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Prehospital AND intubation

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https://www.readbyqxmd.com/read/27903839/the-effect-of-brain-tomography-findings-on-mortality-in-sniper-shot-head-injuries
#1
Çağdaş Can, M Bolatkale, A Sarıhan, Y Savran, A Ç Acara, M Bulut
OBJECTIVES: Penetrating gunshot head injuries have a poor prognosis and require prompt care. Brain CT is a routine component of the standard evaluation of head wounds and suspected brain injury. We aimed to investigate the effect of brain CT findings on mortality in gunshot head injury patients who were admitted to our emergency department (ED) from the Syrian Civil War. METHODS: The study group comprised patients who were admitted to the ED with gunshot brain injury...
November 30, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27894561/apneic-oxygenation-may-not-prevent-severe-hypoxemia-during-rapid-sequence-intubation-a-retrospective-helicopter-emergency-medical-service-study
#2
Sattha Riyapan, Jeffrey Lubin
OBJECTIVE: This study sought to determine the effectiveness of apneic oxygenation in preventing hypoxemia during prehospital rapid sequence intubation (RSI). METHODS: We performed a case-cohort study using a pre-existing database looking at intubation management by a single helicopter emergency medical service between July 2013 and June 2015. Apneic oxygenation using high-flow nasal cannula (15 L/min) was introduced to the standard RSI protocol in July 2014. Severe hypoxemia was defined as an incidence of oxygen saturation less than 90%...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27870588/assessment-of-paramedic-performance-on-difficult-airway-simulation
#3
Ashish R Panchal, Geoffrey Finnegan, David P Way, Thomas Terndrup
OBJECTIVE: Airway management is a common, important intervention for critically ill patients in the United States. A key element of prehospital airway management is endotracheal intubation (ETI). Prehospital ETI success rates have been shown to be as low as 77% compared to in-hospital rates of 95%. Given these rates, the use of backup airway devices is a necessary precaution for patient safety. The extent to which paramedics integrate backup airway use into their airway algorithm is unknown...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27863722/is-nasotracheal-intubation-safe-in-facial-trauma-patients
#4
Omeed Payam Jazayeri-Moghaddas, Wayne Tse, Karen A Herzing, Ronald J Markert, Alyssa J Gans, Mary C McCarthy
BACKGROUND: In the prehospital setting, oral intubation is preferred in facial trauma patients due to the potential for further injury during nasotracheal intubation. This study compared the complications of nasal vs. oral vs. nasal + oral intubations performed by first responder crews in facial trauma patients. Our objective was to assess patient outcomes and complications to determine the risk of nasal intubation in facial trauma patients in the prehospital setting. METHODS: Patients with facial trauma between 2008 and 13 were abstracted from the Miami Valley Hospital trauma registry: 50 were nasal only (n), 27 nasal + oral (no), and 135 oral only (o) intubation...
November 8, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27856146/early-neurological-wake-up-test-in-intubated-brain-injured-patients-a-long-term-single-centre-experience
#5
Pierre Esnault, Ambroise Montcriol, Erwan D'Aranda, Julien Bordes, Philippe Goutorbe, Henry Boret, Eric Meaudre
BACKGROUND: In prehospital setting, a severe traumatic brain injury (TBI) requires tracheal intubation, sedation and mechanical ventilation pending the initial imagery. An early neurological wake-up test (ENWT), soon after the initial imaging assessment, allows a rapid neurological reassessment. This strategy authorises an initial clinical examination of reference with which will be compared the later examinations. The main objective of this study was to describe the characteristics of the patients who underwent an ENWT, and to determine its causes of failure...
November 14, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27846895/development-and-validation-of-a-prehospital-prediction-model-for-acute-traumatic-coagulopathy
#6
Ithan D Peltan, Ali Rowhani-Rahbar, Lisa K Vande Vusse, Ellen Caldwell, Thomas D Rea, Ronald V Maier, Timothy R Watkins
BACKGROUND: Acute traumatic coagulopathy (ATC) is a syndrome of early, endogenous clotting dysfunction that afflicts up to 30% of severely injured patients, signaling an increased likelihood of all-cause and hemorrhage-associated mortality. To aid identification of patients within the likely therapeutic window for ATC and facilitate study of its mechanisms and targeted treatment, we developed and validated a prehospital ATC prediction model. METHODS: Construction of a parsimonious multivariable logistic regression model predicting ATC - defined as an admission international normalized ratio >1...
November 16, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27844474/assessment-of-acute-pain-in-trauma-a-retrospective-prehospital-evaluation
#7
Stine Hebsgaard, Anne Mannering, Stine T Zwisler
OBJECTIVE: To elucidate pain treatment with analgesics in a prehospital trauma population. DESIGN: Retrospective database study. SETTING: Prehospital data from the anesthesiologist-manned Mobile Emergency Care Unit (MECU) in Odense, Denmark, were extracted and subjected to analysis. PATIENTS: During the period of January 1, 2013 to December 31, 2014, patients with the diagnoses "unspecified multiple injuries," "examination and observation following traffic accident," "examination and observation following other accident," and "commotio cerebri" were included in the analysis...
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27775982/evaluating-pre-burn-center-intubation-practices-an-update
#8
Anthony R Cai, Erica I Hodgman, Puneet B Kumar, Alvand J Sehat, Alexander L Eastman, Steven E Wolf
A significant proportion of patients appeared to arrive at our American Burn Association-verified burn center intubated without clear benefit. The current study aims to evaluate regional prehospital intubation practices and their outcomes. All consecutive admissions from November 2012 to June 2014 were reviewed for data points associated with intubation. Demographics and outcomes for patients who were intubated before arrival or within 24 hours of admission were compared using χ, Fisher's exact test, and the Kruskal-Wallis test as appropriate...
October 17, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27755079/performance-of-glidescope-ranger-video-laryngoscope-for-prehospital-emergency-intubation
#9
Fu Shan Xue, Gui Zhen Yang, Chao Sun
No abstract text is available yet for this article.
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27724976/prehospital-treatment-with-continuous-positive-airway-pressure-in-patients-with-acute-respiratory-failure-a-regional-observational-study
#10
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/27700196/pediatric-blunt-neck-trauma-causing-esophageal-and-complete-tracheal-transection
#11
Benjamin Nicholson, Harinder Dhindsa, Louis Seay
BACKGROUND: Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources. CASE SUMMARY: The case presented here involves a clothesline injury to a pediatric patient that resulted in complete tracheal transection and partial esophageal transection...
October 4, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27699989/prehospital-ketamine-use-by-paramedics-in-the-australian-capital-territory-a-12-month-retrospective-analysis
#12
Gregory J Hollis, Toby M Keene, Rory M Ardlie, David Ge Caldicott, Stuart G Stapleton
OBJECTIVE: The aim of this study was to describe prehospital use of ketamine by ACT Ambulance Service, and frequency of endotracheal intubation. METHODS: This was a retrospective study of patients receiving prehospital ketamine between 1 January and 31 December 2013. Episodes were identified from the prehospital electronic patient care records, then linkage to ED records at two receiving hospitals. Demographics, dose, indication and occasions of intubation were analysed...
October 3, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27694275/effect-of-cricoid-pressure-on-laryngeal-view-during-prehospital-tracheal-intubation-a-propensity-based-analysis
#13
Emmanuel Caruana, Sylvie Chevret, Romain Pirracchio
BACKGROUND: The benefit of cricoid pressure during tracheal intubation is still debated and, due to its potential negative impact on laryngeal views, its routine use is questioned. The goal of this study was to estimate its impact on laryngeal view. METHODS: All patients intubated in the prehospital setting were included. Three different propensity score (PS) models were used and compared in terms of the balance achieved between those patients who received cricoid pressure and those who did not...
September 30, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27690714/can-ems-providers-provide-appropriate-tidal-volumes-in-a-simulated-adult-sized-patient-with-a-pediatric-sized-bag-valve-mask
#14
Jeffrey Siegler, Melissa Kroll, Susan Wojcik, Hawnwan Philip Moy
INTRODUCTION: In the prehospital setting, Emergency Medical Services (EMS) professionals rely on providing positive pressure ventilation with a bag-valve-mask (BVM). Multiple emergency medicine and critical care studies have shown that lung-protective ventilation protocols reduce morbidity and mortality. Our primary objective was to determine if a group of EMS professionals could provide ventilations with a smaller BVM that would be sufficient to ventilate patients. Secondary objectives included 1) if the pediatric bag provided volumes similar to lung-protective ventilation in the hospital setting and 2) compare volumes provided to the patient depending on the type of airway (mask, King tube, and intubation)...
October 3, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27650719/tracheal-malplacement-of-the-king-lt-airway-may-be-an-important-cause-of-prehospital-device-failure
#15
Brian E Driver, David Plummer, William Heegaard, Robert F Reardon
BACKGROUND: The King LT airway (King Systems, Noblesville, IN) is a popular extraglottic device that is widely used in the prehospital setting. We report a case of tracheal malplacement of the King airway with a severe kink in the distal tube. CASE REPORT: A 51-year-old unhelmeted motorcyclist collided with a freeway median and was obtunded when paramedics arrived. After bag mask ventilation, a King airway was placed uneventfully and the patient was transported to the emergency department...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27646281/collective-review-of-the-status-of-rapid-sequence-intubation-drugs-of-choice-in-trauma-in-low-and-middle-income-settings-prehospital-emergency-department-and-operating-room-setting
#16
Leressè Pillay, Timothy Hardcastle
INTRODUCTION: Establishing a definitive airway in order to ensure adequate ventilation and oxygenation is an important aspect of resuscitation of the polytrauma patient . AIM: To review the relevant literature that compares the different drugs used for rapid sequence intubation (RSI) of trauma patients, specifically reviewing: premedication, induction agents and neuromuscular blocking agents across the prehospital, emergency department and operating room setting, and to present the best practices based on the reviewed evidence...
September 19, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27640730/intubation-of-profoundly-agitated-patients-treated-with-prehospital-ketamine
#17
Travis D Olives, Paul C Nystrom, Jon B Cole, Kenneth W Dodd, Jeffrey D Ho
BACKGROUND: Profound agitation in the prehospital setting confers substantial risk to patients and providers. Optimal chemical sedation in this setting remains unclear. OBJECTIVE: The goal of this study was to describe intubation rates among profoundly agitated patients treated with prehospital ketamine and to characterize clinically significant outcomes of a prehospital ketamine protocol. METHODS: This was a retrospective cohort study of all patients who received prehospital ketamine, per a predefined protocol, for control of profound agitation and who subsequently were transported to an urban Level 1 trauma center from May 1, 2010 through August 31, 2013...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27637440/the-effect-of-prehospital-intubation-on-treatment-times-in-patients-with-suspected-traumatic-brain-injury
#18
Joshua D Lansom, Kate Curtis, Helen Goldsmith, Alex Tzannes
OBJECTIVE: This study examines whether, in patients requiring intubation with moderate to severe traumatic brain injury (TBI), prehospital intubation compared with emergency department intubation leads to a reduction in treatment times and time to a computed tomographic (CT) scan. METHODS: A retrospective cohort study compared adult patients with a Glasgow Coma Score of less than 14 with a suspected TBI who underwent intubation, either prehospital or on arrival to the emergency department...
September 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27625734/determinants-of-success-and-failure-in-prehospital-endotracheal-intubation
#19
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/27567923/prehospital-intubation-for-isolated-severe-blunt-traumatic-brain-injury-worse-outcomes-and-higher-mortality
#20
Tobias Haltmeier, Elizabeth Benjamin, Stefano Siboni, Evren Dilektasli, Kenji Inaba, Demetrios Demetriades
PURPOSE: Prehospital endotracheal intubation (ETI) for traumatic brain injury (TBI) is a controversial issue. The aim of this study was to investigate the effect of prehospital ETI in patients with TBI. METHODS: Cohort-matched study using the US National Trauma Data Bank (NTDB) 2008-2012. Patients with isolated severe blunt TBI (AIS head ≥3, AIS chest/abdomen <3) and a field GCS ≤8 were extracted from NTDB. A 1:1 matching of patients with and without prehospital ETI was performed...
August 27, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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