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Pre-Hospital Emergency Medicine

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https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#1
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28355527/feasibility-evaluation-of-a-pilot-scribe-training-program-in-an-australian-emergency-department
#2
Katherine Walker, Matthew Johnson, William Dunlop, Margaret Staples, Hamish Rodda, Ian Turner, Michael Ben-Meir
Objective Medical scribes have an emerging and expanding role in health, particularly in Emergency Medicine in the US. Scribes assist physicians with documentation and clerical tasks at the bedside while the physician consults with his or her patient. Scribes increase medical productivity. The aim of the present study was to examine the feasibility of a pilot hospital-administered scribe-training program in Australia and to evaluate the ability of an American training course (Medical Scribe Training Systems) to prepare trainee scribes for clinical training in an emergency department in Australia...
March 7, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#3
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28286822/ability-of-ultrasonography-in-detection-of-different-extremity-bone-fractures-a-case-series-study
#4
Farzad Bozorgi, Massoud Shayesteh Azar, Seyed Hossein Montazer, Aroona Chabra, Seyed Farshad Heidari, Alireza Khalilian
INTRODUCTION: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. METHODS: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28277237/does-rapid-blood-sampling-affect-the-retention-time-of-patients-with-low-acuity-complaints-in-the-emergency-department
#5
Ju Young Lee, Sang Hoon Oh, Kyu Nam Park, Jee Yong Lim, Jung Min Lee, Hyun Suk Park, Han Joon Kim
INTRODUCTION: The objective of this study was to investigate whether rapid blood sampling during triage led to shorter stays in the emergency department for patients with low-acuity complaints. METHODS: A retrospective study was conducted in the emergency department (ED) of a tertiary university hospital in South Korea. A pre- and post-intervention comparison analysis was completed over one-month periods in June and September 2014. Data included triage level of the patient, time from the ED visit to receiving the doctor's orders, result time of complete blood cell count (CBC) and blood chemistry (BC), length of stay (LOS) for all discharged patients who required blood sampling...
October 27, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/28259184/can-we-rely-on-out-of-hospital-blood-samples-a-prospective-interventional-study-on-the-pre-analytical-stability-of-blood-samples-under-prehospital-emergency-medicine-conditions
#6
Johannes Prottengeier, Nicola Jess, Frank Harig, Christine Gall, Joachim Schmidt, Torsten Birkholz
BACKGROUND: Prehospital intravenous access provides the opportunity to sample blood from an emergency patient at the earliest possible moment in the course of acute illness and in a state prior to therapeutic interventions. Our study investigates the pre-analytical stability of biomarkers in prehospital emergency medicine and will answer the question whether an approach of blood sampling out in the field will deliver valid laboratory results. METHODS: We prepared pairs of blood samples from healthy volunteers and volunteering patients post cardio-thoracic surgery...
March 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28228341/doctors-and-nurses-perceptions-of-military-pre-hospital-emergency-care-when-training-becomes-reality
#7
REVIEW
Sten-Ove Andersson, Lars Lundberg, Anders Jonsson, Pia Tingström, Madeleine Abrandt Dahlgren
The aim of this study was to identify physicians' and nurses' perceptions of military pre-hospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The results after pre-deployment training can be categorised as (1) learning about military medicine and (2) taking care of the casualty. The results after an international mission can be categorised as (1) collaborating with others, (2) providing general health care and (3) improving competence in military medicine...
February 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28224346/dedication-increases-productivity-an-analysis-of-the-implementation-of-a-dedicated-medical-team-in-the-emergency-department
#8
Pedro Ramos, José Artur Paiva
BACKGROUND: In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28202076/developing-quality-indicators-for-physician-staffed-emergency-medical-services-a-consensus-process
#9
Helge Haugland, Marius Rehn, Pål Klepstad, Andreas Krüger
BACKGROUND: There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives. METHODS: A four-step modified nominal group technique process (expert panel method) was used. RESULTS: The expert panel reached consensus on 26 quality indicators for P-EMS...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28124018/effectiveness-of-resident-as-teacher-curriculum-in-preparing-emergency-medicine-residents-for-their-teaching-role
#10
Hooman Hosein Nejad, Mehdi Bagherabadi, Alireza Sistani, Helen Dargahi
INTRODUCTION: Over the past 30 years, recognizing the need and importance of training residents in teaching skills has resulted in several resident-as-teacher programs. The purpose of this study was to explore the impact of this teaching initiative and investigate the improvement in residents' teaching skills through evaluating their satisfaction and perceived effectiveness as well as assessing medical students' perception of the residents' teaching quality. METHODS: This research is a quasi-experimental study with pre- and post-tests, continuing from Dec 2010 to May 2011 in Imam Hospital, Tehran University of Medical Sciences...
January 2017: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/28103632/global-health-and-emergency-care-defining-clinical-research-priorities
#11
Bhakti Hansoti, Adam R Aluisio, Meagan A Barry, Kevin Davey, Brian A Lentz, Payal Modi, Jennifer A Newberry, Melissa H Patel, Tricia A Smith, Alexandra M Vinograd, Adam C Levine
OBJECTIVES: Despite recent strides in the development of global emergency medicine (EM), the field continues to lag in applying a scientific approach to identifying critical knowledge gaps and advancing evidence-based solutions to clinical and public health problems seen in emergency departments (EDs) worldwide. Here, progress on the global EM research agenda created at the 2013 Academic Emergency Medicine Global Health and Emergency Care Consensus Conference is evaluated and critical areas for future development in emergency care research internationally are identified...
January 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28043708/emerging-roles-of-sodium-glucose-cotransporter-2-inhibitors-in-cardiology
#12
REVIEW
Atsushi Tanaka, Koichi Node
The ultimate goal of treatment in people with diabetes mellitus is to prevent development of cardiovascular (CV) disease, resulting in prolongation of healthy life expectancy. Although impaired glycemic metabolism has a central role in its pathology, a number of studies have demonstrated that remedy for its imbalance cannot necessarily be accomplished as a therapeutic goal. A comprehensive medical approach against multi-factorial pathologies in diabetes, such as insulin resistance, obesity, hypertension, and dyslipidemia, in addition to diet and exercise therapy should be rather performed in the routine clinical setting...
March 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/27942002/the-impact-of-adding-a-physician-assistant-to-a-critical-care-outreach-team
#13
Hayley B Gershengorn, Yunchao Xu, Carri W Chan, Mor Armony, Michelle N Gong
RATIONALE: Hospitals are increasingly using critical care outreach teams (CCOTs) to respond to patients deteriorating outside intensive care units (ICUs). CCOT staffing is variable across hospitals and optimal team composition is unknown. OBJECTIVES: To assess whether adding a critical care medicine trained physician assistant (CCM-PA) to a critical care outreach team (CCOT) impacts clinical and process outcomes. METHODS: We performed a retrospective study of two cohorts-one with a CCM-PA added to the CCOT (intervention hospital) and one with no staffing change (control hospital)-at two facilities in the same system...
2016: PloS One
https://www.readbyqxmd.com/read/27907982/learners-perspective-where-and-when-pre-residency-trainees-learn-more-to-achieve-their-core-clinical-competencies
#14
Eusang Ahn, Ducksun Ahn, Young-Mee Lee
PURPOSE: While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. METHODS: A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews...
December 2016: Korean Journal of Medical Education
https://www.readbyqxmd.com/read/27871770/ptsd-in-those-who-care-for-the-injured
#15
Kevin Luftman, Jayson Aydelotte, Kevin Rix, Sadia Ali, Katherine Houck, Thomas B Coopwood, Pedro Teixeira, Alex Eastman, Brian Eastridge, Carlos V R Brown, Matthew Davis
BACKGROUND: Post Traumatic Stress Disorder (PTSD) has become a focus for the care of trauma victims, but the incidence of PTSD in those who care for injured patients has not been well studied. Our hypothesis was that a significant proportion of health care providers involved with trauma care are at risk of developing PTSD. METHODS: A system-wide survey was applied using a modified version of the Primary Care PTSD Screen [PC-PTSD], a validated PTSD screening tool currently being used by the VA to screen veterans for PTSD...
February 2017: Injury
https://www.readbyqxmd.com/read/27724970/the-pre-hospital-administration-of-tranexamic-acid-to-patients-with-multiple-injuries-and-its-effects-on-rotational-thrombelastometry-a-prospective-observational-study-in-pre-hospital-emergency-medicine
#16
Nils Kunze-Szikszay, Lennart A Krack, Pauline Wildenauer, Saskia Wand, Tim Heyne, Karoline Walliser, Christopher Spering, Martin Bauer, Michael Quintel, Markus Roessler
BACKGROUND: Hyperfibrinolysis (HF) is a major contributor to coagulopathy and mortality in trauma patients. This study investigated (i) the rate of HF during the pre-hospital management of patients with multiple injuries and (ii) the effects of pre-hospital tranexamic acid (TxA) administration on the coagulation system. METHODS: From 27 trauma patients with pre-hospital an estimated injury severity score (ISS) ≥16 points blood was obtained at the scene and on admission to the emergency department (ED)...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27646649/impact-of-the-mass-drug-administration-for-malaria-in-response-to-the-ebola-outbreak-in-sierra-leone
#17
Maru Aregawi, Samuel J Smith, Musa Sillah-Kanu, John Seppeh, Anitta R Y Kamara, Ryan O Williams, John J Aponte, Andrea Bosman, Pedro Alonso
BACKGROUND: As emergency response to the Ebola epidemic, the Government of Sierra Leone and its partners implemented a large-scale Mass Drug Administration (MDA) with artesunate-amodiaquine (ASAQ) covering >2.7 million people in the districts hardest hit by Ebola during December 2014-January 2015. The World Health Organization (WHO) and the National Malaria Control Programme (NMCP) evaluated the impact of the MDA on malaria morbidity at health facilities and the number of Ebola alerts received at District Ebola Command Centres...
2016: Malaria Journal
https://www.readbyqxmd.com/read/27633781/accidental-hypothermia-an-update-the-content-of-this-review-is-endorsed-by-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#18
REVIEW
Peter Paal, Les Gordon, Giacomo Strapazzon, Monika Brodmann Maeder, Gabriel Putzer, Beat Walpoth, Michael Wanscher, Doug Brown, Michael Holzer, Gregor Broessner, Hermann Brugger
BACKGROUND: This paper provides an up-to-date review of the management and outcome of accidental hypothermia patients with and without cardiac arrest. METHODS: The authors reviewed the relevant literature in their specialist field. Summaries were merged, discussed and approved to produce this narrative review. RESULTS: The hospital use of minimally-invasive rewarming for non-arrested, otherwise healthy, patients with primary hypothermia and stable vital signs has the potential to substantially decrease morbidity and mortality for these patients...
September 15, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27625060/study-protocol-for-a-randomised-controlled-trial-of-invasive-versus-conservative-management-of-primary-spontaneous-pneumothorax
#19
Simon G A Brown, Emma L Ball, Kyle Perrin, Catherine A Read, Stephen E Asha, Richard Beasley, Diana Egerton-Warburton, Peter G Jones, Gerben Keijzers, Frances B Kinnear, Ben C H Kwan, Y C Gary Lee, Julian A Smith, Quentin A Summers, Graham Simpson
INTRODUCTION: Current management of primary spontaneous pneumothorax (PSP) is variable, with little evidence from randomised controlled trials to guide treatment. Guidelines emphasise intervention in many patients, which involves chest drain insertion, hospital admission and occasionally surgery. However, there is evidence that conservative management may be effective and safe, and it may also reduce the risk of recurrence. Significant questions remain regarding the optimal initial approach to the management of PSP...
September 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27606071/evaluation-of-pharmaceutical-lifesaving-skills-training-oriented-pharmaceutical-intervention
#20
Yoshito Zamami, Toru Imai, Masaki Imanishi, Kenshi Takechi, Naoko Shiraishi, Toshihiro Koyama, Hidenori Sagara, Yasukazu Shiino, Toshiaki Sendo, Keisuke Ishizawa
BACKGROUND: Many pharmacists are participating in team-based medical care in emergency hospitals. Therefore, there is a desperate need to improve the education system. In the present study, we provided a "pharmaceutical lifesaving skills training" to the students in their fifth and sixth year of the pharmaceutical school and evaluated the program's impact on the students' learning and confidence in their ability to perform pharmaceutical interventions for emergency patients. METHODS: We conducted a pharmaceutical lifesaving skills training program with 12 participants who were in their fifth and six year of pharmaceutical school...
2016: Journal of Pharmaceutical Health Care and Sciences
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