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Prehospital Emergency

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https://www.readbyqxmd.com/read/28810931/a-comprehensive-regional-clinical-and-educational-ecpr-protocol-decreases-time-to-ecmo-in-patients-with-refractory-out-of-hospital-cardiac-arrest
#1
Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
OBJECTIVE: Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). METHODS: In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital...
August 16, 2017: CJEM
https://www.readbyqxmd.com/read/28807080/a-descriptive-analysis-of-traction-splint-utilization-and-iv-analgesia-by-emergency-medical-services
#2
Joshua Nackenson, Amado A Baez, Jonathan P Meizoso
Study Objectives Traction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) analgesia utilization by Emergency Medical Services (EMS) in Miami, Florida (USA). METHODS: This is a retrospective study of patients who sustained a midshaft femur fracture in the absence of multiple other severe injuries or severe physiologic derangement, as defined by an injury severity score (ISS) <20 and a triage revised trauma score (T-RTS)≥10, who presented to an urban, Level 1 trauma center between September 2008 and September 2013...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28804875/prehospital-pathways-of-occipital-stroke-patients-with-mainly-visual-symptoms
#3
S Räty, K Silvennoinen, T Tatlisumak
OBJECTIVES: Occipital ischemic strokes typically cause homonymous visual field defects, for which means of rehabilitation are limited. Intravenous thrombolysis is increasingly and successfully used for their acute treatment. However, recognition of strokes presenting with mainly visual field defects is challenging for both patients and healthcare professionals. We studied prehospital pathways of occipital stroke patients with mainly visual symptoms to define obstacles in their early recognition...
August 13, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28797317/where-there-is-no-ems-lay-providers-in-emergency-medical-services-care-ems-as-a-public-health-priority
#4
Sierra Debenham, Matthew Fuller, Matthew Stewart, Raymond R Price
By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks...
August 11, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28795061/a-multi-agent-based-approach-for-prehospital-emergency-management
#5
Reza Safdari, Jaleh Shoshtarian Malak, Niloofar Mohammadzadeh, Azimeh Danesh Shahraki
OBJECTIVE: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. METHODS: Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28794661/focused-assessment-with-sonography-for-trauma-current-perspectives
#6
REVIEW
Sorravit Savatmongkorngul, Sirote Wongwaisayawan, Rathachai Kaewlai
Focused assessment with sonography for trauma (FAST) is a part of resuscitation of trauma patients recommended by international panel consensus. The purpose of FAST is to identify free fluid, which necessarily means blood in acute trauma patients. In this article, the authors focused on various aspects of FAST in the emergency department, prehospital care, pediatric setting, training and general pearls/pitfalls. Detailed techniques and interpretation of FAST are beyond the scope of this article.
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28792281/pan-asian-trauma-outcomes-study-patos-rationale-and-methodology-of-an-international-and-multicenter-trauma-registry
#7
So Yeon Kong, Sang Do Shin, Hideharu Tanaka, Akio Kimura, Kyoung Jun Song, Goh E Shaun, Wen-Chu Chiang, Kentaro Kajino, Sabariah Faizah Jamaluddin, Dae Han Wi, Ju Ok Park, Sung Woo Moon, Young Sun Ro, David C Cone, James F Holmes
BACKGROUND: Trauma is a major health burden and a time-dependent critical emergency condition among developing and developed countries. In Asia, trauma has become a rapidly expanding epidemic and has spread out to many underdeveloped and developing countries through rapid urbanization and industrialization. Most casualties of severe trauma, which results in significant mortality and disability are assessed and transported by prehospital providers including physicians, professional providers, and volunteer providers...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28792258/utilization-of-intravenous-catheters-by-prehospital-providers-during-pediatric-transports
#8
Timothy VanderKooy, Kelsey Spaur, Lina Brou, Sean Caffrey, Kathleen M Adelgais
INTRODUCTION: Prehospital intravenous (IV) access in children may be difficult and time-consuming. Emergency Medical Service (EMS) protocols often dictate IV placement; however, some IV catheters may not be needed. The scene and transport time associated with attempting IV access in children is unknown. The objective of this study is to examine differences in scene and transport times associated with prehospital IV catheter attempt and utilization patterns of these catheters during pediatric prehospital encounters...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28792256/triage-of-septic-patients-using-qsofa-criteria-at-the-samu-regulation-a-retrospective-analysis
#9
R Jouffroy, A Saade, A Carpentier, S Ellouze, P Philippe, R Idialisoa, P Carli, B Vivien
PURPOSE: One of the major prognostic factors in the management of sepsis is the early initiation of appropriate treatment. To serve this purpose, early identification and triage of patients are crucial steps, which are still not optimal. The objective of this study was to determine whether the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) score is an accurate method for prehospital triaging of septic patients. We evaluated whether the use of qSOFA criteria collected by the Service Mobile d'Urgence et de Réanimation 15 (SAMU 15) regulation call center during prehospital care would facilitate appropriate intensive care unit (ICU) admission of patients with septic syndromes...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28781312/the-prehospital-predictors-of-tracheal-intubation-for-in-patients-who-experience-convulsive-seizures-in-the-emergency-department
#10
Kenichiro Sato, Noritoshi Arai, Aki Omori-Mitsue, Ayumi Hida, Akio Kimura, Sousuke Takeuchi
Objective To identify the prehospital factors predicting the performance of tracheal intubation (TI) at the emergency department (ED) in patients with convulsive seizure or epilepsy. Methods We performed a retrospective analysis of seizure patients who underwent TI at the ED soon after arrival. The clinical variables obtained in the prehospital setting were reviewed. Patients The study population included consecutive adult patients who were transported to an urban tertiary care ED due to convulsive seizure between August 2010 and September 2015...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28774793/the-relationship-between-functional-outcome-and-prehospital-time-interval-in-patients-with-cerebral-infarction
#11
Soichiro Seno, Satoshi Tomura, Kenichiro Ono, Shinji Akitomi, Yasumasa Sekine, Yuya Yoshimura, Yoshihiro Tanaka, Hisashi Ikeuchi, Daizoh Saitoh
BACKGROUND: When symptoms of cerebral infarction are recognized in a patient, he or she should be transported to a hospital and should be started on the appropriate treatments. The effectiveness of delayed treatment of cerebral infarction with respect to the initial diagnosis or perception of the disease is still unclear. METHODS: We retrospectively investigated whether the functional outcomes would improve if patients with cerebral infarction were transported to the hospital with minimum delay...
July 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28771639/utilisation-of-prehospital-emergency-medical-services-for-hyperglycaemia-a-community-based-observational-study
#12
Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Arul Earnest, Karen Smith, Georgia Soldatos, Helena Teede, Sophia Zoungas
AIMS: This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport. MATERIALS AND METHODS: A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/28754294/prehospital-emergency-medicine-at-the-beach-what-is-the-effect-of-fins-and-rescue-tubes-in-lifesaving-and-cardiopulmonary-resuscitation-after-rescue
#13
Cristian Abelairas-Gómez, Roberto Barcala-Furelos, Marcos Mecías-Calvo, Ezequiel Rey-Eiras, Sergio López-García, Javier Costas-Veiga, Antonio Bores-Cerezal, Jose Palacios-Aguilar
OBJECTIVE: To analyze the influence of fins and rescue tube use in a water rescue, assessed by time and distance to salvage position, physiological parameters, and cardiopulmonary resuscitation (CPR). METHODS: Twenty professional lifeguards (10 men, 10 women) conducted 3 tests: a baseline test of 5 minutes of CPR and 2 water rescues, 1 without rescue equipment (NRE), and the other with fins and rescue tube (FRT). They also had to perform 5 minutes of CPR after each rescue...
July 25, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28751844/anmco-sit-consensus-document-telemedicine-for-cardiovascular-emergency-networks
#14
Pasquale Caldarola, Michele Massimo Gulizia, Domenico Gabrielli, Marco Sicuro, Luisa De Gennaro, Massimo Giammaria, Niccolò Brenno Grieco, Daniele Grosseto, Roberto Mantovan, Marco Mazzanti, Alberto Menotti, Natale Daniele Brunetti, Silva Severi, Giancarmine Russo, Gian Franco Gensini
Telemedicine has deeply innovated the field of emergency cardiology, particularly the treatment of acute myocardial infarction. The ability to record an ECG in the early prehospital phase, thus avoiding any delay in diagnosing myocardial infarction with direct transfer to the cath-lab for primary angioplasty, has proven to significantly reduce treatment times and mortality. This consensus document aims to analyse the available evidence and organizational models based on a support by telemedicine, focusing on technical requirements, education, and legal aspects...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28750882/unrecognized-failed-airway-management-using-a-supraglottic-airway-device
#15
Veer D Vithalani, Sabrina Vlk, Steven Q Davis, Neal J Richmond
BACKGROUND: 911 Emergency Medical Services (EMS) systems utilize supraglottic devices for either primary advanced airway management, or for airway rescue following failed attempts at direct laryngoscopy endotracheal intubation. There is, however, limited data on objective confirmation of supraglottic airway placement in the prehospital environment. Furthermore, the ability of EMS field providers to recognize a misplaced airway is unknown. METHODS: Retrospective review of patients who underwent airway management using the King LTS-D supraglottic airway in a large urban EMS system, between 3/1/15-9/30/2015...
July 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28750691/the-use-of-interpreters-in-medical-triage-during-a-refugee-mass-gathering-incident-in-europe
#16
Lykourgos Christos Alexakis, Anastasia Papachristou, Chiara Baruzzi, Angeliki Konstantinou
Introduction During a refugees' mass-gathering incident in Kos Island, Greece, Médecins Sans Frontières (MSF; Brussels, Belgium) teams provided emergency medical care. A case report of the event focusing on difficulties encountered by the interpreters during triage and emergency response was prepared. METHODS: Data collected during the event were reviewed from the patient's register and qualitative interviews were obtained from the MSF interpreters involved in the response. In addition, a description of the event and a literature review were included...
July 28, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28748771/acute-care-referral-systems-in-liberia-transfer-and-referral-capabilities-in-a-low-income-country
#17
Jimin Kim, Maria Barreix, Christine Babcock, Corey B Bills
Introduction Following two decades of armed conflict in Liberia, over 95% of health care facilities were partially or completely destroyed. Although the Liberian health system has undergone significant rehabilitation, one particular weakness is the lack of organized systems for referral and prehospital care. Acute care referral systems are a critical component of effective health care delivery and have led to improved quality of care and patient outcomes. Problem This study aimed to characterize the referral and transfer systems in the largest county of Liberia...
July 27, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28746084/epidemiology-and-location-of-primary-retrieval-missions-in-a-scottish-aeromedical-service
#18
Gregg Neagle, Lisa Curatolo, John Ferris, Mike Donald, Stephen Hearns, Alasdair R Corfield
INTRODUCTION: Prehospital critical care teams comprising an appropriately trained physician and paramedic or nurse have been associated with improved outcomes in selected trauma patients. These teams are a scarce and expensive resource, especially when delivered by rotary air assets. The optimal tasking of prehospital critical care teams is therefore vital and remains a subject of debate. Emergency Medical Retrieval Service (EMRS) provides a prehospital critical care response team to incidents over a large area of Scotland either by air or by road...
July 25, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28742306/identifying-emergency-department-patients-with-chest-pain-who-are-at-low-risk-for-acute-coronary-syndromes-digest
#19
David Markel, Jeremy Kim
Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing...
July 21, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28741801/attitudes-toward-suicidal-behavior-and-associated-factors-among-nursing-professionals-a-quantitative-study
#20
Kelly Graziani Giacchero Vedana, Daniel Fernando Magrini, Ana Carolina Guidorizzi Zanetti, Adriana Inocenti Miasso, Tatiana Longo Borges, Manoel Antônio Dos Santos
BACKGROUND: The attitudes toward suicide of emergency nurses may affect the care provided. However, the factors associated with these attitudes remain unclear. OBJECTIVE: To investigate attitudes toward suicidal behavior and associated factors among nursing professionals working in emergency settings. METHODS: A cross-sectional observational study including 28 nurses and 118 were nursing assistants employed at two emergency services in Brazil was conducted...
July 25, 2017: Journal of Psychiatric and Mental Health Nursing
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