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https://www.readbyqxmd.com/read/28183742/preventable-injury-deaths-identifying-opportunities-to-improve-timeliness-and-reach-of-emergency-healthcare-services-in-new-zealand
#1
Rebbecca Lilley, Bridget Kool, Gabrielle Davie, Brandon de Graaf, Shanthi N Ameratunga, Pararangi Reid, Ian Civil, Bridget Dicker, Charles C Branas
BACKGROUND: Traumatic injury is a leading cause of premature death and health loss in New Zealand. Outcomes following injury are very time sensitive, and timely access of critically injured patients to advanced hospital trauma care services can improve injury survival. OBJECTIVE: This cross-sectional study will investigate the epidemiology and geographic location of prehospital fatal injury deaths in relation to access to prehospital emergency services for the first time in New Zealand...
February 9, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28169980/epidemiologic-characteristics-of-pediatric-trauma-patients-receiving-prehospital-care-in-kigali-rwanda
#2
Adam R Aluisio, Olivier Félix Umuhire, Gabin Mbanjumucyo, Naomi George, Alexis Kearney, Naz Karim, Jeanne DʼArc Nyinawankusi, Eric Uwitonze, Sam Enumah, John W Scott, Zeta Mutabazi, Georges Ntakiyiruta, Sudha Jayaraman, Robert Riviello, Jean Claude Byiringiro, Adam C Levine
BACKGROUND: Pediatric trauma is a significant public health problem in resource-constrained settings; however, the epidemiology of injuries is poorly defined in Rwanda. This study describes the characteristics of pediatric trauma patients transported to the emergency department (ED) of the Centre Hospitalier Universitaire de Kigali by emergency medical services in Kigali, Rwanda. METHODS: This cohort study was conducted at the Centre Hospitalier Universitaire de Kigali from December 2012 to February 2015...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28163937/a-narrowing-diagnosis-a-rare-cause-of-adult-croup-and-literature-review
#3
Jayshil J Patel, Emily Kitchin, Kurt Pfeifer
Croup or laryngotracheitis is rare in adults. We present a case of an otherwise healthy young woman that presented in the winter with 3 days of increasing dyspnea, cough, and fever. She was hemodynamically stable but was found to have a barking cough, paradoxical abdominal breathing, and stridor. Chest radiograph revealed subglottic narrowing. Respiratory viral nucleic acid amplification testing was positive for respiratory syncytial virus. The patient was treated with nebulized epinephrine, dexamethasone, and a helium-oxygen mixture...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28163926/rapid-analgesia-for-prehospital-hip-disruption-rapid-protocol-for-feasibility-study-of-randomised-controlled-trial
#4
Jenna K Bulger, Alan Brown, Bridie A Evans, Greg Fegan, Simon Ford, Katy Guy, Sian Jones, Leigh Keen, Ashrafunnesa Khanom, Ian Pallister, Nigel Rees, Ian T Russell, Anne C Seagrove, Helen A Snooks
BACKGROUND: Adequate pain relief at the point of injury and during transport to hospital is a major challenge in all acute traumas, especially for those with hip fractures, whose injuries are difficult to immobilise and whose long-term outcomes may be adversely affected by administration of opiate analgesics. Fascia iliaca compartment block (FICB) is a procedure routinely undertaken by doctors and nurses in the emergency department for patients with hip fracture but not yet evaluated for use by paramedics at the scene of emergency calls...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28163573/effect-of-private-versus-emergency-medical-systems-transportation-in-motor-vehicle-accident-victims-trauma-center-experience-in-saudi-arabia
#5
Mohammed S Alshahrani
OBJECTIVE: To assess the effect of the mode of transportation of trauma patients (emergency medical service [EMS] vs. non-EMS) on their final clinical outcome in terms of mortality and length of hospital stay. MATERIALS AND METHODS: A retrospective study included all patients who were involved in motor vehicle crashes, and who were transferred immediately to an emergency department of a trauma care center from December 2008 to December 2012. Patients were classified into two groups: those brought through EMS and those brought by non-EMS (private transport)...
January 2017: Journal of Family & Community Medicine
https://www.readbyqxmd.com/read/28161564/management-of-vascular-trauma-during-the-paris-terrorist-attack-of-november-13-2015
#6
Philippe Tresson, Joseph Touma, Julien Gaudric, Quentin Pellenc, Marielle Le Roux, Charles Pierret, Hicham Kobeiter, Pierre Julia, Olivier Goeau-Brissonniere, Pascal Desgranges, Fabien Koskas, Yves Castier
OBJECTIVES: On November 13, 2015, Paris and Saint-Denis were the targets of terrorist attacks. The hospitals of the Public Hospitals of Paris Organization (AP-HP) and the Percy Armed Forces Instruction Hospitals were mobilized to face the mass casualty situation. The objective of this study was to analyze the management of the victims presenting with a non-thoracic vascular trauma (NTVT). MATERIAL AND METHODS: All the data relating to the victims of NTVT who required a specific vascular open or endovascular treatment were analyzed retrospectively...
February 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#7
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
January 31, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28157743/clinical-evaluation-of-the-patient-with-acute-stroke
#8
Andrew M Southerland
PURPOSE OF REVIEW: This article reviews the clinical evaluation of the patient with acute stroke, including key questions in the focused stroke history, important aspects of the National Institutes of Health Stroke Scale and focused neurologic examination, and the significance of the basic head CT scan in informing a timely treatment decision. RECENT FINDINGS: Advances in both stroke treatment and enhanced diagnostics support an evolving paradigm for acute stroke care, ranging from the prehospital setting to the rehabilitative setting...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28148274/severity-dependent-differences-in-early-management-of-thoracic-trauma-in-severely-injured-patients%C3%A2-analysis-based-on-the-traumaregister-dgu%C3%A2
#9
J Bayer, R Lefering, S Reinhardt, J Kühle, N P Südkamp, T Hammer
BACKGROUND: Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management...
February 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28147427/-new-definitions-for-sepsis-and-septic-shock-sepsis-3
#10
Michal Holub, Ondřej Beran
The article discusses new definitions for sepsis and septic shock called Sepsis-3. The definitions are put in the historical and factual context of the 1992 definition and their extended 2003 version. Also mentioned are potential impacts on clinical practice, with it-being clear that the new definition shifts the sepsis issues more to intensive care as it emphasizes organ failure. In prehospital care, emergency departments and general wards of hospitals where patients are triaged, a new scoring system, the so-called quick SOFA, may be used...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28147415/improving-survival-after-cardiac-arrest
#11
Conrad Arnfinn Bjørshol, Eldar Søreide
Each year, approximately half a million people suffer out-of-hospital cardiac arrest (CA) in Europe: The majority die. Survival after CA varies greatly between regions and countries. The authors give an overview of the important elements necessary to promote improved survival after CA as a function of the chain of survival and formula for survival concepts. The chain of survival incorporates bystanders (who identify warning symptoms, call the emergency dispatch center, initiate cardiopulmonary resuscitation [CPR]), dispatchers (who identify CA, and instruct and reassure the caller), first responders (who provide high-quality CPR, early defibrillation), paramedics and other prehospital care providers (who continue high-quality CPR, and provide timely defibrillation and advanced life support, transport to CA center), and hospitals (targeted temperature management, percutaneous coronary intervention, delayed prognostication)...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28138737/-care-for-severely-injured-persons-update-of-the-2016-s3-guideline-for-the-treatment-of-polytrauma-and-the-severely-injured
#12
P Hilbert-Carius, T Wurmb, H Lier, M Fischer, M Helm, C Lott, B W Böttiger, M Bernhard
In 2011 the first interdisciplinary S3 guideline for the management of patients with serious injuries/trauma was published. After intensive revision and in consensus with 20 different medical societies, the updated version of the guideline was published online in September 2016. It is divided into three sections: prehospital care, emergency room management and the first operative phase. Many recommendations and explanations were updated, mostly in the prehospital care and emergency room management sections...
January 30, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28127213/components-and-determinants-of-therapeutic-delay-in-patients-with-acute-st-elevation-myocardial-infarction-a-tertiary-care-hospital-based-study
#13
Jahangir Rashid Beig, Nisar A Tramboo, Kuldeep Kumar, Irfan Yaqoob, Imran Hafeez, Fayaz A Rather, Tariq R Shah, Hilal A Rather
BACKGROUND: Delayed reperfusion is associated with worse outcomes in ST-segment elevation myocardial infarction (STEMI). This study was conducted to assess the components and determinants of therapeutic delay in STEMI patients of our state. METHODS: This study included consecutive patients of STEMI admitted to the coronary care units of two tertiary care hospitals in Srinagar, between 2012 and 2015. Various components of treatment delay including the patient's decision to delay, referral delay, transportation delay, prehospital delay, and door-to-needle time were calculated...
January 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28126019/telemedical-support-for-prehospital-emergency-medical-service-tems-trial-study-protocol-for-a-randomized-controlled-trial
#14
Ana Stevanovic, Stefan Kurt Beckers, Michael Czaplik, Sebastian Bergrath, Mark Coburn, Jörg Christian Brokmann, Ralf-Dieter Hilgers, Rolf Rossaint
BACKGROUND: Increasing numbers of emergency calls, shortages of Emergency Medical Service (EMS), physicians, prolonged emergency response times and regionally different quality of treatment by EMS physicians require improvement of this system. Telemedical solutions have been shown to be beneficial in different emergency projects, focused on specific disease patterns. Our previous pilot studies have shown that the implementation of a holistic prehospital EMS teleconsultation system, between paramedics and experienced tele-EMS physicians, is safe and feasible in different emergency situations...
January 26, 2017: Trials
https://www.readbyqxmd.com/read/28125389/the-impact-of-trauma-care-systems-in-low-and-middle-income-countries
#15
Teri A Reynolds, Barclay Stewart, Isobel Drewett, Stacy Salerno, Hendry Sawe, Tamitza Toroyan, Charles Mock
Injury is a leading cause of death globally, and organized trauma care systems have been shown to save lives. However, even though most injuries occur in low- and middle-income countries (LMICs), most trauma care research comes from high-income countries where systems have been implemented with few resource constraints. Little context-relevant guidance exists to help policy makers set priorities in LMICs, where resources are limited and where trauma care may be implemented in distinct ways. We have aimed to review the evidence on the impact of trauma care systems in LMICs through a systematic search of 11 databases...
January 11, 2017: Annual Review of Public Health
https://www.readbyqxmd.com/read/28121217/qsofa-has-poor-sensitivity-for-prehospital-identification-of-severe-sepsis-and-septic-shock
#16
Maia Dorsett, Melissa Kroll, Clark S Smith, Phillip Asaro, Stephen Y Liang, Hawnwan P Moy
OBJECTIVES: Sepsis is a common and deadly disease process for which early recognition and intervention can significantly improve clinical outcomes. Despite this, sepsis remains underrecognized and therefore undertreated in the prehospital setting. Recent recommendations by the Society of Critical Care and European Society of Intensive Care Medicine advocate use of the qSOFA (quick Sequential [Sepsis-related] Organ Failure Assessment) score in non-ICU settings to screen for septic patients at greater risk for poor outcomes...
January 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28110568/-patient-care-of-patients-with-myocardial-infarction-in-hungary-analysis-of-national-myocardial-infarction-registry-data-collecting-in-2015
#17
András Jánosi, Péter Ofner, Fahmi Al-Maktari, Erik Hajkó, Krisztina Hati, Zoltán Járai, Mihály Józan-Jilling, Róbert Gábor Kiss, Gerda Lóczi, Géza Lupkovics, Zoltán Ruzsa, Erika Schmidt, Gábor Veress, Tibor Zsifkov, Béla Merkely
: The authors summarize the most relevant data of myocardial infarction patients according to the National Myocardial Infarction Registry data base. In 2015 12,681 patients had 12,941 acute myocardial infarctions. Less than half of patients (44.4%) were treated with ST elevation myocardial infarction. National Ambulance Service was the first medical contact of more than half (51.4%) of patients with ST elevation infarction. Prehospital thrombolysis was occasionally done (0.23%), but 91...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28109938/forced-vital-capacity-assessment-for-risk-stratification-of-blunt-chest-trauma-patients-in-emergency-settings-a-preliminary-study
#18
C Carrie, L Stecken, M Scotto, M Durand, F Masson, P Revel, M Biais
OBJECTIVE: The aim of this study was to assess the performance of Forced Vital Capacity (FCV) for prediction of secondary pulmonary complications in blunt-chest trauma patients. METHODS: During a 15-month period, all consecutive blunt chest trauma patients admitted in our emergency intensive care unit with more than 3 rib fractures were eligible, unless they required mechanical ventilation in the prehospital or emergency settings. FVC was measured at enrolment and at emergency discharge after therapeutic interventions...
January 18, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#19
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28103892/prehospital-intravenous-fentanyl-to-patients-with-hip-fracture-an-observational-cohort-study-of-risk-factors-for-analgesic-non-treatment
#20
Kristian D Friesgaard, Erika F Christensen, Hans Kirkegaard, Mette D Bendtsen, Flemming B Jensen, Lone Nikolajsen
BACKGROUND: Patients with proximal femoral neck fracture have a high short-term mortality, a high risk of postoperative complications, and impaired quality of life. One of the challenges related to the prehospital treatment of these patients is to administer systemic opioids fast and properly. Effective analgesic prehospital treatment ought be initiated rapidly in order to alleviate the stress that follows acute pain, to facilitate transportation, and to improve quality of care. The objectives of this study were to explore the prevalence of prehospital administration of intravenous fentanyl to patients with proximal femoral neck fracture in the ambulances and to assess risk factors for analgesic non-treatment...
January 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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