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Prehospital care

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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
#1
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
#2
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
https://www.readbyqxmd.com/read/28103121/comparison-of-helicopter-emergency-medical-services-transport-types-and-delays-on-patient-outcomes-at-two-level-i-trauma-centers
#3
Brodie Nolan, Homer Tien, Bruce Sawadsky, Sandro Rizoli, Amanda McFarlan, Andrea Phillips, Alun Ackery
BACKGROUND: Helicopter emergency medical services (HEMS) have become an engrained component of trauma systems. In Ontario, transportation for trauma patients is through one of three ways: scene call, modified scene call, or interfacility transfer. We hypothesize that differences exist between these types of transports in both patient demographics and patient outcomes. This study compares the characteristics of patients transported by each of these methods to two level 1 trauma centers and assesses for any impact on morbidity or mortality...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28094089/use-of-emergency-medical-transport-and-impact-on-time-to-care-in-patients-with-ischaemic-stroke
#4
A Olascoaga Arrate, M M Freijo Guerrero, C Fernández Maiztegi, I Azkune Calle, R Silvariño Fernández, M Fernández Rodríguez, P Vazquez Naveira, A Anievas Elena, I Iturraspe González, Y Pérez Díez, R Ruiz Fernández
INTRODUCTION: According to numerous studies, using emergency medical services (EMS) to transport stroke patients to hospitals decreases diagnostic and treatment delays. OBJECTIVES: To determine the frequency of use of EMS by stroke patients in Bizkaia (Spain), analyse the factors associated with using EMS, and study the impact of EMS on time to care. METHODS: We gathered data from 545 patients hospitalised for acute ischaemic stroke and recruited consecutively...
January 13, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28092242/-prehospital-emergency-care-injuries-from-external-causes-in-a-region-of-venezuela
#5
Rafael Herrera, Daniel Bastidas, Everilda Arteaga, Gilberto Bastidas
BACKGROUND: Worldwide, approximately 3 500 000 people die every year as a result of injuries from external causes, in Venezuela these arte the third leading cause of overall morbidity. Nevertheless, in the country there are no records of the defining aspects of prehospital emergency care as a tool to address this socio-health problem, the aim of this investigation. METHODS: A descriptive, transversal, field study based on the information recorded daily for a year paramedics was performed...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28072893/a-pediatric-application-of-the-strac-regional-hospital-trauma-registry-database-pediatric-trauma-deaths-in-south-central-texas-during-2004-2013
#6
Michelle Buehner, Jay Aden, Mathew Borgman, Preston Love, Brandi Wright, Mary Edwards
The purpose of this study was to define the demographics of pediatric traumatic injuries and to understand the predictive value of injury type, prehospital, and emergency department (ED) data regarding the mortality of pediatric trauma patients (<14 years of age) in South Central Texas. We report a retrospective review of pediatric trauma patients presenting to Trauma Service Area P in South Central Texas during 2004-2013. The primary outcome was mortality; secondary outcomes were ventilator days, hospital days, and intensive care unit stay...
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28065635/meals-enhancing-nutrition-after-discharge-findings-from-a-pilot-randomized-controlled%C3%A2-trial
#7
David R Buys, Anthony D Campbell, Alice Godfryd, Kellie Flood, Elizabeth Kitchin, Meredith L Kilgore, Sally Allocca, Julie L Locher
BACKGROUND: After older adults experience episodes of poor health or are hospitalized, they may not return to premorbid or prehospitalization eating behaviors. Furthermore, poor nutrition increases hospital readmission risk, but evidence-based interventions addressing these risks are limited. OBJECTIVE: This pilot study's objective was to evaluate the feasibility of conducting a randomized controlled trial assessing a post-discharge home-delivered meal program's impact on older adults' nutritional intake and hospital readmissions and to assess patient acceptability and satisfaction with the program...
January 5, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28033300/the-degree-of-intubation-difficulties-and-the-frequency-of-complications-in-obese-patients-at-the-hospital-emergency-department-and-the-intensive-care-unit-case-control-study
#8
Marcin Cierniak, Renata Sobczak, Dariusz Timler, Andrzej Wieczorek, Bartosz Borkowski, Tomasz Gaszyński
The intubation difficulties in obese patients are not a new problem. They may result from an accumulation of fat in the oral cavity and cheeks. A thick tongue is also a significant factor. The literature reports that some tests to determine the intubation difficulties in obese people may be unreliable. The observed predictors of difficult intubation were the thyromental and sternomental distance and the intubation difficulty scale: FRONT score.The aim of this study was to assess the degree of difficult intubation in obese patients by the parameters such as the thyromental and sternomental distance...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28005912/benchmarking-prehospital-and-emergency-department-care-for-argentine-children-with-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#9
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Gustavo J Petroni, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Anthony Fabio, Michael J Bell
OBJECTIVE: There is little information on the type of early care provided to children with traumatic brain injury (TBI) in low middle income countries. We benchmarked early prehospital [PH] and emergency department [ED] pediatric TBI care in Argentina. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with TBI. Eligible participants were patients 0-18 years, and had diagnosis of TBI (admission Glasgow Coma scale score [GCS] < 13 or with GCS 14-15 and abnormal head CT scan within 48 hours of admission, and head AIS > 0)...
2016: PloS One
https://www.readbyqxmd.com/read/28005155/on-scene-treatment-of-spinal-injuries-in-motor-sports
#10
REVIEW
M Kreinest, M Scholz, P Trafford
Because spinal cord injuries can have fatal consequences for injured race car drivers, prehospital treatment of spinal injuries is a major concern in motor sports. A structured procedure for assessing trauma patients and their treatment should follow established ABCDE principles. Only then, a stable patient could be further examined and appropriate measures can be undertaken. For patients in an acute life-threatening condition, rapid transport must be initiated and should not be delayed by measures that are not indicated...
December 22, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28003036/improving-pediatric-education-for-emergency-medical-services-providers-a-qualitative-study
#11
Seth A Brown, Theresa C Hayden, Kimberly A Randell, Lara Rappaport, Michelle D Stevenson, In K Kim
OBJECTIVES: Previous studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements. METHODS: Purposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural)...
December 22, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27998633/limitations-in-prehospital-communication-between-trauma-helicopter-ambulance-services-and-dispatch-centers
#12
Annelieke Maria Karien Harmsen, Georgios Giannakopoulos, Gaby Franschman, Herman Christiaans, Frank Bloemers
BACKGROUND: Prehospital communication with Emergency Medical Services (EMS) is carried out in hectic situations. Proper communication among all medical personal is required to enhance collaboration, to provide the best care and enable shared situational awareness. OBJECTIVE: The objective of this article was to give insight into current Dutch prehospital emergency care communication among all EMS and evaluate the usage of a new physician staffed helicopter EMS (P-HEMS) cancellation model...
December 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27986970/optimising-clinical-performance-during-resuscitation-using-video-evaluation
#13
David J Lowe, Alistair Dewar, Adam Lloyd, Simon Edgar, Gareth R Clegg
Video evaluation of resuscitation is becoming increasingly integrated into practice in a number of clinical settings. The purpose of this review article is to examine how video may enhance clinical care during resuscitation. As healthcare and available therapeutic interventions evolve, re-evaluation of accepted paradigms requires data to describe current practice and support change. Analysis of video recordings affords creation of a framework to evaluate individual and team performance and develop unique and tailored strategies to optimise care delivery...
December 16, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27976492/h1-antihistamines-reduce-progression-to-anaphylaxis-among-emergency-department-patients-with-allergic-reactions
#14
T Kawano, F X Scheuermeyer, K Gibo, R Stenstrom, B Rowe, E Grafstein, B Grunau
OBJECTIVES: H1-antihistamines (H1a) can be used to treat ED patients with allergic reactions; however, this is inconsistently done, likely as there is no evidence that this therapy has an impact on serious outcomes. Among emergency department (ED) patients initially presenting with allergic reactions, we investigated whether H1a were associated with lower rates of progression to anaphylaxis. METHODS: This was a retrospective cohort study conducted at two urban Canadian EDs from April 1, 2007 to March 31, 2012...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27976464/methods-for-collecting-paired-observations-from-emergency-medical-services-and-emergency-department-providers-for-pediatric-cervical-spine-injury-risk-factors
#15
Fahd A Ahmad, Hamilton Schwartz, Lorin R Browne, Sherry Lassa-Claxton, Michael Wallendorf, E Brooke Lerner, Nathan Kuppermann, Julie C Leonard
OBJECTIVES: Cervical spine injuries (CSI) after blunt trauma in children are rare but cause substantial morbidity and mortality. Emergency medical services (EMS) and emergency department (ED) providers routinely use spinal precautions and cervical spine imaging respectively during the management of children experiencing blunt trauma. These practices lack evidence, and there is concern that they may be harmful. A pediatric CSI risk-assessment tool is needed to inform EMS and ED provider decision-making...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27974078/operation-canine-lifeline-recommendations-for-enhancing-prehospital-care-for-government-working-dogs
#16
Teija Corse, Chelsea Firth, John Burke, Kenneth Schor, James F Koterski, Sabrina McGraw, Nancy Vincent-Johnson, Lori Gordon
Operation Canine Lifeline was a tabletop exercise developed by students and faculty of Boston University School of Medicine's Healthcare Emergency Management master's program. The tabletop exercise led to discussion on current protocols for canines working in the field, what occurs if a canine encounters a toxin in the field, and what to do in situations of national security that require working with civilian agencies. This discussion led to the creation of a set of recommendations around providing prehospital veterinary care to government working dogs...
December 15, 2016: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/27968968/-recruitment-and-training-of-prehospital-emergency-care-nurses-in-paris
#17
Boris Martin le Pladec, Romuald Menoret, Raphaël Rodes
In collaboration with the ambulance driver and the emergency doctor, the prehospital nurse provides care in a universe which is often difficult and sometimes hostile. Whether they are a nurse from the Samu (urgent medical aid service) or from the Paris fire service, how are they recruited and what training do these emergency care professionals receive?
November 2016: Revue de L'infirmière
https://www.readbyqxmd.com/read/27968964/-evolution-of-the-nurse-s-role-in-the-management-of-a-cardiac-arrest
#18
Florian Loosli, Alice Hutin, Hugues Lefort, Pierre Carli, Lionel Lamhaut
In France, there are 40 000 sudden deaths each year and the cardiac arrest survival rate is less than 10%. The arrival of extracorporeal cardio pulmonary resuscitation (ECPR) offers hope in the event of refractory cardiac arrest in prehospital care. Extending ECPR programmes requires more scientific evidence, training and an evolution of the role of paramedics.
November 2016: Revue de L'infirmière
https://www.readbyqxmd.com/read/27965361/effect-of-preceding-medications-on-resuscitation-outcome-of-out-of-hospital-cardiac-arrest
#19
Shih-Wen Hung, Chien-Ming Chu, Chih-Feng Su, Li-Ming Tseng, Tzong-Luen Wang
As evidence regarding the impact of preceding medications on resuscitation outcomes has been inconsistent, this study aimed to analyze the association between preceding medications and resuscitation outcomes in patients experiencing out-of-hospital cardiac arrest (OHCA). This retrospective study included patients with OHCA presenting to a tertiary care hospital by emergency medical service (EMS) between January 2006 and June 2011. Using the Utstein template, data were collected from EMS and hospital medical records for prehospital care, in-hospital care, and medications which were taken continuously for at least 2 weeks preceding OHCA...
December 13, 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/27965279/sex-differences-in-prodromal-symptoms-in-acute-coronary-syndrome-in-patients-aged-55%C3%A2-years-or-younger
#20
Nadia A Khan, Stella S Daskalopoulou, Igor Karp, Mark J Eisenberg, Roxanne Pelletier, Meytal Avgil Tsadok, Kaberi Dasgupta, Colleen M Norris, Louise Pilote
BACKGROUND: Studies suggest that young women are at highest risk for failing to recognise early symptoms of acute coronary syndrome (ACS). OBJECTIVES: To examine sex differences in prodromal symptoms occurring days and weeks prior to the acute presentation of ACS. We also examined health-seeking behaviours and prehospital management in young patients. METHODS: Prospective cross-sectional analysis of 1145 patients (368 women) hospitalised for ACS, aged ≤55 years, from the GENdEr and Sex DetermInantS of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary SYndrome cohort study (January 2009-April 2013)...
December 13, 2016: Heart: Official Journal of the British Cardiac Society
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