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https://www.readbyqxmd.com/read/27919173/carbon-monoxide-poisoning-during-camping-in-korea
#1
Youn-Jung Kim, Chang Hwan Sohn, Bum Jin Oh, Kyoung Soo Lim, Won Young Kim
OBJECTIVE: The aim of this study was to evaluate the epidemiology and characteristics of unintentional carbon monoxide (CO) poisoning during camping in Korea. METHODS: We performed a retrospective observational study on patients with unintentional camping-related CO poisoning who were admitted to the emergency department (ED) from 1 January 2010 to 31 December 2014. News reports about incidents of camping-related CO poisoning were collected using news search engines...
December 5, 2016: Inhalation Toxicology
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/27890031/a-national-assessment-of-the-health-and-safety-of-emergency-medical-services-professionals
#3
Melissa A Bentley, Roger Levine
OBJECTIVES: The objectives were to assess changes in (1) health and physical fitness, (2) the prevalence of selected health problems, (3) risk behaviors, (4) ambulance safety issues, and (5) the preparedness of Emergency Medical Services (EMS) professionals. In addition, the incidence of patient-initiated violence directed toward EMS personnel and associated factors were assessed. METHODS: Data were obtained from a sample of nationally certified EMS professionals via annual questionnaires between 1999 and 2008...
November 28, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27870588/assessment-of-paramedic-performance-on-difficult-airway-simulation
#4
Ashish R Panchal, Geoffrey Finnegan, David P Way, Thomas Terndrup
OBJECTIVE: Airway management is a common, important intervention for critically ill patients in the United States. A key element of prehospital airway management is endotracheal intubation (ETI). Prehospital ETI success rates have been shown to be as low as 77% compared to in-hospital rates of 95%. Given these rates, the use of backup airway devices is a necessary precaution for patient safety. The extent to which paramedics integrate backup airway use into their airway algorithm is unknown...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27858581/evidence-based-guidelines-for-fatigue-risk-management-in-ems-formulating-research-questions-and-selecting-outcomes
#5
P Daniel Patterson, J Stephen Higgins, Eddy S Lang, Michael S Runyon, Laura K Barger, Jonathan R Studnek, Charity G Moore, Kathy Robinson, Dia Gainor, Allison Infinger, Patricia M Weiss, Denisse J Sequeira, Christian Martin-Gill
BACKGROUND: Greater than half of Emergency Medical Services (EMS) personnel report work-related fatigue, yet there are no guidelines for the management of fatigue in EMS. A novel process has been established for evidence-based guideline (EBG) development germane to clinical EMS questions. This process has not yet been applied to operational EMS questions like fatigue risk management. The objective of this study was to develop content valid research questions in the Population, Intervention, Comparison, and Outcome (PICO) framework, and select outcomes to guide systematic reviews and development of EBGs for EMS fatigue risk management...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27849133/do-heroin-overdose-patients-require-observation-after-receiving-naloxone
#6
Michael W Willman, David B Liss, Evan S Schwarz, Michael E Mullins
CONTEXT: Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses...
November 16, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27818120/efficacy-and-safety-of-prehospital-administration-of-unfractionated-heparin-enoxaparin-or-bivalirudin-in-patients-undergoing-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-insights-from-the-orbi-registry
#7
Vincent Auffret, Guillaume Leurent, Dominique Boulmier, Marc Bedossa, Amer Zabalawi, Jean-Philippe Hacot, Isabelle Coudert, Emmanuelle Filippi, Philippe Castellant, Antoine Rialan, Gilles Rouault, Philippe Druelles, Bertrand Boulanger, Josiane Treuil, Bertrand Avez, Marielle Le Guellec, Martine Gilard, Hervé Le Breton
BACKGROUND: Despite numerous studies in recent years, the best anticoagulant option for primary percutaneous coronary intervention (PCI) remains a matter of debate. AIMS: To compare in-hospital outcomes after prehospital administration of low-dose unfractionated heparin (UFH)±glycoprotein IIb/IIIa inhibitors (GPIs), enoxaparin±GPIs, or bivalirudin in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 1720 patients (median age 62...
November 3, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27658332/prehospital-therapeutic-hypothermia-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis
#8
Chaoran Nie, Jiaxu Dong, Pengjiao Zhang, Xintong Liu, Fei Han
BACKGROUND: The effectiveness and safety of the infusion of ice-cold fluids for prehospital hypothermia in cardiac arrest victims are unclear. This study assessed its effects in adult victims of out-of-hospital cardiac arrest. METHODS: An online search of PubMed and Cochrane Library databases was performed. Cooling methods were limited to ice-cold fluid perfusion. Randomized controlled trials were included in this review. The main outcomes were body temperature at hospital arrival, survival to hospital discharge, neurological recovery, incidence of pulmonary edema, and the rate of rearrest...
September 6, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27559978/safety-and-feasibility-of-the-rhinochill-immediate-transnasal-evaporative-cooling-device-during-out-of-hospital-cardiopulmonary-resuscitation-a-single-center-observational-study
#9
Marie-Sophie Grave, Fritz Sterz, Alexander Nürnberger, Stergios Fykatas, Mathias Gatterbauer, Albert Friedrich Stättermayer, Andreas Zajicek, Reinhard Malzer, Dieter Sebald, Raphael van Tulder
We investigated feasibility and safety of the RhinoChill (RC) transnasal cooling system initiated before achieving a protected airway during cardiopulmonary resuscitation (CPR) in a prehospital setting.In out-of-hospital cardiac arrest (OHCA), transnasal evaporative cooling was initiated during CPR, before a protected airway was established and continued until either the patient was declared dead, standard institutional systemic cooling methods were implemented or cooling supply was empty. Patients were monitored throughout the hypothermia period until either death or hospital discharge...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27475008/current-trends-in-geriatric-emergency-medicine
#10
REVIEW
Joseph H Kahn, Brendan G Magauran, Jonathan S Olshaker, Kalpana N Shankar
The number of geriatric visits to United States emergency departments continues to rise. This article reviews demographics, statistics, and future projections in geriatric emergency medicine. Included are discussions of US health care spending, geriatric emergency departments, prehospital care, frailty of geriatric patients, delirium, geriatric trauma, geriatric screening and prediction tools, medication safety, long-term care, and palliative care.
August 2016: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27436455/barriers-and-facilitators-to-recognition-and-reporting-of-child-abuse-by-prehospital-providers
#11
Gunjan Kamdar Tiyyagura, Marcie Gawel, Aimee Alphonso, Jeannette Koziel, Kyle Bilodeau, Kirsten Bechtel
BACKGROUND: Prehospital care providers are in a unique position to provide initial unadulterated information about the scene where a child is abusively injured or neglected. However, they receive minimal training with respect to detection of Child Abuse and Neglect (CAN) and make few reports of suspected CAN to child protective services. AIMS: To explore barriers and facilitators to the recognition and reporting of CAN by prehospital care providers. DESIGN/METHODS: Twenty-eight prehospital care providers participated in a simulated case of infant abusive head trauma prior to participating in one-on-one semi-structured qualitative debriefs...
July 19, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27411064/multicenter-evaluation-of-prehospital-opioid-pain-management-in-injured-children
#12
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/27405354/physician-staffed-helicopter-emergency-medical-service-case-identification-a-before-and-after-study-in-children
#13
Alan A Garner, Anna Lee, Andrew Weatherall, Mary Langcake, Zsolt J Balogh
BACKGROUND: Severely injured children may have better outcomes when transported directly to a Paediatric Trauma Centre (PTC). A case identification system using the crew of a physician staffed helicopter emergency medical service (P-HEMS) that identified severely injured children for P-HEMS dispatch was previously associated with high rates of direct transfer. It was theorised that discontinuation of this system may have resulted in deterioration of system performance. METHODS: Severe paediatric trauma cases were identified from a state based trauma registry over two time periods...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27394032/related-factors-to-semi-recumbent-position-compliance-and-pressure-ulcers-in-patients-with-invasive-mechanical-ventilation-an-observational-study-capcri-study
#14
Mireia Llaurado-Serra, Marta Ulldemolins, Joan Fernandez-Ballart, Rosa Guell-Baro, Teresa Valentí-Trulls, Neus Calpe-Damians, Angels Piñol-Tena, Mercedes Pi-Guerrero, Cristina Paños-Espinosa, Alberto Sandiumenge, María F Jimenez-Herrera
BACKGROUND: Semi-recumbent position is recommended to prevent ventilator-associated pneumonia. Its implementation, however, is below optimal. OBJECTIVES: We aimed to assess real semi-recumbent position compliance and the degree of head-of-bed elevation in Spanish intensive care units, along with factors determining compliance and head-of-bed elevation and their relationship with the development of pressure ulcers. Finally, we investigated the impact that might have the diagnosis of pressure ulcers in the attitude toward head-of-bed elevation...
September 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27393758/safety-and-efficacy-of-thoracostomy-in-the-air-medical-environment
#15
Kevin High, Jeremy Brywczynski, Oscar Guillamondegui
OBJECTIVE: The use of thoracostomy to treat tension pneumothorax is a core skill for prehospital providers. Tension pneumothoraces are potentially lethal and are often encountered in the prehospital environment. METHODS: The authors reviewed the prehospital electronic medical records of patients who had undergone finger thoracostomy (FT) or tube thoracostomy (TT) while under the care of air medical crewmembers. Demographic data were obtained along with survival and complications...
July 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27323790/elaboration-of-a-risk-map-in-a-paediatric-emergency-department-of-a-teaching-hospital
#16
Elisa Mojica, Estibaliz Izarzugaza, Maria Gonzalez, Eider Astobiza, Javier Benito, Santiago Mintegi
OBJECTIVE: To develop a risk map in a paediatric ED of a tertiary teaching hospital, combining proactive and reactive strategies. METHODS: Between June and December 2013, a multidisciplinary committee in a paediatric Emergency Department (ED) in Bilbao (Basque Country of Spain) mapped the patient's journey and identified potential risks to patients (proactive strategy). The researchers also analysed incidents reported by professionals and caregivers (mainly parents) in the paediatric ED from November 2004-December 2013 (reactive strategies)...
October 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27313802/german-critical-incident-reporting-system-database-of-prehospital-emergency-medicine-analysis-of-reported-communication-and-medication-errors-between-2005-2015
#17
Christian Hohenstein, Thomas Fleischmann, Peter Rupp, Dorothea Hempel, Sophia Wilk, Johannes Winning
BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors. METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27294481/-recommendations-for-releasing-the-pelvic-binder-after-a-non-invasive-pelvic-stabilisation-procedure-under-emergency-room-conditions
#18
U Schweigkofler, B Wohlrath, T Paffrath, S Flohé, D Wincheringer, R Hoffmann, H Trentzsch
Severe brain, thoracic and intrapelvic injuries, as well as heavy bleeding, are the main causes of death in patients with major trauma. Unstable pelvic ring fractures can cause this bleeding and the so-called "C problem". This is usually due to haemorrhagic shock caused by the loss of large volumes of blood from the presacral venous plexus, iliac vessels and the fracture surfaces. Many clinical studies have shown that, in the preclinical setting, unstable pelvic ring injuries are often underestimated. The application of a non-invasive external pelvic ring stabilisation (pelvic binder) is therefore recommended if a pelvic fracture is possible...
June 13, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/27276771/challenges-in-the-use-of-video-laryngoscopes
#19
REVIEW
Branka Maldini, Iljaz Hodžović, Tatjana Goranović, Jasna Mesarić
Despite the lack of uniformity and the need of further investigation, video laryngoscopy continues to gain popularity both inside and outside the operating room. It has quickly become a first line strategy for potential and/or encountered difficult intubation. It is well established that video laryngoscope improves laryngeal view as compared with direct laryngoscopy in patients with suspected difficult intubation and simulated difficult airway scenarios. For novices and experienced anesthesiologists alike, video laryngoscopy is easy to use and the skills involved are easy to master...
March 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/27253653/pediatric-airway-management-and-prehospital-patient-safety-results-of-a-national-delphi-survey-by-the-children-s-safety-initiative-emergency-medical-services-for-children
#20
Matthew Hansen, Garth Meckler, Kerth OʼBrien, Phillip Engle, Caitlin Dickinson, Kathryn Dickinson, Jonathan Jui, William Lambert, Erika Cottrell, Jeanne-Marie Guise
OBJECTIVE: The objective of this study was to determine what aspects of prehospital pediatric airway management may contribute to patient safety events. METHODS: We conducted a 3-phase Delphi survey in prehospital professionals across the United States to identify potential contributors to patient safety events. Respondents ranked how likely factors were to contribute on a 9-point Likert-type scale and were allowed to elaborate through open-ended questions. Analysis was conducted using a mixed-methods approach, including Likert-type responses and open-ended questions which were analyzed for specific themes...
September 2016: Pediatric Emergency Care
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