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https://www.readbyqxmd.com/read/28509774/the-role-of-the-anaesthesiologist-in-air-ambulance-medicine
#1
Stephen J M Sollid, Marius Rehn
PURPOSE OF REVIEW: The care administered on air ambulances has become increasing complex. This has led to a discussion among experts as to whether air ambulance travel should be manned by physicians. This review provides evidence in support of anaesthesiologists being the physician-leaders in air ambulance medicine, because of their training in advanced airway management, critical care, and resuscitation. RECENT FINDINGS: Successful prehospital care requires the ability to perform a complex set of advanced diagnostics and interventions...
May 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28499667/insight-into-the-incidence-of-acute-aortic-dissection-in-the-german-region-of-berlin-and-brandenburg
#2
S D Kurz, V Falk, J Kempfert, M Gieb, T M Ruschinski, M Kukucka, M Tsokos, H Grubitzsch, H Herbst, J Semmler, C Buschmann
BACKGROUND: Stanford acute type A aortic dissection (ATAAD) is a potentially lethal condition. Epidemiology studies show a statistical incidence in Europe of approximately 2-16 cases/100,000 inhabitants/year. In Germany, the estimated incidence (here subsumed under "thoracic aortic dissection" with 4.63 cases/100,000 inhabitants/year) is mainly extracted from medical death certificates by the German Federal Statistical Office. The prehospital incidence of ATAAD deaths is largely unknown...
May 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28487772/incidence-and-risk-factors-for-early-acute-kidney-injury-in-nonsurgical-patients-a-cohort-study
#3
Javier Enrique Cely, Elkin José Mendoza, Carlos Roberto Olivares, Oscar Julián Sepúlveda, Juan Sebastián Acosta, Rafael Andrés Barón, Juan José Diaztagle
Introduction. Detecting acute kidney injury (AKI) in the first days of hospitalization could prevent potentially fatal complications. However, epidemiological data are scarce, especially on nonsurgical patients. Objectives. To determine the incidence and risk factors associated with AKI within five days of hospitalization (EAKI). Methods. Prospective cohort of patients hospitalized in the Internal Medicine Department. Results. A total of 16% of 400 patients developed EAKI. The associated risk factors were prehospital treatment with nephrotoxic drugs (2...
2017: International Journal of Nephrology
https://www.readbyqxmd.com/read/28463098/when-is-a-cardiac-arrest-non-cardiac
#4
Ryan M Carter, David C Cone
Introduction While the overall survival rate for out-of-hospital cardiac arrest (OHCA) is low, ranging from 5%-10%, several characteristics have been shown to decrease mortality, such as presence of bystander cardiopulmonary resuscitation (CPR), witnessed vs unwitnessed events, and favorable initial rhythm (VF/VT). More recently, studies have shown that modified CPR algorithms, such as chest-compression only or cardio-cerebral resuscitation, can further increase survival rates in OHCA. Most of these studies have included only OHCA patients with "presumed cardiac etiology," on the assumption that airway management is of lesser impact than chest compressions in these patients...
May 2, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28440675/near-infrared-spectroscopy-nirs-to-detect-traumatic-intracranial-haematoma-a-systematic-review-and-meta-analysis
#5
Robert J Brogan, Vassilios Kontojannis, Bhavin Garara, Hani J Marcus, Mark H Wilson
OBJECTIVES AND METHODS: Head injury is the most common trauma presentation to UK emergency departments, with around 1.2 million patients each year. The key management principal for this time critical illness remains early surgical intervention. With the development of handheld near-infrared spectroscopy (NIRS) devices, there is now the possibility of triaging and diagnosing these patients immediately, where computed tomography (CT) scanner is unavailable. NIRS has two related but distinct potential uses within clinical medicine...
April 25, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28424835/-future-of-emergency-medicine-in-germany-2-0
#6
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/28411934/tactical-combat-casualty-care-and-wilderness-medicine-advancing-trauma-care-in-austere-environments
#7
REVIEW
Frank K Butler, Brad Bennett, Colonel Ian Wedmore
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. Military units that have trained all of their unit members in TCCC have now documented the lowest incidence of preventable deaths in the history of modern warfare and TCCC is now the standard for battlefield trauma care in the US Military. TCCC and wilderness medicine share the goal of optimizing care for patients with trauma in austere environments that impose significant challenges in both equipment and evacuation capability...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28333828/prehospital-blood-transfusion-programs-capabilities-and-lessons-learned
#8
Martin D Zielinski, James R Stubbs, Kathleen S Berns, Elon Glassberg, Alan D Murdock, Eilat Shinar, Geir Arne Sunde, Steve Williams, Mark H Yazer, Scott Zietlow, Donald H Jenkins
No abstract text is available yet for this article.
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#9
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#10
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#11
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286528/evaluation-of-a-pilot-project-to-introduce-simulation-based-team-training-to-pediatric-surgery-trauma-room-care
#12
Markus Lehner, Ellen Heimberg, Florian Hoffmann, Oliver Heinzel, Hans-Joachim Kirschner, Martina Heinrich
Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28285490/review-of-54-cases-of-prolonged-field-care
#13
Erik DeSoucy, Stacy Shackelford, Joseph J DuBose, Seth Zweben, Stephen C Rush, Russ S Kotwal, Harold R Montgomery, Sean Keenan
BACKGROUND: Prolonged field care (PFC) is field medical care applied beyond doctrinal planning time-lines. As current and future medical operations must include deliberate and contingency planning for such events, data are lacking to support efforts. A case review was conducted to define the epidemiology, environment, and operational factors that affect PFC outcomes. METHODS: A survey distributed to US military medical providers solicited details of PFC encounters lasting more than 4 hours and included patient demographics, environmental descriptors, provider training, modes of transportation, injuries, mechanism of injury, vital signs, treatments, equipment and resources used, duration of PFC, and morbidity and mortality status on delivery to the next level of care...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28284483/tactical-combat-casualty-care-beginnings
#14
REVIEW
Frank K Butler
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. The origins of TCCC were nontraditional. The TCCC program began as a Naval Special Warfare biomedical research effort launched after the realization that extremity hemorrhage, a leading cause of preventable death on the battlefield, was not being treated with a readily available and highly effective intervention: the tourniquet. This insight prompted a systematic reevaluation of all aspects of battlefield trauma care that was conducted from 1993 to 1996 as a joint effort by special operations medical personnel and the Uniformed Services University of the Health Sciences...
March 8, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28274288/improving-data-quality-in-mass-gatherings-health-research
#15
Andrew Guy, Ross Prager, Sheila Turris, Adam Lund
Mass gatherings attract large crowds and can strain the planning and health resources of the community, city, or nation hosting an event. Mass-Gatherings Health (MGH) is an evolving niche of prehospital care rooted in emergency medicine, emergency management, public health, and disaster medicine. To explore front-line issues related to data quality in the context of mass gatherings, the authors draw on five years of management experience with an online, mass-gathering event and patient registry, as well as clinical and operational experience amassed over several decades...
March 9, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#16
Abby M Bailey, Regan A Baum, Karolyn Horn, Tameka Lewis, Kate Morizio, Amy Schultz, Kyle Weant, Stephanie N Justice
BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter. OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine...
March 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28259184/can-we-rely-on-out-of-hospital-blood-samples-a-prospective-interventional-study-on-the-pre-analytical-stability-of-blood-samples-under-prehospital-emergency-medicine-conditions
#17
Johannes Prottengeier, Nicola Jess, Frank Harig, Christine Gall, Joachim Schmidt, Torsten Birkholz
BACKGROUND: Prehospital intravenous access provides the opportunity to sample blood from an emergency patient at the earliest possible moment in the course of acute illness and in a state prior to therapeutic interventions. Our study investigates the pre-analytical stability of biomarkers in prehospital emergency medicine and will answer the question whether an approach of blood sampling out in the field will deliver valid laboratory results. METHODS: We prepared pairs of blood samples from healthy volunteers and volunteering patients post cardio-thoracic surgery...
March 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28255632/population-based-autopsy-study-of-traumatic-fatalities
#18
S Saar, A Lomp, J Laos, V Mihnovitš, R Šalkauskas, T Lustenberger, M Väli, U Lepner, P Talving
BACKGROUND: Injuries result in 5.8 million global fatalities annually and are the leading cause of death in younger individuals. Nevertheless, population-based autopsy investigations on traumatic deaths are scarce. We set out to study all consecutive autopsies on traumatic fatalities performed in a 5-year time segment in Estonia. METHODS: After the ethics review board approval, all consecutive autopsies after blunt or penetrating deaths occurring in prehospital or in-hospital settings between January 1, 2009, and December 31, 2013, were retrospectively reviewed using the National Forensic Medicine Database...
March 2, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#19
Michael W Hubble, Clark Tyson
Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#20
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
March 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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