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https://www.readbyqxmd.com/read/29282591/performance-of-regional-oxygen-saturation-monitoring-by-near-infrared-spectroscopy-nirs-in-pediatric-inter-hospital-transports-with-special-reference-to-air-ambulance-transports-a-methodological-study
#1
Tova Hannegård Hamrin, Peter J Radell, Urban Fläring, Jonas Berner, Staffan Eksborg
The aim of the present study was to evaluate the performance of regional oxygen saturation (rSO2) monitoring with near infrared spectroscopy (NIRS) during pediatric inter-hospital transports and to optimize processing of the electronically stored data. Cerebral (rSO2-C) and abdominal (rSO2-A) NIRS sensors were used during transport in air ambulance and connecting ground ambulance. Data were electronically stored by the monitor during transport, extracted and analyzed off-line after the transport. After removal of all zero and floor effect values, the Savitzky-Golay algorithm of data smoothing was applied on the NIRS-signal...
December 28, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29193631/an-audit-of-change-in-clinical-practice-from-oxygen-driven-to-air-driven-nebulisers-for-prehospital-patients-with-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-aecopd
#2
Deborah Heys, Andrew Swain, Sarah Knowles, Amy Waugh, Mark Bailey
BACKGROUND: In developed countries, ambulances normally carry oxygen cylinders but not compressed air. Treatment of acute exacerbations of COPD (AECOPD) with oxygen-driven nebulisers can result in hypercapnia and acidosis. Attempts to avoid this have involved interrupted administration of oxygen.1 However, small battery-powered air nebulisers are now available. AIMS: This study aims to compare the prehospital oxygen saturations and treatment of patients suffering from AECOPD before and after the introduction of air nebulisers...
November 29, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29149802/associations-of-short-term-exposure-to-ambient-air-pollutants-with-emergency-ambulance-calls-for-the-exacerbation-of-essential-arterial-hypertension
#3
Jone Vencloviene, Agne Braziene, Audrius Dedele, Kristina Lopatiene, Paulius Dobozinskas
We investigated the association between daily emergency ambulance calls (EAC) for elevated blood pressure that occurred during the time intervals of 8:00-13:59, 14:00-21:59, and 22:00-7:59, and exposure to CO, PM10, and ozone. We used Poisson regression to explore the association between the risk of EAC and short-term variation of pollutants, adjusting for seasonality and weather variables. Before noon, the risk was associated with an interquartile range (IQR) (7.9 μg/m(3)) increase in PM10 at lag 2-4 days below the median (RR = 1...
November 17, 2017: International Journal of Environmental Health Research
https://www.readbyqxmd.com/read/29146493/predicting-rosc-in-out-of-hospital-cardiac-arrest-using-expiratory-carbon-dioxide-concentration-is-trend-detection-instead-of-absolute-threshold-values-the-key
#4
Peter Brinkrolf, Matthias Borowski, Camilla Metelmann, Roman-Patrik Lukas, Laura Pidde-Küllenberg, Andreas Bohn
AIM: Guidelines recommend detecting return of spontaneous circulation (ROSC) by a rising concentration of carbon dioxide in the exhalation air. As CO2 is influenced by numerous factors, no absolute cut-off values of CO2 to detect ROSC are agreed on so far. As trends in CO2 might be less affected by influencing factors, we investigated an approach which is based on detecting CO2-trends in real-time. METHODS: We conducted a retrospective case-control study on 169 CO2 time series from out of hospital cardiac arrests resuscitated by Muenster City Ambulance-Service, Germany...
November 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/29141907/emergency-versus-standard-response-time-efficacy-of-london-s-air-ambulance-rapid-response-vehicle
#5
Marius Rehn, Gareth Davies, Paul Smith, David Lockey
OBJECTIVE: The potential increased risk of an emergency response using a rapid response vehicle (RRV) should only be accepted when it allows a clinically significant time saving for management of patients who are critically injured or sick. Air ambulance services often use an RRV to maintain operational resilience. We compared the RRV response time on emergency versus standard driving to inform emergency services of time efficacy of emergency response in an urban environment. METHODS: Prospective observational controlled study of response data of emergency and standard driving...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29132593/the-impact-of-helicopter-emergency-medical-service-night-operations-in-south-east-england
#6
Leigh Curtis, Mark Salmon, Richard M Lyon
OBJECTIVE: This study sought to assess the impact of a helicopter emergency medical service (HEMS) capable of night operations. METHODS: This is a retrospective case review of all night HEMS missions attended by a charity air ambulance service in South East England over a 2-year period (October 1, 2013, to October 1, 2015). RESULTS: During the 2-year trial period, the HEMS service undertook a total of 5,004 missions and attended to 3,728 patients...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29112540/aeromedical-transport-in-children-a-descriptive-analysis-of-96-cases
#7
Guillaume Mortamet, Karen Harrington, Hervé Raffin, Mehdi Oualha, Sylvain Renolleau
OBJECTIVE: Pediatric aeromedical transport (AT) is highly challenging. We aim to describe a series of 96 cases of children requiring medical transport in terms of the indication, modalities, and related adverse events. METHODS: In this single-center retrospective study, we included air-transported patients less than 18 years old. RESULTS: During the study period, 96 patients, with median age of 120 months (range, 0-204), were air transported...
November 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29077228/air-ambulance-delivery-and-administration-of-4-factor-prothrombin-complex-concentrate-is-feasible-and-decreases-time-to-anticoagulation-reversal
#8
Claire Vines, Stephanie J Tesseneer, Robert D Cox, Damon A Darsey, Kristin Carbrey, Michael A Puskarich
OBJECTIVES: To evaluate the feasibility, safety, and preliminary efficacy of four-factor prothrombin complex concentrate (4-factor PCC) administration by an air ambulance service prior to or during transfer of patients with warfarin-associated major hemorrhage to a tertiary care center for definitive management (interventional arm) compared to patients receiving 4-factor PCC following transfer by air ambulance or ground without 4-factor PCC treatment (conventional arm). METHODS: Retrospective chart review of patients presenting to a large academic medical center...
October 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29069984/treatment-of-acute-myocardial-infarction-in-the-sub-arctic-region-of-norway-do-we-offer-an-equal-quality-of-care
#9
J Norum, A Hovland, L Balteskard, T Trovik, B Haug, F H Hansen, S Alterskjær, P Madsen, F Olsen
Patients, relatives, healthcare workers and administrators are concerned about the quality of care offered. We aimed to explore the treatment of acute myocatrdial infarction (AMI) in Northern Norway, compare it with the national figures, and document whether there is an equal quality of care or not. The retrospective study included data on patients' treatment for AMI. The following sources were employed. The Norwegian Patient Registry, National Quality of Care Database, Norwegian Myocardial Infarction Registry and data from the National Air Ambulance Services of Norway...
2017: International Journal of Circumpolar Health
https://www.readbyqxmd.com/read/29067785/pre-hospital-transfusion-of-red-blood-cells-in-civilian-trauma-patients
#10
M Rehn, A E Weaver, S Eshelby, J Røislien, D J Lockey
INTRODUCTION: The current management of severely injured patients includes damage control resuscitation strategies that minimise the use of crystalloids and emphasise earlier transfusion of red blood cells (RBC) to prevent coagulopathy. In 2012, London's air ambulance (LAA) became the first UK civilian pre-hospital service to routinely carry RBC to the trauma scene. OBJECTIVE: To investigate the effect of pre-hospital RBC transfusion (phRTx) on overall blood product consumption...
October 24, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29059493/perinatal-helicopter-ambulance-service-at-wakayama-medical-university-hospital-a-14-year-review
#11
Takeshi Kumagai, Mitsuhiko Riko, Masashi Satoh, Nobuyuki Kakimoto, Takuya Sugimoto, Mina Ueda, Takahiro Okutani, Ryuzo Higuchi, Shigetaka Yagi, Sawako Minami, Asumi Higa, Masakazu Miyawaki, Hiroyuki Suzuki
BACKGROUND: In 2003, a perinatal helicopter air ambulance service was introduced for remote areas of Wakayama and Mie prefectures, Japan. However, its long-term impact on perinatal medicine has not yet been analyzed. METHODS: A retrospective observational study was conducted on helicopter air ambulance cases recorded between January 2003 and December 2016 at Wakayama Medical University Hospital (WMUH). RESULTS: During that period, 61 pregnant mothers were transferred by helicopter air ambulance to WMUH...
October 23, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29052534/specialist-advice-may-improve-patient-selection-for-decompression-therapy-following-diving-accidents-a-retrospective-observational-study
#12
Daniel Steffensmeier, Roland Albrecht, Jürg Wendling, Roger Melliger, Donat R Spahn, Philipp Stein, Christophe Wyss
BACKGROUND: Even in a landlocked country like Switzerland recreational diving is becoming more and more popular. Smaller lakes in the Alps are located at an altitude of 2500 m above sea level. The incidence of diving accidents among all helicopter emergency service missions and the consecutive medical knowledge about decompression injuries is low. Thus, a collaboration between the Swiss Air-Ambulance (Rega) and the divers alert network (DAN) was initiated to improve patient treatment and identification of decompression injury and necessity of hyperbaric oxygen therapy (HBO)...
October 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28959133/traumatic-gastric-perforation-associated-with-cardiopulmonary-resuscitation-a-case-report
#13
Yosuke Arai, Soichiro Honjo, Syota Shimizu, Masaki Morimoto, Masataka Amisaki, Tomohiro Osaki, Naruo Tokuyasu, Teruhisa Sakamoto, Yoshihiko Maeta, Keigo Ashida, Hiroaki Saito, Yoshiyuki Fujiwara
Sternal and rib fractures are well-known complications of cardiopulmonary resuscitation (CPR). We experienced a rare case of traumatic gastric perforation associated with CPR that required emergency laparotomy. In this case, we examined whether surgery is essential for gastric perforation associated with CPR. A 67-year-old man experienced cardiopulmonary arrest in the workplace, and bystander CPR was performed by his colleagues. He was then transported by ambulance to our hospital. A large amount of free air was found in the peritoneal cavity on computed tomography at presentation, and perforation of the gastrointestinal tract was suspected...
September 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28934993/can-a-single-primary-care-paramedic-configuration-safely-transport-low-acuity-patients-in-air-ambulances
#14
Homer Tien, Bruce Sawadsky, Michael Lewell, Sean Moore, Michael Peddle, Alun Ackery, Brodie Nolan, Russell D MacDonald
OBJECTIVE: To determine if utilizing a single paramedic crew configuration is safe for transporting low acuity patients requiring only a primary care paramedic (PCP) level of care in Air Ambulances. METHODS: We studied single-PCP transports of low acuity patients done by contract air ambulance carriers, organized by Ornge (Ontario's Air Ambulance Service) for one year. We only included interfacility transports. We excluded all scene calls, and all Code 4 (emergent) calls...
September 22, 2017: CJEM
https://www.readbyqxmd.com/read/28901538/the-impact-of-fatigue-on-the-non-technical-skills-performance-of-critical-care-air-ambulance-clinicians
#15
J A Myers, D M C Powell, S Aldington, D Sim, A Psirides, K Hathaway, M F Haney
BACKGROUND: The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. METHODS: Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design)...
November 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28880362/cold-platelets-for-trauma-associated-bleeding-regulatory-approval-accreditation-approval-and-practice-implementation-just-the-tip-of-the-iceberg
#16
James R Stubbs, Sheryl A Tran, Richard L Emery, Scott A Hammel, De Anna L Haugen, Martin D Zielinski, Scott P Zietlow, Donald Jenkins
BACKGROUND: Laboratory and clinical evidence suggest that cold-stored platelets (CS-PLTs) might be preferable to room temperature platelets (RT-PLTs) for active bleeding. Ease of prehospital use plus potential hemostatic superiority led our facility to pursue approval of CS-PLTs for actively bleeding trauma patients. STUDY DESIGN AND METHODS: From November 18, 2013, through October 8, 2015, correspondence was exchanged between our facility, the AABB, and the US Food and Drug Administration (FDA)...
September 6, 2017: Transfusion
https://www.readbyqxmd.com/read/28876574/holding-the-torch-up-high-a-medical-historical-evaluation-of-surgical-advances-during-the-great-war-1914-1918-in-memory-of-those-that-served-and-fell
#17
G Scharf
"How wide and varied is the experience of the battlefield and how fertile the blood of warriors in raising good surgeons" Sir Clifford Allbutt (1898). With these sentiments of the medical lessons learned in war and conflict, with the background of the poem of "In Flanders Field", written by a doctor who had South African War connections, reasons (the Somme and third Ypres battles) will be given that this was indeed a "GREAT WAR" as the world history, weapons, strategy, tactics and wounding patterns had changed dramatically...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28746084/epidemiology-and-location-of-primary-retrieval-missions-in-a-scottish-aeromedical-service
#18
Gregg Neagle, Lisa Curatolo, John Ferris, Mike Donald, Stephen Hearns, Alasdair R Corfield
INTRODUCTION: Prehospital critical care teams comprising an appropriately trained physician and paramedic or nurse have been associated with improved outcomes in selected trauma patients. These teams are a scarce and expensive resource, especially when delivered by rotary air assets. The optimal tasking of prehospital critical care teams is therefore vital and remains a subject of debate. Emergency Medical Retrieval Service (EMRS) provides a prehospital critical care response team to incidents over a large area of Scotland either by air or by road...
July 25, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28739238/characteristics-of-fixed-wing-air-ambulance-transports-in-victoria-australia
#19
Ashleigh J Delorenzo, Jeremy W Abetz, Emily Andrew, Anthony de Wit, Brett Williams, Karen Smith
OBJECTIVE: Air medical transport is important for the transfer of patients in the prehospital and interhospital environment. Few studies have described the services provided by fixed wing ambulances or the broader clinical profiles of patients they transport. Such information may be useful for the planning and allocation of resources, assistance with training, and refining clinical protocols. We sought to describe the characteristics of patients transported by fixed wing aircraft at Air Ambulance Victoria (AAV) and the service AAV provides in Victoria, Australia...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28697471/the-relationship-between-airborne-fine-particle-matter-and-emergency-ambulance-dispatches-in-a-southwestern-city-in-chengdu-china
#20
Ruicong Liu, Jie Zeng, Xianyan Jiang, Jianyu Chen, Xufang Gao, Li Zhang, Tiantian Li
High levels of fine particulate matter (PM2.5) are known to cause adverse effects to human health. The goal of this study was to estimate the acute health effects of short-term exposure to ambient PM2.5 by analyzing cause-specific emergency ambulance dispatches as the endpoint in Chengdu, a city in Sichuan Province in southwest China. The ambient PM2.5 concentration of Chengdu reached 63 μg/m(3) in 2015. Data related to the causes of specific emergency ambulance dispatches, air pollution, and meteorological conditions were collected from 2013 to 2015 (1095 days)...
October 2017: Environmental Pollution
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