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https://www.readbyqxmd.com/read/28500463/comparison-of-four-different-intraosseous-access-devices-during-simulated-pediatric-resuscitation-a-randomized-crossover-manikin-trial
#1
Karol Bielski, Lukasz Szarpak, Jacek Smereka, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
The aim of the study was to compare the success rate, procedure time, and user satisfaction of pediatric NIO™ compared to Pediatric BIG®, EZ-IO®, and Jamshidi intraosseous access devices. This was a randomized, crossover manikin trial with 87 paramedics. The correct location of intraosseous access when using NIO, BIG, EZ-IO, and Jamshidi was varied and was respectively 100, 90, 90, and 90%. The time required to obtain intravascular access (time T1) in the case of NIO, BIG, EZ-IO, and Jamshidi was varied and amounted to 9 s [IQR, 8-12] for NIO, 12 s [IQR, 9-16] for BIG, 13...
May 12, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28460858/analysis-of-out-of-hospital-pediatric-intubation-by%C3%A2-an-australian-helicopter-emergency-medical%C3%A2-service
#2
Brian J Burns, Joanna B Watterson, Sandra Ware, Luke Regan, Cliff Reid
STUDY OBJECTIVE: We examine first-look success in emergency pediatric intubation by a physician-staffed helicopter emergency medical service (EMS). METHODS: A database analysis of all pediatric (<16 years) intubations during a 64-month period was undertaken, using data from a prospectively enrolled electronic airway registry form. Recorded findings included patient demographics, operator background, airway intervention including intubation attempts, complications, and critical timings...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28433454/a-randomized-comparison-of-three-chest-compression-techniques-and-associated-hemodynamic-effect-during-infant-cpr-a-randomized-manikin-study
#3
Jacek Smereka, Lukasz Szarpak, Antonio Rodríguez-Núñez, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#4
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
April 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28395992/does-transport-time-of-out-of-hospital-cardiac-arrest-patients-matter-a-systematic-review-and-meta-analysis
#5
REVIEW
Guillaume Geri, Joshua Gilgan, Wen Wu, Sandy Vijendira, Carolyn Ziegler, Ian R Drennan, Laurie Morrison, Steve Lin
BACKGROUND: Despite increasing evidence for specialized cardiac arrest centers, the impact of transport time on out-of-hospital cardiac arrest (OHCA) patients' outcome remains unclear. We systematically reviewed the prognostic impact of transport time in OHCA patients. METHODS: We searched PubMed, Embase, the Cochrane Library, and Web of Science from inception to May 2016 for studies that had reported the relationship between transport time and outcome in OHCA patients...
April 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28257249/pediatric-prehospital-medication-dosing-errors-a-national-survey-of-paramedics
#6
John D Hoyle, Remle P Crowe, Melissa A Bentley, Gerald Beltran, William Fales
BACKGROUND: Pediatric drug dosing errors occur at a high rate in the prehospital environment. OBJECTIVE: To describe paramedic training and practice regarding pediatric drug administration, exposure to pediatric drug dose errors and safety culture among paramedics and EMS agencies in a national sample. METHODS: An electronic questionnaire was sent to a random sample of 10,530 nationally certified paramedics. Descriptive statistics were calculated...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28235958/prehospital-emergency-care-in-childhood-arterial-ischemic-stroke
#7
Belinda Stojanovski, Paul T Monagle, Ian Mosley, Leonid Churilov, Fiona Newall, Grant Hocking, Mark T Mackay
BACKGROUND AND PURPOSE: Immediately calling an ambulance is the key factor in reducing time to hospital presentation for adult stroke. Little is known about prehospital care in childhood arterial ischemic stroke (AIS). We aimed to determine emergency medical services call-taker and paramedic diagnostic sensitivity and to describe timelines of care in childhood AIS. METHODS: This is a retrospective study of ambulance-transported children aged <18 years with first radiologically confirmed AIS, from 2008 to 2015...
February 24, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28163912/the-benefits-of-youth-are-lost-on-the-young-cardiac-arrest-patient
#8
REVIEW
Brian Griffith, Patrick Kochanek, Cameron Dezfulian
Children and young adults tend to have reduced mortality and disability after acquired brain injuries such as trauma or stroke and across other disease processes seen in critical care medicine. However, after out-of-hospital cardiac arrest (OHCA), outcomes are remarkably similar across age groups. The consistent lack of witnessed arrests and a high incidence of asphyxial or respiratory etiology arrests among pediatric and young adult patients with OHCA account for a substantial portion of the difference in outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28057478/developments-in-ambulatory-surgery-in-orthopedics-in-france-in-2016
#9
REVIEW
C Hulet, G Rochcongar, C Court
Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives...
February 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27918863/ems-providers-beliefs-regarding-spinal-precautions-for-pediatric-trauma-transport
#10
Cindy D Chang, Remle P Crowe, Melissa A Bentley, Alyssa R Janezic, Julie C Leonard
OBJECTIVE: Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. METHODS: We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors. RESULTS: We received 5,400 responses (17%)...
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27858502/prehospital-providers-perceptions-on-providing-patient-and-family-centered-care
#11
Emily M Ayub, Esther M Sampayo, Manish I Shah, Cara B Doughty
BACKGROUND: A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. METHODS: We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27749145/pediatric-disaster-triage-multiple-simulation-curriculum-improves-prehospital-care-providers-assessment-skills
#12
Mark Xavier Cicero, Travis Whitfill, Frank Overly, Janette Baird, Barbara Walsh, Jorge Yarzebski, Antonio Riera, Kathleen Adelgais, Garth D Meckler, Carl Baum, David Christopher Cone, Marc Auerbach
OBJECTIVE: Paramedics and emergency medical technicians (EMTs) triage pediatric disaster victims infrequently. The objective of this study was to measure the effect of a multiple-patient, multiple-simulation curriculum on accuracy of pediatric disaster triage (PDT). METHODS: Paramedics, paramedic students, and EMTs from three sites were enrolled. Triage accuracy was measured three times (Time 0, Time 1 [two weeks later], and Time 2 [6 months later]) during a disaster simulation, in which high and low fidelity manikins and actors portrayed 10 victims...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27690289/emergency-medical-dispatchers-can-obtain-accurate-pediatric-weights-from-9-1-1-callers
#13
Todd Chassee, Diann Reischmann, Michael Mancera, John D Hoyle
BACKGROUND: Prehospital pediatric drug dosing errors affect 56,000 U.S. children annually. An accurate weight is the first step in accurate dosing. To date, the accuracy of Emergency Medical Dispatcher (EMD) obtained weights has not been evaluated. We hypothesized that EMD could obtain accurate pediatric weights. METHODS: We used a convenience sample of patients 12 years and younger that were transported by EMS to one children's hospital. EMD obtained patient weight (DW) from the 9-1-1 caller...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27547282/geospatial-and-clinical-analyses-on-pediatric-related-road-traffic-injury-in-malaysia
#14
Nik Hisamuddin Rahman, Ruslan Rainis, Syed Hatim Noor, Sharifah Mastura Syed Mohamad
BACKGROUND: The main aim of this study is to utilize the geographical information system (GIS) software and perform the spatial analysis in relation to clinical data for road traffic injury (RTI) pediatric cases attending the emergency department. METHODS: The study sample included pediatric patients (age less than 18 years) with road-related injuries within a district in Malaysia who attended emergency departments of two tertiary hospitals within the district. In addition to injury, pre-hospital care and outcome data, the coordinate of the locations were obtained by the ambulance paramedics by using portable handheld GPS unit brand Garmin(®) model GPS 72 H...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27505717/frequency-composition-and-predictors-of-in-transit-critical-events-during-pediatric-critical-care-transport
#15
Jeffrey M Singh, Anna C Gunz, Sonny Dhanani, Mahvareh Aghari, Russell D MacDonald
OBJECTIVES: Transport of pediatric patients is common due to healthcare regionalization. We set out to determine the frequency of in-transit critical events during pediatric critical care transport and identify factors associated with these events. DESIGN: Retrospective cohort study using administrative and clinical data. SETTING: Single pediatric critical care transport provider in Ontario, Canada. PATIENTS: All pediatric care transports between January 1, 2005, and December 31, 2010...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27483523/role-1-pediatric-trauma-care-on-the-israeli-syrian-border-first-year-of-the-humanitarian-effort
#16
Yuval Bitterman, Avi Benov, Elon Glassberg, Alexandra Satanovsky, Tarif Bader, Ram Sagi
BACKGROUND: This article summarizes the experience with Role 1 care for 135 Syrian children who received medical care during the year 2013 as part of an ongoing humanitarian effort. METHODS: The database included demographic information, point-of-injury assessment and outcome, and was analyzed using SPSS. RESULTS: Trauma casualties were the majority of the group (84 cases), and mostly male. Almost one-third of casualties arrived more than 6 hours after injury, and time of injury was unknown in another third...
August 2016: Military Medicine
https://www.readbyqxmd.com/read/27350111/-pedagogic-focus-group-in-pediatrics
#17
E Merlin, A Chausset, M Verdan, B Cambon, C Sarret, J Kanold, J Chazal, A Labbé
AIM: To assess a new behavioral teaching technique called "focus group pedagogy" (FGP), which consists in a three-step meeting between sick children's parents and medical students (first with students alone, then with parents and students together, then with students alone). METHODS: This qualitative research ran two sessions (each totaling four to six parents and six students) in which parents were questioned on four main themes: their knowledge of the medical hierarchy, their ability to identify the people in the hospital, their communication with medical staff, and the overall care delivered to their children...
August 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27253653/pediatric-airway-management-and-prehospital-patient-safety-results-of-a-national-delphi-survey-by-the-children-s-safety-initiative-emergency-medical-services-for-children
#18
Matthew Hansen, Garth Meckler, Kerth OʼBrien, Phillip Engle, Caitlin Dickinson, Kathryn Dickinson, Jonathan Jui, William Lambert, Erika Cottrell, Jeanne-Marie Guise
OBJECTIVE: The objective of this study was to determine what aspects of prehospital pediatric airway management may contribute to patient safety events. METHODS: We conducted a 3-phase Delphi survey in prehospital professionals across the United States to identify potential contributors to patient safety events. Respondents ranked how likely factors were to contribute on a 9-point Likert-type scale and were allowed to elaborate through open-ended questions. Analysis was conducted using a mixed-methods approach, including Likert-type responses and open-ended questions which were analyzed for specific themes...
September 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27217077/prevalence-of-unique-pediatric-pathologies-encountered-by-paramedic-students-across-age-groups
#19
Eric V Ernest, Tom B Brazelton, Elliot D Carhart, Jonathan R Studnek, Patricia L Tritt, Genghis A Philip, Aaron M Burnett
UNLABELLED: Introduction Traditionally, Emergency Medical Services (EMS) educators have divided the pediatric population into age groups to assist in targeting their clinical and didactic curriculum. Currently, the accrediting body for paramedic training programs requires student exposure to pediatric patients based entirely on age without specifying exposure to specific pathologies within each age stratification. Identifying which pathologies are most common within the different pediatric age groups would allow educators to design curriculum targeting the most prevalent pathologies in each age group and incorporating the physiologic and psychological developmental milestones commonly seen at that age...
August 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/26953677/impact-of-high-fidelity-pediatric-simulation-on-paramedic-seizure-management
#20
Manish I Shah, John M Carey, Sarah E Rapp, Marina Masciale, Wendy B Alcanter, Juan A Mondragon, Elizabeth A Camp, Samuel J Prater, Cara B Doughty
BACKGROUND: A simulation-based course, Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPs), was developed to optimize pediatric prehospital care. Seizures are common in Emergency Medical Services (EMS), and no studies have evaluated pediatric outcomes after EMS simulation training. OBJECTIVES: The primary objective was to determine if PediSTEPPs enhances seizure protocol adherence in blood glucose measurement and midazolam administration for seizing children...
July 2016: Prehospital Emergency Care
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