-does-not-improve-the-intubation-outcomes-in-emergency-and-critical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
Jia Jiang, Danxu Ma, Bo Li, Yun Yue, Fushan Xue
BACKGROUND: There is significant controversy regarding the influence of video laryngoscopy on the intubation outcomes in emergency and critical patients. This systematic review and meta-analysis was designed to determine whether video laryngoscopy could improve the intubation outcomes in emergency and critical patients. METHODS: We searched the Cochrane Central Register of Controlled Trials, PubMed, Embase, and Scopus databases from database inception until 15 February 2017...
November 24, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29109872/severe-decompression-illness-case-report-prehospital-recognition-and-regional-transport-considerations
#9
Julie Estrada, David Meurer, Kevin De Boer, Karl Huesgen
A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29108735/emergency-department-patient-burden-from-an-electronic-dance-music-festival
#10
Neeraj Chhabra, Renee P Gimbar, Lisa M Walla, Trevonne M Thompson
BACKGROUND: Electronic dance music (EDM) festivals are increasingly common and psychoactive substance use is prevalent. Although prehospital care can obviate the transfer of many attendees to health care facilities (HCFs), little is known regarding the emergency department (ED) burden of patients presenting from EDM festivals. OBJECTIVES: This study describes the patient volume, length of stay (LOS), and presenting complaints of patients from a 3-day EDM festival in close proximity to an area ED...
November 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29100652/team-focused-cardiopulmonary-resuscitation-prehospital%C3%A2-principles-adapted-for-emergency-department%C3%A2-cardiac%C3%A2-arrest-resuscitation
#11
Blake Johnson, Michael Runyon, Anthony Weekes, David Pearson
BACKGROUND: Out-of-hospital cardiac arrest has high rates of morbidity and mortality, and a growing body of evidence is redefining our approach to the resuscitation of these high-risk patients. OBJECTIVES: Team-focused cardiopulmonary resuscitation (TFCPR), most commonly deployed and described by prehospital care providers, is a focused approach to cardiac arrest care that emphasizes early defibrillation and high-quality, minimally interrupted chest compressions while de-emphasizing endotracheal intubation and intravenous drug administration...
January 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29096887/definitive-airway-management-after-prehospital-supraglottic-rescue-airway-in-pediatric-trauma
#12
Matthew C Hernandez, Ryan M Antiel, Karthik Balakrishnan, Martin D Zielinski, Denise B Klinkner
INTRODUCTION: Supraglottic airway (SGA) use and outcomes in pediatric trauma are poorly understood. We compared outcomes between patients receiving prehospital SGA versus bag mask ventilation (BVM). METHODS: We reviewed pediatric multisystem trauma patients (2005-2016), comparing SGA and BVM. Primary outcome was adequacy of oxygenation and ventilation. Additional measures included tracheostomy, mortality and abbreviated injury scores (AIS). RESULTS: Ninety patients were included (SGA, n=17 and BVM, n=73)...
October 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29096666/prehospital-prognosis-is-difficult-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#13
Katrine P Lindvig, Anne C Brøchner, Annmarie T Lassen, Søren Mikkelsen
BACKGROUND: Patients with acute exacerbation of chronic obstructive pulmonary disease often require prehospital emergency treatment. This enables patients who are less ill to be treated on-site and to avoid hospital admission, while severely ill patients can receive immediate ventilatory support in the form of intubation. The emergency physician faces difficult treatment decisions, however, and prognostic tools that could assist in determining which patients would benefit from intubation and ventilator support would be helpful...
November 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29055890/utility-of-prehospital-electrocardiogram-characteristics-as-prognostic-markers-in-out-of-hospital-pulseless-electrical-activity-arrests
#14
Michael L Ho, Mathieu Gatien, Christian Vaillancourt, Veronica Whitham, Ian G Stiell
BACKGROUND: It is unclear if there are predictors of survival, including ECG characteristics, that can guide resuscitative efforts in pulseless electrical activity (PEA) cardiac arrests. We studied the predictive potential of presenting prehospital ECGs on survival for patients with out-of-hospital cardiac arrest (OHCA) with PEA. METHODS: We studied prehospital ECGs of patients with OHCA prospectively enrolled between June 2007 and November 2009 at the Ottawa/OPALS (Ontario Prehospital Advanced Life Support Study) site of the Resuscitation Outcomes Consortium PRIMED study (Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis)...
October 21, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29033344/a-prospective-study-of-ketamine-as-primary-therapy-for-prehospital-profound-agitation
#15
Jon B Cole, Lauren R Klein, Paul C Nystrom, Johanna C Moore, Brian E Driver, Brandon J Fryza, Justin Harrington, Jeffrey D Ho
OBJECTIVE: We investigated the effectiveness of ketamine as a primary therapy for prehospital profound agitation. METHODS: This was a prospective observational study of patients receiving 5mg/kg of intramuscular ketamine for profound agitation, defined as a score of +4 on the Altered Mental Status Scale (AMSS), a validated ordinal scale of agitation from -4 (unresponsive) to +4 (most agitated). The primary outcome was time to adequate sedation (AMSS<+1). Secondary outcomes included need for additional sedatives, intubation frequency, complications associated with ketamine, and mortality...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28975883/prehospital-interventions-before-and-after-implementation-of-a-physician-staffed-helicopter
#16
Asger Sonne, Sandra Wulffeld, Jacob Steinmetz, Lars S Rasmussen, Rasmus Hesselfeldt
INTRODUCTION: Implementation of a physician-staffed helicopter emergency medical service (HEMS) in eastern Denmark was associated with increased survival for severely injured patients. This study aimed to assess the potential impact of advanced prehospital interventions by comparing the proportion of patients who received those interventions before and after the HEMS implementation. METHODS: A post-hoc analysis of a prospective before-after study. We included trauma patients with Injury Severity Scores above three who had been admitted to seven emergency departments or one level 1 trauma centre in the course of a five-month period before and a 12-month period after the HEMS implementation...
October 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28934985/factors-influencing-on-scene-time-in-a-rural-norwegian-helicopter-emergency-medical-service-a-retrospective-observational-study
#17
Øyvind Østerås, Jon-Kenneth Heltne, Bjørn-Christian Vikenes, Jörg Assmus, Guttorm Brattebø
BACKGROUND: Critically ill patients need to be immediately identified, properly managed, and rapidly transported to definitive care. Extensive prehospital times may increase mortality in selected patient groups. The on-scene time is a part of the prehospital interval that can be decreased, as transport times are determined mostly by the distance to the hospital. Identifying factors that affect on-scene time can improve training, protocols, and decision making. Our objectives were to assess on-scene time in the Helicopter Emergency Medical Service (HEMS) in our region and selected factors that may affect it in specific and severe conditions...
September 21, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28927951/definitive-airway-management-after-pre-hospital-supraglottic-airway-insertion-outcomes-and-a-management-algorithm-for-trauma-patients
#18
Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski, Scott P Zietlow, Brian D Kim, David S Morris
BACKGROUND: Prehospital airway management increasingly involves supraglottic airway insertion and a paucity of data evaluates outcomes in trauma populations. We aim to describe definitive airway management in traumatically injured patients who necessitated prehospital supraglottic airway insertion. METHODS: We performed a single institution retrospective review of multisystem injured patients (≥15years) that received prehospital supraglottic airway insertion during 2009 to 2016...
September 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28898557/improved-survival-for-rural-trauma-patients-transported-by-helicopter-to-a-verified-trauma-center-a-propensity-score-analysis
#19
Thein Hlaing Zhu, Lisa Hollister, Dazar Opoku, Samuel M Galvagno
OBJECTIVES: Recent studies using advanced statistical methods to control for confounders have demonstrated an association between helicopter transport (HT) versus ground ambulance transport (GT) in terms of improved survival for adult trauma patients. The aim of this study was to apply a methodologically vigorous approach to determine if HT is associated with a survival benefit for when trauma patients are transported to a verified trauma center in a rural setting. METHODS: The ascertainment of trauma patients age ≥ 15 years (n = 469 cases) by HT and (n = 580 cases) by GT between 1999 and 2012 was restricted to the scene of injury in a rural area of 10 to 35 miles from the trauma center...
September 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28863949/impact-of-rapid-response-car-system-on-extracorporeal-life-support-in-out-of-hospital-cardiac-arrest-a-retrospective-cohort-study
#20
Ryota Sato, Akira Kuriyama, Michitaka Nasu, Shinnji Gima, Wataru Iwanaga, Tadaaki Takada, Yusuke Kitahara, Hideto Fukui, Terutake Yonemori, Masaharu Yagi
INTRODUCTION: Extracorporeal life support (ECLS) has been reported to be more effective than conventional cardiopulmonary resuscitation (CPR). In ECLS, a shorter time from arrival to implantation of extracorporeal membrane oxygenation (ECMO; door-to-ECMO) time was predicted to be associated with better survival rates. This study aimed to examine the impact of the physician-based emergency medical services (P-EMS) using a rapid response car (RRC) on door-to-ECMO time in patients with out-of-hospital cardiac arrest (OHCA)...
August 29, 2017: American Journal of Emergency Medicine
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