keyword
MENU ▼
Read by QxMD icon Read
search

Prehospital Emergency

keyword
https://www.readbyqxmd.com/read/29781051/prehospital-prediction-of-large-vessel-occlusion-in-suspected-stroke-patients
#1
REVIEW
Kevin J Keenan, Charles Kircher, Jason T McMullan
PURPOSE OF REVIEW: Recent advances in endovascular thrombectomy have made acute ischemic stroke due to a large vessel occlusion more treatable than ever. Rapid access to treatment remains paramount and multiple large vessel occlusion prediction scales have been created to enhance prehospital identification and triage of these patients. This review summarizes the current state of large vessel occlusion prediction scales, proposes a set of ideal scale features, and discusses the future of these scales and prehospital neurological emergency response systems...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29776701/nonstandard-advance-directives-in-emergency-medicine-what-should-we-do
#2
Kenneth V Iserson
BACKGROUND: Critically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a "Do Not Resuscitate" tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. DISCUSSION: Advance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29775117/intravenous-low-dose-ketamine-provides-greater-pain-control-compared-to-fentanyl-in-a-civilian-prehospital-trauma-system-a-propensity-matched-analysis
#3
E Stein Bronsky, Catherine Koola, Alessandro Orlando, Diane Redmond, Cecile D'Huyvetter, Heather Sieracki, Allen Tanner, Ray Fowler, Charles Mains, David Bar-Or
OBJECTIVE: A few studies report comparable analgesic efficacy between low-dose ketamine and opioids such as morphine or fentanyl; however, limited research has explored the safety and effectiveness of intravenous low-dose ketamine as a primary analgesic in a civilian prehospital setting. The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016...
May 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29770601/prehospital-identification-of-factors-associated-with-death-during-one-year-follow-up-after-acute-stroke
#4
Per-Olof Hansson, Magnus Andersson Hagiwara, Peter Brink, Johan Herlitz, Birgitta Wireklint Sundström
OBJECTIVES: In acute stroke, the risk of death and neurological sequelae are obvious threats. The aim of the study was to evaluate the association between various clinical factors identified by the emergency medical service (EMS) system before arriving at hospital and the risk of death during the subsequent year among patients with a confirmed stroke. MATERIAL AND METHODS: All patients with a diagnosis of stroke as the primary diagnosis admitted to a hospital in western Sweden (1...
May 16, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29769369/comparison-of-severe-trauma-treatment-standards-in-civilian-china-with-current-practice-in-the-chinese-military-peacekeeping-level-2-military-hospital-in-gao-mali
#5
Jian Li, J Tian, Y B Wang, H Zhang
INTRODUCTION: The People's Republic of China has been successfully deploying medical teams to support the peacekeeping mission at the Level 2 Military Hospital in Mali since December 2013. The aim of this paper was to compare the current practice in Chinese Peacekeeping Level 2 Military Hospital with the severe trauma treatment standards reported in China. METHODS: A retrospective analysis was conducted between 26 April 2014 and 18 May 2016 using records stored in the Chinese Peacekeeping Level 2 Hospital (CHN L2)...
May 16, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29760852/altered-mental-status-current-evidence-based-recommendations-for-prehospital-care
#6
REVIEW
Ashley Sanello, Marianne Gausche-Hill, William Mulkerin, Karl A Sporer, John F Brown, Kristi L Koenig, Eric M Rudnick, Angelo A Salvucci, Gregory H Gilbert
Introduction: In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29760838/comparing-quick-sequential-organ-failure-assessment-scores-to-end-tidal-carbon-dioxide-as-mortality-predictors-in-prehospital-patients-with-suspected-sepsis
#7
Christopher L Hunter, Salvatore Silvestri, George Ralls, Amanda Stone, Ayanna Walker, Neal Mangalat, Linda Papa
Introduction: Early identification of sepsis significantly improves outcomes, suggesting a role for prehospital screening. An end-tidal carbon dioxide (ETCO2 ) value ≤ 25 mmHg predicts mortality and severe sepsis when used as part of a prehospital screening tool. Recently, the Quick Sequential Organ Failure Assessment (qSOFA) score was also derived as a tool for predicting poor outcomes in potentially septic patients. Methods: We conducted a retrospective cohort study among patients transported by emergency medical services to compare the use of ETCO2 ≤ 25 mmHg with qSOFA score of ≥ 2 as a predictor of mortality or diagnosis of severe sepsis in prehospital patients with suspected sepsis...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759850/differences-in-prehospital-patient-assessments-for-pediatric-versus-adult-patients
#8
Sriram Ramgopal, Jonathan Elmer, Jeremiah Escajeda, Christian Martin-Gill
OBJECTIVE: To evaluate whether completion of vital signs assessments in pediatric transports by emergency medical services (EMS) differs by patient age. STUDY DESIGN: We reviewed records by 20 agencies in a regional EMS system in Southwestern Pennsylvania between April 1, 2013 and December 31, 2016. We abstracted demographics, vital signs (systolic blood pressure, heart rate, respiratory rate), clinical, and transport characteristics. We categorized age as neonates (≤30 days), infants (1 month to <1 year), toddler (1 to <2 years), early childhood (2 to <6 years), middle childhood (6 to <12 years), adolescent (12 to <18 years), and adult (≥18 years)...
May 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29753877/developing-a-decision-support-system-for-patients-with-severe-infection-conditions-in-prehospital-care
#9
Niclas Johansson, Carl Spindler, John Valik, Veronica Vicente
OBJECTIVE: To develop and validate a prehospital decision support system (DSS) for the emergency medical services (EMS), enabling identification and steering of patients with critical infectious conditions - severe respiratory tract infections, severe CNS-infections and sepsis - to a specialized emergency department (ED) for infectious diseases. METHODS: The development process has involved four consecutive steps. The first step was gathering data from the electronic Patient Care Record on patients transported by the EMS, to identify retrospectively appropriate patient categories for steering...
May 10, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29742635/trauma-simulation-in-prehospital-emergency-care
#10
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/29742138/a-novel-early-risk-assessment-tool-for-detecting-clinical-outcomes-in-patients-with-heat-related-illness-j-erato-score-development-and-validation-in-independent-cohorts-in-japan
#11
Kei Hayashida, Yutaka Kondo, Toru Hifumi, Junya Shimazaki, Yasutaka Oda, Shinichiro Shiraishi, Tatsuma Fukuda, Junichi Sasaki, Keiki Shimizu
BACKGROUND: We sought to develop a novel risk assessment tool to predict the clinical outcomes after heat-related illness. METHODS: Prospective, multicenter observational study. Patients who transferred to emergency hospitals in Japan with heat-related illness were registered. The sample was divided into two parts: 60% to construct the score and 40% to validate it. A binary logistic regression model was used to predict hospital admission as a primary outcome. The resulting model was transformed into a scoring system...
2018: PloS One
https://www.readbyqxmd.com/read/29731285/prehospital-acute-st-elevation-myocardial-infarction-identification-in-san-diego-a-retrospective-analysis-of-the-effect-of-a-new-software-algorithm
#12
Christanne Coffey, John Serra, Mat Goebel, Sarah Espinoza, Edward Castillo, James Dunford
BACKGROUND: A significant increase in false positive ST-elevation myocardial infarction (STEMI) electrocardiogram interpretations was noted after replacement of all of the City of San Diego's 110 monitor-defibrillator units with a new brand. These concerns were brought to the manufacturer and a revised interpretive algorithm was implemented. OBJECTIVES: This study evaluated the effects of a revised interpretation algorithm to identify STEMI when used by San Diego paramedics...
May 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#13
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
May 6, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29724738/gender-disparities-in-first-medical-contact-and-delay-in-st-elevation-myocardial-infarction-a-prospective-multicentre-swedish-survey-study
#14
Sofia Sederholm Lawesson, Rose-Marie Isaksson, Maria Ericsson, Karin Ängerud, Ingela Thylén
OBJECTIVES: Compare gender disparities in ST-elevation myocardial infarction (STEMI) regarding first medical contact (FMC) and prehospital delay times and explore factors associated with prehospital delay in men and women separately. DESIGN: Cross-sectional study based on medical records and a validated questionnaire. Eligible patients were enrolled within 24 hours after admittance to hospital. SETTING: Patients were included from November 2012 to January 2014 from five Swedish hospitals with catheterisation facilities 24/7...
May 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29719558/pomona-large-vessel-occlusion-screening-tool-for-prehospital-and-emergency-room-settings
#15
Kessarin Panichpisal, Kenneth Nugent, Maharaj Singh, Richard Rovin, Reji Babygirija, Yogesh Moradiya, Karen Tse-Chang, Kimberly A Jones, Katrina J Woolfolk, Debbie Keasler, Bhupat Desai, Parinda Sakdanaraseth, Paphavee Sakdanaraseth, Alimohammad Moalem, Nazli Janjua
Background: Early identification of patients with acute ischemic strokes due to large vessel occlusions (LVO) is critical. We propose a simple risk score model to predict LVO. Method: The proposed scale (Pomona Scale) ranges from 0 to 3 and includes 3 items: gaze deviation, expressive aphasia, and neglect. We reviewed a cohort of all acute stroke activation patients between February 2014 and January 2016. The predictive performance of the Pomona Scale was determined and compared with several National Institutes of Health Stroke Scale (NIHSS) cutoffs (≥4, ≥6, ≥8, and ≥10), the Los Angeles Motor Scale (LAMS), the Cincinnati Prehospital Stroke Severity (CPSS) scale, the Vision Aphasia and Neglect Scale (VAN), and the Prehospital Acute Stroke Severity Scale (PASS)...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29716933/taking-the-reins-on-systems-of-care-for-st-segment-elevation-myocardial-infarction-patients-a-report-from-the-american-heart-association-mission-lifeline-program
#16
Jacqueline L Green, Alice K Jacobs, DaJuanicia Holmes, Karen Chiswell, Rosalia Blanco, Eric R Bates, William French, Douglas F Kupas, Greg Mears, Matthew Roe, Brahmajee K Nallamothu
BACKGROUND: Early success with regionalization of ST-segment-elevation myocardial infarction (STEMI) care has led many states to adopt statewide prehospital STEMI hospital destination policies, allowing emergency medical services to bypass non-percutaneous coronary intervention-capable hospitals. The association between adoption of these policies and patterns of care among STEMI patients is unknown. METHODS AND RESULTS: Using data from January 1, 2013, to December 31, 2014, from the National Cardiovascular Data Registry and Acute Coronary Treatment and Intervention Outcomes Network Registry, 6 states with bypass policies (cases included Delaware, Iowa, Maryland, North Carolina, Pennsylvania, and Massachusetts) were matched to 6 states without bypass policies (controls included South Carolina, Minnesota, Virginia, Texas, New York, and Connecticut) a priori on region, hospital density, and percent state participation in the registry...
May 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29710068/association-of-prehospital-advanced-life-support-by-physician-with-survival-after-out-of-hospital-cardiac-arrest-with-blunt-trauma-following-traffic-collisions-japanese-registry-based-study
#17
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Yutaka Kondo, Kei Hayashida, Ichiro Kukita
Importance: Controversy remains as to whether advanced life support (ALS) or basic life support (BLS) is superior for critically ill and injured patients, including out-of-hospital cardiac arrest (OHCA) and major trauma, in the prehospital setting. Objective: To assess whether prehospital ALS should be provided for traumatic OHCA and who should perform it. Design, Setting, and Participants: Japanese government-managed nationwide population-based registry data of patients with OHCA transported to an emergency hospital were analyzed...
April 25, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29709397/prognosis-value-of-partial-arterial-oxygen-pressure-in-patients-with-septic-shock-subjected-to-pre-hospital-invasive-ventilation
#18
Romain Jouffroy, Anastasia Saade, Laure Castres Saint Martin, Pascal Philippe, Pierre Carli, Benoit Vivien
OBJECTIVE: Mechanical ventilation can help improve the prognosis of septic shock. While adequate delivery of oxygen to the tissue is crucial, hyperoxemia may be deleterious. Invasive out-of-hospital ventilation is often promptly performed in life-threatening emergencies. We propose to determine whether the arterial oxygen pressure (PaO2 ) at the intensive care unit (ICU) admission is associated with mortality in patients with septic shock subjected to pre-hospital mechanical ventilation...
April 24, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29703777/prehospital-neurological-deterioration-in-stroke
#19
Sabreena J Slavin, Heidi Sucharew, Kathleen Alwell, Charles J Moomaw, Daniel Woo, Opeolu Adeoye, Matthew L Flaherty, Simona Ferioli, Jason McMullan, Jason Mackey, Felipe De Los Rios La Rosa, Sharyl Martini, Brett M Kissela, Dawn O Kleindorfer
BACKGROUND AND PURPOSE: Patients with stroke can experience neurological deterioration in the prehospital setting. We evaluated patients with stroke to determine factors associated with prehospital neurological deterioration (PND). METHODS: Among the Greater Cincinnati/Northern Kentucky region (population ~1.3 million), we screened all 15 local hospitals' admissions from 2010 for acute stroke and included patients aged ≥20. The GCS was compared between emergency medical services (EMS) arrival and hospital arrival, with decrease ≥2 points considered PND...
April 27, 2018: Emergency Medicine Journal: EMJ
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
#20
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
keyword
keyword
40493
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"