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"Emergency medical services"

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https://www.readbyqxmd.com/read/28921731/inter-observer-agreement-in-pediatric-cervical-spine-injury-assessment-between-prehospital-and-emergency-department-providers
#1
Lorin R Browne, Hamilton Schwartz, Fahd A Ahmad, Michael Wallendorf, Nathan Kuppermann, E Brooke Lerner, Julie C Leonard
BACKGROUND: Investigators have derived cervical spine injury (CSI) decision support tools from physician observations. There is a need to demonstrate that prehospital emergency medical services (EMS) providers can use these tools to appropriately determine the need for spinal motion restrictions and make field disposition decisions. OBJECTIVE: To determine the inter-observer agreement between EMS and emergency department (ED) providers for CSI risk assessment variables and overall gestalt for CSI in children after blunt trauma...
September 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28916666/regional-evaluation-of-the-severity-based-stroke-triage-algorithm-for-emergency-medical-services-using-discrete-event-simulation
#2
Brittany M Bogle, Andrew W Asimos, Wayne D Rosamond
BACKGROUND AND PURPOSE: The Severity-Based Stroke Triage Algorithm for Emergency Medical Services endorses routing patients with suspected large vessel occlusion acute ischemic strokes directly to endovascular stroke centers (ESCs). We sought to evaluate different specifications of this algorithm within a region. METHODS: We developed a discrete event simulation environment to model patients with suspected stroke transported according to algorithm specifications, which varied by stroke severity screen and permissible additional transport time for routing patients to ESCs...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28916174/evaluation-of-beat-to-beat-ventricular-repolarization-lability-from-standard-12-lead-ecg-during-acute-myocardial-ischemia
#3
Salah S Al-Zaiti, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, David Mortara, Jan Nemec
BACKGROUND: Acute myocardial ischemia is a common cause of ventricular arrhythmias, yet recent ECG methods predicting susceptibility to ventricular tachyarrhythmia have not been fully evaluated during spontaneous ischemia. We sought to evaluate the clinical utility of alternans and non-alternans components of repolarization variability from the standard 10-second 12-lead ECG signals to risk stratify patients with acute chest pain. METHODS: We enrolled consecutive, non-traumatic, chest pain patients transported through Emergency Medical Services (EMS) to three tertiary care hospitals with cardiac catheterization lab capabilities in Pittsburgh, PA...
August 10, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#4
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28910472/a-descriptive-analysis-of-occupational-fatalities-due-to-felonious-assault-among-u-s-law-enforcement-officers-during-tactical-incidents-1996-2014
#5
Moriah S Thompson, Tyler M Hartman, Matthew D Sztajnkrycer
INTRODUCTION: Little is known about occupational fatalities among tactical officers. A greater understanding of such injuries is needed to improve officer safety. The purpose of this study was to provide a descriptive analysis of line-of-duty deaths secondary to felonious assault during tactical incidents. METHODS: Retrospective analysis was performed of open-source de-identified Federal Bureau of Investigation Uniform Crime Reporting Law Enforcement Officers Killed and Assaulted (LEOKA) data inclusive of the years 1996-2014...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910212/feasibility-of-paramedic-performed-prehospital-lung-ultrasound-in-medical-patients-with-respiratory-distress
#6
Torben K Becker, Christian Martin-Gill, Clifton W Callaway, Francis X Guyette, Christopher Schott
OBJECTIVE: Prehospital ultrasound is not yet widely implemented. Most studies report on convenience samples and trauma patients, often by prehospital physicians or critical care clinicians. We assessed the feasibility of paramedic performed prehospital lung ultrasound in medical patients with respiratory distress. METHODS: Paramedics at 2 ambulance stations in the city of Pittsburgh, Pennsylvania, USA underwent a 2-hour training session in prehospital lung ultrasound using the SonoSite iViz, a handheld ultrasound device...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28905989/assessment-of-futility-in-out-of-hospital-cardiac-arrest
#7
P Setälä, S Hoppu, I Virkkunen, A Yli-Hankala, A Kämäräinen
BACKGROUND: Our aim was to evaluate the impact of futile resuscitation attempts to the outcome calculations of attempted resuscitation in out-of-hospital cardiac arrest (OHCA). Defined as partial resuscitations, we focused on a subgroup of patients in whom cardiopulmonary resuscitation (CPR) was initiated, but further efforts were soon abandoned due to evidence of futility. METHODS: We conducted this study using the Utstein template during a 12-month study period...
September 14, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28904912/assessment-of-anxiety-level-of-emergency-health-care-workers-by-generalized-anxiety-disorder-7-tool
#8
Nesrin Alharthy, Osama Abdulrahman Alrajeh, Mohammed Almutairi, Ahmed Alhajri
BACKGROUND: Dealing with emergency patients is considered to be a stressful situation to all health-care workers in the emergency department (ED). Prolonged stress predispose to physical and inconsequential psychiatric disturbances. Anxiety and depressive mode were found to be the most commonly experienced psychiatric manifestation among emergency health-care workers. The aim of this study is to screen and assess the severity of anxiety among health professionals working in ED. METHODS: Cross-sectional study design was used...
July 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28894773/the-pattern-of-pre-hospital-medical-service-delivery-in-iran-a-cross-sectional-study
#9
Mashyaneh Haddadi, Mohammad Sarvar, Hamid Soori, Elaheh Ainy
INTRODUCTION: Pre-hospital emergency systems provide service by Franco-German and Anglo American models. This study was carried out to compare the Iranian emergency medical service (EMS) with the two models regarding timing and equipment. METHODS: In this cross sectional study, response time, scene time, and transport time to hospital as well as ambulance equipment of five hundred thousand Tehran EMS recorded missions, during one year, were compared with Franco-German and Anglo American models, trying to determine the pattern of EMS delivery in Iran...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28893725/improvements-in-patient-acceptance-by-hospitals-following-the-introduction-of-a-smartphone-app-for-the-emergency-medical-service-system-a-population-based-before-and-after-observational-study-in-osaka-city-japan
#10
Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Taku Iwami, Takashi Kawamura, Junichi Izawa, Koichiro Gibo, Sho Komukai, Sumito Hayashida, Takeyuki Kiguchi, Mitsuo Ohnishi, Hiroshi Ogura, Takeshi Shimazu
BACKGROUND: Recently, the number of ambulance dispatches has been increasing in Japan, and it is therefore difficult for hospitals to accept emergency patients smoothly and appropriately because of the limited hospital capacity. To facilitate the process of requesting patient transport and hospital acceptance, an emergency information system using information technology (IT) has been built and introduced in various communities. However, its effectiveness has not been thoroughly revealed...
September 11, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28886611/-mass-casualty-incident-special-features-of-threatening-situations
#11
Björn Hossfeld, Thomas Wurmb, Florent Josse, Matthias Helm
Terrorist attacks or amok runs may cause "threatening situations" for emergency medical services (EMS), fire fighters and physicians. Cooperation with the police is of paramount importance. In order to minimize the risk to rescue personnel and affected persons, emergency medical care has to follow tactical principles. So, the strategy in such "threatening situations" is "Stop the bleeding and clear the scene". The police define three areas of danger: unsafe, partly safe and secure. Medical care in these areas follows the concept of Tactical Combat Casualty Care...
September 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28882638/delayed-onset-of-atrial-fibrillation-and-ventricular-tachycardia-after-an-automobile-lightning-strike
#12
Dorian Drigalla, Shannon E Essler, C Keith Stone
BACKGROUND: Lightning strike is a rare medical emergency. The primary cause of death in lightning strike victims is immediate cardiac arrest. The mortality rate from lightning exposure can be as high as 30%, with up to 70% of patients left with significant morbidity. CASE REPORT: An 86-year-old male was struck by lightning while driving his vehicle and crashed. On initial emergency medical services evaluation, he was asymptomatic with normal vital signs. During his transport, he lost consciousness several times and was found to be in atrial fibrillation with intermittent runs of ventricular tachycardia during the unconscious periods...
September 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28877728/we-need-support-a-delphi-study-about-desirable-support-during-the-first-year-in-the-emergency-medical-service
#13
Anna Hörberg, Maria Jirwe, Susanne Kalén, Veronica Vicente, Veronica Lindström
BACKGROUND: New and inexperienced emergency medical service (EMS) professionals lack important experience. To prevent medical errors and improve retention there is an urgent need to identify ways to support new professionals during their first year in the EMS. METHODS: A purposeful sample and snowball technique was used and generated a panel of 32 registered nurses with 12-48 months of EMS experience. A Delphi technique in four rounds was used. Telephone interviews were undertaken in round one to identify what desirable support professionals new to the EMS desire during their first year...
September 6, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28875599/the-impact-of-middle-east-respiratory-syndrome-outbreak-on-trends-in-emergency-department-utilization-patterns
#14
So Hyun Paek, Do Kyun Kim, Jin Hee Lee, Young Ho Kwak
Changes occurred in the patterns of utilization of emergency medical services during the Middle East respiratory syndrome (MERS) outbreak. The purpose of this study was to analyze the patterns of adult and pediatric patients who visited the emergency department (ED) during the outbreak. This retrospective study was conducted by analyzing changes in the patterns of visits among adult and pediatric patients in the ED at one tertiary teaching hospital in Korea. The study was performed from June 1, 2013 to July 31, 2015...
October 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28874938/availability-and-accuracy-of-ems-information-about-chronic-health-and-medications-in-cardiac-arrest
#15
Alexander Foster, Victor Florea, Carol Fahrenbruch, Jennifer Blackwood, Thomas D Rea
INTRODUCTION: Field information available to emergency medical services (EMS) about a patient's chronic health conditions or medication therapies could help direct patient care or be used to investigate outcome disparities. However, little is known about the field availability or accuracy of information of chronic health conditions or chronic medication treatments in emergent circumstances, especially when the patient cannot serve as an information resource. We evaluated the prehospital availability and accuracy of specific chronic health conditions and medication treatments among out-of-hospital cardiac arrest (OHCA) patients...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28873019/the-effects-of-in-hospital-intravenous-cold-saline-in-postcardiac-arrest-patients-treated-with-targeted-temperature-management
#16
Nissi Suppogu, Gregory A Panza, Sena Kilic, Shreyas Gowdar, Kamala R Kallur, Ramya Jayaraman, Justin Lundbye, Antonio B Fernandez
BACKGROUND: Recent data suggest that rapid infusion of intravenous (IV) cold saline for Targeted Temperature Management (TTM) after cardiac arrest is associated with higher rates of rearrest, pulmonary edema, and hypoxia, with no difference in neurologic outcomes or survival when administered by Emergency Medical Services. We sought to determine the effects of IV cold saline administration in the hospital setting in postcardiac arrest patients to achieve TTM and its effect on clinical parameters and neurologic outcomes...
September 5, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28870719/increased-survival-from-out-of-hospital-cardiac-arrest-when-off-duty-medically-educated-personnel-perform-cpr-compared-with-laymen
#17
Anette Nord, Leif Svensson, Thomas Karlsson, Andreas Claesson, Johan Herlitz, Lennart Nilsson
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) has been proved to save lives; however, whether survival is affected by the training level of the bystander is not fully described. AIM: To describe if the training level of laymen and medically educated bystanders affect 30-day survival in out-of-hospital cardiac arrests (OHCA). METHODS: This observational study included all witnessed and treated cases of bystander CPR reported to the Swedish Registry of Cardiopulmonary Resuscitation between 2010-2014...
September 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28870382/simulation-based-decision-support-framework-for-dynamic-ambulance-redeployment-in-singapore
#18
Sean Shao Wei Lam, Clarence Boon Liang Ng, Francis Ngoc Hoang Long Nguyen, Yih Yng Ng, Marcus Eng Hock Ong
OBJECTIVE: Dynamic ambulance redeployment policies tend to introduce much more flexibilities in improving ambulance resource allocation by capitalizing on the definite geospatial-temporal variations in ambulance demand patterns over the time-of-the-day and day-of-the-week effects. A novel modelling framework based on the Approximate Dynamic Programming (ADP) approach leveraging on a Discrete Events Simulation (DES) model for dynamic ambulance redeployment in Singapore is proposed in this paper...
October 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28867265/implantable-cardioverter-defibrillator-implantation-rates-after-out-of-hospital-cardiac-arrest-are-the-rates-guideline-concordant
#19
Edwin C Ho, Sheldon Cheskes, Paul Angaran, Laurie J Morrison, Theresa Aves, Cathy Zhan, Dennis T Ko, Paul Dorian
BACKGROUND: Clinical practice guidelines recommend implantable cardioverter defibrillators (ICDs) for the secondary prevention of sudden death after a cardiac arrest not from a reversible cause, but "real world" implantation rates are not well described. METHODS: Adults with out of hospital cardiac arrest attended by Emergency Medical Services are captured in the Toronto Regional RescuNET database. We analyzed those who survived to hospital discharge and collected data on age, sex, initial rhythm, ST-elevation myocardial infarction (STEMI) on presenting electrocardiogram (ECG), in-hospital revascularization, neurologic status (Modified Rankin Scale [MRS]) at discharge, and admission hospital type...
August 23, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28864702/design-and-validation-of-a-clinical-scale-for-prehospital-stroke-recognition-severity-grading-and-prediction-of-large-vessel-occlusion-the-shortened-nih-stroke-scale-for-emergency-medical-services
#20
Jan Christoph Purrucker, Florian Härtig, Hardy Richter, Andreas Engelbrecht, Johannes Hartmann, Jonas Auer, Christian Hametner, Erik Popp, Peter Arthur Ringleb, Simon Nagel, Sven Poli
OBJECTIVE: To develop an NIH Stroke Scale (NIHSS)-compatible, all-in-one scale for rapid and comprehensive prehospital stroke assessment including stroke recognition, severity grading and progression monitoring as well as prediction of large vessel occlusion (LVO). METHODS: Emergency medical services (EMS) personnel and stroke physicians (n=326) rated each item of the NIHSS regarding suitability for prehospital use; best rated items were included. Stroke recognition was evaluated retrospectively in 689 consecutive patients with acute stroke or stroke mimics, prediction of LVO in 741 consecutive patients with ischaemic stroke with acute vessel imaging independent of admission NIHSS score...
September 1, 2017: BMJ Open
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