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https://www.readbyqxmd.com/read/29452732/efficacy-of-pre-hospital-rapid-sequence-intubation-in-paediatric-traumatic-brain-injury-a-9-year-observational-study
#1
Stefan Heschl, Ben Meadley, Emily Andrew, Warwick Butt, Stephen Bernard, Karen Smith
INTRODUCTION: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29441840/the-ethics-of-real-time-ems-direction-suggested-curricular-content
#2
Jay M Brenner, Andrew L Aswegan, Laura E Vearrier, Jesse B Basford, Kenneth V Iserson
Ethical dilemmas can create moral distress in even the most experienced emergency physicians (EPs). Following reasonable and justified approaches can help alleviate such distress. The purpose of this article is to guide EPs providing Emergency Medical Services (EMS) direction to navigate through common ethical issues confronted in the prehospital delivery of care, including protecting privacy and confidentiality, decision-making capacity and refusal of treatment, withholding of treatment, and termination of resuscitation (TOR)...
February 14, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29433888/trauma-registry-implementation-in-low-and-middle-income-countries-challenges-and-opportunities
#3
REVIEW
Krishna Bommakanti, Isabelle Feldhaus, Girish Motwani, Rochelle A Dicker, Catherine Juillard
BACKGROUND: Trauma registries are an essential part of trauma quality improvement programs aimed at decreasing morbidity and mortality in high-income countries. In low- and middle-income countries (LMICs), where the burden of injury is disproportionately high, hospitals have faced challenges in adapting trauma registry models implemented in high-income countries. We analyze the barriers to trauma registry implementation in LMICs to inform development of sustainable models in resource-constrained settings...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29433603/is-distance-to-the-nearest-registered-public-automated-defibrillator-associated-with-the-probability-of-bystander-shock-for-victims-of-out-of-hospital-cardiac-arrest
#4
Joel Neves Briard, Luc de Montigny, Dave Ross, François de Champlain, Eli Segal
Introduction Rapid access to defibrillation is a key element in the management of out-of-hospital cardiac arrests (OHCAs). Public automated external defibrillators (PAEDs) are becoming increasingly available, but little information exists regarding the relation between the proximity to the arrest and their usage in urban areas. METHODS: This study is a retrospective, observational, cross-sectional analysis of non-traumatic OHCA during a 24-month period in the greater Montreal area (Quebec, Canada)...
February 13, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29432381/systematic-review-of-prehospital-tourniquet-use-in-civilian-limb-trauma
#5
David S Kauvar, Michael A Dubick, Thomas J Walters, John F Kragh
BACKGROUND: Military enthusiasm for limb tourniquet use in combat casualty care has resulted in acceptance by the trauma community for use in the prehospital care of civilian limb injuries. To date there has been no report synthesizing the published data on civilian tourniquet use. The objective of this systematic review was to compile and analyze the content and quality of published data on the civilian use of tourniquets in limb trauma. METHODS: The MEDLINE database was searched for studies on civilian limb tourniquet use in adults published between 2001 and 2017...
February 9, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29428327/the-effect-of-being-found-with-stroke-symptoms-on-predictors-of-hospital-arrival
#6
Mellanie V Springer, Daniel L Labovitz
BACKGROUND: Studies examining predictors of delay in hospital arrival after stroke symptom onset have not accounted for patients who are found with their symptoms and cannot seek help independently. Our objective is to show that inclusion of patients who are "found down" in studies of prehospital delay biases the estimated association of sociodemographic and clinical variables with time of hospital arrival. METHODS: We performed a retrospective analysis of sociodemographic and clinical characteristics of patients with acute ischemic stroke presenting to a tertiary care hospital in the Bronx, New York...
February 8, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29428152/assessing-burn-care-in-brazil-an-epidemiologic-cross-sectional-nationwide-study
#7
Isabelle Citron, Julia Amundson, Saurabh Saluja, Aline Guilloux, Hillary Jenny, Mario Scheffer, Mark Shrime, Nivaldo Alonso
BACKGROUND: The aim of this study was to describe the national epidemiology of burns in Brazil and evaluate regional access to care by defining the contribution of out-of-hospital mortality to total burn deaths. METHODS: We reviewed admissions data for Brazil's single-payer, free-at-point-of-care, public-sector provider and national death registry data abstracted from DATASUS for 2008-2014. Admissions, in-hospital mortality, hospital reimbursement, and total deaths from the death registry were assessed for records coded under ICD-10 codes corresponding to flame, scald, contact, and electrical burns...
February 8, 2018: Surgery
https://www.readbyqxmd.com/read/29417828/early-heart-attack-care-as-a-prehospital-programme-designed-to-supplement-the-established-chest-pain-unit-concept-in-germany
#8
Frank Breuckmann, Tienush Rassaf
No abstract text is available yet for this article.
February 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29415812/prediction-of-massive-bleeding-in-a-prehospital-setting-validation-of-six-scoring-systems
#9
L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto Del Portillo, C Mudarra-Reche, H Domínguez-Aguado, R Viejo-Moreno, J Barea-Mendoza, R Gómez-Soler, I Casado-Flores, M Chico-Fernández
OBJECTIVE: To validate the diagnostic ability of six different scores to predict massive bleeding in a prehospital setting. DESIGN: Retrospective cohort. SETTING: Prehospital attention of patients with severe trauma. SUBJECTS: Subjects with more than 15 years, a history of severe trauma (defined by code 15 criteria), that were initially assisted in a prehospital setting by the emergency services between January 2010 and December 2015 and were then transferred to a level one trauma center in Madrid...
February 4, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29412051/prehospital-analgesia-for-pediatric-trauma-patients-in-iraq-and-afghanistan
#10
Steven G Schauer, Allyson A Arana, Jason F Naylor, Guyon J Hill, Michael D April
BACKGROUND: Previous studies have evaluated prehospital analgesia during combat operations in Iraq and Afghanistan, but were limited to the adult population. However, a significant portion of the casualties of those conflicts were children. We describe the prehospital analgesia administered to wartime pediatric trauma patients. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients (<18 years of age) admitted to United States and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016...
February 7, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29412043/acute-crisis-care-for-patients-with-mental-health-crises-initial-assessment-of-an-innovative-prehospital-alternative-destination-program-in-north-carolina
#11
Jamie O Creed, Julianne M Cyr, Hillary Owino, Shannen E Box, Mia Ives-Rublee, Brian B Sheitman, Beat D Steiner, Jefferson G Williams, Michael W Bachman, Jose G Cabanas, J Brent Myers, Seth W Glickman
OBJECTIVE: Emergency Departments (ED) are overburdened with patients experiencing acute mental health crises. Pre-hospital transport by Emergency Medical Services (EMS) to community mental health and substance abuse treatment facilities could reduce ED utilization and costs. Our objective was to describe characteristics, treatment, and outcomes of acute mental health crises patients who were transported by EMS to an acute crisis unit at WakeBrook, a North Carolina community mental health center...
February 7, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29409595/the-pediatric-resuscitative-thoracotomy-during-combat-operations-in-iraq-and-afghanistan-a-retrospective-cohort-study
#12
Steven G Schauer, Guyon J Hill, Richard E Connor, John S Oh, Michael D April
BACKGROUND: Combat zone trauma poses a unique set of challenges and injury patterns not seen in the civilian setting. The role of the pediatric resuscitative thoracotomy in combat zones remains unclear given a paucity of data regarding procedure outcomes in this setting. We compare outcomes among children in traumatic arrest undergoing resuscitative thoracotomy versus cardiopulmonary (CPR) resuscitation only. METHODS: We queried the Department of Defense Trauma Registry (DODTR) from 2007 to 2016 for all pediatric subjects that underwent a resuscitative thoracotomy or CPR in the prehospital or emergency department setting during operations in Iraq or Afghanistan...
January 31, 2018: Injury
https://www.readbyqxmd.com/read/29409085/-point-of-care-sonography-in-emergency-and-intensive-care-medicine
#13
Caroline Busche, Hans-Jörg Busch, Guido Michels
The use of Point-of-care ultrasonography (POC Ultrasonography) is getting more and more important in the bedside care of patients, especially in emergency- and intensive care units. In addition to the focused sonography of the heart, lungs and abdomen, the POC Ultrasonography recently includes also cases in prehospital care. Increasingly special applications in intensive care, e.g. the assessment of weaning from mechanical ventilation or evaluation of the hemodynamics of a patient by means of sonographic control, gain meaning...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29408229/trends-in-care-processes-and-survival-following-prehospital-resuscitation-improvement-initiatives-for-out-of-hospital-cardiac-arrest-in-british-columbia-2006-2016
#14
Brian Grunau, Takahisa Kawano, William Dick, Ronald Straight, Helen Connolley, Robert Schlamp, Frank Scheuermeyer, Christopher B Fordyce, David Barbic, John Tallon, Jim Christenson
BACKGROUND: British Columbia (BC) Emergency Health Services implemented a strategy to improve outcomes for out-of-hospital cardiac arrest (OHCA), focusing on paramedic-led high-quality on-scene resuscitation. We measured changes in care metrics and survival trends. METHODS: This was a post-hoc study of prospectively identified consecutive non-traumatic ambulance-treated adult OHCAs from 2006 to 2016 within BC's four metropolitan areas. The primary outcome was survival to hospital discharge; we described available favourable neurological outcomes (mRS ≤3)...
February 2, 2018: Resuscitation
https://www.readbyqxmd.com/read/29406555/brister-i-systematiskt-omh%C3%A3-ndertagande-p%C3%A3-olycksplatser-en-studie-av-traumasimuleringar-inom-ambulanssjukv%C3%A3-rden
#15
Jonas Aléx, Lina Gyllencreutz
Trauma care at an accident site is of great importance for patient survival. The purpose of the study was to observe the compliance of ambulance nurses with the Prehospital Trauma Life Support (PHTLS) concept of trauma care in a simulation situation. The material consisted of video recordings in trauma simulation and an observation protocol was designed to analyze the video material. The result showed weaknesses in systematic exam and an ineffective use of time at the scene of injury. Development of observation protocols in trauma simulation can ensure the quality of ambulance nurses' compliance with established concepts...
February 5, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29406393/trends-and-predictors-of-prehospital-delay-in-patients-undergoing-primary-coronary-intervention
#16
Gilad Margolis, Sevan Letourneau-Shesaf, Shafik Khoury, David Pereg, Natalia Kofman, Gad Keren, Yacov Shacham
OBJECTIVE: Delay in seeking medical care following symptom onset in patients with acute ST-elevation myocardial infarction (STEMI) is related to increased morbidity and mortality. Actual trends of prehospital delays in patients hospitalized with STEMI have not been well characterized. We evaluated trends in the length of time that had elapsed from symptom onset to hospital presentation among STEMI patients admitted to our hospital. PATIENTS AND METHODS: We retrospectively studied 2203 consecutive patients hospitalized for acute STEMI who underwent primary percutaneous coronary intervention (PCI) between January 2008 and December 2016...
February 5, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29405803/prehospital-rapid-sequence-intubation-by-intensive-care-flight-paramedics
#17
Ashleigh Delorenzo, Toby St Clair, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Rapid sequence intubation (RSI) is an advanced airway procedure for critically ill or injured patients. Paramedic-performed RSI in the prehospital setting remains controversial, as unsuccessful or poorly conducted RSI is known to result in significant complications. In Victoria, intensive care flight paramedics (ICFPs) have a broad scope of practice including RSI in both the adult and pediatric population. We sought to describe the success rates and characteristics of patients undergoing RSI by ICFPs in Victoria, Australia...
February 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29404658/-miscommunication-as-a-risk-focus-in-patient-safety-work-process-analysis-in-prehospital-emergency-care
#18
S Wilk, L Siegl, K Siegl, C Hohenstein
BACKGROUND: In an analysis of a critical incident reporting system (CIRS) in out-of-hospital emergency medicine, it was demonstrated that in 30% of cases deficient communication led to a threat to patients; however, the analysis did not show what exactly the most dangerous work processes are. Current research shows the impact of poor communication on patient safety. OBJECTIVES: An out-of-hospital workflow analysis collects data about key work processes and risk areas...
February 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29402334/developing-prehospital-clinical-practice-guidelines-for-resource-limited-settings-why-re-invent-the-wheel
#19
Michael McCaul, Ben de Waal, Peter Hodkinson, Jennifer L Pigoga, Taryn Young, Lee A Wallis
OBJECTIVES: Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, the volume of literature is not matched by research into alternative methods of CPG development using existing CPG documents-a specific issue for guideline development groups in low- and middle-income countries. We report on how we developed a context specific prehospital CPG using an alternative guideline development method. Difficulties experienced and lessons learnt in applying existing global guidelines' recommendations to a national context are highlighted...
February 5, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29402312/perceptions-and-experiences-of-community-first-responders-on-their-role-and-relationships-qualitative-interview-study
#20
Viet-Hai Phung, Ian Trueman, Fiona Togher, Roderick Ørner, Aloysius Niroshan Siriwardena
BACKGROUND: Community First Responders (CFRs) are lay volunteers who respond to medical emergencies. We aimed to explore perceptions and experiences of CFRs in one scheme about their role. METHODS: We conducted semi-structured interviews with a purposive sample of CFRs during June and July 2016 in a predominantly rural UK county. Interviews were transcribed verbatim and analysed using the Framework method, supported by NVivo 10. RESULTS: We interviewed four female and 12 male adult CFRs aged 18-65+ years with different levels of expertise and tenures...
February 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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