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https://www.readbyqxmd.com/read/28545930/the-knowledge-desired-by-emergency-medical-service-managers-of-their-ambulance-clinicians-a-modified-delphi-study
#1
Mats Holmberg, Ingegerd Fagerberg, Anna Carin Wahlberg
AIM: The aim of the study was to identify the types of knowledge that Swedish Emergency Medical Service (EMS) managers considered desirable in their Ambulance Clinicians. BACKGROUND: Emergency medical service managers are responsible for organisational tasking and in this are dependent on the knowledge possessed by their ambulance clinicians. It would therefore be of value to explore EMS managers' approach to this knowledge. DESIGN: A modified Delphi method in three rounds...
May 22, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28544078/emergency-medical-services-providers-perspective-of-end-of-life-decision-making-for-people-with-intellectual-disabilities
#2
Jacqueline McGinley, Deborah P Waldrop, Brian Clemency
BACKGROUND: Emergency medical services (EMS) providers are often called to rapidly determine and act upon patients' wishes for end-of-life care. People with intellectual disabilities are living increasingly longer with complex conditions leading to international calls for person-centred advance care planning. Yet, best estimates suggest that very few people with intellectual disabilities document their wishes. METHODS: This exploratory-descriptive study incorporated mixed methods to analyse data collected consecutively (surveys, n = 239; interviews, n = 48) with EMS providers from five agencies...
May 24, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28542027/retrospective-population-based-study-of-emergency-medical-services-attended-out-of-hospital-cardiac-arrests-in-children-in-belgium
#3
Sophie Vandeplassche, Patrick van de Voorde
OBJECTIVE: This study presents an analysis of clinical data of the circumstances and outcome of paediatric (0-16 years) out-of-hospital cardiac arrests (p-OHCA) in Belgium. METHODS: This was a retrospective study of a prospective population-based registration of physician-attended [mobile emergency group (MUG)] emergency medical services (EMS) interventions of p-OHCA in Belgium between 2010 and 2012. RESULTS: We identified 365 OHCA in 18 295 paediatric MUG interventions (2%)...
May 24, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28541419/acute-toxicity-from-intravenous-use-of-the-tricyclic-antidepressant-tianeptine
#4
Sara K Dempsey, Justin L Poklis, Kacie Sweat, Kirk Cumpston, Carl E Wolf
Tianeptine (7-[([3-chloro-6,11]-dihydro-6-methyldibenzo[c,f][1,2]thiazepin-11-yl) amino] heptanoic acid S, S dioxide) is a tricyclic compound prescribed as an antidepressant in European countries, but is not currently approved for use in the United States. There are few published case reports of tianeptine intoxication. Presented is the first case of acute toxicity associated with the intravenous use of tianeptine. A 36-year-old male intentionally injected tianeptine powder intravenously to "help him see into the future"...
May 24, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28536170/door-to-needle-delays-in-minor-stroke-a-causal-inference-approach
#5
Sara K Rostanski, Zachary Shahn, Mitchell S V Elkind, Ava L Liberman, Randolph S Marshall, Joshua I Stillman, Olajide Williams, Joshua Z Willey
BACKGROUND AND PURPOSE: Thrombolysis rates among minor stroke (MS) patients are increasing because of increased recognition of disability in this group and guideline changes regarding treatment indications. We examined the association of delays in door-to-needle (DTN) time with stroke severity. METHODS: We performed a retrospective analysis of all stroke patients who received intravenous tissue-type plasminogen activator in our emergency department between July 1, 2011, and February 29, 2016...
May 23, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28522129/provision-of-prehospital-emergency-medical-services-in-punjab-pakistan-case-study-of-a-public-sector-provider
#6
Veena M Sriram, Rizwan Naseer, Adnan A Hyder
BACKGROUND: The availability and quality of emergency medical services in low- and middle-income countries, including Pakistan, are extremely limited. New models for prehospital emergency medical services provision have recently emerged across multiple sectors, and research on these models is urgently needed to inform current and future emergency medical services systems in low-resource settings. The objective of this case study was to provide a comprehensive description of the organizational structure and service delivery model of a public sector provider in the Punjab Province of Pakistan, Rescue 1122, with a focus on operations in Lahore...
May 15, 2017: Surgery
https://www.readbyqxmd.com/read/28521902/differences-between-the-sexes-in-motorcycle-related-injuries-and-fatalities-at-a-taiwanese-level-i-trauma-center
#7
Ching-Hua Hsieh, Shiun-Yuan Hsu, Hsiao-Yun Hsieh, Yi-Chun Chen
BACKGROUND: Female patients present with unique physiological and behavioral characteristics compared to male patients. The aim of this study was to investigate and compare the injury patterns, injury characteristics, and mortality of male and female patients hospitalized for treatment of motorcycle accident-related trauma in a level I trauma center. METHODS: Retrospective analysis of motorcycle-related injuries from the Trauma Registry System was performed to identify and compare 4028 male and 2919 female patients hospitalized for treatment between January 1, 2009 and December 31, 2013...
April 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28520711/inhalational-chlorine-injuries-at-public-aquatic-venues-california-2008-2015
#8
Jason A Wilken, Michele DiMaggio, Matthew Kaufmann, Kevin O'Connor, Svetlana Smorodinsky, Christina Armatas, Tracy Barreau, Richard Kreutzer, Lino Ancheta
In June 2015, personnel from California's Contra Costa Health Services Environmental Health and Hazardous Materials (hazmat) divisions were alerted to a possible chemical release at a swimming pool in an outdoor municipal water park. Approximately 50 bathers were in the pool when symptoms began; 34 (68%) experienced vomiting, coughing, or eye irritation. Among these persons, 17 (50%) were treated at the scene by Contra Costa's Emergency Medical Services (EMS) and released, and 17 (50%) were transported to local emergency departments; five patients also were evaluated later at an emergency department or by a primary medical provider...
May 19, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28515604/development-and-psychometric-evaluation-of-the-pre-hospital-medical-emergencies-early-warning-scale
#9
Abbasali Ebrahimian, Gholamreza Masoumi, Roohangiz Jamshidi-Orak, Hesam Seyedin
INTRODUCTION: The number of requests for emergency medical services (EMSs) has increased during the past decade. However, most of the transports are not essential. Therefore, it seems crucial to develop an instrument to help EMS staff accurately identify patients who need pre-hospital care and transportation. The aim of this study was to develop and evaluate the psychometric properties of the Pre-hospital Medical Emergencies Early Warning Scale (Pre-MEWS). MATERIALS AND METHODS: This mixed-method study was conducted in two phases...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28508236/an-exploratory-analysis-of-the-geographical-distribution-of-trauma-incidents-in-shenzhen-china
#10
Gui Xi Zhang, Joe King Man Fan, Fion Siu Yin Chan, Gilberto Ka Kit Leung, Chung Mao Lo, Yi Min Yu, Hong Zhang, Susan I Brundage, Jan O Jansen
BACKGROUND: The city of Shenzhen, China, is planning to establish a trauma system. At present, there are few data on the geographical distribution of incidents, which is key to deciding on the location of trauma centres. The aim of this study was to perform a geographical analysis in order to inform the development of a trauma system in Shenzhen. METHODS: Retrospective analysis of trauma incidents attended by Shenzhen Emergency Medical Services (EMS) in 2014. Data were obtained from Shenzhen EMS...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28501121/validation-of-a-field-spinal-motion-restriction-protocol-in-a-level-i-trauma-center
#11
James M Tatum, Nicolas Melo, Ara Ko, Navpreet K Dhillon, Eric J T Smith, Dorothy A Yim, Galinos Barmparas, Eric J Ley
BACKGROUND: Spinal motion restriction (SMR) after traumatic injury has been a mainstay of prehospital trauma care for more than 3 decades. Recent guidelines recommend a selective approach with cervical spine clearance in the field when criteria are met. MATERIALS AND METHODS: In January 2014, the Department of Health Services of the City of Los Angeles, California, implemented revised guidelines for cervical SMR after blunt mechanism trauma. Adult patients (aged ≥18 y) with an initial Glasgow Coma Scale (GCS) score of ≥13 presented to a single level I trauma center after blunt mechanism trauma over the following 1-y period were retrospectively reviewed...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28495830/establishing-recommendations-for-stroke-systems-in-the-thrombectomy-era-the-upstate-new-york-stakeholder-proceedings
#12
Zainab Magdon-Ismail, Curtis Benesch, Jeremy T Cushman, Ian Brissette, Andrew M Southerland, Ethan S Brandler, Cemal B Sozener, Sue Flor, Roseanne Hemmitt, Kathleen Wales, Krystal Parrigan, Steven R Levine
BACKGROUND AND PURPOSE: The American Heart Association/American Stroke Association and Department of Health Stroke Coverdell Program convened a stakeholder meeting in upstate NY to develop recommendations to enhance stroke systems for acute large vessel occlusion. METHODS: Prehospital, hospital, and Department of Health leadership were invited (n=157). Participants provided goals/concerns and developed recommendations for prehospital triage and interfacility transport, rating each using a 3-level impact (A [high], B, and C [low]) and implementation feasibility (1 [high], 2, and 3 [low]) scale...
May 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28495422/reduced-frequency-of-severe-hypoglycemia-at-mild-ambient-temperatures-between-10-and-20-%C3%A2-c-a-population-based-study-under-marine-west-coast-climate-conditions
#13
Mario Hensel, Markus Stuhr, Daniel Geppert, Jan Felix Kersten, Jürgen Lorenz, Thoralf Kerner
AIMS: To determine the association between ambient temperature and severe hypoglycemia. METHODS: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period. Lowess-regression analysis was conducted to assess the relationship between ambient temperature and frequency of severe hypoglycemia. Additionally, three temperature-ranges were defined in order to compare them with each other with regard to frequency of severe hypoglycemia (<10°C vs...
February 14, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28494674/should-nurses-receive-formal-commendations
#14
Mike Parker
On 22 March news broke that an incident had occurred at the Palace of Westminster in London. The Metropolitan Police, London Ambulance Service and the Helicopter Emergency Medical Service responded and, as details emerged, it became clear there had been a terrorist attack.
May 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28489643/factors-influencing-quality-of-pain-management-in-a-physician-staffed-helicopter-emergency-medical-service
#15
Nicole Oberholzer, Alexander Kaserer, Roland Albrecht, Burkhardt Seifert, Mario Tissi, Donat R Spahn, Konrad Maurer, Philipp Stein
BACKGROUND: Pain is frequently encountered in the prehospital setting and needs to be treated quickly and sufficiently. However, incidences of insufficient analgesia after prehospital treatment by emergency medical services are reported to be as high as 43%. The purpose of this analysis was to identify modifiable factors in a specific emergency patient cohort that influence the pain suffered by patients when admitted to the hospital. METHODS: For that purpose, this retrospective observational study included all patients with significant pain treated by a Swiss physician-staffed helicopter emergency service between April and October 2011 with the following characteristics to limit selection bias: Age > 15 years, numerical rating scale (NRS) for pain documented at the scene and at hospital admission, NRS > 3 at the scene, initial Glasgow coma scale > 12, and National Advisory Committee for Aeronautics score < VI...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28487253/the-drone-ambulance-a-uas-golden-bullet-or-just-a-blank
#16
P Van de Voorde, S Gautama, A Momont, C M Ionescu, P De Paepe, N Fraeyman
Defibrillation within the first minutes after sudden cardiac arrest can save many quality-adjusted life years. Yet, despite enormous investments, 'healthcare' is still unable to provide this for the majority of patients. Emergency Medical Services often have a too long mean response time and many issues surround Public Access Defibrillation programs. In this article we argument that AED-equipped drones could be the 'magic bullet'. They are easily deployed and fast, and have a relatively low operational cost...
May 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28485255/a-system-based-intervention-to-improve-access-to-hyperacute-stroke-care
#17
Richard H Swartz, Elizabeth Linkewich, Shelley Sharp, Jacqueline Willems, Chris Olynyk, Nicola Tahair, Megan L Cayley, Mark T Bayley
BACKGROUND: Hyperacute stroke is a time-sensitive emergency for which outcomes improve with faster treatment. When stroke systems are accessed via emergency medical services (EMS), patients are routed to hyperacute stroke centres and are treated faster. But over a third of patients with strokes do not come to the hospital by EMS, and may inadvertently arrive at centres that do not provide acute stroke services. We developed and studied the impact of protocols to quickly identify and move "walk-in" patients from non-hyperacute hospitals to regional stroke centres (RSCs)...
May 9, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28484212/quality-of-analgesia-in-physician-operated-telemedical-prehospital-emergency-care-is-comparable-to-physician-based-prehospital-care-a-retrospective-longitudinal-study
#18
Niklas Lenssen, Andreas Krockauer, Stefan K Beckers, Rolf Rossaint, Frederik Hirsch, Jörg C Brokmann, Sebastian Bergrath
Acute pain is a common reason for summoning emergency medical services (EMS). Yet in several countries the law restricts opioid-based analgesia administration to physicians. Telemedical support of paramedics is a novel approach to enable timely treatment under the guidance of a physician. In this retrospective observational study, conducted in the EMS of Aachen, Germany, the analgesic quality and occurrence of adverse events were compared between telemedically-supported paramedics (July-December, 2014) and a historical control group (conventional on-scene EMS physicians; January-March, 2014)...
May 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28483389/battlefield-trauma-induced-hypothermia-transitioning-the-preferred-method-of-casualty-rewarming
#19
REVIEW
Brad L Bennett, John B Holcomb
For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an overview of trauma-induced hypothermia (TIH); 2) highlight the Department of Defense strategy for the implementation of a hypothermia clinical management program for battlefield (prehospital) casualties; 3) highlight the research and development of the Hypothermia Prevention and Management Kit (HPMK) as the preferred field rewarming system for battlefield TIH; and 4) emphasize how the HPMK can be easily transitioned to the civilian sector for active rewarming of both accidental and TIH patients...
May 5, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28481669/prehospital-fluid-administration-in-trauma-patients-a-survey-of-state-protocols
#20
Sahil Dadoo, Joseph M Grover, Lukas G Keil, Kay S Hwang, Jane H Brice, Timothy F Platts-Mills
OBJECTIVE: The optimal resuscitation approach during the initial treatment of hypotensive trauma patients remains unknown, but some clinical trials have observed a survival benefit from restricting fluid administration prior to definitive hemorrhage control. We sought to characterize emergency medical services (EMS) protocols for the administration of intravenous fluids in this setting. METHODS: Publicly accessible statewide EMS protocols for the treatment of hypotensive trauma patients were included and characterized by: 1) goal of fluid administration, 2) dosing strategy, 3) maximum dose, 4) type of fluid, and 5) specific protocols for head trauma, if present...
May 8, 2017: Prehospital Emergency Care
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