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https://www.readbyqxmd.com/read/28652316/the-modified-jo-burg-technique-for-securing-intercostal-chest-drains
#1
Daniel J Ablett, L Navaratne, D Chua, C G Streets, N R M Tai
Insertion of an intercostal chest drain (ICD) is a common intervention in the management of either blunt or penetrating thoracic trauma. It is frequently performed by junior medical personnel as an emergency procedure during the initial resuscitation period and often within a stressful environment. Approximately one-fifth of all ICD insertions are associated with complications. In a retrospective review of over 1000 ICD insertions, 7% of the complications observed were due to inadequate fixation, resulting in dislodgement...
June 26, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28630743/comparison-of-five-video-assisted-intubation-devices-by-novice-and-expert-laryngoscopists-for-use-in-the-aeromedical-evacuation-environment
#2
Matthew C Wallace, SSgt Tyler Britton, Robbie Meek, Sharon Walsh-Hart, Col Todd E Carter, Steven J Lisco
BACKGROUND: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks. The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices (VAIDs) was best suited for in-flight use by U...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28622074/disparities-in-feedback-provision-to-emergency-medical-services-professionals
#3
Rebecca E Cash, Remle P Crowe, Severo A Rodriguez, Ashish R Panchal
INTRODUCTION: Feedback to EMS professionals is a critical component for optimizing patient care and outcomes in the prehospital setting. There is a paucity of data concerning the feedback received by prehospital providers. OBJECTIVES: The objective of this study was to describe the prevalence of feedback received by EMS professionals in the past 30 days including the types, sources, modes, and utility of feedback. The secondary objective was to identify factors associated with receiving any feedback and, specifically, feedback regarding medical care provided...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28611883/altitude-related-change-in-endotracheal-tube-cuff-pressures-in-helicopter-ems
#4
Stacy N Weisberg, Jonathan C McCall, Joseph Tennyson
INTRODUCTION: Over-inflation of endotracheal tube (ETT) cuffs has the potential to lead to scarring and stenosis of the trachea.1, 2,3, 4 The air inside an ETT cuff is subject to expansion as atmospheric pressure decreases, as happens with an increase in altitude. Emergency medical services helicopters are not pressurized, thereby providing a good environment for studying the effects of altitude changes ETT cuff pressures. This study aims to explore the relationship between altitude and ETT cuff pressures in a helicopter air-medical transport program...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28608962/image-based-computational-fluid-dynamics-in-the-lung-virtual-reality-or-new-clinical-practice
#5
REVIEW
Kelly S Burrowes, Jan De Backer, Haribalan Kumar
The development and implementation of personalized medicine is paramount to improving the efficiency and efficacy of patient care. In the respiratory system, function is largely dictated by the choreographed movement of air and blood to the gas exchange surface. The passage of air begins in the upper airways, either via the mouth or nose, and terminates at the alveolar interface, while blood flows from the heart to the alveoli and back again. Computational fluid dynamics (CFD) is a well-established tool for predicting fluid flows and pressure distributions within complex systems...
June 13, 2017: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
https://www.readbyqxmd.com/read/28604832/insects-and-associated-arthropods-analyzed-during-medicolegal-death-investigations-in-harris-county-texas-usa-january-2013-april-2016
#6
Michelle R Sanford
The application of insect and arthropod information to medicolegal death investigations is one of the more exacting applications of entomology. Historically limited to homicide investigations, the integration of full time forensic entomology services to the medical examiner's office in Harris County has opened up the opportunity to apply entomology to a wide variety of manner of death classifications and types of scenes to make observations on a number of different geographical and species-level trends in Harris County, Texas, USA...
2017: PloS One
https://www.readbyqxmd.com/read/28601203/the-care-of-thermally-injured-patients-in-operational-austere-and-mass-casualty-situations
#7
REVIEW
Booker T King, Wylan C Peterson
Burn injury affects a half million people in the United States annually. The severe thermal injury can have long-term debilitating effects. The management of burn patients in austere and operational environments is more complex. Mass casualty incidents can result in a large number of patients with multiple traumatic injuries, which often include burn injury. Appropriate triage of casualties is essential. Severely burned patients should be evacuated to a burn center if possible. Airway management and fluid resuscitation of burn patients present unique challenges...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28570350/impact-of-critical-care-air-transport-team-ccatt-ventilator-management-on-combat-mortality
#8
Joseph K Maddry, Alejandra G Mora, Shelia C Savell, Crystal A Perez, Phillip E Mason, James K Aden, Vikhyat S Bebarta
BACKGROUND: Aeromedical evacuation platforms such as Critical Care Air Transport Teams (CCATTs) play a vital role in the transport and care of critically injured and ill patients in the combat theater. Mechanical ventilation is used to support patients with failing respiratory function and patients requiring high levels of sedation. Mechanical ventilation, if not managed appropriately, can worsen or cause lung injury, as well as contribute to increased morbidity.The purpose of this study was to evaluate the impact of ARDSNet protocol compliance during aeromedical evacuation of ventilated combat injured patients...
May 30, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28570313/the-cost-of-burn-transfers-a-retrospective-review-of-7-years-of-admissions-to-a-regional-burn-center
#9
Ryan E Austin, Sofie Schlagintweit, Marc G Jeschke, Russell MacDonald, Mahvareh Ahghari, Shahriar Shahrokhi
The transport of thermally injured patients can involve significant costs; however, not all thermally injured patients necessitate transfer to a burn center. The purpose of this study was to review transfers to an American Burn Association-verified regional burn center to determine whether the transfers were necessary and the cost associated with unnecessary transfers. A retrospective chart review identified 707 patients transferred to an American Burn Association-verified burn center with an acute burn injury during a 7-year period...
May 19, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28558908/state-level-geographic-variation-in-prompt-access-to-care-for-children-after-motor-vehicle-crashes
#10
Lindsey L Wolf, Ritam Chowdhury, Jefferson Tweed, Lori Vinson, Elena Losina, Adil H Haider, Faisal G Qureshi
BACKGROUND: Motor vehicle crashes (MVCs) are a principal cause of death in children; fatal MVCs and pediatric trauma resources vary by state. We sought to examine state-level variability in and predictors of prompt access to care for children in MVCs. MATERIALS AND METHODS: Using the 2010-2014 Fatality Analysis Reporting System, we identified passengers aged <15 y involved in fatal MVCs (crashes on US public roads with ≥1 death, adult or pediatric, within 30 d)...
May 8, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#11
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28518007/patient-centric-side-effect-risk-assessment-for-medications-used-during-aeromedical-evacuations
#12
Shana A Huntsberger, William P Butler, Richard R Chapleau
BACKGROUND: The U.S. Air Force performs more than 6000 aeromedical transport flights annually, both internationally and domestically. Many of these flights include patients requiring pain relief medications. The risk of side effects from such medications administered at altitude is unknown, but understanding these risks is vital when selecting the safest pain management strategies to achieve optimal postflight outcomes. METHODS: Using an evidence-based medication side effect risk assessment model, we compared our patient-centric approach to an aircrew-centric approach using medications approved for use in U...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28499681/is-nifedipine-as-a-tocolytic-effective-in-facilitating-in-utero-transfer
#13
Jodie Martin, Jodie Mills, David Stanley
OBJECTIVE: Previous studies have reported that air medical transfer of women in preterm labor can be safely accomplished, without preterm birth occurring; in fact, many women were later discharged without preterm birth occurring. The purpose of this study was to determine if nifedipine, when used as a tocolytic, is effective at facilitating in utero transfer of women in preterm labor in the Top End of the Northern Territory of Australia. METHODS: This was a retrospective descriptive study over a 3-year period of all women transported in preterm labor between 23 + 6 to 36 + 6 weeks' gestation of pregnancy (N = 325)...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28499454/risk-for-intracranial-pressure-increase-related-to-enclosed-air-in-post-craniotomy-patients-during-air-ambulance-transport-a-retrospective-cohort-study-with-simulation
#14
Helge Brändström, Anna Sundelin, Daniela Hoseason, Nina Sundström, Richard Birgander, Göran Johansson, Ola Winsö, Lars-Owe Koskinen, Michael Haney
BACKGROUND: Post-craniotomy intracranial air can be present in patients scheduled for air ambulance transport to their home hospital. We aimed to assess risk for in-flight intracranial pressure (ICP) increases related to observed intracranial air volumes, hypothetical sea level pre-transport ICP, and different potential flight levels and cabin pressures. METHODS: A cohort of consecutive subdural hematoma evacuation patients from one University Medical Centre was assessed with post-operative intracranial air volume measurements by computed tomography...
May 12, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28490566/a-retrospective-cohort-study-of-the-utility-of-the-modified-early-warning-score-for-interfacility-transfer-of-patients-with-traumatic-injury
#15
Kristin Salottolo, Matthew Carrick, Jacob Johnson, Mark Gamber, David Bar-Or
OBJECTIVE: The modified early warning score (MEWS) is a 'track and trigger' score using routine physiological vital signs. The objective is to determine if the pretransfer MEWS can be used for predicting outcomes in trauma patients requiring interfacility transfer to higher levels of care. DESIGN, SETTING AND PARTICIPANTS: Retrospective study of consecutively transferred trauma patients into a level-II trauma centre from 2013 to 2014. INTERVENTIONS: None...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28489506/prehospital-intubation-is-associated-with-favorable-outcomes-and-lower-mortality-in-protect-iii
#16
Kurt R Denninghoff, Tomas Nuño, Qi Pauls, Sharon D Yeatts, Robert Silbergleit, Yuko Y Palesch, Lisa H Merck, Geoff T Manley, David W Wright
OBJECTIVE: Traumatic brain injury (TBI) causes more than 2.5 million emergency department visits, hospitalizations, or deaths annually. Prehospital endotracheal intubation has been associated with poor outcomes in patients with TBI in several retrospective observational studies. We evaluated the relationship between prehospital intubation, functional outcomes, and mortality using high quality data on clinical practice collected prospectively during a randomized multicenter clinical trial...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28467125/do-trauma-patients-aged-55-and-older-benefit-from-air-medical-transport
#17
Howard A Werman, Subrahmanyam Darbha, Michael Cudnik, Jeffrey Caterino
INTRODUCTION: A recent analysis of the National Sample Project demonstrated that the mortality benefits of air medical transport do not extend to patients age 55 or older. The purpose of the current investigation was to evaluate mortality benefits of air transport in adult trauma patients ≥ 55 years of age. METHODS: A retrospective analysis of all adult patients greater than age 55 years directly transported from a trauma scene to a Level I or II facility was conducted...
May 3, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28457359/transport-of-human-organs-in-italy-location-time-and-performances
#18
L Mantecchini, F Paganelli, D Peritore, S Trapani, V Morabito, A Oliveti, D Stabile, P Fiaschetti, L Rizzato, A Nanni Costa
INTRODUCTION: The outcome of transplantation activities depends on a variety of unpredictable factors. Up-to-date criteria on organ allocation foresee an efficient transport chain along with compliant performance parameters. METHODS AND OBJECTIVES: The Centro Nazionale Trapianti and the Department of Civil, Chemical, Environmental, and Materials Engineering of the University of Bologna (respectively, CNT and DICAM) have been updating a national database of organ transplantation activities to investigate performance parameters and the main causes of disruption...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28438222/hypothermia-in-trauma-victims-at-first-arrival-of-ambulance-personnel-an-observational-study-with-assessment-of-risk-factors
#19
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/28437783/evacuation-of-a-tertiary-neonatal-centre-lessons-from-the-2016-kumamoto-earthquakes
#20
Osuke Iwata, Akihiko Kawase, Masanori Iwai, Kazuko Wada
BACKGROUND: Newborn infants hospitalised in the neonatal intensive care unit (NICU) are vulnerable to natural disasters. However, publications on evacuation from NICUs are sparse. The 2016 Kumamoto Earthquakes caused serious damage to Kumamoto City Hospital and its level III regional core NICU. Local/neighbour NICU teams and the disaster-communication team of a neonatal academic society cooperated to evacuate 38 newborn infants from the ward. OBJECTIVE: The aim of this paper was to highlight potential key factors to improve emergency NICU evacuation and coordination of hospital transportation following natural disasters...
2017: Neonatology
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