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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
#1
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/28459301/role-of-guideline-adherence-in-improving-field-triage
#2
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/28398935/emergency-medical-services-utilization-by-children
#3
Parul Dayal, Timothy Horeczko, Cheryl Wraa, Larry Karsteadt, Wendy Chapman, Louis Bruhnke, Rebecca Litman, Timothy Ruttan, Nathan Kuppermann, James Marcin
OBJECTIVE: The aim of this study was to compare demographic and clinical features of children (0-14 years old) who arrived at general emergency departments (EDs) by emergency medical services (EMS) to those who arrived by private vehicles and other means in a rural, 3-county region of northern California. METHODS: We reviewed 507 ED records of children who arrived at EDs by EMS and those who arrived by other means in 2013. We also analyzed prehospital procedures performed on all children transported to an area hospital by EMS...
April 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28350719/previous-emergency-medical-services-use-by-victims-of-child-homicide
#4
Rohit P Shenoi, Anriada Nassif, Elizabeth A Camp, Faria A Pereira
INTRODUCTION: The medical diagnoses and frequency of emergency department visits made by children who are later given a diagnosis of maltreatment do not differ much from those of nonabused children. However, the type of medical complaints and frequency of emergency medical services (EMS) use by child homicide victims before their death are not known. We compared EMS use between child homicide victims and children who died from natural causes before their death. METHODS: This was a retrospective case-control study of children 0 to 5 years old who died in Houston, Texas, from 2005 to 2010...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28349529/continuous-chest-compression-versus-interrupted-chest-compression-for-cardiopulmonary-resuscitation-of-non-asphyxial-out-of-hospital-cardiac-arrest
#5
REVIEW
Lei Zhan, Li J Yang, Yu Huang, Qing He, Guan J Liu
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a major cause of death worldwide. Cardiac arrest can be subdivided into asphyxial and non asphyxial etiologies. An asphyxia arrest is caused by lack of oxygen in the blood and occurs in drowning and choking victims and in other circumstances. A non asphyxial arrest is usually a loss of functioning cardiac electrical activity. Cardiopulmonary resuscitation (CPR) is a well-established treatment for cardiac arrest. Conventional CPR includes both chest compressions and 'rescue breathing' such as mouth-to-mouth breathing...
March 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28246139/emergency-medical-services-responders-perceptions-of-the-effect-of-stress-and-anxiety-on-patient-safety-in-the-out-of-hospital-emergency-care-of-children-a-qualitative-study
#6
Jeanne-Marie Guise, Matthew Hansen, Kerth O'Brien, Caitlin Dickinson, Garth Meckler, Phil Engle, William Lambert, Jonathan Jui
OBJECTIVE: Prehospital emergency medical services (EMS) providers report anxiety as the second most common contributor to paediatric patient safety events. The objective of this study was to understand how EMS providers perceive the effect of stress and anxiety on paediatric out-of-hospital patient safety. SETTING: This was a nationwide study of EMS providers from 44 of 50 (88%) US states. PARTICIPANTS: A total of 753 eligible EMS professionals, including emergency medical technicians, emergency department physicians and nurses (general and paediatric), and respiratory therapists who participate in out-of-hospital transports...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28124200/operational-demands-on-pre-hospital-emergency-care-for-burn-injuries-in-a-middle-income-setting-a-study-in-the-western-cape-south-africa
#7
Rachel L Allgaier, Lucie Laflamme, Lee A Wallis
BACKGROUND: Burns occur disproportionately within low-socioeconomic populations. The Western Cape Province of South Africa represents a middle-income setting with a high rate of burns, few specialists and few burn centres, yet a well-developed pre-hospital system. This paper describes the burn cases from a viewpoint of operational factors important to pre-hospital emergency medical services. METHODS: A retrospective, cross-sectional study of administrative and patient records was conducted...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28103120/compassionate-options-for-pediatric-ems-cope-addressing-communication-skills
#8
Aaron W Calhoun, Erica R H Sutton, Anita P Barbee, Beth McClure, Carrie Bohnert, Richard Forest, Peter Taillac, Mary E Fallat
INTRODUCTION: Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills...
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28072893/a-pediatric-application-of-the-strac-regional-hospital-trauma-registry-database-pediatric-trauma-deaths-in-south-central-texas-during-2004-2013
#9
Michelle Buehner, Jay Aden, Mathew Borgman, Preston Love, Brandi Wright, Mary Edwards
The purpose of this study was to define the demographics of pediatric traumatic injuries and to understand the predictive value of injury type, prehospital, and emergency department (ED) data regarding the mortality of pediatric trauma patients (<14 years of age) in South Central Texas. We report a retrospective review of pediatric trauma patients presenting to Trauma Service Area P in South Central Texas during 2004-2013. The primary outcome was mortality; secondary outcomes were ventilator days, hospital days, and intensive care unit stay...
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28059586/resource-document-coordination-of-pediatric-emergency-care-in-ems-systems
#10
Katherine Remick, Toni Gross, Kathleen Adelgais, Manish I Shah, Julie C Leonard, Marianne Gausche-Hill
BACKGROUND: Citing numerous pediatric-specific deficiencies within Emergency Medical Services (EMS) systems, the Institute of Medicine (IOM) recommended that EMS systems appoint a pediatric emergency care coordinator (PECC) to provide oversight of EMS activities related to care of children, to promote the integration of pediatric elements into day-to-day services as well as local and/or regional disaster planning, and to promote pediatric education across all levels of EMS providers. METHODS: A systematic review of the literature was undertaken to describe the evidence for pediatric coordination across the emergency care continuum...
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#11
Michelle M Corrado, Junxin Shi, Krista K Wheeler, Jin Peng, Brian Kenney, Sarah Johnson, Huiyun Xiang
OBJECTIVES: This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. METHODS: We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer...
March 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27976464/methods-for-collecting-paired-observations-from-emergency-medical-services-and-emergency-department-providers-for-pediatric-cervical-spine-injury-risk-factors
#12
Fahd A Ahmad, Hamilton Schwartz, Lorin R Browne, Sherry Lassa-Claxton, Michael Wallendorf, E Brooke Lerner, Nathan Kuppermann, Julie C Leonard
OBJECTIVES: Cervical spine injuries (CSIs) after blunt trauma in children are rare, but cause substantial morbidity and mortality. Emergency medical services (EMS) and emergency department (ED) providers routinely use spinal precautions and cervical spine imaging, respectively, during the management of children experiencing blunt trauma. These practices lack evidence, and there is concern that they may be harmful. A pediatric CSI risk assessment tool is needed to inform EMS and ED provider decision making...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27927227/adult-termination-of-resuscitation-tor-criteria-may-not-be-suitable-for-children-a-retrospective-analysis
#13
Victoria Maria Rotering, Sonja Trepels-Kottek, Konrad Heimann, Jörg-Christian Brokmann, Thorsten Orlikowsky, Mark Schoberer
BACKGROUND: Only a small number of patients survive out-of-hospital-cardiac-arrest (OHCA). The duration of CPR varies considerably and transportation of patients under CPR is often unsuccessful. Termination-of-resuscitation (TOR)-criteria aim to preclude futile resuscitation efforts. Our goal was to find out to which extent existing TOR-criteria can be transferred to paediatric OHCA-patients with special regard to their prognostic value. METHODS: We performed a retrospective analysis of an eleven-year single centre patient cohort...
December 7, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27902671/prehospital-transport-for-pediatric-trauma-a-comparison-of-private-transport-and-emergency-medical-services
#14
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
#15
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/27732713/evaluation-of-rural-vs-urban-trauma-patients-served-by-9-1-1-emergency-medical-services
#16
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...
January 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27710155/ability-of-the-physiologic-criteria-of-the-field-triage-guidelines-to-identify-children-who-need-the-resources-of-a-trauma-center
#17
E Brooke Lerner, Amy L Drendel, Jeremy T Cushman, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: There is limited research on how well the American College of Surgeons/Center for Disease Control and Prevention Guidelines for Field Triage of Injured Patients assist EMS providers in identifying children who need the resources of a trauma center. OBJECTIVE: To determine the accuracy of the Physiologic Criteria (Step 1) of the Field Triage Guidelines in identifying injured children who need the resources of a trauma center. METHODS: EMS providers who transported injured children 15 years and younger to pediatric trauma centers in 3 mid-sized cities were interviewed regarding patient demographics and the presence or absence of each of the Field Triage Guidelines criteria...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27690289/emergency-medical-dispatchers-can-obtain-accurate-pediatric-weights-from-9-1-1-callers
#18
Todd Chassee, Diann Reischmann, Michael Mancera, John D Hoyle
BACKGROUND: Prehospital pediatric drug dosing errors affect 56,000 U.S. children annually. An accurate weight is the first step in accurate dosing. To date, the accuracy of Emergency Medical Dispatcher (EMD) obtained weights has not been evaluated. We hypothesized that EMD could obtain accurate pediatric weights. METHODS: We used a convenience sample of patients 12 years and younger that were transported by EMS to one children's hospital. EMD obtained patient weight (DW) from the 9-1-1 caller...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27662548/in-utero-exposure-to-nelfinavir-ethyl-methyl-sulfone
#19
Mira Hleyhel, Stéphanie Goujon, Jeanne Sibiude, Stéphane Blanche, Josiane Warszawski
Ethyl methyl sulfone contained in nelfinavir between 2007 and 2008 accidentally exposed embryos and fetuses to a powerful mutagen. We report data for 101 HIV-uninfected children exposed in utero included in the French prospective national cohort. The incidence of malformation was similar to that in the cohort as a whole with different drug exposures; no children had developed cancer after 9 years of follow-up.
November 13, 2016: AIDS
https://www.readbyqxmd.com/read/27636352/prehospital-glucose-testing-for-children-with-seizures-a-proposed-change-in-management
#20
Katherine Remick, Christopher Redgate, Daniel Ostermayer, Amy H Kaji, Marianne Gausche-Hill
OBJECTIVE: Many Emergency Medicine Services (EMS) protocols require point-of-care blood glucose testing (BGT) for any pediatric patient who presents with seizure or altered level of conscious. Few data describe the diagnostic yield of BGT when performed on all pediatric seizures regardless of presenting mental status. We analyzed a large single center dataset of pediatric patients presenting with prehospital seizures to determine the prevalence of hypoglycemic seizures and the utility of repeat BGT in the emergency department (ED)...
March 2017: Prehospital Emergency Care
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