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Prehospital emergency care

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https://www.readbyqxmd.com/read/28445501/out-of-hospital-cardiac-arrest-survival-in-drug-related-versus-cardiac-causes-in-ontario-a-retrospective-cohort-study
#1
Aaron M Orkin, Chun Zhan, Jason E Buick, Ian R Drennan, Michelle Klaiman, Pamela Leece, Laurie J Morrison
BACKGROUND: Drug overdose causes approximately 183,000 deaths worldwide annually and 50,000 deaths in Canada and the United States combined. Drug-related deaths are concentrated among young people, leading to a substantial burden of disease and loss of potential life years. Understanding the epidemiology, patterns of care, and prognosis of drug-related prehospital emergencies may lead to improved outcomes. METHODS: We conducted a retrospective cohort study of out-of-hospital cardiac arrests with drug-related and presumed cardiac causes between 2007 and 2013 using the Toronto Regional RescuNet Epistry database...
2017: PloS One
https://www.readbyqxmd.com/read/28438478/acute-coronary-syndrome-in-relation-to-the-occurrence-of-associated-symptoms-a-quantitative-study-in-prehospital-emergency-care
#2
Henrik Andersson, Andreas Ullgren, Mats Holmberg, Thomas Karlsson, Johan Herlitz, Birgitta Wireklint Sundström
INTRODUCTION: Acute chest pain is a common symptom among prehospital emergency care patients. Therefore, it is crucial that ambulance nurses (ANs) have the ability to identify symptoms and assess patients suffering from acute coronary syndrome (ACS). The aim of this study is to explore the occurrence of dyspnoea and nausea and/or vomiting in the prehospital phase of a suspected ACS and the associations with patients' outcome. METHODS: This study has a quantitative design based on data from hospital records and from a previous interventional study (randomised controlled trial) including five Emergency Medical Service (EMS) systems in western Sweden in the years 2008-2010...
April 21, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28438334/understanding-patterns-of-injury-in-kenya-analysis-of-a-trauma-registry-data-from-a-national-referral-hospital
#3
Isaac M Botchey, Yuen Wai Hung, Abdulgafoor M Bachani, Hassan Saidi, Fatima Paruk, Adnan A Hyder
BACKGROUND: Injuries contribute to a substantial proportion of the burden of disease in Kenya. Trauma registries can be a very useful source of data to understand patterns of injuries and serve to provide information about potential improvements in the care of injured patients. In Kenya, health facility-based injury data has been largely administrative. Our aim was to develop and implement a prospective trauma registry at the largest trauma hospital in Kenya, the Kenyatta National Hospital, and to understand the nature of injuries presenting to the hospital, their treatment and care, and their outcomes...
April 21, 2017: Surgery
https://www.readbyqxmd.com/read/28438222/hypothermia-in-trauma-victims-at-first-arrival-of-ambulance-personnel-an-observational-study-with-assessment-of-risk-factors
#4
Frédéric Lapostolle, James Couvreur, François Xavier Koch, Dominique Savary, Armelle Alhéritière, Michel Galinski, Jean-Luc Sebbah, Karim Tazarourte, Frédéric Adnet
BACKGROUND: Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. METHODS: This was an ancillary analysis of data recorded in the HypoTraum study, a prospective multicenter study conducted by the emergency medical services (EMS) of 8 hospitals in France. Inclusion criteria were: trauma victim, age over 18 years, and victim receiving prehospital care from an EMS team and transported to hospital by the EMS team in a medically equipped mobile intensive care unit...
April 24, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28435902/emergency-medical-service-personnel-need-to-improve-knowledge-and-attitude-regarding-prehospital-sepsis-care
#5
Joongmin Park, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Hee Yoon, Tae Rim Lee, Won Chul Cha, Min Seob Sim
OBJECTIVE: We aimed to evaluate the knowledge and attitudes of emergency medical service (EMS) personnel pertaining to sepsis. We also compared EMS personnel's knowledge of sepsis and their intention to engage in prehospital sepsis management. METHODS: The survey was conducted during education conferences for EMS personnel in December 2013 and January 2015 in Seoul, Korea. The questionnaire composed of 10 questions relevant to sepsis, was distributed on-scene, and was retrieved by investigators after the conference...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28435495/areas-of-potential-impact-of-the-patient-protection-and-affordable-care-act-on-ems-a-synthesis-of-the-literature
#6
REVIEW
Daniel G Ostermayer, Charles A Brown, William G Fernandez, Emily Couvillon
INTRODUCTION: This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. METHODS: We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. RESULTS: Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435493/prehospital-care-for-the-adult-and-pediatric-seizure-patient-current-evidence-based-recommendations
#7
Eric C Silverman, Karl A Sporer, Justin M Lemieux, John F Brown, Kristi L Koenig, Marianne Gausche-Hill, Eric M Rudnick, Angelo A Salvucci, Greg H Gilbert
INTRODUCTION: We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS) agencies in California. METHODS: We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434773/mstroke-mobile-stroke-improving-acute-stroke-care-with-smartphone-technology
#8
Benjamin Y Andrew, Colleen M Stack, Julian P Yang, Jodi A Dodds
OBJECTIVE: This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. METHODS: A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation...
April 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28432194/diagnostic-value-of-prehospital-ecg-in-acute-stroke-patients
#9
Tobias Bobinger, Bernd Kallmünzer, Markus Kopp, Natalia Kurka, Martin Arnold, Stefan Heider, Stefan Schwab, Martin Köhrmann
OBJECTIVE: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. METHODS: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit...
April 21, 2017: Neurology
https://www.readbyqxmd.com/read/28426466/physician-variation-in-time-to-antimicrobial-treatment-for-septic-patients-presenting-to-the-emergency-department
#10
Ithan D Peltan, Kristina H Mitchell, Kristina E Rudd, Blake A Mann, David J Carlbom, Catherine L Hough, Thomas D Rea, Samuel M Brown
OBJECTIVES: Delayed initiation of appropriate antimicrobials is linked to higher sepsis mortality. We investigated interphysician variation in septic patients' door-to-antimicrobial time. DESIGN: Retrospective cohort study. SETTING: Emergency department of an academic medical center. SUBJECTS: Adult patients treated with antimicrobials in the emergency department between 2009 and 2015 for fluid-refractory severe sepsis or septic shock...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28424835/-future-of-emergency-medicine-in-germany-2-0
#11
REVIEW
A Gries, M Bernhard, M Helm, J Brokmann, J-T Gräsner
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment...
April 19, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#12
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28419017/the-evaluation-of-trauma-care-the-comparison-of-2-high-level-pediatric-emergency-departments-in-the-united-states-and-turkey
#13
Alkan Bal, Michael Cooper, Amanda Lee, Murat Anil, Halim Hennes
OBJECTIVE: The purpose of the study is to compare the outcomes of pediatric trauma patients with motor vehicle crashes (MVCs) and motor vehicle versus pedestrian crashes (MPCs) at a level 1 pediatric trauma center in the United States and a pediatric trauma center in Turkey. METHODS: The medical records of all pediatric MVC and MPC subjects presenting to the emergency departments (EDs) of a level 3 hospital in Turkey (Izmir Tepecik Training and Research Hospital [ITTRH]) and a level 1 pediatric trauma center in the United States (Children's Medical Center Dallas [CMCD]) over a 1-year period were reviewed...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28414588/prehospital-predictors-of-traumatic-spinal-cord-injury-in-victoria-australia
#14
Alaa O Oteir, Karen Smith, Johannes Stoelwinder, James W Middleton, Shelley Cox, Lisa N Sharwood, Paul A Jennings
OBJECTIVES: To identify the predictors of traumatic spinal cord injury (TSCI) and describe the differences between confirmed and potential TSCI cases in the prehospital setting. METHODS: A retrospective cohort study including all adult patients over a six-year period (2007-12) with potential TSCI who were attended and transported by Ambulance Victoria (AV). We extracted potential TSCI cases from the AV data warehouse and linked with the Victorian State Trauma Registry to compare with final hospital diagnosis...
April 17, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28392369/compression-to-ventilation-ratio-and-incidence-of-rearrest-a-secondary-analysis-of-the-roc-ccc-trial
#15
David D Salcido, Robert H Schmicker, Jason E Buick, Sheldon Cheskes, Brian Grunau, Peter Kudenchuk, Brian Leroux, Stephanie Zellner, Dana Zive, Tom P Aufderheide, Allison C Koller, Heather Herren, Jack Nuttall, Matthew L Sundermann, James J Menegazzi
BACKGROUND: Previous work has demonstrated that when out-of-hospital cardiac arrest (OHCA) patients achieve return of spontaneous circulation (ROSC), but subsequently have another cardiac arrest prior to hospital arrival (rearrest), the probability of survival to hospital discharge is significantly decreased. Additionally, few modifiable factors for rearrest are known. We sought to examine the association between rearrest and compression-to-ventilation ratio during cardiopulmonary resuscitation (CPR) and to confirm the association between rearrest and outcomes...
April 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28374471/a-high-proportion-of-prehospital-emergency-patients-are-not-transported-by-ambulance-a-retrospective-cohort-study-in-northern-finland
#16
M Hoikka, T Silfvast, T I Ala-Kokko
BACKGROUND: The number of missions in the emergency medical services (EMS) has increased considerably in recent years. People are requesting ambulance for even minor illnesses and non-medical problems, which is placing financial and resource burdens on the EMS. The aim of this study was to determine the rate of non-transportation missions in Northern Finland and the reasons for these missions. METHODS: All ambulance missions in two hospital districts in Northern Finland during the 6-month period of January 1 through June 30, 2014, were retrospectively evaluated from the EMS charts to identify missions in which the patients were not transported by the EMS...
May 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28372825/trauma-care-in-india-a-review-of-the-literature
#17
Hadley K H Wesson, Mimmie Kwong
BACKGROUND: We reviewed the published literature related to prehospital and hospital trauma care in India to identify how trauma care is defined in the literature and what factors limit the delivery of appropriate trauma care. In summarizing the evidence and recommendations regarding trauma care, this review identifies essential research and development goals to address the burden of injury in India. METHODS: A review of the literature was conducted between August 2014 and September 2014...
March 31, 2017: Surgery
https://www.readbyqxmd.com/read/28367760/methodological-challenges-in-studies-comparing-prehospital-advanced-life-support-with-basic-life-support
#18
Timmy Li, Courtney M C Jones, Manish N Shah, Jeremy T Cushman, Todd A Jusko
Determining the most appropriate level of care for patients in the prehospital setting during medical emergencies is essential. A large body of literature suggests that, compared with Basic Life Support (BLS) care, Advanced Life Support (ALS) care is not associated with increased patient survival or decreased mortality. The purpose of this special report is to synthesize the literature to identify common study design and analytic challenges in research studies that examine the effect of ALS, compared to BLS, on patient outcomes...
April 3, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28367010/prehospital-delay-and-time-to-reperfusion-therapy-in-st-elevation-myocardial-infarction
#19
Linsha George, Lakshmi Ramamoorthy, Santhosh Satheesh, Rama Prakasha Saya, D K S Subrahmanyam
BACKGROUND: Despite efforts aimed at reducing the prehospital delay and treatment delay, a considerable proportion of patients with ST elevation myocardial infarction (STEMI) present late and receive the reperfusion therapy after unacceptably long time periods. This study aimed at finding out the patients' decision delay, prehospital delay, door-to-electrocardiography (ECG), door-to-needle, and door-to-primary percutaneous coronary intervention (PCI) times and their determinants among STEMI patients...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28363752/are-prehospital-deaths-from-trauma-and-accidental-injury-preventable-a-direct-historical-comparison-to-assess-what-has-changed-in-two-decades
#20
G J Oliver, D P Walter, A D Redmond
BACKGROUND & OBJECTIVES: In 1994, Hussain and Redmond revealed that up to 39% of prehospital deaths from accidental injury might have been preventable had basic first aid care been given. Since then there have been significant advances in trauma systems and care. The exclusion of prehospital deaths from the analysis of trauma registries, giv en the high rate of those, is a major limitation in prehospital research on preventable death. We have repeated the 1994 study to identify any changes over the years and potential developments to improve patient outcomes...
May 2017: Injury
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