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https://www.readbyqxmd.com/read/28612168/civilian-cerebral-gunshot-wounds-in-rural-south-african-patients-are-associated-with-significantly-higher-mortality-rates-than-in-urban-patients
#1
V Y Kong, J L Bruce, B Sartorius, G L Laing, J Odendaal, P Brysiewicz, D L Clarke
INTRODUCTION: This study focuses on a specific and often dramatic injury, namely gunshot wounds (GSW) of the head in order to determine whether there is a discrepancy in outcome between patients who sustain their injury in a rural setting and those who sustain it in an urban setting. MATERIALS AND METHODS: This study involves a retrospective review of our prospectively maintained regional electronic trauma registry. All patients who sustained a cerebral GSW from January 2010 to December 2014 were reviewed...
June 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28598904/deaths-and-high-risk-trauma-patients-missed-by-standard-trauma-data-sources
#2
Craig D Newgard, Rochelle Fu, E Brooke Lerner, Mohamud Daya, Dagan Wright, Jonathan Jui, N Clay Mann, Eileen Bulger, Jerris Hedges, Lynn Wittwer, David Lehrfeld, Thomas Rea
BACKGROUND: Trauma registries are used to evaluate and improve trauma care, yet potentially miss certain trauma deaths and high-risk patients. We estimated the number of missed deaths and high-risk trauma patients using commonly-available sources of trauma data, and bias in quality metrics for field trauma triage. METHODS: This was a pre-planned secondary analysis of a population-based prospective cohort of injured patients transported by 44 EMS agencies to 28 hospitals in 7 Northwest counties from 1/1/2011 to 12/31/2011 and followed through hospitalization...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28559075/impact-of-pre-hospital-transportation-on-survival-in-skiers-and-snowboarders-with-traumatic-brain-injury
#3
Hai Sun, Navdeep S Samra, Piyush Kalakoti, Kanika Sharma, Devi Prasad Patra, Rimal H Dossani, Jai Deep Thakur, Elizabeth A Disbrow, Kevin Phan, Sreenivas P Veeranki, Aqueel Pabaney, Christina Notarianni, John T Owings, Anil Nanda
INTRODUCTION: Prehospital helicopter utilization and its impact on outcomes in snowboarders and skiers incurring traumatic brain injury (TBI) is unknown. The present study investigates the association of helicopter transport with survival of snowboarders and skiers with TBI, in comparison with ground emergency medical services (EMS) using data derived from the National Trauma Data Bank (2007-2014). METHODS: Primary and secondary endpoints were defined as in-hospital survival, and absolute risk reduction based upon number needed to transport (treat) respectively...
May 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28558908/state-level-geographic-variation-in-prompt-access-to-care-for-children-after-motor-vehicle-crashes
#4
Lindsey L Wolf, Ritam Chowdhury, Jefferson Tweed, Lori Vinson, Elena Losina, Adil H Haider, Faisal G Qureshi
BACKGROUND: Motor vehicle crashes (MVCs) are a principal cause of death in children; fatal MVCs and pediatric trauma resources vary by state. We sought to examine state-level variability in and predictors of prompt access to care for children in MVCs. MATERIALS AND METHODS: Using the 2010-2014 Fatality Analysis Reporting System, we identified passengers aged <15 y involved in fatal MVCs (crashes on US public roads with ≥1 death, adult or pediatric, within 30 d)...
May 8, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28520711/inhalational-chlorine-injuries-at-public-aquatic-venues-california-2008-2015
#5
Jason A Wilken, Michele DiMaggio, Matthew Kaufmann, Kevin O'Connor, Svetlana Smorodinsky, Christina Armatas, Tracy Barreau, Richard Kreutzer, Lino Ancheta
In June 2015, personnel from California's Contra Costa Health Services Environmental Health and Hazardous Materials (hazmat) divisions were alerted to a possible chemical release at a swimming pool in an outdoor municipal water park. Approximately 50 bathers were in the pool when symptoms began; 34 (68%) experienced vomiting, coughing, or eye irritation. Among these persons, 17 (50%) were treated at the scene by Contra Costa's Emergency Medical Services (EMS) and released, and 17 (50%) were transported to local emergency departments; five patients also were evaluated later at an emergency department or by a primary medical provider...
May 19, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28508236/an-exploratory-analysis-of-the-geographical-distribution-of-trauma-incidents-in-shenzhen-china
#6
Gui Xi Zhang, Joe King Man Fan, Fion Siu Yin Chan, Gilberto Ka Kit Leung, Chung Mao Lo, Yi Min Yu, Hong Zhang, Susan I Brundage, Jan O Jansen
BACKGROUND: The city of Shenzhen, China, is planning to establish a trauma system. At present, there are few data on the geographical distribution of incidents, which is key to deciding on the location of trauma centres. The aim of this study was to perform a geographical analysis in order to inform the development of a trauma system in Shenzhen. METHODS: Retrospective analysis of trauma incidents attended by Shenzhen Emergency Medical Services (EMS) in 2014. Data were obtained from Shenzhen EMS...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28489506/prehospital-intubation-is-associated-with-favorable-outcomes-and-lower-mortality-in-protect-iii
#7
Kurt R Denninghoff, Tomas Nuño, Qi Pauls, Sharon D Yeatts, Robert Silbergleit, Yuko Y Palesch, Lisa H Merck, Geoff T Manley, David W Wright
OBJECTIVE: Traumatic brain injury (TBI) causes more than 2.5 million emergency department visits, hospitalizations, or deaths annually. Prehospital endotracheal intubation has been associated with poor outcomes in patients with TBI in several retrospective observational studies. We evaluated the relationship between prehospital intubation, functional outcomes, and mortality using high quality data on clinical practice collected prospectively during a randomized multicenter clinical trial...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28489503/does-prehospital-time-influence-clinical-outcomes-in-severe-trauma-patients-a-cross-sectional-study
#8
Jungeun Kim, Kyoung Jun Song, Sang Do Shin, Young Sun Ro, Ki Jeong Hong, James F Holmes
OBJECTIVE: Prehospital time potentially impacts clinical outcomes in severely injured trauma patients. The importance of individual components, including scene and response time, however, is controversial. Our objective was to determine the impact of prehospital times on survival in severely injured patients. METHODS: We reviewed injured trauma patients enrolled in a Korean EMS trauma registry during 2012. Severe trauma patients were defined as having either a "V" or lower in the AVPU system, a systolic blood pressure ≤90mmHg, or respiratory rate <10 or >29...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28489471/effect-of-the-2011-revisions-to-the-field-triage-guidelines-on-under-and-over-triage-rates-for-pediatric-trauma-patients
#9
E Brooke Lerner, Jeremy T Cushman, Amy L Drendel, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: In 2011, revised Field Triage Guidelines were released jointly by the Centers for Disease Control and Prevention (CDC) and the American College of Surgeons - Committee on Trauma (ACS-COT). It is unknown how the modifications will affect the number of injured children identified by EMS providers as needing transport to a trauma center. OBJECTIVE: To determine the change in under- and over-triage rates when the 2011 Field Triage Guidelines are compared to the 2006 and 1999 versions...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28481163/body-temperature-after-ems-transport-association-with-traumatic-brain-injury-outcomes
#10
Joshua B Gaither, Vatsal Chikani, Uwe Stolz, Chad Viscusi, Kurt Denninghoff, Bruce Barnhart, Terry Mullins, Amber D Rice, Moses Mhayamaguru, Jennifer J Smith, Samuel M Keim, Bentley J Bobrow, Daniel W Spaite
INTRODUCTION: Low body temperatures following prehospital transport are associated with poor outcomes in patients with traumatic brain injury (TBI). However, a minimal amount is known about potential associations across a range of temperatures obtained immediately after prehospital transport. Furthermore, a minimal amount is known about the influence of body temperature on non-mortality outcomes. The purpose of this study was to assess the correlation between temperatures obtained immediately following prehospital transport and TBI outcomes across the entire range of temperatures...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28478999/integration-of-tactical-ems-in-the-national-park-service
#11
REVIEW
William Will R Smith
The National Park Service (NPS) has domestic responsibility for emergency medical services (EMS) in remote and sometimes tactical situations in 417 units covering over 34 million hectares (84 million acres). The crossover between conflicting patient care priorities and complex medical decision making in the tactical, technical, and wilderness/remote environments often has many similarities. Patient care in these diverse locations, when compared with military settings, has slightly different variables but often similar corresponding risks to the patients and providers...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28463096/border-injuries-an-analysis-of-prehospital-demographics-mechanisms-and-patterns-of-injuries-encountered-by-usbp-ems-agents-in-the-el-paso-texas-usa-sector
#12
Russell A Baker
Study Objective The aim of this study was to evaluate Emergency Medical Services (EMS), use, injury mechanisms, prehospital assessments, and injuries among those receiving aid from the United States Border Patrol (USBP) in the El Paso (Texas USA) Sector. DESIGN: This is a time-series, retrospective analysis of all prehospital data for injuries among patients receiving care from USBP EMS on the US Mexico border in the El Paso sector from February 6, 2014 to February 6, 2016. RESULTS: A total of 473 documented EMS encounters occurred in this two-year period and demonstrated a male gender predominance (male 63%; female 37%) with the most prominent ages between 22-40 years old...
May 2, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28459301/role-of-guideline-adherence-in-improving-field-triage
#13
Craig D Newgard, Rongwei Fu, E Brooke Lerner, Mohamud Daya, Jonathan Jui, Lynn Wittwer, Terri A Schmidt, Dana Zive, Eileen M Bulger, Ritu Sahni, Craig Warden, Nathan Kuppermann
OBJECTIVE: To compare the sensitivity of current field triage practices for identifying high-risk trauma patients to strict guideline adherence, including changes in triage specificity, ambulance transport patterns, and trauma center volumes. METHODS: This was a pre-planned secondary analysis of an out-of-hospital prospective cohort of injured children and adults transported by 44 EMS agencies to 28 trauma and non-trauma hospitals in 7 Northwest U.S. counties from January 1, 2011 through December 31, 2011...
May 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28366241/teammate-familiarity-teamwork-and-risk-of-workplace-injury-in-emergency-medical-services-teams
#14
Ashley M Hughes, P Daniel Patterson, Matthew D Weaver, Megan E Gregory, Shirley C Sonesh, Douglas P Landsittel, David Krackhardt, David Hostler, Elizabeth H Lazzara, Xiao Wang, John E Vena, Eduardo Salas, Donald M Yealy
Increased teammate familiarity in emergency medical services (EMS) promotes development of positive teamwork and protects against workplace injury. METHODS: Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent partnerships and tested the hypothesized role of teamwork as a mediator in the relationship between teammate familiarity and injury with the PROCESS macro...
March 30, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28363752/are-prehospital-deaths-from-trauma-and-accidental-injury-preventable-a-direct-historical-comparison-to-assess-what-has-changed-in-two-decades
#15
G J Oliver, D P Walter, A D Redmond
BACKGROUND & OBJECTIVES: In 1994, Hussain and Redmond revealed that up to 39% of prehospital deaths from accidental injury might have been preventable had basic first aid care been given. Since then there have been significant advances in trauma systems and care. The exclusion of prehospital deaths from the analysis of trauma registries, giv en the high rate of those, is a major limitation in prehospital research on preventable death. We have repeated the 1994 study to identify any changes over the years and potential developments to improve patient outcomes...
May 2017: Injury
https://www.readbyqxmd.com/read/28345221/effect-of-timing-of-electromyostimulation-on-denervated-skeletal-muscle-atrophy
#16
Eun Sil Koh, Hee Chan Kim, Jae-Young Lim
INTRODUCTION: In this study we evaluated the effect of electromyostimulation (EMS) on myosin heavy chain (MHC) isoform expression in denervated rat muscles to determine the optimal timing for EMS application. METHODS: EMS was initiated on post-injury day 1 for the group with denervation receiving immediate EMS (DIEMS) and on post-injury day 15 for the group with denervation receiving delayed EMS (DDEMS) in rat denervated muscles. Muscle wet weight and muscle fiber cross-sectional area (FCSA) were measured...
March 27, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28272851/the-effect-of-emergency-medical-services-response-on-outcome-of-trauma-laparotomy-at-a-level-1-trauma-centre-in-south-africa
#17
S Chowdhury, P H Navsaria, S Edu, A J Nicol
BACKGROUND: Due to resource constrained pre-hospital emergency medical services (EMSs) there is a significant delay in injured patients arriving at Groote Schuur Hospital Trauma Centre (GSHTC). The aim of the study was to examine the effectiveness of EMSs in transferring trauma patients to GSHTC. The effect of any delay to laparotomy from injury was noted. METHOD: A prospective audit of patients presented directly from the scene to GSHTC following abdominal trauma over a four-month period was performed...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28238499/out-of-hospital-triage-of-older-adults-with-head-injury-a-retrospective-study-of-the-effect-of-adding-anticoagulation-or-antiplatelet-medication-use-as-a-criterion
#18
Daniel K Nishijima, Samuel D Gaona, Trent Waechter, Ric Maloney, Troy Bair, Adam Blitz, Andrew R Elms, Roel D Farrales, Calvin Howard, James Montoya, Jeneita M Bell, Mark Faul, David R Vinson, Hernando Garzon, James F Holmes, Dustin W Ballard
STUDY OBJECTIVE: Field triage guidelines recommend that emergency medical services (EMS) providers consider transport of head-injured older adults with anticoagulation use to trauma centers. However, the triage patterns and the incidence of intracranial hemorrhage or neurosurgery in these patients are unknown. Our objective is to describe the characteristics and outcomes of older adults with head trauma who are transported by EMS, particularly for patients who do not meet physiologic, anatomic, or mechanism-of-injury (steps 1 to 3) field triage criteria but are receiving anticoagulant or antiplatelet medications...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28228178/the-state-of-emergency-medical-services-ems-systems-in-africa
#19
Nee-Kofi Mould-Millman, Julia M Dixon, Nana Sefa, Arthur Yancey, Bonaventure G Hollong, Mohamed Hagahmed, Adit A Ginde, Lee A Wallis
Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. METHODS: A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment...
February 23, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28215192/music-genre-as-a-predictor-of-resource-utilization-at-outdoor-music-concerts
#20
Michael S Westrol, Susmith Koneru, Norah McIntyre, Andrew T Caruso, Faizan H Arshad, Mark A Merlin
OBJECTIVES: The aim of this study was to examine the various modern music genres and their effect on the utilization of medical resources with analysis and adjustment for potential confounders. METHODS: A retrospective review of patient logs from an open-air, contemporary amphitheater over a period of 10 years was performed. Variables recorded by the medical personnel for each concert included the attendance, description of the weather, and a patient log in which nature and outcome were recorded...
June 2017: Prehospital and Disaster Medicine
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