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Prehospital life support

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https://www.readbyqxmd.com/read/30106867/pediatric-transport-practices-among-prehospital-providers
#1
G Anthony Fidacaro, Christopher W Jones, Lisa A Drago
OBJECTIVE: There are nearly 1000 annual ambulance crashes within the United States involving pediatric patients. In 2012 National Highway Traffic Safety Administration/US Department of Transportation released Best-Practice Recommendations for the Safe Transportation of Children in Emergency Ground Ambulances. The aim of our study was to measure emergency medical services (EMS) providers' knowledge and opinions of how to safely transport pediatric patients. In addition, we aimed to gather information on barriers to safe pediatric transport...
August 13, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/30044053/epidemiology-of-trauma-patients-attended-by-ambulance-paramedics-in-perth-western-australia
#2
Elizabeth Brown, Teresa A Williams, Hideo Tohira, Paul Bailey, Judith Finn
OBJECTIVE: The aim of the study was to describe the epidemiology of trauma in adult patients attended by ambulance paramedics in Perth, Western Australia. METHODS: A retrospective cohort study of trauma patients aged ≥16 years attended by St John Ambulance Western Australia (SJA-WA) paramedics in greater metropolitan Perth between 2013 and 2016 using the SJA-WA database and WA death data. Incidence and 30 day mortality rates were calculated. Patients who died prehospital (immediate deaths), on the day of injury (early deaths), within 30 days (late deaths) and those who survived longer than 30 days (survivors) were compared for age, sex, mechanism of injury and acuity level...
July 25, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/30001817/prehospital-advanced-cardiac-life-support-by-emt-with-a-smartphone-based-direct-medical-control-for-nursing-home-cardiac-arrest
#3
Changsun Kim, Hyuk Joong Choi, Hyungjun Moon, Giwoon Kim, Choungah Lee, Jin Sung Cho, Seongjung Kim, Kyoungmi Lee, Hanjoo Choi, Wonjung Jeong
OBJECTIVE: To compare the survival to discharge between nursing home (NH) cardiac arrest patients receiving smartphone-based advanced cardiac life support (SALS) and basic life support (BLS). METHODS: The SALS registry includes data on cardiac arrest from 7 urban and suburban areas in Korea between July 2015 and December 2016. We include adult patients (>18) with out-of-hospital cardiac arrest (OHCA) of medical causes and EMS attended and dispatched in. SALS is an advanced field resuscitation including drug administration by paramedics with video communication-based direct medical direction...
July 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29914554/prehospital-point-of-care-emergency-ultrasound-a-cohort-study
#4
Maximilian Scharonow, Christian Weilbach
BACKGROUND: In the prehospital situation, the diagnostic armamentarium available to the rescue physician is limited. Emergency ultrasound has proven to be a useful diagnostic tool, providing crucial information for the management of critically ill and injured patients. The proportion of performed ultrasound scans in all patients attended to by the rescue service team, the quality of the findings and the ultrasound-related changes in management approach and patient transport were evaluated...
June 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29872865/-successful-prehospital-emergency-thoracotomy-after-blunt-thoracic-trauma-case-report-and-lessons-learned
#5
Janosch Dahmen, Marko Brade, Christian Gerach, Martin Glombitza, Jan Schmitz, Simon Zeitter, Eva Steinhausen
BACKGROUND: The European Resuscitation Council guidelines for resuscitation in patients with traumatic cardiac arrest recommend the immediate treatment of all reversible causes, if necessary even prior to continuous chest compression. In the case of cardiac tamponade immediate emergency thoracotomy should also be considered. OBJECTIVE: The authors report the case of a 23-year-old male patient with multiple injuries including blunt thoracic trauma, which caused a witnessed cardiac arrest...
June 5, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29866213/clinical-adverse-events-in-prehospital-patients-with-st-elevation-myocardial-infarction-transported-to-a-percutaneous-coronary-intervention-centre-by-basic-life-support-paramedics-in-a-rural-region
#6
Sylvain Bussières, François Bégin, Pierre-Alexandre Leblanc, Alain Tanguay, Jean-Michel Paradis, Denise Hébert, Richard Fleet
CLINICIAN'S CAPSULE What is known about the topic? ST-elevation myocardial infarction (STEMI) patients transported by ambulance are at risk for adverse events. What did this study ask? What is the impact of transport time on the occurrence of adverse events in the presence of basic life support paramedics? What did this study find? Transport time is not associated with a higher risk of adverse events. Why does this study matter to clinicians? Largest investigation of adverse events in a Canadian cohort of STEMI patients transported by ambulance...
June 5, 2018: CJEM
https://www.readbyqxmd.com/read/29732946/prehospital-trauma-care-among-68-european-neurotrauma-centers-results-of-the-center-tbi-provider-profiling-questionnaires
#7
Maryse C Cnossen, Ruben van der Brande, Hester F Lingsma, Suzanne Polinder, Fiona Lecky, Andrew I R Maas
The first hour following traumatic brain injury (TBI) is considered crucial to prevent death and disability. It is, however, not established yet how the prehospital care should be organized to optimize recovery during the first hour. The objective of the current study was to examine variation in prehospital trauma care across Europe aiming to inform comparative effectiveness analyses on care for neurotrauma patients. A survey on prehospital trauma care was sent to 68 neurotrauma centers from 20 European countries participating in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study...
July 24, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#8
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
June 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29710131/in-blunt-traumatic-cardiac-arrest-does-it-really-matter-who-performs-prehospital-advanced-life-support
#9
Sandra DiBrito, Elliott R Haut
No abstract text is available yet for this article.
June 20, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29710068/association-of-prehospital-advanced-life-support-by-physician-with-survival-after-out-of-hospital-cardiac-arrest-with-blunt-trauma-following-traffic-collisions-japanese-registry-based-study
#10
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Yutaka Kondo, Kei Hayashida, Ichiro Kukita
Importance: Controversy remains as to whether advanced life support (ALS) or basic life support (BLS) is superior for critically ill and injured patients, including out-of-hospital cardiac arrest (OHCA) and major trauma, in the prehospital setting. Objective: To assess whether prehospital ALS should be provided for traumatic OHCA and who should perform it. Design, Setting, and Participants: Japanese government-managed nationwide population-based registry data of patients with OHCA transported to an emergency hospital were analyzed...
June 20, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29690809/factors-that-contribute-to-recovery-of-community-mobility-after-hospitalization-among-community-dwelling-older-adults
#11
Elina U Wells, Courtney P Williams, Richard E Kennedy, Patricia Sawyer, Cynthia J Brown
This study aimed to determine the proportion of older adults who recovered community mobility after hospitalization and identify factors associated with recovery. Using a random sample of 1,000 Medicare beneficiaries ≥65 years of age, we identified individuals with at least one hospitalization over 8.5 years of follow-up. Data were collected at baseline and every 6 months, including demographics, function, social support, community mobility measured by the UAB Life-Space Assessment (LSA), and overnight hospital admissions...
April 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#12
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
May 29, 2018: Circulation
https://www.readbyqxmd.com/read/29669612/prehospital-blood-product-administration-opportunities-in-ground-transport-als-ems-a-descriptive-study
#13
Felicia M Mix, Martin D Zielinski, Lucas A Myers, Kathy S Berns, Anurahda Luke, James R Stubbs, Scott P Zietlow, Donald H Jenkins, Matthew D Sztajnkrycer
IntroductionHemorrhage remains the major cause of preventable death after trauma. Recent data suggest that earlier blood product administration may improve outcomes. The purpose of this study was to determine whether opportunities exist for blood product transfusion by ground Emergency Medical Services (EMS). METHODS: This was a single EMS agency retrospective study of ground and helicopter responses from January 1, 2011 through December 31, 2015 for adult trauma patients transported from the scene of injury who met predetermined hemodynamic (HD) parameters for potential transfusion (heart rate [HR]≥120 and/or systolic blood pressure [SBP]≤90)...
June 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29613954/left-ventricular-compressions-improve-return-of-spontaneous-circulation-and-hemodynamics-in-a-swine-model-of-traumatic-cardiopulmonary-arrest
#14
Kenton L Anderson, Kristin C Fiala, Maria G Castaneda, Susan M Boudreau, Allyson A Araña, Vikhyat S Bebarta
BACKGROUND: Prehospital cardiopulmonary resuscitation, including closed chest compressions, has commonly been considered ineffective in traumatic cardiopulmonary arrest (TCPA) because traditional chest compressions do not produce substantial cardiac output. However, recent evidence suggests that chest compressions located over the left ventricle produce greater hemodynamics when compared to traditional compressions. We hypothesized that chest compressions located directly over the left ventricle would improve return of spontaneous circulation (ROSC) and hemodynamics, when compared to traditional chest compressions, in a swine model of traumatic cardiopulmonary arrest (TCPA)...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29569679/the-success-of-endotracheal-intubation-with-a-modified-laryngoscope-using-night-vision-goggles
#15
Attila Aydın, Sedat Bilge, Cemile Aydın, Meltem Bilge, Erdem Çevik, Mehmet Eryılmaz
BACKGROUND: Endotracheal intubation (ETI) procedure in the combat area differs from prehospital trauma life support procedures because of the danger of gunfire and the dark environment. We aimed to determine the success, difficulty degree, and duration of ETI procedures with a classical laryngoscope (CL) in a bright room and with a modified laryngoscope (ML) model in a dark room. METHODS: All interventions were performed by a combatant medical staff of 10 members...
March 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29560047/prehospital-lactate-predicts-need-for-resuscitative-care-in-non-hypotensive-trauma-patients
#16
Alexander E St John, Andrew M McCoy, Allison G Moyes, Francis X Guyette, Eileen M Bulger, Michael R Sayre
Introduction: The prehospital decision of whether to triage a patient to a trauma center can be difficult. Traditional decision rules are based heavily on vital sign abnormalities, which are insensitive in predicting severe injury. Prehospital lactate (PLac) measurement could better inform the triage decision. PLac's predictive value has previously been demonstrated in hypotensive trauma patients but not in a broader population of normotensive trauma patients transported by an advanced life support (ALS) unit...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29533448/prehospital-medicine-and-the-future-will-ecmo-ever-play-a-role
#17
David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29469616/prehospital-echocardiography-during-resuscitation-impacts-treatment-in-a-physician-staffed-helicopter-emergency-medical-service-an-observational-study
#18
Rein Ketelaars, Christian Beekers, Geert-Jan Van Geffen, Gert Jan Scheffer, Nico Hoogerwerf
BACKGROUND: Patients in cardiac arrest must receive algorithm-based management such as basic life support and advanced (cardiac) life support. International guidelines dictate diagnosing and treating any factor that may have caused the arrest or may be complicating the resuscitation. Ultrasound may be of potential value in this process and can be used in a prehospital setting. The objective is to evaluate the use of prehospital ultrasound during traumatic and non-traumatic CPR and determine its impact on prehospital treatment decisions in a Dutch helicopter emergency medical service (HEMS)...
July 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29408229/trends-in-care-processes-and-survival-following-prehospital-resuscitation-improvement-initiatives-for-out-of-hospital-cardiac-arrest-in-british-columbia-2006-2016
#19
Brian Grunau, Takahisa Kawano, William Dick, Ronald Straight, Helen Connolly, Robert Schlamp, Frank X Scheuermeyer, Christopher B Fordyce, David Barbic, John Tallon, Jim Christenson
BACKGROUND: British Columbia (BC) Emergency Health Services implemented a strategy to improve outcomes for out-of-hospital cardiac arrest (OHCA), focusing on paramedic-led high-quality on-scene resuscitation. We measured changes in care metrics and survival trends. METHODS: This was a post-hoc study of prospectively identified consecutive non-traumatic ambulance-treated adult OHCAs from 2006 to 2016 within BC's four metropolitan areas. The primary outcome was survival to hospital discharge; we also described available favourable neurological outcomes (mRS ≤3)...
April 2018: Resuscitation
https://www.readbyqxmd.com/read/29406555/brister-i-systematiskt-omh%C3%A3-ndertagande-p%C3%A3-olycksplatser-en-studie-av-traumasimuleringar-inom-ambulanssjukv%C3%A3-rden
#20
Jonas Aléx, Lina Gyllencreutz
Trauma care at an accident site is of great importance for patient survival. The purpose of the study was to observe the compliance of ambulance nurses with the Prehospital Trauma Life Support (PHTLS) concept of trauma care in a simulation situation. The material consisted of video recordings in trauma simulation and an observation protocol was designed to analyze the video material. The result showed weaknesses in systematic exam and an ineffective use of time at the scene of injury. Development of observation protocols in trauma simulation can ensure the quality of ambulance nurses' compliance with established concepts...
February 5, 2018: Läkartidningen
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