keyword
https://read.qxmd.com/read/38509815/implementing-tourniquet-conversion-guidelines-for-civilian-ems-and-prehospital-organizations-a-case-report-and-review
#21
REVIEW
Colin H Standifird, Sean Kaisler, Hunter Triplett, Michael J Lauria, Andrew D Fisher, Andrew J Harrell, Chelsea C White
Since the first documented use of a tourniquet in 1674, the popularity of tourniquets has waxed and waned. During recent wars and more recently in Emergency Medical Services systems, the tourniquet has been proven to be a valuable tool in the treatment of life-threatening hemorrhage. However, tourniquet use is not without risk, and several studies have demonstrated adverse events and morbidity associated with tourniquet use in the prehospital setting, particularly when left in place for more than 2 h. Consequently, the US military's Committee on Tactical Combat Casualty Care has recommended guidelines for prehospital tourniquet conversion to reduce the risk of adverse events associated with tourniquets once the initial hemorrhage has been controlled...
March 21, 2024: Wilderness & Environmental Medicine
https://read.qxmd.com/read/38509186/in-hospital-mortality-after-prehospital-endotracheal-intubation-versus-alternative-methods-of-airway-management-in-trauma-patients-a-cohort-study-from-the-traumaregister-dgu%C3%A2
#22
JOURNAL ARTICLE
Moritz Weigeldt, Stefan Schulz-Drost, Dirk Stengel, Rolf Lefering, Sascha Treskatsch, Christian Berger
PURPOSE: Prehospital airway management in trauma is a key component of care and is associated with particular risks. Endotracheal intubation (ETI) is the gold standard, while extraglottic airway devices (EGAs) are recommended alternatives. There is limited evidence comparing their effectiveness. In this retrospective analysis from the TraumaRegister DGU®, we compared ETI with EGA in prehospital airway management regarding in-hospital mortality in patients with trauma. METHODS: We included cases only from German hospitals with a minimum Abbreviated Injury Scale score ≥ 2 and age ≥ 16 years...
March 20, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/38508774/defining-capabilities-in-deployed-uk-military-prehospital-emergency-care
#23
EDITORIAL
Michael Thompson, O Jefferson, T James, B Waller, R Reed, H Slade, K Swift, H J Pynn
The UK military prehospital emergency care (PHEC) operational clinical capability framework must be updated in order that it retains its use as a valid operational planning tool. Specific requirements include accurately defining the PHEC levels and the ' Medical Emergency Response Team ' (MERT), while reinforcing PHEC as a specialist area of clinical practice that requires an assured set of competencies at all levels and mandatory clinical currency for vocational providers.A military PHEC review panel was convened by the Defence Consultant Advisor (DCA) for PHEC...
March 20, 2024: BMJ military health
https://read.qxmd.com/read/38508613/temporal-trends-of-ambulance-time-intervals-for-suspected-stroke-transient-ischaemic-attack-tia-before-and-during-the-covid-19-pandemic-in-ireland-a-quasi-experimental-study
#24
JOURNAL ARTICLE
Edel Burton, Rory Quinn, Kieran Crosbie-Staunton, Conor Deasy, Siobhan Masterson, Cathal O'Donnell, Áine Merwick, David Willis, Patricia M Kearney, Vera J C Mc Carthy, Claire M Buckley
OBJECTIVES: Time is a fundamental component of acute stroke and transient ischaemic attack (TIA) care, thus minimising prehospital delays is a crucial part of the stroke chain of survival. COVID-19 restrictions were introduced in Ireland in response to the pandemic, which resulted in major societal changes. However, current research on the effects of the COVID-19 pandemic on prehospital care for stroke/TIA is limited to early COVID-19 waves. Thus, we aimed to investigate the effect of the COVID-19 pandemic on ambulance time intervals and suspected stroke/TIA call volume for adults with suspected stroke and TIA in Ireland, from 2018 to 2021...
March 20, 2024: BMJ Open
https://read.qxmd.com/read/38506492/enhancing-patient-safety-in-prehospital-environment-analyzing-patient-perspectives-on-non-transport-decisions-with-natural-language-processing-and-machine-learning
#25
JOURNAL ARTICLE
Hassan Farhat, Guillaume Alinier, Reem Tluli, Montaha Chakif, Fatma Babay Ep Rekik, Ma Cleo Alcantara, Padarath Gangaram, Kawther El Aifa, Ahmed Makhlouf, Ian Howland, Mohamed Chaker Khenissi, Sailesh Chauhan, Cyrine Abid, Nicholas Castle, Loua Al Shaikh, Moncef Khadhraoui, Imed Gargouri, James Laughton
OBJECTIVE: This research explored the experiences and perspectives of patients declining hospital transportation after receiving prehospital emergency care using advanced computational techniques. METHOD: Between 15th June and 1st August 2023, 210 patients in Qatar, treated by Hamad Medical Corporation Ambulance Service (HMCAS) but refusing transportation to hospital, were interviewed. Key outcome variables stratified by demographics included "reasons for refusing transport," "satisfaction with HMCAS service," and "postrefusal actions...
March 21, 2024: Journal of Patient Safety
https://read.qxmd.com/read/38504553/pulmonary-evaluation-of-earthquake-victims-followed-up-in-the-intensive-care-unit-after-the-2023-turkey-kahramanmaras-earthquakes
#26
JOURNAL ARTICLE
Sinem Berik Safçi, Esra Aybal, Özlem Erçen Diken
INTRODUCTION AND STUDY OBJECTIVE: In Turkey, a total of 269 earthquakes took place from 1900 through 2023. The most devastating earthquakes in terms of casualties and extensive destruction occurred at 4:17am and 1:24pm local time on February 6, 2023 with the epicenters located in Pazarcik (Kahramanmaras) and Ekinozu (Kahramanmaras) and magnitudes of 7.7Mw and 7.6Mw, respectively. The aim of this study was to define the frequency of lung complications that occurred directly and/or developed during the intensive care follow-up of individuals affected by the Kahramanmaras earthquakes...
March 20, 2024: Prehospital and Disaster Medicine
https://read.qxmd.com/read/38504354/gender-sensitive-considerations-of-prehospital-teamwork-in-critical-situations
#27
JOURNAL ARTICLE
Matthias Zimmer, Daria Magdalena Czarniecki, Stephan Sahm
BACKGROUND: Teamwork in emergency medical services is a very important factor in efforts to improve patient safety. The potential differences of staff gender on communication, patient safety, and teamwork were omitted. The aim of this study is to evaluate these inadequately examined areas. METHODS: A descriptive and anonymous study was conducted with an online questionnaire targeting emergency physicians and paramedics. The participants were asked about teamwork, communication, patient safety and handling of errors...
March 20, 2024: Philosophy, Ethics, and Humanities in Medicine: PEHM
https://read.qxmd.com/read/38500638/risk-factors-for-the-need-for-advanced-care-among-prescription-and-over-the-counter-drug-overdose-patients
#28
JOURNAL ARTICLE
Chie Tanaka, Takashi Tagami, Makihiko Nagano, Fumihiko Nakayama, Junya Kaneko, Masamune Kuno
AIM: Prescription drug and over-the-counter (OTC) drug overdose is a major problem in emergency departments in Japan, and some need advanced care which is more than observation. We aimed to identify the prehospital risk factors for the need of advanced care among overdose patients. METHODS: This was a single-center retrospective cohort study. We included overdoses patients of prescription drugs or OTC drugs, who admitted to our hospital between 2016 and 2021. We grouped them into advanced care and non-advanced care...
2024: Acute Medicine & Surgery
https://read.qxmd.com/read/38500598/intra-arrest-blood-based-biomarkers-for-out-of-hospital-cardiac-arrest-a-scoping-review
#29
JOURNAL ARTICLE
Justin L Benoit, Andrew N Hogan, Katherine M Connelly, Jason T McMullan
OBJECTIVE: Blood-based biomarkers play a central role in the diagnosis and treatment of critically ill patients, yet none are routinely measured during the intra-arrest phase of out-of-hospital cardiac arrest (OHCA). Our objective was to describe methodological aspects, sources of evidence, and gaps in research surrounding intra-arrest blood-based biomarkers for OHCA. METHODS: We used scoping review methodology to summarize existing literature. The protocol was designed a priori following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews...
April 2024: Journal of the American College of Emergency Physicians open
https://read.qxmd.com/read/38500397/associations-between-paramedics-salutogenic-health-experience-and-the-intention-to-stay-in-the-profession-a-cross-sectional-survey
#30
JOURNAL ARTICLE
Eve Hulkkonen, Anne Kouvonen, Hilla Nordquist
AIM: To investigate the association between paramedics' salutogenic health and their intentions to stay in their profession. DESIGN: A cross-sectional survey. METHODS: Paramedics from eight purposively selected organizations participated in this study (n = 433). The data were collected in 2022 with the Salutogenic Health Indicator Scale and validated single questions that assessed work ability, recovery and self-rated stress...
March 2024: Nursing Open
https://read.qxmd.com/read/38498782/factors-impacting-the-implementation-of-mobile-integrated-health-programs-for-the-acute-care-of-older-adults
#31
JOURNAL ARTICLE
Laurel O'Connor, Stephanie Behar, Jade Refuerzo, Xhenifer Mele, Elsa Sundling, Sharon A Johnson, Jamie M Faro, Peter K Lindenauer, Kristin M Mattocks
Objective: Emergency services utilization is increasing in older adult populations. Many such encounters may be preventable with better access to acute care in the community. Mobile integrated health (MIH) programs leverage mobile resources to deliver care and services to patients in the out-of-hospital environment and have the potential to improve clinical outcomes and decrease health care costs; however, they have not been widely implemented. We assessed barriers, potential facilitators, and other factors critical to the implementation of MIH programs with key vested partners...
March 18, 2024: Prehospital Emergency Care
https://read.qxmd.com/read/38498777/shock-index-as-a-predictor-of-mortality-and-hospital-admission-in-prehospital-gastrointestinal-bleeding-a-retrospective-cohort-study
#32
JOURNAL ARTICLE
Joshua Lowe, Zacharia Lowe, Rachel Ely
Objective: To evaluate the Shock Index (SI) as a predictive tool for triage of gastrointestinal bleeding (GI) in the prehospital setting, assessing its correlation with mortality, admission rates, and hospital length of stay. Methods: In this retrospective cohort study, we analyzed data from the ESO Data Collaborative encompassing EMS records from the year 2022, focusing on 1525 patients with a primary GI bleeding diagnosis. The primary measure was the SI, calculated at initial contact and highest recorded prior to ED arrival...
March 18, 2024: Prehospital Emergency Care
https://read.qxmd.com/read/38495915/what-else-should-hemostatic-materials-do-beyond-hemostasis-a-review
#33
REVIEW
Xinran Yang, Xiudan Wang, Xing Gao, Xiaoqin Guo, Shike Hou, Jie Shi, Qi Lv
Massive blood loss due to injury is the leading cause of prehospital deaths in disasters and emergencies. Hemostatic materials are used to realize rapid hemostasis and protect patients from death. Researchers have designed and developed a variety of hemostatic materials. However, in addition to their hemostatic effect, hemostatic materials must be endowed with additional functions to meet the practical application requirements in different scenarios. Here, strategies for modifications of hemostatic materials for use in different application scenarios are listed: effective positioning at the site of deep and narrow wounds to stop bleeding, resistance to high blood pressure and wound movement to maintain wound formation, rapid and easy removal from the wound without affecting further treatment after hemostasis is completed, and continued function when retained in the wound as a dressing (such as antibacterial, antiadhesion, tissue repair, etc...
April 2024: Materials today. Bio
https://read.qxmd.com/read/38493957/emergency-medical-service-response-for-cases-of-stroke-suspected-seizure-a-population-based-study
#34
JOURNAL ARTICLE
Hidetada Yamada, Shiro Aoki, Tomohisa Nezu, Shuichiro Neshige, Atsuko Motoda, Yu Yamazaki, Hirofumi Maruyama
OBJECTIVES: We evaluated the on-scene time of emergency medical services (EMS) for cases where discrimination between acute stroke and epileptic seizures at the initial examination was difficult and identified factors linked to delays in such scenarios. MATERIALS AND METHODS: A retrospective review of cases with suspected seizure using the EMS database of fire departments across six Japanese cities between 2016 and 2021 was conducted. Patient classification was based on transport codes...
March 15, 2024: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://read.qxmd.com/read/38492632/pediatric-utilization-of-emergency-medical-services-from-outpatient-offices-and-urgent-care-centers
#35
JOURNAL ARTICLE
Jennifer K Saper, Michelle L Macy, Christian Martin-Gill, Sriram Ramgopal
OBJECTIVE: National efforts have highlighted the need for pediatric emergency readiness across all settings where children receive care. Outpatient offices and urgent care centers are frequent starting points for acutely injured and ill children, emphasizing the need to maintain pediatric readiness in this setting. We aimed to characterize emergency medical services (EMS) utilization from outpatient offices and urgent care centers to better understand pediatric readiness needs. METHODS: We performed a retrospective cross-sectional analysis of EMS encounters using the National Emergency Medical Services Information System, a nationally representative EMS registry (2019-2022)...
March 14, 2024: Academic Pediatrics
https://read.qxmd.com/read/38491932/factors-predisposing-emergency-medical-technicians-to-workplace-violence-a-cross-sectional-study
#36
JOURNAL ARTICLE
Tshikani Lewis Khoza, Maureen Nokuthula Sibiya, Nombeko Mshunqane
Emergency medical technicians (EMT) are at high risk of workplace violence as they often care for patients in uncontrolled and often hostile emergency settings. Gauteng Province, the most populous province in South Africa, caters for 75% of the total population which is dependant on state funded health care. Public sector EMTs' have been robbed with aggravated circumstances, assaulted with intent to do grievous bodily harm, raped and even murdered whilst on duty. Despite this, comprehensive studies investigating the factors that predispose public sector EMTs' to workplace violence in Gauteng Province are lacking...
2024: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://read.qxmd.com/read/38491816/advancing-access-to-care-an-assessment-of-the-prehospital-system-in-senegal
#37
JOURNAL ARTICLE
Kamil Michalski, Moustapha Diedhiou, Matin Kerachian, Jeremy Grushka, Jacques Noel Tendeng, Mohamed Lamine Diao, Mamadou D Beye, Johana Montero Ortiz, Tarek Razek, Dan L Deckelbaum, Ibrahim Konate
BACKGROUND: Most low- and middle-income countries do not have a mature prehospital system limiting access to definitive care. This study sought to describe the current state of the prehospital system in Senegal and offer recommendations aimed at improving system capacity and population access to definitive care. METHODS: Structured interviews were conducted with key informants in various regions throughout the country using qualitative and quantitative techniques...
March 16, 2024: World Journal of Surgery
https://read.qxmd.com/read/38490851/functional-outcome-and-associations-with-prehospital-time-and-urban-remote-disparities-in-trauma-a-norwegian-national-population-based-study
#38
JOURNAL ARTICLE
Imw Nilsbakken, T Wisborg, S Sollid, E Jeppesen
BACKGROUND: There is a lack of knowledge regarding the functional outcomes of patients after trauma. Remote areas in Norway has been associated with an increased risk of trauma-related mortality. However, it is unknown how this might influence trauma-related morbidity. The aim of this study was to assess the functional outcomes of patients in the Norwegian trauma population and the relationship between prehospital time and urban-remote disparities on functional outcome. METHODS: This registry-based study included 34,611 patients from the Norwegian Trauma Registry from 2015 - 2020...
March 5, 2024: Injury
https://read.qxmd.com/read/38490791/applications-of-artificial-intelligence-in-helicopter-emergency-medical-services-a-scoping-review
#39
REVIEW
Jennifer Hsueh, Christie Fritz, Caroline E Thomas, Andrew P Reimer, Andrew T Reisner, David Schoenfeld, Adrian Haimovich, Stephen H Thomas
OBJECTIVE: Recent systematic reviews of acute care medicine applications of artificial intelligence (AI) have focused on hospital and general prehospital uses. The purpose of this scoping review was to identify and describe the literature on AI use with a focus on applications in helicopter emergency medical services (HEMS). METHODS: A literature search was performed with specific inclusion and exclusion criteria. Articles were grouped by characteristics such as publication year and general subject matter with categoric and temporal trend analyses...
2024: Air Medical Journal
https://read.qxmd.com/read/38490790/ketamine-efficacy-for-management-of-status-epilepticus-considerations-for-prehospital-clinicians
#40
REVIEW
Nikhil C Williams, Lindsey A Morgan, Jonathan Friedman, Jeffrey Siegler
Current first-line therapies for seizure management recommend benzodiazepines, which target gamma-aminobutyric acid type A channels to stop the seizure activity. However, seizures may be refractory to traditional first-line therapies, transitioning into status epilepticus and becoming resistant to gamma-aminobutyric acid type A augmenting drugs. Although there are other antiseizure medications available for clinicians to use in the intensive care unit, these options can be less readily available outside of the intensive care unit and entirely absent in the prehospital setting...
2024: Air Medical Journal
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