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Prehospital emergency care

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https://www.readbyqxmd.com/read/29769369/comparison-of-severe-trauma-treatment-standards-in-civilian-china-with-current-practice-in-the-chinese-military-peacekeeping-level-2-military-hospital-in-gao-mali
#1
Jian Li, J Tian, Y B Wang, H Zhang
INTRODUCTION: The People's Republic of China has been successfully deploying medical teams to support the peacekeeping mission at the Level 2 Military Hospital in Mali since December 2013. The aim of this paper was to compare the current practice in Chinese Peacekeeping Level 2 Military Hospital with the severe trauma treatment standards reported in China. METHODS: A retrospective analysis was conducted between 26 April 2014 and 18 May 2016 using records stored in the Chinese Peacekeeping Level 2 Hospital (CHN L2)...
May 16, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29760852/altered-mental-status-current-evidence-based-recommendations-for-prehospital-care
#2
REVIEW
Ashley Sanello, Marianne Gausche-Hill, William Mulkerin, Karl A Sporer, John F Brown, Kristi L Koenig, Eric M Rudnick, Angelo A Salvucci, Gregory H Gilbert
Introduction: In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759850/differences-in-prehospital-patient-assessments-for-pediatric-versus-adult-patients
#3
Sriram Ramgopal, Jonathan Elmer, Jeremiah Escajeda, Christian Martin-Gill
OBJECTIVE: To evaluate whether completion of vital signs assessments in pediatric transports by emergency medical services (EMS) differs by patient age. STUDY DESIGN: We reviewed records by 20 agencies in a regional EMS system in Southwestern Pennsylvania between April 1, 2013 and December 31, 2016. We abstracted demographics, vital signs (systolic blood pressure, heart rate, respiratory rate), clinical, and transport characteristics. We categorized age as neonates (≤30 days), infants (1 month to <1 year), toddler (1 to <2 years), early childhood (2 to <6 years), middle childhood (6 to <12 years), adolescent (12 to <18 years), and adult (≥18 years)...
May 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29753877/developing-a-decision-support-system-for-patients-with-severe-infection-conditions-in-prehospital-care
#4
Niclas Johansson, Carl Spindler, John Valik, Veronica Vicente
OBJECTIVE: To develop and validate a prehospital decision support system (DSS) for the emergency medical services (EMS), enabling identification and steering of patients with critical infectious conditions - severe respiratory tract infections, severe CNS-infections and sepsis - to a specialized emergency department (ED) for infectious diseases. METHODS: The development process has involved four consecutive steps. The first step was gathering data from the electronic Patient Care Record on patients transported by the EMS, to identify retrospectively appropriate patient categories for steering...
May 10, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29742635/trauma-simulation-in-prehospital-emergency-care
#5
Anna Abelsson, Lars Lundberg
Well-educated ambulance staff is a prerequisite for high-quality prehospital trauma care. The aim of this study was to examine how nurses in the ambulance service experienced participation in trauma simulation. Sixty-one nurses, working in an emergency ambulance service, performed simulated trauma care on four different occasions and afterward rated three statements on a 5-point Likert scale. A descriptive and inferential analysis was conducted. There are statistically significant increases between the pre- and posttests regarding all three statements: "I think simulation of severe trauma with manikins is realistic" (0...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29742138/a-novel-early-risk-assessment-tool-for-detecting-clinical-outcomes-in-patients-with-heat-related-illness-j-erato-score-development-and-validation-in-independent-cohorts-in-japan
#6
Kei Hayashida, Yutaka Kondo, Toru Hifumi, Junya Shimazaki, Yasutaka Oda, Shinichiro Shiraishi, Tatsuma Fukuda, Junichi Sasaki, Keiki Shimizu
BACKGROUND: We sought to develop a novel risk assessment tool to predict the clinical outcomes after heat-related illness. METHODS: Prospective, multicenter observational study. Patients who transferred to emergency hospitals in Japan with heat-related illness were registered. The sample was divided into two parts: 60% to construct the score and 40% to validate it. A binary logistic regression model was used to predict hospital admission as a primary outcome. The resulting model was transformed into a scoring system...
2018: PloS One
https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#7
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
May 6, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29716933/taking-the-reins-on-systems-of-care-for-st-segment-elevation-myocardial-infarction-patients-a-report-from-the-american-heart-association-mission-lifeline-program
#8
Jacqueline L Green, Alice K Jacobs, DaJuanicia Holmes, Karen Chiswell, Rosalia Blanco, Eric R Bates, William French, Douglas F Kupas, Greg Mears, Matthew Roe, Brahmajee K Nallamothu
BACKGROUND: Early success with regionalization of ST-segment-elevation myocardial infarction (STEMI) care has led many states to adopt statewide prehospital STEMI hospital destination policies, allowing emergency medical services to bypass non-percutaneous coronary intervention-capable hospitals. The association between adoption of these policies and patterns of care among STEMI patients is unknown. METHODS AND RESULTS: Using data from January 1, 2013, to December 31, 2014, from the National Cardiovascular Data Registry and Acute Coronary Treatment and Intervention Outcomes Network Registry, 6 states with bypass policies (cases included Delaware, Iowa, Maryland, North Carolina, Pennsylvania, and Massachusetts) were matched to 6 states without bypass policies (controls included South Carolina, Minnesota, Virginia, Texas, New York, and Connecticut) a priori on region, hospital density, and percent state participation in the registry...
May 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29709397/prognosis-value-of-partial-arterial-oxygen-pressure-in-patients-with-septic-shock-subjected-to-pre-hospital-invasive-ventilation
#9
Romain Jouffroy, Anastasia Saade, Laure Castres Saint Martin, Pascal Philippe, Pierre Carli, Benoit Vivien
OBJECTIVE: Mechanical ventilation can help improve the prognosis of septic shock. While adequate delivery of oxygen to the tissue is crucial, hyperoxemia may be deleterious. Invasive out-of-hospital ventilation is often promptly performed in life-threatening emergencies. We propose to determine whether the arterial oxygen pressure (PaO2 ) at the intensive care unit (ICU) admission is associated with mortality in patients with septic shock subjected to pre-hospital mechanical ventilation...
April 24, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29703777/prehospital-neurological-deterioration-in-stroke
#10
Sabreena J Slavin, Heidi Sucharew, Kathleen Alwell, Charles J Moomaw, Daniel Woo, Opeolu Adeoye, Matthew L Flaherty, Simona Ferioli, Jason McMullan, Jason Mackey, Felipe De Los Rios La Rosa, Sharyl Martini, Brett M Kissela, Dawn O Kleindorfer
BACKGROUND AND PURPOSE: Patients with stroke can experience neurological deterioration in the prehospital setting. We evaluated patients with stroke to determine factors associated with prehospital neurological deterioration (PND). METHODS: Among the Greater Cincinnati/Northern Kentucky region (population ~1.3 million), we screened all 15 local hospitals' admissions from 2010 for acute stroke and included patients aged ≥20. The GCS was compared between emergency medical services (EMS) arrival and hospital arrival, with decrease ≥2 points considered PND...
April 27, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29691243/role-and-prevalence-of-impaired-awareness-of-hypoglycaemia-in-ambulance-service-attendances-to-people-who-have-had-a-severe-hypoglycaemic-emergency-a-mixed-methods-study
#11
Edward A S Duncan, David Fitzpatrick, Theresa Ikegwuonu, Josie Evans, Margaret Maxwell
OBJECTIVES: (1) To compare the experiences of people who are affected by diabetes-related hypoglycaemia and either do or do not require an emergency attendance and (2) to measure the prevalence of impaired awareness of hypoglycaemia in patients who are attended by an ambulance service due to a severe hypoglycaemic event. DESIGN: A sequential mixed-methods study. SETTING: A qualitative interview study was undertaken with 31 people with diabetes (types 1 and 2) resident in the central belt of Scotland...
April 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29679408/prehospital-emergency-care-nurses-strategies-while-caring-for-patients-with-limited-swedish-english-proficiency
#12
A Alm Pfrunder, A Falk, V Vicente, V Lindström
AIMS AND OBJECTIVES: To explore the strategies of nurses working in the ambulance service while caring for patients with limited Swedish-English proficiency. BACKGROUND: Communication difficulties due to lack of mutual language is a challenge in health care systems around the world. Little is known about nurses' strategies while caring for patients with whom they do not share a mutual language in an unstructured, unplanned prehospital emergency environment, the ambulance service...
April 20, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29673360/identifying-barriers-for-out-of-hospital-emergency-care-in-low-and-low-middle-income-countries-a-systematic-review
#13
Antony Gatebe Kironji, Peter Hodkinson, Sarah Stewart de Ramirez, Trisha Anest, Lee Wallis, Junaid Razzak, Alexander Jenson, Bhakti Hansoti
BACKGROUND: Out-of-hospital emergency care (OHEC), also known as prehospital care, has been shown to reduce morbidity and mortality from serious illness. We sought to summarize literature for low and low-middle income countries to identify barriers to and key interventions for OHEC delivery. METHODS: We performed a systematic review of the peer reviewed literature from January 2005 to March 2015 in PubMed, Embase, Cochrane, and Web of Science. All articles referencing research from low and low-middle income countries addressing OHEC, emergency medical services, or transport/transfer of patients were included...
April 19, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29669612/prehospital-blood-product-administration-opportunities-in-ground-transport-als-ems-a-descriptive-study
#14
Felicia M Mix, Martin D Zielinski, Lucas A Myers, Kathy S Berns, Anurahda Luke, James R Stubbs, Scott P Zietlow, Donald H Jenkins, Matthew D Sztajnkrycer
IntroductionHemorrhage remains the major cause of preventable death after trauma. Recent data suggest that earlier blood product administration may improve outcomes. The purpose of this study was to determine whether opportunities exist for blood product transfusion by ground Emergency Medical Services (EMS). METHODS: This was a single EMS agency retrospective study of ground and helicopter responses from January 1, 2011 through December 31, 2015 for adult trauma patients transported from the scene of injury who met predetermined hemodynamic (HD) parameters for potential transfusion (heart rate [HR]≥120 and/or systolic blood pressure [SBP]≤90)...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669574/effects-of-modifiable-prehospital-factors-on-survival-after-out-of-hospital-cardiac-arrest-in-rural-versus-urban-areas
#15
Wenche Torunn Mathiesen, Conrad Arnfinn Bjørshol, Jan Terje Kvaløy, Eldar Søreide
BACKGROUND: The modifiable prehospital system factors, bystander cardiopulmonary resuscitation (CPR), emergency medical services (EMS), response time, and EMS physician attendance, may affect short- and long-term survival for both rural and urban out-of-hospital cardiac arrest (OHCA) patients. We studied how such factors influenced OHCA survival in a mixed urban/rural region with a high survival rate after OHCA. METHODS: We analyzed the association between modifiable prehospital factors and survival to different stages of care in 1138 medical OHCA patients from an Utstein template-based cardiac arrest registry, using Kaplan-Meier type survival curves, univariable and multivariable logistic regression and mortality hazard plots...
April 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29664893/occupational-exposure-during-emergency-department-thoracotomy-a-prospective-multi-institution-study
#16
Andrew Nunn, Priya Prakash, Kenji Inaba, Alvarez Escalante, Zoë Maher, Seiji Yamaguchi, Dennis Y Kim, James Maciel, William C Chiu, Byron Drumheller, Joshua P Hazelton, Kaushik Mukherjee, Xian Luo-Owen, Rachel M Nygaard, Ashley P Marek, Bryan C Morse, Caitlin A Fitzgerald, Patrick L Bosarge, Randeep S Jawa, Susan E Rowell, Louis J Magnotti, Adrian W Ong, Tejal S Brahmbhatt, Michael D Grossman, Mark J Seamon
BACKGROUND: Occupational exposure is an important consideration during emergency department thoracotomy (EDT). While HIV/hepatitis prevalence in trauma patients (0-16.8%) and occupational exposure rates during operative trauma procedures (1.9-18.0%) have been reported, exposure risk during EDT is unknown. We hypothesized that occupational exposure risk during EDT would be greater than other operative trauma procedures. METHODS: A prospective, observational study at 16 US trauma centers was performed (2015-2016)...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29657727/preoperative-fluid-restriction-for-trauma-patients-with-hemorrhagic-shock-decreases-ventilator-days
#17
Shigenari Matsuyama, Ryusuke Miki, Hirotada Kittaka, Haruki Nakayama, Shota Kikuta, Satoshi Ishihara, Shinichi Nakayama
Aim: In recent years, with the concept of damage control resuscitation, hemostasis and preoperative fluid restriction have been carried out, but there is controversy regarding the effectiveness of fluid restriction. Methods: From April 2007 to March 2013, 101 trauma patients presented with hemorrhagic shock (systolic blood pressure ≤90 mmHg) at the prehospital or emergency department and were admitted to Hyogo Emergency Medical Center (Hyogo, Japan). They underwent emergency hemostasis by surgery and transcatheter arterial embolization...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29649845/-early-palliative-care-in-emergency-medicine
#18
Maximilian Spickermann, Philipp Lenz
At the end of life patients with a life-limiting disease are often admitted to emergency departments (ED). Mostly, in the setting of an ED there may not be enough time to meet the needs for palliative care (PC) of these patients. Therefore, integration of PC into the ED offers a solution to improve their treatment. In the outpatient setting a cooperation between prehospital emergency services, the patient's general practitioner and specialized outpatient PC teams may allow the patient to die at home - this is what most patients prefer at the end of life...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29619383/-foamems-engaging-paramedics-with-free-online-open-access-education
#19
Paige Mason, Alan M Batt
BACKGROUND AND AIM: Twitter® use among paramedics and other prehospital care clinicians is on the rise and is increasingly being used as a platform for continuing education and international collaboration. In 2014, the hashtag #FOAMems was registered. It is used for the sharing of emergency medical services, paramedicine, and prehospital care-related content. It is a component of the 'free open-access meducation' (FOAM) movement. The aim of this study was to characterize and evaluate the content of #FOAMems tweets since registration...
2018: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/29602932/-the-epidemiology-of-sudden-cardiac-arrest-in-prehospital-care-in-the-area-of-the-silesian-voivodeship
#20
Klaudiusz Nadolny, Joanna Gotlib, Mariusz Panczyk, Jerzy Robert Ładny, Zbigniew Białczak, Marcin Podgórski, Oksana Makar, Nataliya Izhytska, Robert Gałązkowski
OBJECTIVE: Introduction: Sudden cardiac arrest (SCA) is a serious medical and social issue. The incidence of SCA varies depending on the location and the circumstances. The aim: A retrospective analysis of non-hospital SCA cases from an epidemiological perspective. The research involved the population monitored by the Voivodeship Rescue Service (VRS) in Katowice. PATIENTS AND METHODS: Material and methods The analysis covered dispatch order forms and emergency medical procedure forms of the VRS in Katowice in 2016 (n = 249 872)...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
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