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Patient Injury EMS

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https://www.readbyqxmd.com/read/27918863/ems-providers-beliefs-regarding-spinal-precautions-for-pediatric-trauma-transport
#1
Cindy D Chang, Remle P Crowe, Melissa A Bentley, Alyssa R Janezic, Julie C Leonard
OBJECTIVE: Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. METHODS: We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors. RESULTS: We received 5,400 responses (17%)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918858/d10-in-the-treatment-of-prehospital-hypoglycemia-a-24-month-observational-cohort-study
#2
H Gene Hern, Matthew Kiefer, Derex Louie, Joseph Barger, Harrison J Alter
INTRODUCTION: Prehospital first responders historically have used an IV bolus of 50 mL of 50% dextrose solution (D50) for the treatment of hypoglycemia in the field. A local Emergency Medical Services (EMS) system recently approved a hypoglycemia treatment protocol of IV 10% dextrose solution (D10) due to occasional shortages and higher cost of D50. We use the experience of this EMS system to report the feasibility, safety, and efficacy of this approach. METHODS: Over the course of 104 weeks, paramedics treated 1,323 hypoglycemic patients with D10 and recorded patient demographics and clinical outcomes...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27914232/resuscitation-attempts-and-duration-in-traumatic-out-of-hospital-cardiac-arrest
#3
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: This study aimed to understand factors associated with paramedics' decision to attempt resuscitation in traumatic out-of-hospital cardiac arrest (OHCA) and to characterise resuscitation attempts ≤10min in patients who die at the scene. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all cases of traumatic OHCA between July 2008 and June 2014. We excluded cases <16 years of age or with a mechanism of hanging or drowning...
November 30, 2016: Resuscitation
https://www.readbyqxmd.com/read/27906867/external-validation-of-the-air-medical-prehospital-triage-score-for-identifying-trauma-patients-likely-to-benefit-from-scene-helicopter-transport
#4
Joshua B Brown, Mark L Gestring, Francis X Guyette, Matthew R Rosengart, Nicole A Stassen, Raquel M Forsythe, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry
BACKGROUND: The Air Medical Prehospital Triage (AMPT) score was developed to identify injured patients who may benefit from scene helicopter emergency medical services (HEMS) transport. External validation using a different dataset is essential to ensure reliable performance. The study objective was to validate the effectiveness of the AMPT score to identify patients with a survival benefit from HEMS using the Pennsylvania Trauma Outcomes Study (PTOS) registry. METHODS: Patients age≥16years undergoing scene HEMS or ground EMS (GEMS) transport in the PTOS registry 2000-2013 were included...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27902671/prehospital-transport-for-pediatric-trauma-a-comparison-of-private-transport-and-emergency-medical-services
#5
Yea-Chyi Lin, York Tien Lee, Jasmine Xun Yi Feng, Li Wei Chiang, Shireen Anne Nah
OBJECTIVES: We describe the demographics of pediatric patients with trauma transferred using private transport (PT) versus emergency medical services (EMS) and evaluate the potential impact on their treatment and outcome. METHODS: We accessed data from our national trauma registry, a prospectively collected database. Data were extracted on all patients with trauma admitted to our institution between January 2011 and June 2013, with injury severity score (ISS) higher than 8...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27894559/helicopter-transport-in-regionalized-burn-care-one-program-s-perspective
#6
Benjamin Nicholson, Harinder Dhindsa
BACKGROUND: The decision to use helicopter EMS (HEMS) for the transport of burn patients is a complex decision. This analysis sought to evaluate burn patients flown to burn centers who met predetermined criteria for patients who likely benefit from HEMS care. METHODS: A retrospective transport chart review of all burn transports covering the preceding nine and a half years was conducted to evaluate for HEMS appropriate criteria defined as patients requiring advanced airway management, ventilator support, facial burns, inhalation injury, circumferential burns, electrical or chemical burn, or major burns...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27833679/endotracheal-tube-cuff-pressures-in-patients-intubated-prior-to-helicopter-ems-transport
#7
Joseph Tennyson, Tucker Ford-Webb, Stacy Weisberg, Donald LeBlanc
INTRODUCTION: Endotracheal intubation is a common intervention in critical care patients undergoing helicopter emergency medical services (HEMS) transportation. Measurement of endotracheal tube (ETT) cuff pressures is not common practice in patients referred to our service. Animal studies have demonstrated an association between the pressure of the ETT cuff on the tracheal mucosa and decreased blood flow leading to mucosal ischemia and scarring. Cuff pressures greater than 30 cmH2O impede mucosal capillary blood flow...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27806488/in-hospital-outcome-based-on-the-mode-of-ems-transportation-in-a-high-income-rapidly-developing-middle-eastern-country
#8
Hassan Al-Thani, Ayman El-Menyar, Yugan Pillay, Monira Mollazehi, Ahammed Mekkodathil, Rafael Consunji
BACKGROUND: Helicopter emergency medical services (HEMS) are considered as a standard component of advanced pre-hospital emergency care system. We assessed the clinical presentation and outcomes of trauma patients transported by HEMS versus ground emergency medical services (GEMS). METHODS: A retrospective analysis of prospectively collected trauma registry data at a level I trauma center was conducted for patients transported by GEMS and HEMS between 2011 and 2013...
July 6, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27732713/evaluation-of-rural-vs-urban-trauma-patients-served-by-9-1-1-emergency-medical-services
#9
Craig D Newgard, Rongwei Fu, Eileen Bulger, Jerris R Hedges, N Clay Mann, Dagan A Wright, David P Lehrfeld, Carol Shields, Gregory Hoskins, Craig Warden, Lynn Wittwer, Jennifer N B Cook, Michael Verkest, William Conway, Stephanie Somerville, Matthew Hansen
Importance: Despite a large rural US population, there are potential differences between rural and urban regions in the processes and outcomes following trauma. Objectives: To describe and evaluate rural vs urban processes of care, injury severity, and mortality among injured patients served by 9-1-1 emergency medical services (EMS). Design, Setting, and Participants: This was a preplanned secondary analysis of a prospective cohort enrolled from January 1 through December 31, 2011, and followed up through hospitalization...
October 12, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27723516/characterization-of-the-occult-nature-of-injury-for-frequently-occurring-motor-vehicle-crash-injuries
#10
Samantha L Schoell, Andrea N Doud, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, James E Winslow, Joel D Stitzel
BACKGROUND: Occult injuries are not easily detected and can be potentially life-threatening. The purpose of this study was to quantify the perceived occultness of the most frequent motor vehicle crash injuries according to emergency medical services (EMS) professionals. STUDY DESIGN: An electronic survey was distributed to 1,125 EMS professionals who were asked to quantify the likelihood that first responders would miss symptoms related to a particular injury on a 5-point Likert scale...
October 7, 2016: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/27697403/the-helicopter-as-a-caring-context-experiences-of-people-suffering-trauma
#11
Linda Sandström, Carina Nilsson, Päivi Juuso, Åsa Engström
INTRODUCTION: When emergency medical services (EMS) are needed, the choice of transport depends on several factors. These may include the patient's medical condition, transport accessibility to the accident site and the receiving hospital's resources. Emergency care research is advancing, but little is known about the patient's perspective of helicopter emergency medical services (HEMS). AIM: The aim of this study was to describe trauma patients' experiences of HEMS...
September 30, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/27689248/trends-and-predictors-of-limb-tourniquet-use-by-civilian-emergency-medical-services-in-the-united-states
#12
Mazen J El Sayed, Hani Tamim, Aurelie Mailhac, N Clay Mann
BACKGROUND: Tourniquet use by Emergency Medical Services (EMS) can be life saving for severely injured patients. The adoption of this intervention is not well described in civilian settings. This study describes patterns and trends of tourniquet use by civilian EMS and identifies predictors of such use. METHODS: A retrospective study of four consecutive releases of the U.S. National Emergency Medical Services Information System (NEMSIS) public research dataset (2011-14) was conducted...
September 30, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27633344/obstacle-course-runs-review-of-acquired-injuries-and-illnesses-at-a-series-of-canadian-events-race
#13
Alana Hawley, Mathew Mercuri, Kerstin Hogg, Erich Hanel
BACKGROUND: The growing popularity of obstacle course runs (OCRs) has led to significant concerns regarding their safety. The influx of injuries and illnesses in rural areas where OCRs are often held can impose a large burden on emergency medical services (EMS) and local EDs. Literature concerning the safety of these events is minimal and mostly consists of media reports. We sought to characterise the injury and illness profile of OCRs and the level of medical care required. METHODS: This study analysed OCR events occurring in eight locations across Canada from May to August 2015 (total 45 285 participants)...
September 15, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27537514/police-transport-versus-ground-ems-a-trauma-system-level-evaluation-of-prehospital-care-policies-and-their-effect-on-clinical-outcomes
#14
Michael W Wandling, Avery B Nathens, Michael B Shapiro, Elliott R Haut
BACKGROUND: Rapid transport to definitive care ("scoop and run") versus field stabilization in trauma remains a topic of debate and has resulted in variability in prehospital policy. We aimed to identify trauma systems frequently using a true "scoop and run" police transport approach and to compare mortality rates between police and ground emergency medical services (EMS) transport. METHODS: Using the National Trauma Databank (NTDB), we identified adult gunshot and stab wound patients presenting to Level 1 or 2 trauma centers from 2010 to 2012...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27497673/geographic-discordance-between-patient-residence-and-incident-location-in-emergency-medical-services-responses
#15
Renee Y Hsia, Mengtao Dai, Ran Wei, Sarah Sabbagh, N Clay Mann
STUDY OBJECTIVE: The location of a patient's residence is often used for emergency medical services (EMS) system planning. Our objective is to evaluate the association between patient residence and emergency incident zip codes for 911 calls. METHODS: We used data from the 2013 National Emergency Medical Services Information System (NEMSIS) Public-Release Research Dataset. We studied all 911 calls with a valid complaint by dispatch, identifying zip codes for both the residence and incident locations (n=12,376,784)...
July 25, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27438027/privately-insured-medical-patients-are-more-likely-to-have-a-head-ct
#16
Emily M Fortin, Jerry Fisher, Sheng Qiu, Charlene Irvin Babcock
Previous studies suggest overuse disparity of head computed tomography (CT) in white pediatric trauma patients with minor head injuries. Our study is meant to determine if race or insurance status impacts the probability of obtaining head CT in patients with a Glasgow Coma Scale (GCS) = 15. Using the 2008-2010 National Hospital Ambulatory Medical Care Survey for Emergency Departments (NHAMCS) database, the following variables were analyzed: race, emergency medical services (EMS) arrival, triage category, admission status, gender, age, and insurance status...
July 20, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27429680/a-derivation-and-validation-study-of-an-early-blood-transfusion-needs-score-for-severe-trauma-patients
#17
Hao Wang, Johnbosco Umejiego, Richard D Robinson, Chet D Schrader, JoAnna Leuck, Michael Barra, Stefan Buca, Andrew Shedd, Andrew Bui, Nestor R Zenarosa
BACKGROUND: There is no existing adequate blood transfusion needs determination tool that Emergency Medical Services (EMS) personnel can use for prehospital blood transfusion initiation. In this study, a simple and pragmatic prehospital blood transfusion needs scoring system was derived and validated. METHODS: Local trauma registry data were reviewed retrospectively from 2004 through 2013. Patients were randomly assigned to derivation and validation cohorts. Multivariate logistic regression was used to identify the independent approachable risks associated with early blood transfusion needs in the derivation cohort in which a scoring system was derived...
August 2016: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27411064/multicenter-evaluation-of-prehospital-opioid-pain-management-in-injured-children
#18
Lorin R Browne, Manish I Shah, Jonathan R Studnek, Daniel G Ostermayer, Stacy Reynolds, Clare E Guse, David C Brousseau, E Brooke Lerner
BACKGROUND: The National Association of Emergency Medical Services Physicians' (NAEMSP) Position Statement on Prehospital Pain Management and the joint National Highway Traffic Safety Administration (NHTSA) and Emergency Medical Services for Children (EMSC) Evidence-based Guideline for Prehospital Analgesia in Trauma aim to improve the recognition, assessment, and treatment of prehospital pain. The impact of implementation of these guidelines on pain management in children by emergency medical services (EMS) agencies has not been assessed...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27357894/workplace-violence-process-against-emergency-medical-services-staffs-a-grounded-theory
#19
Majid Pourshaikhian, Davood Khorasani-Zavareh, Hassan Abolghasem Gorji, Aidin Aryankhesal, Ahmad Barati
BACKGROUND: Workplace Violence (WPV) is an undesirable social phenomenon that threatens patients and staff safety and work environments. Despite the high prevalence of WPV and its serious consequences, limited studies have been conducted on its roots and formation in pre-hospital emergency. The aim of this study was to explore and explain the process of workplace violence against emergency medical service personnel. METHODS: This qualitative study was performed using grounded theory approach in 2015...
2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27349211/early-maladaptive-schemas-in-eating-disordered-patients-with-or-without-non-suicidal-self-injury
#20
Els Pauwels, Eva Dierckx, Katrien Schoevaerts, Laurence Claes
This study investigates early maladaptive schemas (EMSs) in function of eating disorder (ED) subtypes (restrictive/bulimic) and the presence/absence of non-suicidal self-injury (NSSI). Female inpatients (N = 491) completed the Young Schema Questionnaire and the Self-Injury Questionnaire. The influence of ED subtype and the presence/absence of NSSI and their interaction on the EMS were investigated by means of a MANCOVA. The results showed main effects of ED subtype and the presence of NSSI on EMS. Patients with bulimia scored significantly higher on insufficient self-control and emotional deprivation, which are more related to cluster B compared with restrictive patients, whereas restrictive patients scored significantly higher on social undesirability, failure to achieve, subjugation and unrelenting standards compared with patients with bulimia that are more related to cluster C...
September 2016: European Eating Disorders Review: the Journal of the Eating Disorders Association
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