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Prehospital patient safety

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https://www.readbyqxmd.com/read/29438134/better-compliance-with-triage-criteria-in-trauma-would-reduced-costs-with-maintained-patient-safety
#1
Fredrik Linder, Lina Holmberg, Hampus Eklöf, Martin Björck, Claes Juhlin, Kevin Mani
OBJECTIVE: To evaluate trauma triage criteria in terms of compliance, undertriage, and overtriage and identify risk factors for mistriage. METHODS: In a retrospective cohort study, all consecutive trauma patients at a University Hospital in Sweden in 2012 were included. Patients were stratified into three groups on the basis of trauma team activation (full trauma team, limited trauma team, and no trauma team). Case records were reviewed for mechanism of injury, vital signs, and injuries...
February 12, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29404658/-miscommunication-as-a-risk-focus-in-patient-safety-work-process-analysis-in-prehospital-emergency-care
#2
S Wilk, L Siegl, K Siegl, C Hohenstein
BACKGROUND: In an analysis of a critical incident reporting system (CIRS) in out-of-hospital emergency medicine, it was demonstrated that in 30% of cases deficient communication led to a threat to patients; however, the analysis did not show what exactly the most dangerous work processes are. Current research shows the impact of poor communication on patient safety. OBJECTIVES: An out-of-hospital workflow analysis collects data about key work processes and risk areas...
February 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29384586/emergency-patient-handoffs-identifying-essential-elements-and-developing-an-evidence-based-training-tool
#3
Andrew P Reimer, Celeste M Alfes, Amanda S Rowe, Bianca M Rodriguez-Fox
BACKGROUND: Patient handoffs between care teams have been recognized as a major patient safety risk due to inadequate exchange or loss of critical information, especially during emergent patient transfers. The purpose of this literature review was to identify the essential elements of effective patient handoffs in emergency situations to develop a standardized tool to support a structured patient handoff procedure capable of guiding education and training. METHOD: A literature search of handoff procedures and patient transfers was conducted using the Cumulative Index to Nursing and Allied Health Literature and PubMed between 2008 and 2015...
January 1, 2018: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/29287058/activities-of-the-thor-aabb-working-party
#4
Mark H Yazer, Philip C Spinella
The AABB (formerly the American Association of Blood Banks) is an international authority on transfusion medicine and tissue banking. The Trauma, Hemostasis and Oxygenation Research (THOR) Network is an international multidisciplinary network of civilian and military providers ranging from first responders and medics to critical care physicians, and from basic scientists to clinical trialists. The THOR Network's vision is to improve outcomes from traumatic hemorrhagic shock by optimizing the acute phase of resuscitation...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29189297/are-on-scene-blood-transfusions-by-a-helicopter-emergency-medical-service-useful-and-safe-a-multicentre-case-control-study
#5
Joost H Peters, Pascal S H Smulders, Xavier R J Moors, Stef J M Bouman, Claartje M E M Meijs, Nico Hoogerwerf, Michael J R Edwards
INTRODUCTION: In the prehospital setting, crystalloid fluids are frequently used, but only erythrocytes are capable of transporting oxygen to tissues. The aim of this study was to establish the efficacy and safety of the prehospital use of uncross matched type O rhesus-negative packed red blood cells (URBC) by the Dutch physician-staffed helicopter emergency medical service. We hypothesized that prehospital URBC transfusions are safe and more effective with respect to survival than resuscitations with crystalloids...
November 17, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29158691/project-for-the-introduction-of-prehospital-analgesia-with-fentanyl-and-morphine-administered-by-specially-trained-paramedics-in-a-rural-service-area-in-germany
#6
Maximilian Scharonow, Timo Alberding, Wolfgang Oltmanns, Christian Weilbach
Background: In patients with serious illness or trauma, reduction of severe pain is a key therapeutic goal of emergency medical service (EMS) teams. In Germany, only physicians are allowed to use opioid analgesics. In the rural EMS area studied, the mean arrival time for paramedics is 8 minutes, 23 seconds, and for the rescue physician between 10 minutes, 30 seconds and 16 minutes, 59 seconds, depending on EMS site. In cases of parallel callouts, rescue-physician arrival times may be considerably longer...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29127102/algorithms-to-guide-ambulance-clinicians-in-the-management-of-emergencies-in-patients-with-implanted-rotary-left-ventricular-assist-devices
#7
REVIEW
Christopher T Bowles, Rachel Hards, Neil Wrightson, Paul Lincoln, Shishir Kore, Laura Marley, Jonathan R Dalzell, Binu Raj, Tracey A Baker, Diane Goodwin, Petra Carroll, Jane Pateman, John J M Black, Paul Kattenhorn, Mark Faulkner, Jayan Parameshwar, Charles Butcher, Mark Mason, Alexander Rosenberg, Ian McGovern, Alexander Weymann, Carl Gwinnutt, Nicholas R Banner, Stephan Schueler, Andre R Simon, David W Pitcher
Advances in left ventricular assist device (LVAD) therapy have resulted in increasing numbers of adult LVAD recipients in the community. However, device failure, stroke, bleeding, LVAD thrombosis and systemic infection can be life-threatening emergencies. Currently, four LVAD systems are implanted in six UK transplant centres, each of which provides device-specific information to local emergency services. This has resulted in inconsistent availability and content of information with the risks of delayed or inappropriate decision-making...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29113021/trauma-case-review-a-quality-and-safety-feature-of-the-victorian-state-trauma-system
#8
Carolyn Pinto, Peter A Cameron, Belinda Gabbe, Susan McLellan, Tony Walker
The aim of the present study was to describe the trauma case review process and its role in a regionalised trauma system. Victoria has a population of 5.9 million people, accounting for 26% of Australia's population. Victoria has been serviced by an inclusive, organised trauma system since 2000 comprising 138 health services with trauma designations and three major trauma services. Pre- and interhospital guidelines prescribe the timely transport of patients to the appropriate level of trauma service. A review of the role and contribution of 10 years of operation of the trauma case review group (CRG) was undertaken to describe the aims, processes and governance surrounding the implementation of an individual case review for specified major trauma patients...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29021725/prehospital-hydroxocobalamin-for-inhalation-injury-and-cyanide-toxicity-in-the-united-states-analysis-of-a-database-and-survey-of-ems-providers
#9
M V Purvis, H Rooks, J Young Lee, S Longerich, S A Kahn
Prehospital use of hydroxocobalamin as an antidote for cyanide toxicity, a serious complication of smoke inhalation, has yet to be universally adopted in the United States though its efficacy and safety have been demonstrated since 2006. The purpose of this study was to characterize practices of prehospital hydroxocobalamin administration via a survey of emergency medical services (EMS) and to report a case series from an EMS database to track use of hydroxocobalamin. The Fire Smoke Coalition Newsletter emailed a voluntary survey to EMS subscribers regarding hydroxocobalamin use...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28956680/scene-safety-and-force-protection-in-the-era-of-ultra-potent-opioids
#10
Michael J Lynch, Joe Suyama, Francis X Guyette
Ultra-potent opioids (fentanyl, carfentanil) are now widely available and fueling an epidemic of overdose. First responders are increasingly exposed to these potent narcotics necessitating guidance for scene safety and force protection from medical directors. Reports in lay media have sensationalized accounts of exposure and harm that may lead providers to fear providing care to patients suspected of opioid overdose. The likelihood of prehospital providers suffering ill effects from opioid exposure during routine emergency medical services (EMS) operations is extremely low...
September 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28939567/association-between-gender-and-short-term-outcome-in-patients-with-st-elevation-myocardial-infraction-participating-in-the-international-prospective-randomised-administration-of-ticagrelor-in-the-catheterisation-laboratory-or-in-the-ambulance-for-new-st-elevation
#11
Dimitrios Venetsanos, Sofia Sederholm Lawesson, Joakim Alfredsson, Magnus Janzon, Angel Cequier, Mohamed Chettibi, Shaun G Goodman, Arnoud W Van't Hof, Gilles Montalescot, Eva Swahn
OBJECTIVES: To evaluate gender differences in outcomes in patents with ST-segment elevation myocardial infarction (STEMI) planned for primary percutaneous coronary intervention (PPCI). SETTINGS: A prespecified gender analysis of the multicentre, randomised, double-blind Administration of Ticagrelor in the catheterisation Laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery. PARTICIPANTS: Between September 2011 and October 2013, 1862 patients with STEMI and symptom duration <6 hours were included...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28930960/prehospital-administration-of-freeze-dried-plasma-is-it-the-solution-for-trauma-casualties
#12
Amir Shlaifer, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg, Avi Shina, Erez Nachum Baruch, Elon Glassberg, Avraham Yitzhak
BACKGROUND: Hemorrhage is the leading cause of possible preventable death in the battlefield. There is an increasing evidence for the effectiveness of blood component therapy in general, and plasma infusion in particular but their use is less applicable in the prehospital setting due to logistic difficulties. Israeli Defense Force has implemented the use of freeze-dried plasma (FDP) at the point of injury (POI), this adoption of FDP use entailed doubts regarding the feasibility and effectiveness of this practice...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28887388/minocycline-in-acute-cerebral-hemorrhage-an-early-phase-randomized-trial
#13
RANDOMIZED CONTROLLED TRIAL
Abdelrahman Y Fouda, Andrea S Newsome, Samantha Spellicy, Jennifer L Waller, Wenbo Zhi, David C Hess, Adviye Ergul, David J Edwards, Susan C Fagan, Jeffrey A Switzer
BACKGROUND AND PURPOSE: Minocycline is under investigation as a neurovascular protective agent for stroke. This study evaluated the pharmacokinetic, anti-inflammatory, and safety profile of minocycline after intracerebral hemorrhage. METHODS: This study was a single-site, randomized controlled trial of minocycline conducted from 2013 to 2016. Adults ≥18 years with primary intracerebral hemorrhage who could have study drug administered within 24 hours of onset were included...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28878305/effects-of-intensive-blood-pressure-reduction-on-acute-intracerebral-hemorrhage-a-systematic-review-and-meta-analysis
#14
Shun Gong, Chao Lin, Danfeng Zhang, Xiangyi Kong, Jigang Chen, Chunhui Wang, Zhenxing Li, Rongbin Chen, Ping Sheng, Yan Dong, Lijun Hou
Current opinions about the effect of intensive blood pressure (BP) reduction for acute intracerebral hemorrhage (ICH) are inconsistent. We performed a meta-analysis to evaluate the efficacy and safety of intensive BP reduction for acute ICH by analyzing data from several recent randomized controlled trials (RCTs). There were six eligible studies that met the inclusion criteria, for a total of 4,385 acute ICH patients in this meta-analysis. After analyzing these data, we found differences between intensive and standard BP lowering treatment groups in total mortality rates, unfavorable outcomes, hematoma expansion, neurologic deterioration, and severe hypotension were not significant...
September 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28857641/safety-events-in-high-risk-prehospital-neonatal-calls
#15
Rebecca Duby, Matt Hansen, Garth Meckler, Barbara Skarica, William Lambert, Jeanne-Marie Guise
OBJECTIVE: The objective of this study was to quantify and characterize patient safety events during high-risk neonatal transports in the prehospital setting. METHOD: We conducted a retrospective chart review of all "lights and sirens" ambulance transports of neonates ≤30 days old over a four-year period in a metropolitan area. Each case was independently reviewed for potential patient safety events that may have occurred in clinical assessment and decision making, resuscitation, airway management, fluid or medication administration, procedures performed, and/or equipment used...
August 31, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28806988/subjective-safety-and-self-confidence-in-prehospital-trauma-care-and-learning-progress-after-trauma-courses-part-of-the-prospective-longitudinal-mixed-methods-epptc-trial
#16
David Häske, Stefan K Beckers, Marzellus Hofmann, Rolf Lefering, Paul A Grützner, Ulrich Stöckle, Vassilios Papathanassiou, Matthias Münzberg
BACKGROUND: Prehospital trauma care is stressful and requires multi-professional teamwork. A decrease in the number of accident victims ultimately affects the routine and skills and underlines the importance of effective training. Standardized courses, like PHTLS, are established for health care professionals to improve the prehospital care of trauma patients. The aim of the study was to investigate the subjective safety in prehospital trauma care and learning progress by paramedics in a longitudinal analysis...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28750882/unrecognized-failed-airway-management-using-a-supraglottic-airway-device
#17
Veer D Vithalani, Sabrina Vlk, Steven Q Davis, Neal J Richmond
BACKGROUND: 911 Emergency Medical Services (EMS) systems utilize supraglottic devices for either primary advanced airway management, or for airway rescue following failed attempts at direct laryngoscopy endotracheal intubation. There is, however, limited data on objective confirmation of supraglottic airway placement in the prehospital environment. Furthermore, the ability of EMS field providers to recognize a misplaced airway is unknown. METHODS: Retrospective review of patients who underwent airway management using the King LTS-D supraglottic airway in a large urban EMS system, between 3/1/15-9/30/2015...
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28739239/acute-coronary-syndrome-evacuated-by-a-helicopter-from-the-scene
#18
Hiromichi Ohsaka, Kazuhio Omori, Ikuto Takeuchi, Kei Jitsuiki, Toshihiko Yoshizawa, Kouhei Ishikawa, Kikuo Isoda, Satoru Suwa, Youichi Yanagawa
OBJECTIVE: The purpose of this study was to investigate the safety of evacuating patients using a physician-staffed helicopter (Dr. Heli). METHODS: We retrospectively investigated all of the patients with acute coronary syndrome (ACS) who were transported by a Dr. Heli between April 2004 and March 2016. The scene group included subjects evacuated from the scene by the Dr. Heli. The interhospital group included subjects transported to a nearby medical facility by a ground ambulance and then transported to our hospital by a Dr...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28719478/a-review-of-nonfatal-drowning-in-the-pediatric-age-group-a-10-year-experience-at-a-university-hospital-in-saudi-arabia
#19
Faisal O Al-Qurashi, Abdullah A Yousef, Abdullah Aljoudi, Saleh M Alzahrani, Nasser Y Al-Jawder, Abdulrahman K Al-Ahmar, Mosab S Al-Majed, Hussam M Abouollo
OBJECTIVE: The aim of this study was to evaluate the nonfatal drowning experience, risk factors, intrahospital assessment and postincidental outcomes for children admitted to King Fahd Hospital of the University, AlKhobar, Saudi Arabia, over a 10-year period. METHODS: Children up to the age of 14 years who were admitted with the diagnosis of nonfatal drowning from July 2005 to June 2015 were included. Data regarding demographics, timing, season and location of drowning, presence of an assigned lifeguard, duration of submersion and transport to hospital, cardiopulmonary resuscitation, initial Glasgow Coma Scale, temperature, pH, blood sugar level, total hospital stay, and discharge status were extrapolated, and their effects on the patient's outcome analyzed...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28669372/observational-study-on-safety-of-prehospital-bls-cpap-in-dyspnea
#20
Novneet Sahu, Patrick Matthews, Kathryn Groner, Mia A Papas, Ross Megargel
Introduction Continuous positive airway pressure (CPAP) improves outcomes in patients with respiratory distress. Additional benefits are seen with CPAP application in the prehospital setting. Theoretical safety concerns regarding Basic Life Support (BLS) providers using CPAP exist. In Delaware's (USA) two-tiered Emergency Medical Service (EMS) system, BLS often arrives before Advanced Life Support (ALS). Hypothesis This study fills a gap in literature by evaluating the safety of CPAP applied by BLS prior to ALS arrival...
July 3, 2017: Prehospital and Disaster Medicine
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