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https://www.readbyqxmd.com/read/27747839/falls-and-injuries-to-polo-players-risk-perception-mitigation-and-risk-factors
#1
C M Inness, K L Morgan
Polo, one of the world's oldest sports, is played in over 80 countries. It is unique in combining the skills of a person with the agility and performance of an animal in a contact sport. There is only one report of the frequency and type of injuries in this population. Here we report risk perception, mitigation and risk factors for injuries and falls in UK polo players. Data were collected retrospectively from a random sample of 112 UK polo players by telephone questionnaire. Injuries (commonly to a shoulder or wrist) requiring a hospital visit were sustained by 17...
December 2015: Sports Medicine—Open
https://www.readbyqxmd.com/read/27747560/the-epidemiology-of-pre-hospital-potential-spinal-cord-injuries-in-victoria-australia-a-six-year-retrospective-cohort-study
#2
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27685491/pre-hospital-fast-positive-cases-identified-by-dfb-ambulance-paramedics-final-clinical-diagnosis
#3
A Feeney, T Barry, D Hayden, L Higgins, E Kavanagh, P MacMahon, M O'Reilly, S P Teeling, P J Kelly, S Murphy
Ischaemic stroke clinical outcomes are improved by earlier treatment with intravenous thrombolysis. An existing pathway at the Mater University Hospital for assessment of suspected acute stroke in the Emergency Department was updated, aiming to shorten door-to-needle time. This study examines the final clinical diagnosis of Dublin Fire Brigade Ambulance Paramedic identified Face-Arm-Speech-Test (FAST) positive patients presenting to the Emergency Department over a 7 month period. A retrospective analysis was carried out of 177 consecutive FAST positive patients presenting between March and November 2014...
April 11, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27650864/pre-hospital-assessment-of-the-role-of-adrenaline-measuring-the-effectiveness-of-drug-administration-in-cardiac-arrest-paramedic-2-trial-protocol
#4
Gavin D Perkins, Tom Quinn, Charles D Deakin, Jerry P Nolan, Ranjit Lall, Anne-Marie Slowther, Matthew Cooke, Sarah E Lamb, Stavros Petrou, Felix Achana, Judith Finn, Ian G Jacobs, Andrew Carson, Mike Smyth, Kyee Han, Sonia Byers, Nigel Rees, Richard Whitfield, Fionna Moore, Rachael Fothergill, Nigel Stallard, John Long, Susie Hennings, Jessica Horton, Charlotte Kaye, Simon Gates
Despite its use since the 1960s, the safety or effectiveness of adrenaline as a treatment for cardiac arrest has never been comprehensively evaluated in a clinical trial. Although most studies have found that adrenaline increases the chance of return of spontaneous circulation for short periods, many studies found harmful effects on the brain and raise concern that adrenaline may reduce overall survival and/or good neurological outcome. The PARAMEDIC-2 trial seeks to determine if adrenaline is safe and effective in out-of-hospital cardiac arrest...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/27625737/the-medical-duty-officer-an-attempt-to-mitigate-the-ambulance-at-hospital-interval
#5
Megan H Halliday, Andrew J Bouland, Benjamin J Lawner, Angela C Comer, Daniel C Ramos, Mark Fletcher
INTRODUCTION: A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27547282/geospatial-and-clinical-analyses-on-pediatric-related-road-traffic-injury-in-malaysia
#6
Nik Hisamuddin Rahman, Ruslan Rainis, Syed Hatim Noor, Sharifah Mastura Syed Mohamad
BACKGROUND: The main aim of this study is to utilize the geographical information system (GIS) software and perform the spatial analysis in relation to clinical data for road traffic injury (RTI) pediatric cases attending the emergency department. METHODS: The study sample included pediatric patients (age less than 18 years) with road-related injuries within a district in Malaysia who attended emergency departments of two tertiary hospitals within the district. In addition to injury, pre-hospital care and outcome data, the coordinate of the locations were obtained by the ambulance paramedics by using portable handheld GPS unit brand Garmin(®) model GPS 72 H...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27377669/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-the-pre-hospital-setting-an-additional-resuscitation-option-for-uncontrolled-catastrophic-haemorrhage
#7
Samy Sadek, David J Lockey, Robbie A Lendrum, Zane Perkins, Jonathan Price, Gareth Edward Davies
This report describes the first use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the pre-hospital setting to control catastrophic haemorrhage. The patient, who had fallen 15 meters, suffered catastrophic internal haemorrhage associated with a pelvic fracture. He was treated by London's Air Ambulance's Physician-Paramedic team. This included insertion of a REBOA balloon catheter at the scene to control likely fatal exsanguination. The patient survived transfer to hospital, emergency angio-embolization and subsequent surgery...
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27154472/does-the-norwegian-emergency-medical-dispatch-classification-as-non-urgent-predict-no-need-for-pre-hospital-medical-treatment-an-observational-study
#8
Eystein Grusd, Jo Kramer-Johansen
BACKGROUND: The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current dispatch triage tools could reliably identify patients who only required transport, and not pre-hospital medical care. This could allow selection of such patients for designated transport units, freeing up highly trained ambulance staff to attend patients in greater need...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27027598/paramedic-checklists-do-not-accurately-identify-post-ictal-or-hypoglycaemic-patients-suitable-for-discharge-at-the-scene
#9
Hideo Tohira, Daniel Fatovich, Teresa A Williams, Alexandra Bremner, Glenn Arendts, Ian R Rogers, Antonio Celenza, David Mountain, Peter Cameron, Peter Sprivulis, Tony Ahern, Judith Finn
OBJECTIVES: The objective of this study was to assess the accuracy and safety of two pre-defined checklists to identify prehospital post-ictal or hypoglycemic patients who could be discharged at the scene. METHODS: A retrospective cohort study of lower acuity, adult patients attended by paramedics in 2013, and who were either post-ictal or hypoglycemic, was conducted. Two self-care pathway assessment checklists (one each for post-ictal and hypoglycemia) designed as clinical decision tools for paramedics to identify patients suitable for discharge at the scene were used...
June 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/26948870/paramedics-involvement-in-planned-home-birth-a-one-year-case-study
#10
Gayle McLelland, Lisa McKenna, Amee Morgans, Karen Smith
OBJECTIVE: to report findings from a study performed prior to the introduction of publicly funded home birth programmes in Victoria, Australia, that investigated the incidence of planned home births attended by paramedics and explored the clinical support they provided as well as the implications for education and practice. METHODS: retrospective data previously collected via an in-field electronic patient care record (VACIS(®)) was provided by a state-wide ambulance service...
July 2016: Midwifery
https://www.readbyqxmd.com/read/26873720/regulation-and-registration-as-drivers-of-continuous-professional-competence-for-irish-pre-hospital-practitioners-a-discussion-paper
#11
REVIEW
S Knox, S S Dunne, M Hughes, S Cheeseman, C P Dunne
BACKGROUND: The regulatory body responsible for the registration of Irish pre-hospital practitioners, the Pre-Hospital Emergency Care Council (PHECC), identified the need to implement a continuing professional competence (CPC) framework. The first cycle of CPC (focused on emergency medical technicians) commenced in November 2013 creating for the first time a formal relationship between continuing competence and registration to practice. AIMS: To review current literature and to describe benefits and challenges relevant to CPC, regulation, registration and their respective contributions to professionalism of pre-hospital practitioners: advanced paramedics, paramedics and emergency medical technicians...
May 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/26627881/providing-rapid-out-of-hospital-acute-cardiovascular-treatment-4-proact-4
#12
RANDOMIZED CONTROLLED TRIAL
Justin A Ezekowitz, Robert C Welsh, Dale Weiss, Michael Chan, William Keeble, Fadi Khadour, Sanjay Sharma, Wayne Tymchak, Sunil Sookram, Neil Brass, Darren Knapp, Thomas L Koshy, Yinggan Zheng, Paul W Armstrong
BACKGROUND: Whether prehospital point-of-care (POC) troponin further accelerates the time to diagnosis in patients with chest pain (CP) is unknown. We conducted a randomized trial of POC-Troponin testing in the ambulance. METHODS AND RESULTS: Patients with chest pain presenting by ambulance were randomized to usual care (UC) or POC-Troponin; ST-elevation myocardial infarction patients or those with noncardiovascular symptoms were excluded. Pre-hospital high-sensitivity troponin was analyzed on a POC device and available to the paramedic and emergency department (ED) staff...
December 1, 2015: Journal of the American Heart Association
https://www.readbyqxmd.com/read/26375661/the-impact-of-a-pre-hospital-critical-care-team-on-survival-from-out-of-hospital-cardiac-arrest
#13
Johannes von Vopelius-Feldt, Archibald Coulter, Jonathan Benger
AIM: To assess the impact of a pre-hospital critical care team (CCT) on survival from out-of-hospital cardiac arrest (OHCA). METHODS: We undertook a retrospective observational study, comparing OHCA patients attended by advanced life support (ALS) paramedics with OHCA patients attended by ALS paramedics and a CCT between April 2011 and April 2013 in a single ambulance service in Southwest England. We used multiple logistic regression to control for an anticipated imbalance of prognostic factors between the groups...
November 2015: Resuscitation
https://www.readbyqxmd.com/read/26102313/pre-hospital-non-invasive-ventilation-for-acute-respiratory-failure-a-systematic-review-and-cost-effectiveness-evaluation
#14
REVIEW
Abdullah Pandor, Praveen Thokala, Steve Goodacre, Edith Poku, John W Stevens, Shijie Ren, Anna Cantrell, Gavin D Perkins, Matt Ward, Jerry Penn-Ashman
BACKGROUND: Non-invasive ventilation (NIV), in the form of continuous positive airway pressure (CPAP) or bilevel inspiratory positive airway pressure (BiPAP), is used in hospital to treat patients with acute respiratory failure. Pre-hospital NIV may be more effective than in-hospital NIV but requires additional ambulance service resources. OBJECTIVES: We aimed to determine the clinical effectiveness and cost-effectiveness of pre-hospital NIV compared with usual care for adults presenting to the emergency services with acute respiratory failure and to identify priorities for future research...
June 2015: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/26022936/the-assessment-of-acute-pain-in-pre-hospital-care-using-verbal-numerical-rating-and-visual-analogue-scales
#15
Ahmad K Ismail, Muhammad A Abdul Ghafar, Noor Shaza A Shamsuddin, Nurul A Roslan, Hilwani Kaharuddin, Nik A Nik Muhamad
BACKGROUND: Prehospital care (PHC) pain evaluation is an essential patient assessment to be performed by paramedics. Pain intensity is frequently assessed using Verbal Numerical Rating Scale (VNRS) or Visual Analog Scale (VAS). OBJECTIVE: Our aim was to evaluate the agreement between VNRS and VAS in measuring acute pain in prehospital setting and to identify the preference among paramedics and patients. METHODS: This was a 3-month cross-sectional study...
September 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25991779/using-an-education-session-to-develop-ambulance-clinicians-understanding-and-awareness-of-childrens-distress-distraction-techniques-and-holding-in-the-pre-hospital-setting
#16
Christopher Preston, Lucy Bray
- Accepted for publication in Journal of Paramedic Practice.
June 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25991778/development-and-impact-of-a-dedicated-cardiac-arrest-response-unit-in-a-uk-regional-ambulance-service
#17
Paul Younger, Graham McClelland, Paul Fell
BACKGROUND: Survival rates from out-of-hospital cardiac arrest (OHCA) vary, with figures from 2% to 12% reported nationally. Our ambulance service introduced a dedicated cardiac arrest response unit (CARU) as a trial in order to improve local patient outcomes by focussing training, extending the scope of practice and increasing exposure to cardiac arrests. CARU launched in January 2014 using a rapid response car staffed by senior paramedics responding to cardiac arrests within a 19 minute radius of their location...
June 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25907401/survival-benefit-of-physician-staffed-helicopter-emergency-medical-services-hems-assistance-for-severely-injured-patients
#18
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/25890971/stroke-mimics-in-the-pre-hospital-setting
#19
M J Edwards, R T Fothergill, J Williams, P Gompertz
Accurate identification of stroke patients is essential to ensure appropriate and timely treatment. Stroke mimics-patients initially suspected to have suffered a stroke who are subsequently diagnosed with a condition other than stroke-are estimated to account for 5-33% of suspected stroke patients conveyed by paramedics to a hospital stroke unit. The prevalence of stroke mimics in London has not been investigated although pan-London hospital data suggests that one quarter of all patients admitted to hyper-acute stroke units (HASUs) are stroke mimics...
May 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25890962/stocklist-a-study-of-clinical-skills-of-critical-care-paramedics-in-the-uk
#20
Jim Walmsley, Janette Turner
INTRODUCTION: The Critical Care Paramedic (CCP) is a relatively new advanced practitioner. CCPs provide advanced clinical skills, knowledge and expertise for primary response and critical care retrieval and transfer. In the UK it is currently an undefined role with no common code of practice, clinical governance or national guidance. The aim of this study was to explore the current use of CCPs and assess the views of a range of stakeholders on the required skills and role development within a British context...
May 2015: Emergency Medicine Journal: EMJ
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