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Prehospital sepsis

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https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#1
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27908332/prehospital-sepsis-care
#2
REVIEW
Jerrilyn Jones, Benjamin J Lawner
Prehospital care providers are tasked with the delivery of time-sensitive care, and emergency medical services (EMS) systems must match patients to appropriate clinical resources. Modern systems are uniquely positioned to recognize and treat patients with sepsis. Interventions such as administration of intravenous fluid and transporting patients to the appropriate level of definitive care are linked to improved patient outcomes. As EMS systems refine their protocols for the recognition and stabilization of patients with suspected or presumed sepsis, EMS providers need to be educated about the spectrum of sepsis-related presentations and treatment strategies need to be standardized...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27851057/1421-prehospital-level-of-care-prehospital-iv-access-and-timing-of-antibiotics-in-sepsis
#3
Ithan Peltan, Kristina Mitchell, Kristina Rudd, Blake Mann, David Carlbom, Thomas Rea, Catherine Hough, Samuel Brown
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27625735/prehospital-lactate-measurement-by-emergency-medical-services-in-patients-meeting-sepsis-criteria
#4
Lori L Boland, Jonathan S Hokanson, Karl M Fernstrom, Tyler G Kinzy, Charles J Lick, Paul A Satterlee, Brian K LaCroix
INTRODUCTION: We aimed to pilot test the delivery of sepsis education to emergency medical services (EMS) providers and the feasibility of equipping them with temporal artery thermometers (TATs) and handheld lactate meters to aid in the prehospital recognition of sepsis. METHODS: This study used a convenience sample of prehospital patients meeting established criteria for sepsis. Paramedics received education on systemic inflammatory response syndrome (SIRS) criteria, were trained in the use of TATs and hand-held lactate meters, and enrolled patients who had a recent history of infection, met ≥ 2 SIRS criteria, and were being transported to a participating hospital...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27496231/identification-of-adults-with-sepsis-in-the-prehospital-environment-a-systematic-review
#5
Michael A Smyth, Samantha J Brace-McDonnell, Gavin D Perkins
OBJECTIVE: Early identification of sepsis could enable prompt delivery of key interventions such as fluid resuscitation and antibiotic administration which, in turn, may lead to improved patient outcomes. Limited data indicate that recognition of sepsis by paramedics is often poor. We systematically reviewed the literature on prehospital sepsis screening tools to determine whether they improved sepsis recognition. DESIGN: Systematic review. The electronic databases MEDLINE, EMBASE, CINAHL, the Cochrane Library and PubMed were systematically searched up to June 2015...
August 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27429693/impact-of-prehospital-care-on-outcomes-in-sepsis-a-systematic-review
#6
REVIEW
Michael A Smyth, Samantha J Brace-McDonnell, Gavin D Perkins
INTRODUCTION: Sepsis is a common and potentially life-threatening response to an infection. International treatment guidelines for sepsis advocate that treatment be initiated at the earliest possible opportunity. It is not yet clear if very early intervention by ambulance clinicians prior to arrival at hospital leads to improved clinical outcomes among sepsis patients. METHODA: We systematically searched the electronic databases MEDLINE, EMBASE, CINAHL, the Cochrane Library and PubMed up to June 2015...
July 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27393760/management-of-septic-shock-in-the-remote-prehospital-setting
#7
Emma Lucy Joynes, Jodie Martin, Mark Ross
This study aims to assess the management of septic shock by air medical retrieval teams in the remote setting. A retrospective observational study was performed over 36 months. Sixty-seven adult patients who met the criteria for septic shock were included. Respiratory sepsis was the working diagnosis for 53% of patients; this was confirmed on intensive care unit (ICU) discharge in 39% of patients. Intravenous antibiotics and oxygen were delivered in over 90% of patients. Central and arterial line insertions were performed in 48% and 40% of patients, respectively, and 79% of patients were catheterized...
July 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27211803/opportunities-for-emergency-medical-services-ems-care-of-syncope
#8
Brit J Long, Luis A Serrano, Jose G Cabanas, M Fernanda Bellolio
UNLABELLED: Introduction Emergency Medical Service (EMS) systems are vital in the identification, assessment, and treatment of trauma, stroke, myocardial infarction, and sepsis patients, improving early recognition, resuscitation, and transport. Emergency Medical Service personnel provide similar care for patients with syncope. The role of EMS in the management of patients with syncope has not been reported. Hypothesis/Objective The objective of this study was to describe the management of out-of-hospital syncope by prehospital providers in an urban EMS system...
August 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27176727/prehospital-administration-of-tranexamic-acid-in-trauma-patients
#9
Arasch Wafaisade, Rolf Lefering, Bertil Bouillon, Andreas B Böhmer, Michael Gäßler, Matthias Ruppert
BACKGROUND: Evidence on prehospital administration of the antifibrinolytic tranexamic acid (TXA) in civilian trauma populations is scarce. The aim was to study whether prehospital TXA use in trauma patients was associated with improved outcomes. METHODS: The prehospital database of the ADAC (General German Automobile Club) Air Rescue Service was linked with the TraumaRegister of the German Trauma Society to reidentify patients documented in both registries. Primarily admitted trauma patients (2012 until 2014) who were treated with TXA during the prehospital phase were matched with patients who had not received prehospital TXA, applying propensity score-based matching...
May 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27051533/paramedic-recognition-of-sepsis-in-the-prehospital-setting-a-prospective-observational-study
#10
Robert S Green, Andrew H Travers, Edward Cain, Samuel G Campbell, Jan L Jensen, David A Petrie, Mete Erdogan, Gredi Patrick, Ward Patrick
Background. Patients with sepsis benefit from early diagnosis and treatment. Accurate paramedic recognition of sepsis is important to initiate care promptly for patients who arrive by Emergency Medical Services. Methods. Prospective observational study of adult patients (age ≥ 16 years) transported by paramedics to the emergency department (ED) of a Canadian tertiary hospital. Paramedic identification of sepsis was assessed using a novel prehospital sepsis screening tool developed by the study team and compared to blind, independent documentation of ED diagnoses by attending emergency physicians (EPs)...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27033336/improving-sepsis-recognition-and-utilization-of-early-goal-directed-therapy-in-the-prehospital-environment-a-review-of-the-literature
#11
Scott David Baker
No abstract text is available yet for this article.
September 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/27026077/the-early-chain-of-care-in-patients-with-bacteraemia-with-the-emphasis-on-the-prehospital-setting
#12
Christer Axelsson, Johan Herlitz, Anders Karlsson, Henrik Sjöberg, Maria Jiménez-Herrera, Angela Bång, Anders Jonsson, Anders Bremer, Henrik Andersson, Martin Gellerstedt, Lars Ljungström
UNLABELLED: Purpose There is a lack of knowledge about the early phase of severe infection. This report describes the early chain of care in bacteraemia as follows: (a) compare patients who were and were not transported by the Emergency Medical Services (EMS); (b) describe various aspects of the EMS chain; and (c) describe factors of importance for the delay to the start of intravenous antibiotics. It was hypothesized that, for patients with suspected sepsis judged by the EMS clinician, the delay until the onset of antibiotic treatment would be shorter...
June 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/26905389/the-ability-of-early-warning-scores-ews-to-detect-critical-illness-in-the-prehospital-setting-a-systematic-review
#13
REVIEW
Teresa A Williams, Hideo Tohira, Judith Finn, Gavin D Perkins, Kwok M Ho
AIM: To examine whether early warning scores (EWS) can accurately predict critical illness in the prehospital setting and affect patient outcomes. METHODS: We searched bibliographic databases for comparative studies that examined prehospital EWS for patients transported by ambulance in the prehospital setting. The ability of the different EWS, including pre-alert protocols and physiological-based EWS, to predict critical illness (sensitivity, odds ratio [OR], area under receiver operating characteristic [AUROC] curves) and hospital mortality was summarised...
May 2016: Resuscitation
https://www.readbyqxmd.com/read/26879597/a-prehospital-screening-tool-utilizing-end-tidal-carbon-dioxide-predicts-sepsis-and-severe-sepsis
#14
Christopher L Hunter, Salvatore Silvestri, George Ralls, Amanda Stone, Ayanna Walker, Linda Papa
OBJECTIVE: To determine the utility of a prehospital sepsis screening protocol utilizing systemic inflammatory response syndrome (SIRS) criteria and end-tidal carbon dioxide (ETCO2). METHODS: We conducted a prospective cohort study among sepsis alerts activated by emergency medical services during a 12 month period after the initiation of a new sepsis screening protocol utilizing ≥2 SIRS criteria and ETCO2 levels of ≤25 mmHg in patients with suspected infection...
May 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26864327/prehospital-management-and-identification-of-sepsis-by-emergency-medical-services-a-systematic-review
#15
Daniel Lane, Robbie I Ichelson, Ian R Drennan, Damon C Scales
OBJECTIVE: To identify studies describing the accuracy of prehospital sepsis identification and to summarise results of studies of prehospital management of patients with sepsis, severe sepsis or septic shock. METHODS: We conducted a systematic review to retrieve studies that evaluated the prehospital identification or treatment of patients with sepsis by emergency medical services (EMS). Two authors extracted data describing the study characteristics, incidence of sepsis among EMS-transported patients, criteria used to identify sepsis and specific treatments provided to patients with sepsis...
June 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26851062/ethical-and-regulatory-challenges-in-advancing-prehospital-research-focus-on-sepsis
#16
Carmen C Polito, Jonathan E Sevransky, Neal W Dickert
No abstract text is available yet for this article.
March 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26808233/2015-pediatric-research-priorities-in-prehospital-care
#17
Lorin R Browne, Manish I Shah, Jonathan R Studnek, Brittany M Farrell, Linda M Mattrisch, Stacy Reynolds, Daniel G Ostermayer, David C Brousseau, E Brooke Lerner
BACKGROUND: Pediatric prehospital research has been limited, but work in this area is starting to increase particularly with the growth of pediatric-specific research endeavors. Given the increased interest in pediatric prehospital research, there is a need to identify specific research priorities that incorporate the perspective of prehospital providers and other emergency medical services (EMS) stakeholders. OBJECTIVES: To develop a list of specific research priorities that is relevant, specific, and important to the practice of pediatric prehospital care...
May 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26759980/outcomes-and-resource-use-of-sepsis-associated-stays-by-presence-on-admission-severity-and-hospital-type
#18
Stephen L Jones, Carol M Ashton, Lisa B Kiehne, Juan C Nicolas, Alexis L Rose, Beverly A Shirkey, Faisal Masud, Nelda P Wray
OBJECTIVE: To establish a baseline for the incidence of sepsis by severity and presence on admission in acute care hospital settings before implementation of a broad sepsis screening and response initiative. METHODS: A retrospective cohort study using hospital discharge abstracts of 5672 patients, aged 18 years and above, with sepsis-associated stays between February 2012 and January 2013 at an academic medical center and 5 community hospitals in Texas. RESULTS: Sepsis was present on admission in almost 85% of cases and acquired in-hospital in the remainder...
March 2016: Medical Care
https://www.readbyqxmd.com/read/26700287/mcgrath-mac-videolaryngoscope-versus-macintosh-laryngoscope-for-orotracheal-intubation-in-intensive-care-patients-the-randomised-multicentre-macman-trial-study-protocol
#19
RANDOMIZED CONTROLLED TRIAL
Arthur Bailly, Jean Baptiste Lascarrou, Aurelie Le Thuaut, Julie Boisrame-Helms, Toufik Kamel, Emmanuelle Mercier, Jean Damien Ricard, Virginie Lemiale, Benoit Champigneulle, Jean Reignier
INTRODUCTION: Critically ill patients with acute respiratory, neurological or cardiovascular failure requiring invasive mechanical ventilation are at high risk of difficult intubation and have organ dysfunctions associated with complications of intubation and anaesthesia such as hypotension and hypoxaemia. The complication rate increases with the number of intubation attempts. Videolaryngoscopy improves elective endotracheal intubation. McGRATH MAC is the lightest videolaryngoscope and the most similar to the Macintosh laryngoscope...
December 23, 2015: BMJ Open
https://www.readbyqxmd.com/read/26699259/-delayed-appendectomy-because-of-diagnostic-malpractice-experiences-of-the-arbitration-board-of-the-north-german-medical-associations
#20
Heinrich Vinz, Markward von Bülow, Johann Neu
From 2000 to 2012, 447 panel proceedings concerning acute appendicitis were evaluated. 271 cases (57 %) were related to alleged diagnostic malpractice. This was confirmed in 176 cases (67 %). The following medical specialities were involved (m = quote of malpractice): general surgery 33 %, m = 51 %; paediatric surgery 3 %, m = 44 %; general practitioner and prehospital emergency services 24 %, m = 62 %; internal medicine 19 %, m = 70 %; paediatrics 13 %, m = 57 %; gynaecology 3 %, m = 91 %; urology 2 %, m = 17 %...
2015: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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