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https://www.readbyqxmd.com/read/29773569/mobile-stroke-unit-reduces-time-to-image-acquisition-and-reporting
#1
E M Nyberg, J R Cox, R G Kowalski, D V Duarte, B Schimpf, W J Jones
Timely administration of thrombolytic therapy is critical to maximizing the likelihood of favorable outcomes in patients with acute ischemic stroke. Although emergency medical service activation overall improves the timeliness of acute stroke treatment, the time from emergency medical service dispatch to hospital arrival unavoidably decreases the timeliness of thrombolytic administration. Our mobile stroke unit, a new-generation ambulance with on-board CT scanning capability, reduces key imaging time metrics and facilitates in-the-field delivery of IV thrombolytic therapy...
May 17, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29769024/hems-inter-facility-transfer-a-case-mix-analysis
#2
Damien Di Rocco, Mathieu Pasquier, Eric Albrecht, Pierre-Nicolas Carron, Fabrice Dami
BACKGROUND: Helicopter emergency medical services (HEMS) are popular rescue systems despite inconsistent evidence in the scientific literature to support their use for primary interventions, as well as for inter-facility transfer (IFT). There is little research about IFT by HEMS, hence questions remain about the appropriateness of this method of transport. The aim of this study was to describe a case-mix of operational and medical characteristics for IFT activity of a sole HEMS base, and identify indicators of over-triage...
May 16, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29766565/a-retrospective-observational-study-of-people-with-type-1-diabetes-with-self-reported-severe-hypoglycaemia-reveals-high-level-of-ambulance-attendance-but-low-levels-of-therapy-change-and-specialist-intervention
#3
B C T Field, R Nayar, A Kilvert, M Baxter, J Hickey, M Cummings, S C Bain
AIM: To evaluate the impact of severe hypoglycaemia on NHS resources and overall glycaemic control in adults with Type 1 diabetes. METHODS: An observational, retrospective study of adults (aged ≥ 18 years) with Type 1 diabetes reporting one or more episodes of severe hypoglycaemia during the preceding 24 months in 10 NHS hospital diabetes centres in England and Wales. The primary outcome was healthcare resource utilization associated with severe hypoglycaemia...
May 15, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29760676/helsinki-stroke-model-is-transferrable-with-real-world-resources-and-reduced-stroke-thrombolysis-delay-to-34-min-in-christchurch
#4
Teddy Y Wu, Erin Coleman, Sarah L Wright, Deborah F Mason, Jon Reimers, Roderick Duncan, Mary Griffiths, Michael Hurrell, David Dixon, James Weaver, Atte Meretoja, John N Fink
Background: Christchurch hospital is a tertiary hospital in New Zealand supported by five general neurologists with after-hours services provided mainly by onsite non-neurology medical residents. We assessed the transferrability and impact of the Helsinki Stroke model on stroke thrombolysis door-to-needle time (DNT) in Christchurch hospital. Methods: Key components of the Helsinki Stroke model were implemented first in 2015 with introduction of patient pre-notification and thrombolysis by the computed tomography (CT) suite, followed by implementation of direct transfer to CT on ambulance stretcher in May 2017...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29760243/underutilisation-of-public-access-defibrillation-is-related-to-retrieval-distance-and-time-dependent-availability
#5
Charles D Deakin, Steve Anfield, Gillian A Hodgetts
INTRODUCTION: Public access defibrillation doubles the chances of neurologically intact survival following out-of-hospital cardiac arrest (OHCA). Although there are increasing numbers of defibrillators (automated external defibrillator (AEDs)) available in the community, they are used infrequently, despite often being available. We aimed to match OHCAs with known AED locations in order to understand AED availability, the effects of reduced AED availability at night and the operational radius at which they can be effectively retrieved...
May 14, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29758577/-structure-parameters-and-quality-outcomes-of-ambulant-home-care
#6
Ralf Suhr, Kathrin Raeder, Simone Kuntz, Sandra Strube-Lahmann, Antje Latendorf, Jürgen Klingelhöfer-Noe, Nils Lahmann
INTRODUCTION: So far, there are few data available on the changes of ambulant home-care in Germany over the last decades. Therefore, the aim of this research was to provide structure data on nursing personnel, funding, size, regional differences, and training needs of ambulant home-care services in Germany. In addition, a possible association between structure parameters and quality outcomes for pressure ulcer and malnutrition was investigated. METHODS: In 2015, a multicenter cross-sectional study was conducted in home-care services in Germany...
May 14, 2018: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29752776/influence-of-prehospital-airway-management-on-neurological-outcome-in-patients-transferred-to-a-heart-attack-centre-following-out-of-hospital-cardiac-arrest
#7
Timothy Edwards, Julia Williams, Michaela Cottee
OBJECTIVE: To describe the association between prehospital airway management and neurological outcomes in patients transferred by the ambulance service directly to a heart attack centre (HAC) post-return of spontaneous circulation (ROSC). METHODS: A retrospective observational cohort study in which ambulance records were reviewed to determine prehospital airway management strategy and collect physiological and demographic data. HAC notes were obtained to determine in-hospital management and quantify neurological outcome via the cerebral performance category (CPC) scale...
May 11, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29742635/trauma-simulation-in-prehospital-emergency-care
#8
Anna Abelsson, Lars Lundberg
Well-educated ambulance staff is a prerequisite for high-quality prehospital trauma care. The aim of this study was to examine how nurses in the ambulance service experienced participation in trauma simulation. Sixty-one nurses, working in an emergency ambulance service, performed simulated trauma care on four different occasions and afterward rated three statements on a 5-point Likert scale. A descriptive and inferential analysis was conducted. There are statistically significant increases between the pre- and posttests regarding all three statements: "I think simulation of severe trauma with manikins is realistic" (0...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29736276/pregnant-women-who-requested-a-108-ambulance-in-two-states-of-india
#9
Samiksha Singh, Pat Doyle, Oona Maeve Renee Campbell, Govindaraju Venkata Ramana Rao, Gudlavalleti V S Murthy
We studied the pregnant women, who requested a '108' ambulance in two Indian states (Andhra Pradesh (AP) and Himachal Pradesh (HP)). We conducted a cross-sectional telephone survey to study the characteristics and outcomes of those who (1) were transported using '108' ambulance, (2) were sent '108' ambulance but did not use it and (3) were not assigned a '108' ambulance. We conducted interviews within 24 hours of clients' call and followed them up at 48 hours, on the 7th and 28th day. 90% of pregnant women callers in AP and only 16% in HP were from poorer socioeconomic circumstances...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29735230/management-of-multiple-burned-patients-with-inhalation-injuries
#10
Kouhei Ishikawa, Youichi Yanagawa, Yukino Kato, Yoko Nozawa, Hiroki Nagasawa, Ikuto Takeuchi, Kei Jitsuiki, Akihiko Kondo, Hiromichi Ohsaka, Kazuhiko Omori
The fire department in Atami received an emergency call at 6:17 am, with notification of 4 or 5 casualties because of a fire. Because there was only 1 ambulance (O) at the station, an additional ambulance (P) was also requested. Ambulance O transported 2 patients (A and B), and ambulance P transported 2 patients (C and D). These 4 patients were judged to have severe inhalation injuries at the scene and were transported to 2 local hospitals (X and Y). After patients C and D arrived at hospital Y, the medical staff decided to transfer them to the emergency medical service center...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29735228/direct-air-versus-ground-transport-predictors-for-rural-pediatric-trauma
#11
Andrew B Starnes, Babawale Oluborode, Curtis Knoles, Boyd Burns, Henderson McGinnis, Kenneth Stewart
OBJECTIVE: Traumatic injury is the leading cause of mortality in children and the most common cause of emergency medical services transport in pediatric populations. We aimed to identify what factors are currently associated with selection for helicopter transport (HEMS) over ground ambulance (GEMS) in a primarily rural state. METHODS: We performed a retrospective case-control study of trauma patients younger than 18 years old reported to the Oklahoma State Trauma Registry between 2005 and 2014 who received direct transport from the scene of injury to a tertiary trauma center within the state...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29729284/direct-transport-to-a-pci-capable-hospital-is-associated-with-improved-survival-after-adult-out-of-hospital-cardiac-arrest-of-medical-aetiology
#12
Nicole McKenzie, Teresa A Williams, Kwok M Ho, Madoka Inoue, Paul Bailey, Antonio Celenza, Daniel Fatovich, Ian Jenkins, Judith Finn
AIM: To compare survival outcomes of adults with out-of-hospital cardiac arrest (OHCA) of medical aetiology directly transported to a percutaneous-coronary-intervention capable (PCI-capable) hospital (direct transport) with patients transferred to a PCI-capable hospital via another hospital without PCI services available (indirect transport) by emergency medical services (EMS). METHODS: This retrospective cohort study used the St John Ambulance Western Australia OHCA Database and medical chart review...
May 2, 2018: Resuscitation
https://www.readbyqxmd.com/read/29727776/knee-adduction-moment-peak-and-impulse-do-not-change-during-the-first-six-months-of-walking-with-a-prosthesis
#13
Rebecca L Krupenevich, Ross H Miller, Brad D Hendershot, Barri L Schnall, Alison L Pruziner
BACKGROUND: Individuals with unilateral lower limb loss are at increased risk for developing knee osteoarthritis in their contralateral limb. The mechanisms underlying this phenomenon are unknown, but large or unusual loads on the limb are thought to contribute to osteoarthritis development. Yet, to our knowledge, there have been no longitudinal assessments of knee joint kinetics to assist with identifying the origin or progression of such loads. RESEARCH QUESTION: This study aimed to examine knee joint kinetics of individuals with lower limb loss as a function of time from independent ambulation...
April 26, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29720290/effectiveness-of-a-home-based-missing-incident-prevention-program-for-community-dwelling-elderly-patients-with-dementia
#14
Wing Man Lau, Tak Yeung Chan, Sze Lok Szeto
ABSTRACTBackground:Getting lost is a recognized complication in patients with dementia. Preventive measures are lacking. This study aims to investigate the effectiveness of a home-based missing incident prevention program (HMIPP) in reducing missing incidents, time of searching, and caregivers' stress. METHODS: The design was a pre- and post-intervention study. Patients were recruited from a hospital-based Geriatric Memory Clinic. Inclusion criteria were as follows: aged 60 years or above, established dementia, and Modified Functional Ambulation Categories score VI or VII...
May 3, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29693623/impact-of-the-introduction-of-the-electronic-health-insurance-card-on-the-use-of-medical-services-by-asylum-seekers-in-germany
#15
Kevin Claassen, Pia Jäger
Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence regarding its actual impact on the use of medical services. The aim of the study is to examine this impact on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR)...
April 25, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29691243/role-and-prevalence-of-impaired-awareness-of-hypoglycaemia-in-ambulance-service-attendances-to-people-who-have-had-a-severe-hypoglycaemic-emergency-a-mixed-methods-study
#16
Edward A S Duncan, David Fitzpatrick, Theresa Ikegwuonu, Josie Evans, Margaret Maxwell
OBJECTIVES: (1) To compare the experiences of people who are affected by diabetes-related hypoglycaemia and either do or do not require an emergency attendance and (2) to measure the prevalence of impaired awareness of hypoglycaemia in patients who are attended by an ambulance service due to a severe hypoglycaemic event. DESIGN: A sequential mixed-methods study. SETTING: A qualitative interview study was undertaken with 31 people with diabetes (types 1 and 2) resident in the central belt of Scotland...
April 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29689085/determining-the-scope-of-attacks-on-health-in-four-governorates-of-syria-in-2016-results-of-a-field-surveillance-program
#17
Rohini J Haar, Casey B Risko, Sonal Singh, Diana Rayes, Ahmad Albaik, Mohammed Alnajar, Mazen Kewara, Emily Clouse, Elise Baker, Leonard S Rubenstein
BACKGROUND: Violent attacks on and interferences with hospitals, ambulances, health workers, and patients during conflict destroy vital health services during a time when they are most needed and undermine the long-term capacity of the health system. In Syria, such attacks have been frequent and intense and represent grave violations of the Geneva Conventions, but the number reported has varied considerably. A systematic mechanism to document these attacks could assist in designing more protection strategies and play a critical role in influencing policy, promoting justice, and addressing the health needs of the population...
April 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29679408/prehospital-emergency-care-nurses-strategies-while-caring-for-patients-with-limited-swedish-english-proficiency
#18
A Alm Pfrunder, A Falk, V Vicente, V Lindström
AIMS AND OBJECTIVES: To explore the strategies of nurses working in the ambulance service while caring for patients with limited Swedish-English proficiency. BACKGROUND: Communication difficulties due to lack of mutual language is a challenge in health care systems around the world. Little is known about nurses' strategies while caring for patients with whom they do not share a mutual language in an unstructured, unplanned prehospital emergency environment, the ambulance service...
April 20, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29673398/assessment-of-orthotic-needs-in-iranian-veterans-with-ankle-and-foot-disorders
#19
Kamiar Ghoseiri, Mostafa Allami, Mohammad Reza Soroush
BACKGROUND: War-related traumas can lead to orthopedic and neurological disorders in victims. However, the scope of such disorders may expand months or even years after the trauma. Orthotic treatment as a rehabilitation process aims to enable people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological, and social functional levels. This study aimed to investigate the rate of using orthoses among Iranian veterans with neuromuscular and skeletal disorders of the ankle and foot...
April 20, 2018: Military Medical Research
https://www.readbyqxmd.com/read/29673360/identifying-barriers-for-out-of-hospital-emergency-care-in-low-and-low-middle-income-countries-a-systematic-review
#20
Antony Gatebe Kironji, Peter Hodkinson, Sarah Stewart de Ramirez, Trisha Anest, Lee Wallis, Junaid Razzak, Alexander Jenson, Bhakti Hansoti
BACKGROUND: Out-of-hospital emergency care (OHEC), also known as prehospital care, has been shown to reduce morbidity and mortality from serious illness. We sought to summarize literature for low and low-middle income countries to identify barriers to and key interventions for OHEC delivery. METHODS: We performed a systematic review of the peer reviewed literature from January 2005 to March 2015 in PubMed, Embase, Cochrane, and Web of Science. All articles referencing research from low and low-middle income countries addressing OHEC, emergency medical services, or transport/transfer of patients were included...
April 19, 2018: BMC Health Services Research
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