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https://www.readbyqxmd.com/read/29769024/hems-inter-facility-transfer-a-case-mix-analysis
#1
Damien Di Rocco, Mathieu Pasquier, Eric Albrecht, Pierre-Nicolas Carron, Fabrice Dami
BACKGROUND: Helicopter emergency medical services (HEMS) are popular rescue systems despite inconsistent evidence in the scientific literature to support their use for primary interventions, as well as for inter-facility transfer (IFT). There is little research about IFT by HEMS, hence questions remain about the appropriateness of this method of transport. The aim of this study was to describe a case-mix of operational and medical characteristics for IFT activity of a sole HEMS base, and identify indicators of over-triage...
May 16, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29735228/direct-air-versus-ground-transport-predictors-for-rural-pediatric-trauma
#2
Andrew B Starnes, Babawale Oluborode, Curtis Knoles, Boyd Burns, Henderson McGinnis, Kenneth Stewart
OBJECTIVE: Traumatic injury is the leading cause of mortality in children and the most common cause of emergency medical services transport in pediatric populations. We aimed to identify what factors are currently associated with selection for helicopter transport (HEMS) over ground ambulance (GEMS) in a primarily rural state. METHODS: We performed a retrospective case-control study of trauma patients younger than 18 years old reported to the Oklahoma State Trauma Registry between 2005 and 2014 who received direct transport from the scene of injury to a tertiary trauma center within the state...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29735227/care-of-the-injured-patients-at-nursing-stations-and-during-air-medical-transport
#3
Brodie Nolan, Alun Ackery, Sol Mamakwa, Shari Glenn, David VanderBurgh, Aaron Orkin, Michael Kirlew, Evelyn Dell, Homer Tien
INTRODUCTION: Nursing stations are the only access point into the health care system for some communities and have limited capabilities and resources. We describe characteristics of patients injured in Northern Ontario who present to nursing stations and require transport by air ambulance. Secondary objectives are to compare interventions performed at nursing stations with those performed by flight paramedics and to identify systemic gaps in trauma care. METHODS: A retrospective cohort study was performed of all injured patients transported by air ambulance from April 1, 2014, to March 31, 2015...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29712881/delays-in-the-air-or-ground-transfer-of-patients-for-endovascular-thrombectomy
#4
Robert W Regenhardt, Adam P Mecca, Stephanie A Flavin, Gregoire Boulouis, Arne Lauer, Kori Sauser Zachrison, James Boomhower, Aman B Patel, Joshua A Hirsch, Lee H Schwamm, Thabele M Leslie-Mazwi
BACKGROUND AND PURPOSE: For suspected large vessel occlusion patients efficient transfer to centers that provide endovascular therapy (ET) is critical to maximizing treatment opportunity. Our objective was to examine associations between transfer time, modes of transfer, ET, and outcomes within a hub-and-spoke telestroke network. METHODS: Patients with ischemic stroke were included if transferred to a single hub hospital between January 2011 and October 2015 with National Institutes of Health Stroke Scale>6, onset<12 hours from hub arrival with complete clinical, imaging, and transfer data...
April 30, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29706622/ambient-particulate-matter-air-pollution-associated-with-acute-respiratory-distress-syndrome-in-guangzhou-china
#5
Hualiang Lin, Jun Tao, Haidong Kan, Zhengmin Qian, Ailan Chen, Yaodong Du, Tao Liu, Yonghui Zhang, Yongqing Qi, Jianjun Ye, Shuangming Li, Wanglin Li, Jianpeng Xiao, Weilin Zeng, Xing Li, Katherine A Stamatakis, Xinyu Chen, Wenjun Ma
Limited evidence exists concerning the impact of particulate pollution on acute respiratory distress syndrome (ARDS). We examined the effects of particulate pollution on emergency ambulance dispatches (EAD) for ARDS in Guangzhou, China. Daily air pollution concentrations for PM10 , PM2.5 , and PM1 , as well as PM2.5 chemical compositions, were available from a central air monitoring station. The association between incident ARDS and air pollution on the concurrent and previous 5 days was estimated by an over-dispersed Poisson generalized additive model controlling for meteorological factors, temporal trends, public holidays and day of the week...
April 30, 2018: Journal of Exposure Science & Environmental Epidemiology
https://www.readbyqxmd.com/read/29706249/isolated-traumatic-brain-injury-results-in-significant-pre-hospital-derangement-of-cardiovascular-physiology
#6
M Gavrilovski, M El-Zanfaly, R M Lyon
INTRODUCTION: Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. METHODS: Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015-31 December 2016...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29698341/early-hospital-discharge-after-helicopter-transport-of-pediatric-trauma-patients-analysis-of-rates-of-over-and-undertriage
#7
Aodhnait S Fahy, Stephanie F Polites, Cornelius A Thiels, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, Scott P Zietlow, Donald H Jenkins, Martin D Zielinski
OBJECTIVES: Helicopter air ambulance (HAA) of pediatric trauma patients is a life-saving intervention. Triage remains a challenge for both scene transport and interhospital transfer of injured children. We aimed to understand whether overtriage or undertriage was a feature of scene or interhospital transfer and how in or out of state transfers affected these rates. METHODS: Children (<18 years) who underwent trauma activation at a level I trauma center between 2011 and 2013 were identified and reviewed...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29664833/effect-of-pre-hospital-red-blood-cell-transfusion-on-mortality-and-time-of-death-in-civilian-trauma-patients
#8
Marius Rehn, Anne Weaver, Karim Brohi, Sarah Eshelby, Laura Green, Jo Røislien, David J Lockey
BACKGROUND: Current management principles of haemorrhagic shock after trauma emphasize earlier transfusion therapy to prevent dilution of clotting factors and correct coagulopathy. London's air ambulance (LAA) was the first UK civilian pre-hospital service to routinely offer pre-hospital red blood cell (RBC) transfusion (phRTx). We investigated the effect of phRTx on mortality. METHODS: Retrospective trauma database study comparing mortality before-implementation with after-implementation of phRTx in exsanguinating trauma patients...
April 16, 2018: Shock
https://www.readbyqxmd.com/read/29628668/evaluation-of-change-in-knowledge-and-attitude-of-emergency-medicine-residents-after-introduction-of-a-rotation-in-emergency-medical-services-and-disaster-medicine
#9
Nawfal Aljerian, Aamir Omair, Sami A Yousif, Abdulrahman S Alqahtani, Faisal A Alhusain, Bader Alotaibi, Mohammad F Alshehri, Majed Aljuhani, Saad Albaiz, Yasser Alaska, Abdullah F Alanazi
Background: Saudi Board of Emergency Medicine (SBEM) graduates are involved in a 1-month rotation in emergency medical services (EMSs) and disaster medicine. The purpose of this study was to evaluate change in knowledge and attitude of EM residents after the introduction of the EMS and disaster medicine rotation. Materials and Methods: The study included 32 3rd -year SBEM residents. A pretest/posttest design and a five-point Likert scale were used. The data included a response to a questionnaire developed by EMS and disaster experts...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29564472/should-pre-hospital-resuscitative-thoracotomy-be-reserved-only-for-penetrating-chest-trauma
#10
REVIEW
Edward J Nevins, Parisa L Moori, Jonathan Smith-Williams, Nicholas T E Bird, John V Taylor, Nikhil Misra
PURPOSE: The indications for pre-hospital resuscitative thoracotomy (PHRT) remain undefined. The aim of this paper is to explore the variation in practice for PHRT in the UK, and review the published literature. METHODS: MEDLINE and PUBMED search engines were used to identify all relevant articles and 22 UK Air Ambulance Services were sent an electronic questionnaire to assess their PHRT practice. RESULTS: Four European publications report PHRT survival rates of 9...
March 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29494976/heatwave-and-health-events-a-systematic-evaluation-of-different-temperature-indicators-heatwave-intensities-and-durations
#11
Zhiwei Xu, Jian Cheng, Wenbiao Hu, Shilu Tong
OBJECTIVES: Temperature observation time and type influenced the assessment of heat impact on mortality, and different health events may have different temperature thresholds beyond which these health events increase substantially. This study aimed to investigate whether temperature observation time and type influenced the assessment of heatwave impact on morbidity, to assess how heatwave duration modified heatwave impact on morbidity, and to examine whether there was a consistent temperature threshold beyond which five different types of health events increased sharply...
July 15, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29491330/-paradoxical-embolism-due-to-right-superior-vena-cava-draining-into-the-left-atrium
#12
Tsuneo Nakajima, Toshihiro Sakai, Hitoshi Hara
We report a forty-six-year-old man with a past history of brain abscess managed by surgical drainage and recurrent ischemic strokes. After treatment of brain abscess, he had been on medication for symptomatic epilepsy, but had ceased medication by his judgment. He was taken to a hospital in an ambulance for an epileptic seizure. In the hospital he suffered from drug-induced renal dysfunction caused by the intravenous anti-epileptic drug, and right hemiparesis due to ischemic stroke occurred on the third hospitalization day...
March 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29478587/exploration-of-a-preflight-acuity-scale-for-fixed-wing-air-ambulance-transport
#13
Marcy Phipps, Virginia Conley, William H Constantine
INTRODUCTION: Despite the prevalence of fixed wing medical flights for specialized care and repatriation, few acuity rating scales exist aimed at the prediction of adverse in-flight medical events. An acuity scoring system can provide information to flight crews, allowing for staffing enhancements, protocol modifications, and flight planning, with the aim of improving patient care, outcomes, and preventing losses to providers because of costly diversions. METHODS: Our medical crew developed an acuity scale, which was applied retrospectively to 296 patients transported between January 2016 and March 2017...
March 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29362272/what-fluids-are-given-during-air-ambulance-treatment-of-patients-with-trauma-in-the-uk-and-what-might-this-mean-for-the-future-results-from-the-rescuer-observational-cohort-study
#14
David N Naumann, James M Hancox, James Raitt, Iain M Smith, Nicholas Crombie, Heidi Doughty, Gavin D Perkins, Mark J Midwinter
OBJECTIVES: We investigated how often intravenous fluids have been delivered during physician-led prehospital treatment of patients with hypotensive trauma in the UK and which fluids were given. These data were used to estimate the potential national requirement for prehospital blood products (PHBP) if evidence from ongoing trials were to report clinical superiority. SETTING: The Regional Exploration of Standard Care during Evacuation Resuscitation (RESCUER) retrospective observational study was a collaboration between 11 UK air ambulance services...
January 23, 2018: BMJ Open
https://www.readbyqxmd.com/read/29353856/-pneumatosis-cystoides-intestinalis-pci-with-sigmoid-volvulus-a-case-potentially-associated-with-lymphatic-vessels
#15
Haruyasu Honda, Seiichi Hayashi, Toshihisa Tsukadaira, Yasuhiro Sekiguchi
An 80-year-old woman was brought to our hospital in an ambulance because of signs of peritoneal irritation. Computed tomography revealed volvulus, sigmoid colon dilation, and free air and pneumatosis within the colonic and bowel wall. An emergency laparotomy was performed after the diagnosis of colonic perforation associated with volvulus or pneumatosis. Numerous gas-filled cysts, up to 10mm in diameter, were located in the resected bowel wall. The cells at the inner lining of the cysts tested positive for D2-40 immunoreactivity, seemingly originating from the lymphatic vessels...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
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
#16
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
#17
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
#18
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/m3 ) increase in PM10 at lag 2-4 days below the median (RR = 1...
December 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
#19
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...
January 2018: Resuscitation
https://www.readbyqxmd.com/read/29141907/emergency-versus-standard-response-time-efficacy-of-london-s-air-ambulance-rapid-response-vehicle
#20
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
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