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Physician staffed pre-hospital

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https://www.readbyqxmd.com/read/27650943/physician-staffed-helicopter-emergency-medical-systems-can-provide-advanced-trauma-life-support-in-mountainous-and-remote-areas
#1
Julia Ausserer, Elizabeth Moritz, Matthias Stroehle, Hermann Brugger, Giacomo Strapazzon, Simon Rauch, Peter Mair
INTRODUCTION: In remote and mountainous areas, helicopter emergency medical systems (HEMS) are used to expedite evacuation and provide pre-hospital advanced trauma life support (ATLS) in major trauma victims. Aim of the study was to investigate feasibility of ATLS in HEMS mountain rescue missions and its influence on patient condition at hospital admission. PATIENTS: 58 major trauma victims (Injury Severity Score ≥16), evacuated by physician staffed HEMS from remote and mountainous areas in the State of Tyrol, Austria between 1...
September 8, 2016: Injury
https://www.readbyqxmd.com/read/27629235/ten-year-maturation-period-in-a-level-i-trauma-center-a-cohort-comparison-study
#2
A M K Harmsen, G F Giannakopoulos, M Terra, E S M de Lange de Klerk, F W Bloemers
PURPOSE: Many changes have been made to improve trauma care. Improved trauma team response and usage of a hybrid resuscitation room are examples of how this trauma center has developed. The aim was to assess how the outcome of the trauma population was influenced by the maturation. METHODS: A cohort comparison, between June 2004-July 2005 and 2014, was performed. All adult trauma patients with an Injury Severity Score (ISS) >15 were included. Variables collected were: patient demographics, mechanism of trauma, total prehospital time, pre- and inhospital trauma scores, vital signs, blood values and interventions, and physician staffed helicopter emergency medical services (P-HEMS) involvement and outcome...
September 15, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27554262/the-probability-of-having-advanced-medical-interventions-is-associated-with-age-in-out-of-hospital-life-threatening-situations
#3
Vania Tavares, Pierre-Nicolas Carron, Bertrand Yersin, Patrick Taffé, Bernard Burnand, Valérie Pittet
BACKGROUND: The use of out-of-hospital emergency medical services by old and very old individuals is increasing. These patients frequently require complex evaluation and decision-making processes to determine a strategy of care, therapeutic choices or withdrawal of care in life-threatening situations. During out-of-hospital missions, thorough decision-making is difficult because of the limited amount of time and lack of direct access to medical charts or to pre-existing advance directives...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27130216/pre-hospital-severe-traumatic-brain-injury-comparison-of-outcome-in-paramedic-versus-physician-staffed-emergency-medical-services
#4
Toni Pakkanen, Ilkka Virkkunen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Janne Virta, Tarja Randell, Arvi Yli-Hankala
BACKGROUND: Traumatic brain injury (TBI) is one of the leading causes of death and permanent disability. Emergency Medical Services (EMS) personnel are often the first healthcare providers attending patients with TBI. The level of available care varies, which may have an impact on the patient's outcome. The aim of this study was to evaluate mortality and neurological outcome of TBI patients in two regions with differently structured EMS systems. METHODS: A 6-year period (2005 - 2010) observational data on pre-hospital TBI management in paramedic-staffed EMS and physician-staffed EMS systems were retrospectively analysed...
April 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27075015/pediatric-pre-hospital-emergencies-in-belgium-a-2-year-national-descriptive-study
#5
Pierre Demaret, Frédéric Lebrun, Philippe Devos, Caroline Champagne, Roland Lemaire, Isabelle Loeckx, Marie Messens, André Mulder
UNLABELLED: This study aims to describe the pediatric physician-staffed EMS missions at a national level and to compare the pediatric and the adult EMS missions. Using a national database, we analyzed 254,812 interventions including 15,294 (6 %) pediatric emergencies. Less children than adults received an intravenous infusion (52.7 versus 77.1 %, p < 0.001), but the intra-osseous access was used more frequently in children (1.3 versus 0.8 %, p < 0.001). More children than adults benefited from a therapeutic immobilization (16...
July 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/26608599/an-update-on-emergency-care-and-emergency-medicine-in-russia
#6
Anthony Rodigin
Russia's national healthcare system is undergoing significant changes. Those changes which affect healthcare financing are particularly vital. As has often been the case in other nations, the emergency care field is at the forefront of such reforms. The ongoing challenges constitute the environment in which the hospital-based specialty of emergency medicine needs to develop as part of a larger system. Emergency care has to evolve in order to match true needs of the population existing today. New federal regulations recently adopted have recognized emergency departments as the new in-hospital component of emergency care, providing the long-needed legal foundation upon which the new specialty can advance...
December 2015: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26307040/anaesthetist-provided-pre-hospital-advanced-airway-management-in-children-a-descriptive-study
#7
COMPARATIVE STUDY
Mona Tarpgaard, Troels Martin Hansen, Leif Rognås
BACKGROUND: Pre-hospital advanced airway management has been named one of the top-five research priorities in physician-provided pre-hospital critical care. Few studies have been made on paediatric pre-hospital advanced airway management. The aim of this study was to investigate pre-hospital endotracheal intubation success rate in children, first-pass success rates and complications related to pre-hospital advanced airway management in patients younger than 16 years of age treated by pre-hospital critical care teams in the Central Denmark Region (1...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/26107880/improving-documentation-timeliness-a-brighter-future-for-the-electronic-medical-record-in-resident-clinics
#8
Kathryn L Carlson, Sara E McFadden, Shari Barkin
PROBLEM: Electronic medical records have many observed benefits but may cause work disruption, resulting in delayed documentation completion. The purpose of this project was to improve compliance with institutional standards of documentation of well child checks for residents and attendings without increasing stress. APPROACH: This project was completed at Children's Hospital Primary Care Clinic at Vanderbilt, which is staffed by 74 residents, supervised by 17 attendings...
December 2015: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/25907401/survival-benefit-of-physician-staffed-helicopter-emergency-medical-services-hems-assistance-for-severely-injured-patients
#9
Dennis Den Hartog, Jamie Romeo, Akkie N Ringburg, Michael H J Verhofstad, Esther M M Van Lieshout
BACKGROUND: Physician-staffed Helicopter Emergency Medical Services (HEMS) provide specialist medical care to the accident scene and aim to improve survival of severely injured patients. Previous studies were often underpowered and showed heterogeneous results, leaving the subject at debate. The aim of this retrospective, adequately powered, observational study was to determine the effect of physician-staffed HEMS assistance on survival of severely injured patients. METHODS: All consecutive severely injured trauma patients (ISS >15) between October 1, 2000 and February 28, 2013 were included...
July 2015: Injury
https://www.readbyqxmd.com/read/25247043/implementation-of-a-team-based-physician-staffing-model-at-an-academic-emergency-department
#10
Jose V Nable, John C Greenwood, Michael K Abraham, Michael C Bond, Michael E Winters
INTRODUCTION: There is scant literature regarding the optimal resident physician staffing model of academic emergency departments (ED) that maximizes learning opportunities. A department of emergency medicine at a large inner-city academic hospital initiated a team-based staffing model. Its pre-interventional staffing model consisted of residents and attending physicians being separately assigned patients, resulting in residents working with two different faculty providers in the same shift...
September 2014: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25227414/capacity-building-for-emergency-care-training-the-first-emergency-specialists-in-myanmar
#11
Georgina Ann Phillips, Zaw Wai Soe, James Han Boon Kong, Chris Curry
OBJECTIVES: The Myanmar Ministry of Health has formed a partnership with Australasian professional colleges and international medical specialists to deliver a comprehensive programme for emergency care training and development. We describe this programme, emphasising the training of the first emergency specialists for Myanmar. METHODS: Eighteen junior specialists (EM18) joined a new postgraduate diploma in emergency medicine (Dip EM) through the University of Medicine (1) (UM1), Yangon...
December 2014: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/25145390/the-role-of-general-practitioners-in-the-pre-hospital-setting-as-experienced-by-emergency-medicine-technicians-a-qualitative-study
#12
Magnus Hjortdahl, Erik Zakariassen, Torben Wisborg
BACKGROUND: Together with the ambulances staffed with emergency medical technicians (EMTs), general practitioners (GPs) on call are the primary resources for handling emergencies outside hospitals in Norway. The benefit of the GP accompanying the ambulance to pre-hospital calls is a matter of controversy in Norway. The purpose of the present study was to gain better insight into the EMT's experiences with the role of the GPs in the care for critically ill patients in the pre-hospital setting...
2014: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/25144407/surge-capacity-logistics-care-of-the-critically-ill-and-injured-during-pandemics-and-disasters-chest-consensus-statement
#13
REVIEW
Sharon Einav, John L Hick, Dan Hanfling, Brian L Erstad, Eric S Toner, Richard D Branson, Robert K Kanter, Niranjan Kissoon, Jeffrey R Dichter, Asha V Devereaux, Michael D Christian
BACKGROUND: Successful management of a pandemic or disaster requires implementation of preexisting plans to minimize loss of life and maintain control. Managing the expected surges in intensive care capacity requires strategic planning from a systems perspective and includes focused intensive care abilities and requirements as well as all individuals and organizations involved in hospital and regional planning. The suggestions in this article are important for all involved in a large-scale disaster or pandemic, including front-line clinicians, hospital administrators, and public health or government officials...
October 2014: Chest
https://www.readbyqxmd.com/read/24878117/efficacy-of-pre-hospital-use-of-glycoprotein-iib-iiia-inhibitors-in-st-segment-elevation-myocardial-infarction-before-mechanical-reperfusion-in-a-rapid-transfer-network-from-the-acute-myocardial-infarction-registry-of-brittany
#14
MULTICENTER STUDY
Vincent Auffret, Emmanuel Oger, Guillaume Leurent, Emmanuelle Filippi, Isabelle Coudert, Jean Philippe Hacot, Philippe Castellant, Antoine Rialan, Régis Delaunay, Gilles Rouault, Philippe Druelles, Bertrand Boulanger, Josiane Treuil, Bertrand Avez, Marc Bedossa, Dominique Boulmier, Marielle Le Guellec, Hervé Le Breton
Previous studies investigating prehospital use of glycoprotein IIb/IIIa inhibitors (GPIs) in patients with ST-segment elevation myocardial infarction reached conflicting conclusions. The benefit of this strategy in addition to in-ambulance loading of dual-antiplatelet therapy remains controversial. The aim of this study was to analyze data from a prospective registry of patients with ST-segment elevation myocardial infarctions admitted <24 hours after symptom onset (July 2006 to May 2012). A total of 2,052 patients managed in a physician-staffed mobile intensive care unit (MICU)<12 hours after symptom onset and scheduled for primary percutaneous coronary intervention (PPCI) were retrospectively included...
July 15, 2014: American Journal of Cardiology
https://www.readbyqxmd.com/read/24691947/-prediction-of-further-hospital-treatment-for-emergency-patients-by-emergency-medical-service-physicians
#15
M Bernhard, S Trautwein, R Stepan, P Zahn, C-A Greim, A Gries
INTRODUCTION: Prehospital assessment of illness and injury severity with the National Advisory Committee for Aeronautics (NACA) score and hospital pre-arrival notification of a patient who is likely to need intensive care unit (ICU) or intermediate care unit (IMC) admission are both common in Germany's physician-staffed emergency medical services (EMS) system. AIM: This study aimed at comparing the prehospital evaluation of severity of disease or injuries by EMS physicians and the subsequent clinical treatment in unselected emergency department (ED) patients...
May 2014: Der Anaesthesist
https://www.readbyqxmd.com/read/24528532/the-effect-of-paramedic-training-on-pre-hospital-trauma-care-epptc-study-a-study-protocol-for-a-prospective-semi-qualitative-observational-trial
#16
David Häske, Stefan K Beckers, Marzellus Hofmann, Christoph G Wölfl, Bernhard Gliwitzky, Paul Grützner, Ulrich Stöckle, Matthias Münzberg
BACKGROUND: Accidents are the leading cause of death in adults prior to middle age. The care of severely injured patients is an interdisciplinary challenge. Limited evidence is available concerning pre-hospital trauma care training programs and the advantage of such programs for trauma patients. The effect on trauma care procedures or on the safety of emergency crews on the scene is limited; however, there is a high level of experience and expert opinion. METHODS: I - Video-recorded case studies are the basis of an assessment tool and checklist being developed to verify the results of programs to train participants in the care of seriously injured patients, also known as "objective structured clinical examination" (OSCE)...
2014: BMC Medical Education
https://www.readbyqxmd.com/read/24279612/developing-templates-for-uniform-data-documentation-and-reporting-in-critical-care-using-a-modified-nominal-group-technique
#17
Hans Morten Lossius, Andreas J Krüger, Kjetil Gorseth Ringdal, Stephen J M Sollid, David J Lockey
BACKGROUND: Clinical practice in trauma and critical care is predominantly derived from quantitative observational cohort studies based on data retrospectively collected from medical records. Such data create uncontrolled bias and influence external and internal validity, thereby hindering systematic reviews. Templates or standards for uniform documenting and scientific reporting may result in high quality and internationally standardised data being collected on a regular basis, enhance large international multi-centre studies, and increase the quality of evidence...
2013: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/24001223/pre-hospital-critical-care-by-anaesthesiologist-staffed-pre-hospital-services-in-scandinavia-a-prospective-population-based-study
#18
A J Krüger, H M Lossius, S Mikkelsen, J Kurola, M Castrén, E Skogvoll
BACKGROUND: All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence and severity. METHODS: This population-based, prospective study recorded activity in 16 anaesthesiologist-staffed pre-hospital services in Denmark, Finland, Norway and Sweden serving half of the Scandinavian population...
October 2013: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/23910503/statement-of-severe-trauma-management-in-france-teachings-of-the-first-study
#19
C Tissier, C Bonithon-Kopp, M Freysz
INTRODUCTION: The blunt trauma victim management is still a matter of debate and comparing studies involving different emergency medical services and health care organization remains fictitious. Hence, the French Intensive care Recorded in Severe Trauma (FIRST) was conducted in order to describe the severe blunt trauma management in France. The present paper aimed at recalling the main results of FIRST study. METHODS: The FIRST study was based on a multicenter prospective cohort of patients aged 18 or over with severe exclusive blunt trauma requiring admission to university hospital care unit within the first 72h and/or managed by medical-Staffed Emergency Mobile Unit (SMUR)...
July 2013: Annales Françaises D'anesthèsie et de Rèanimation
https://www.readbyqxmd.com/read/23883447/pre-hospital-advanced-airway-management-by-experienced-anaesthesiologists-a-prospective-descriptive-study
#20
MULTICENTER STUDY
Leif Rognås, Troels Martin Hansen, Hans Kirkegaard, Else Tønnesen
INTRODUCTION: We report data from the first Utstein-style study of physician-provided pre-hospital advanced airway management. MATERIALS AND METHODS: Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) prospectively registered data according to the template for reporting data from pre-hospital advanced airway management. Data collection took place from February 1st 2011 to October 31st 2012...
2013: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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