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Prehospital Trauma

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https://www.readbyqxmd.com/read/29220128/trauma-resuscitation-an-evidence-based-review-of-prehospital-traumatic-cardiac-arrest
#1
Matthew Chinn, M Riccardo Colella
No abstract text is available yet for this article.
April 2017: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/29214626/a-descriptive-analysis-of-data-from-the-department-of-defense-joint-trauma-system-prehospital-trauma-registry
#2
Stephen G Schauer, Michael D April, Jason F Naylor, Joshua J Oliver, Cord W Cunningham, Andrew D Fisher, Russ S Kotwal
The active battlefield is an environment of chaos and confusion. Depending on the scale of combat, the chaos and confusion often extend into the prehospital combat setting with multiple personnel and units involved in the chain of care of casualties. The chaos of the prehospital combat setting has led to limitations in the availability of data for performance improvement and research. The Department of Defense (DoD) Joint Trauma System (JTS) Prehospital Trauma Registry (PHTR) was developed in conjunction with the updated Tactical Combat Casualty Care (TCCC) card and a TCCC after action report (AAR), and currently serves as the prehospital repository and module of the DoD Trauma Registry (DoDTR)...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29211386/blood-therapy-considerations-for-using-blood-products-for-prehospital-trauma-patients
#3
Mark E A Escott, Eric A Bank, Faroukh M Mehkri, Brett J Monroe
No abstract text is available yet for this article.
March 2017: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/29205811/prehospital-analgesic-choice-in-injured-patients-does-not-impact-on-rates-of-vomiting-experience-from-a-new-south-wales-primary-retrieval-service
#4
Michael Zhang, Timothy Cowan, John-Paul Smiles, Mary Morgan, Jessica Armstrong, Chinky Goswami, Claire Sewell
OBJECTIVE: This study aimed to explore the analgesic regimes adopted in our contemporary retrieval practice and the incidence of vomiting in ED after prehospital analgesic use. METHOD: A retrospective review was conducted on trauma patients retrieved by the Hunter Primary Retrieval Service in the Hunter New England Local Health District, New South Wales, Australia, during 2015. RESULTS: Of the 379 patients attended by the service in 2015, 196 of them (mean age 38...
December 4, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29203049/the-use-of-clinical-cervical-spine-clearance-in-trauma-patients-a-literature-review
#5
Sandra Larson, Andrew U Delnat, Jill Moore
INTRODUCTION: Five million patients in America are placed in spinal immobilization annually, with only 1% to 2% of these patients suffering from an unstable cervical spine injury. Prehospital agencies are employing selective and limited immobilization practices, but there is concern that this practice misses cervical spine injuries and therefore possibly predisposes patients to worsening injuries. METHODS: A systematic review was conducted that examined literature from the last 5 years that reviewed cervical spine immobilization application and/or clearance in alert trauma patients...
December 1, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29198373/the-development-and-implementation-of-a-layperson-trauma-first-responder-course-in-la-paz-bolivia-a-pilot-study
#6
Marissa A Boeck, Tyler E Callese, Sarah K Nelson, Steven J Schuetz, Christian Fuentes Bazan, Juan Mauricio P Saavedra Laguna, Michael B Shapiro, Nabil M Issa, Mamta Swaroop
BACKGROUND: Ninety percent of nearly five million annual global injury deaths occur in low- and middle-income countries (LMICs), where prehospital care systems are frequently rudimentary or nonexistent. The World Health Organization considers layperson first-responders as essential for emergency medical services in low-resource settings lacking more formalized systems. This study sought to develop and implement a layperson trauma first responder course (TFRC) in Bolivia. MATERIALS AND METHODS: In March and April 2013 nine sessions of the eight-hour TFRC were held in La Paz, Bolivia...
November 22, 2017: Injury
https://www.readbyqxmd.com/read/29197385/qualitative-evaluation-of-trauma-delays-in-road-traffic-injury-patients-in-maring%C3%A3-brazil
#7
Anjni Patel, João Ricardo Nickenig Vissoci, Michael Hocker, Enio Molina, Nelly Moraes Gil, Catherine Staton
BACKGROUND: Road traffic injuries (RTIs) are the eighth leading cause of death worldwide, with an estimated 90% of RTIs occurring in low- and middle-income countries (LMICs) like Brazil. There has been minimal research in evaluation of delays in transport of RTI patients to trauma centers in LMICs. The objective of this study is to determine specific causes of delays in prehospital transport of road traffic injury patients to designated trauma centers in Maringá, Brazil. METHODS: A qualitative method was used based on the Consolidated Criteria for Reporting Qualitative Research (COREQ) approach...
December 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29196046/prehospital-antibiotics-in-the-ambulance-for-sepsis-a-multicentre-open-label-randomised-trial
#8
Nadia Alam, Erick Oskam, Patricia M Stassen, Pieternel van Exter, Peter M van de Ven, Harm R Haak, Frits Holleman, Arthur van Zanten, Hien van Leeuwen-Nguyen, Victor Bon, Bart A M Duineveld, Rishi S Nannan Panday, Mark H H Kramer, Prabath W B Nanayakkara
BACKGROUND: Emergency medical services (EMS) personnel have already made substantial contributions to improving care for patients with time-dependent illnesses, such as trauma and myocardial infarction. Patients with sepsis could also benefit from timely prehospital care. METHODS: After training EMS personnel in recognising sepsis, we did a randomised controlled open-label trial in ten large regional ambulance services serving 34 secondary and tertiary care hospitals in the Netherlands...
November 28, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29191378/patients-with-head-trauma-a-study-on-initial-prehospital-assessment-and-care
#9
Rebecka Rubenson Wahlin, Veronica Lindström, Sari Ponzer, Veronica Vicente
BACKGROUND: Best evidence guidelines are intended to standardise assessment and treatment of patients with head trauma and improve outcomes for TBI patients. The primary aim was to explore pre-hospital emergency care nurses' (PECNs') documented assessment and care of patients with head trauma and the secondary aim to study gender differences in the documented care and interventions given by the PECNs. METHODS: A retrospective observational study was conducted by evaluating 2750 prehospital medical records...
November 27, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29189678/attempting-to-validate-the-overtriage-undertriage-matrix-at-a-level-i-trauma-center
#10
James W Davis, Rachel C Dirks, Lawrence P Sue, Krista L Kaups
BACKGROUND: The Optimal Resources Document mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the overtriage/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different, and Matrix does not discriminate the needs or outcomes of these different groups of patients...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29183537/continuing-trauma-the-unmet-needs-of-trauma-patients-in-the-postacute-care-setting
#11
Samir M Fakhry, Pamela L Ferguson, Jama L Olsen, Jennifer J Haughney, Heidi S Resnick, Kenneth J Ruggiero
Trauma care has traditionally focused on prehospital and hospital settings, yet many injured patients report emotional distress in the postacute care setting, which is known to impair recovery. The objective of this study was to assess postdischarge emotional recovery and communication preferences. An observational cohort of 100 adult patients from our Level 1 Trauma Center was surveyed one to two months postdischarge. Among those employed preinjury, 44 per cent had not returned to work. Nearly half screened positive for emotional issues (posttraumatic stress disorder, depression, and/or psychological distress); of these, only 35 per cent considered getting professional help and only 10 per cent received help...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29183276/the-effectiveness-of-prehospital-hypertonic-saline-for-hypotensive-trauma-patients-a-systematic-review-and-meta-analysis
#12
I E Blanchard, A Ahmad, K L Tang, P E Ronksley, D Lorenzetti, G Lazarenko, E S Lang, C J Doig, H T Stelfox
BACKGROUND: The optimal prehospital fluid for the treatment of hypotension is unknown. Hypertonic fluids may increase circulatory volume and mute the pro-inflammatory response of the body to injury and illness. The purpose of this systematic review is to determine whether in patients presenting with hypotension in the prehospital setting (population), the administration of hypertonic saline (intervention), compared to an isotonic fluid (control), improves survival to hospital discharge (outcome)...
November 28, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29180189/impact-of-triage-guidelines-on-prehospital-triage-comparison-of-guidelines-with-a-statistical-model
#13
Priti P Parikh, Pratik Parikh, Bradley Guthrie, Logan Mamer, Melissa Whitmill, Timothy Erskine, Randy Woods, Jonathan Saxe
BACKGROUND: The American College of Surgeons developed the National Field Triage Decision Scheme (NFTDS) that has been adapted by many trauma centers in the nation, but quantitative evidence of its efficacy is unclear. We compare the NFTDS and state of Ohio guidelines to the "observed" rates and with rates derived using a statistical model. METHODS: We used 4757 trauma records from 2008-2012 available from the state and calculated undertriage (UT) and overtriage (OT) rates...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29175878/ionised-calcium-levels-in-major-trauma-patients-who-received-blood-en-route-to-a-military-medical-treatment-facility
#14
Tony Kyle, Ian Greaves, Anthony Beynon, Vicky Whittaker, Mike Brewer, Jason Smith
BACKGROUND: Hypocalcaemia is a common metabolic derangement in critically ill patients. Blood transfusion can also contribute to depleted calcium levels. The aims of this study were to identify the incidence of hypocalcaemia in military trauma patients receiving blood products en route to a deployed hospital facility and to determine if intravenous calcium, given during the prehospital phase, has an effect on admission calcium levels. METHODS: This was a retrospective review of patients transported by the UK Medical Emergency Response Team in Afghanistan between January 2010 and December 2014 who were treated with blood products in the prehospital setting...
November 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29162267/the-prehospital-management-of-hypothermia-an-up-to-date-overview
#15
REVIEW
Frederike J C Haverkamp, Gordon G Giesbrecht, Edward C T H Tan
BACKGROUND: Accidental hypothermia concerns a body core temperature of less than 35°C without a primary defect in the thermoregulatory system. It is a serious threat to prehospital patients and especially injured patients, since it can induce a vicious cycle of the synergistic effects of hypothermia, acidosis and coagulopathy; referred to as the trauma triad of death. To prevent or manage deterioration of a cold patient, treatment of hypothermia should ideally begin prehospital. Little effort has been made to integrate existent literature about prehospital temperature management...
November 4, 2017: Injury
https://www.readbyqxmd.com/read/29158691/project-for-the-introduction-of-prehospital-analgesia-with-fentanyl-and-morphine-administered-by-specially-trained-paramedics-in-a-rural-service-area-in-germany
#16
Maximilian Scharonow, Timo Alberding, Wolfgang Oltmanns, Christian Weilbach
Background: In patients with serious illness or trauma, reduction of severe pain is a key therapeutic goal of emergency medical service (EMS) teams. In Germany, only physicians are allowed to use opioid analgesics. In the rural EMS area studied, the mean arrival time for paramedics is 8 minutes, 23 seconds, and for the rescue physician between 10 minutes, 30 seconds and 16 minutes, 59 seconds, depending on EMS site. In cases of parallel callouts, rescue-physician arrival times may be considerably longer...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#17
Stefan Heschl, Emily Andrew, Anthony de Wit, Stephen Bernard, Marcus Kennedy, Karen Smith
OBJECTIVE: The optimal volume and type of intravenous fluid for the treatment of blood loss in the prehospital setting is controversial. The use of red cell concentrates (RCCs) may be associated with improved outcomes; however, the administration of blood products is limited to physicians in many jurisdictions. We sought to describe the characteristics of RCC transfusions in a paramedic-staffed helicopter emergency medical system in Victoria, Australia. METHODS: We performed a retrospective analysis of all cases where paramedics consulted the responsible physician for approval of RCC transfusion between July 2011 and December 2015 in Victoria, Australia...
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#18
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29142380/epidemiological-study-of-patients-of-road-traffic-injuries-attending-emergency-department-of-a-trauma-center-in-new-delhi
#19
Puneet Misra, Anindo Majumdar, Mahesh Chandra Misra, Shashi Kant, Sanjeev Kumar Gupta, Amit Gupta, Subodh Kumar
Background and Aims: There is paucity of data regarding some of the lesser known contextual and epidemiological factors with respect to road traffic injuries (RTIs). The objective was to study the epidemiological profile of RTI victims attending an emergency department of a tertiary care trauma center. Methods: The present study was a hospital-based cross-sectional study conducted in the emergency department of a tertiary care trauma center in New Delhi. All patients of RTI attending the emergency department during the designated data collection days were included in the study...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29135535/blood-glucose-concentrations-in-prehospital-trauma-patients-with-traumatic-shock-a-retrospective-analysis
#20
Janett Kreutziger, Wolfgang Lederer, Stefan Schmid, Hanno Ulmer, Volker Wenzel, Maarten W Nijsten, Daniel Werner, Thomas Schlechtriemen
BACKGROUND: Deranged glucose metabolism after moderate to severe trauma with either high or low concentrations of blood glucose is associated with poorer outcome. Data on prehospital blood glucose concentrations and trauma are scarce. OBJECTIVES: The primary aim was to describe the relationship between traumatic shock and prehospital blood glucose concentrations. The secondary aim was to determine the additional predictive value of prehospital blood glucose concentration for traumatic shock when compared with vital parameters alone...
November 11, 2017: European Journal of Anaesthesiology
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