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https://www.readbyqxmd.com/read/29972850/-implementation-of-medical-emergency-teams-to-improve-perioperative-patient-safety-who-when-how
#1
Jens-Christian Schewe, Stefan Lenkeit, Janina Ganser, Axel R Heller, Thea Koch
In contrast to prehospital emergency medicine, there are no comparable established structures or statutory requirements for structural and procedural organisation, or qualification of personnel and equipment for in-hospital emergency care in Germany. However, in perioperative patients, unexpected complications are fairly common on regular wards. Often, even hours before a possible critical event, warning signs of deterioration are present, which too often go unnoticed. Subsequently, potentially avoidable serious complications or cardiac arrest may occur...
July 4, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29945983/are-medical-students-in-prehospital-care-at-risk-of-moral-injury
#2
Esther Murray, Charlotte Krahé, Danë Goodsman
BACKGROUND: The term 'moral injury' may be useful in conceptualising the negative psychological effects of delivering emergency and prehospital medicine as it provides a non-pathological framework for understanding these effects. This is in contrast to concepts such as burnout and post-traumatic stress disorder which suggest practitioners have reached a crisis point. We conducted an exploratory, pilot study to determine whether the concept of moral injury resonated with medical students working in emergency medicine and what might mitigate that injury for them...
June 26, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29913751/parenteral-opioids-in-emergency-medicine-a-systematic-review-of-efficacy-and-safety
#3
Leila Niemi-Murola, Jani Unkuri, Katri Hamunen
Introduction and aim Pain is a frequent symptom in emergency patients and opioids are commonly used to treat it at emergency departments and at pre-hospital settings. The aim of this systematic review is to examine the efficacy and safety of parenteral opioids used for acute pain in emergency medicine. Method Qualitative review of randomized controlled trials (RCTs) on parenteral opioids for acute pain in adult emergency patients. Main outcome measures were: type and dose of the opioid, analgesic efficacy as compared to either placebo or another opioid and adverse effects...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29907602/improvised-first-aid-techniques-for-terrorist-attacks
#4
EDITORIAL
Andrew Loftus, Harvey Pynn, Paul Parker
Terrorist acts occur every day around the world. Healthcare professionals are often present as bystander survivors in these situations, with none of the equipment or infrastructure they rely on in their day-to-day practice. Within several countries there has been a move to disseminate the actions to take in the event of such attacks: in the UK, Run, Hide, Tell , and in the USA, Fight Back This paper outlines how a very basic medical knowledge combined with everyday high-street items can render highly effective first aid and save lives...
June 15, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29802441/-sepsis-detection-in-emergency-medicine-results-of-an-interprofessional-survey-on-sepsis-detection-in-prehospital-emergency-medicine-and-emergency-departments
#5
C Metelmann, B Metelmann, C Scheer, M Gründling, B Henkel, K Hahnenkamp, P Brinkrolf
BACKGROUND: Sepsis is associated with a high mortality, which can be reduced by starting screening, diagnostics and treatment as early as possible. Due to multiple educational programs and increased awareness, a decreased sepsis mortality on intensive care units has been achieved. Many patients with sepsis are admitted by the prehospital emergency service to hospital emergency departments. Thus, prehospital emergency services and emergency departments provide an opportunity to start screening, diagnosis and treatment earlier...
May 25, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29799611/tourniquet-use-in-the-prehospital-setting-are-they-being-used-appropriately
#6
Kevin M Duignan, Laura C Lamb, Monica M DiFiori, John Quinlavin, James M Feeney
OBJECTIVE: The objective of this study was to evaluate tourniquet use in the Hartford prehospital setting during a 34-month period after the Hartford Consensus was published, which encouraged increasing tourniquet use in light of military research. DESIGN: This was a retrospective review of patients with bleeding from a serious extremity injury to determine appropriateness of tourniquet use or omission. SETTING: Level II trauma center between April 2014 and January 2017...
January 2018: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/29776701/nonstandard-advance-directives-in-emergency-medicine-what-should-we-do
#7
Kenneth V Iserson
BACKGROUND: Critically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a "Do Not Resuscitate" tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. DISCUSSION: Advance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation...
July 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29649845/-early-palliative-care-in-emergency-medicine
#8
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/29615073/advanced-airway-management-in-hoist-and-longline-operations-in-mountain-hems-considerations-in-austere-environments-a-narrative-review-this-review-is-endorsed-by-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#9
REVIEW
Urs Pietsch, Jürgen Knapp, Oliver Kreuzer, Ludwig Ney, Giacomo Strapazzon, Volker Lischke, Roland Albrecht, Patrick Phillips, Simon Rauch
BACKGROUND: Providing sufficient oxygenation and ventilation is of paramount importance for the survival of emergency patients. Therefore, advanced airway management is one of the core tasks for every rescue team. Endotracheal intubation is the gold standard to secure the airway in the prehospital setting. This review aims to highlight special considerations for advanced airway management preceding human external cargo (HEC) evacuations. METHODS: We systematically searched MEDLINE, EMBASE, and PubMed in August 2017 for articles on airway management and ventilation in patients before hoist or longline operation in HEMS...
April 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29569679/the-success-of-endotracheal-intubation-with-a-modified-laryngoscope-using-night-vision-goggles
#10
Attila Aydın, Sedat Bilge, Cemile Aydın, Meltem Bilge, Erdem Çevik, Mehmet Eryılmaz
BACKGROUND: Endotracheal intubation (ETI) procedure in the combat area differs from prehospital trauma life support procedures because of the danger of gunfire and the dark environment. We aimed to determine the success, difficulty degree, and duration of ETI procedures with a classical laryngoscope (CL) in a bright room and with a modified laryngoscope (ML) model in a dark room. METHODS: All interventions were performed by a combatant medical staff of 10 members...
March 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29564473/-palliative-medicine-in-emergency-medical-services
#11
REVIEW
M Roessler, N Eulitz
The scope of emergency calls for emergency medical services staffed by an emergency physician (EMS-EP) includes calls to patients with life-limiting diseases. Symptom exacerbation as well as psychosocial overburdening of caring relatives are the most frequent reasons for activation of an EMS-EP. Pain crises, acute dyspnea, massive bleeding and/or an impending or overt cardiac arrest are the most frequent symptom exacerbations. Under the conditions of a prehospital emergency physician mission, particular challenges are the evaluation of the overall situation, the prognosis and the presumed will of the patient...
May 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29545057/intravenous-recombinant-tissue-plasminogen-activator-and-ischemic-stroke-focused-update-of-2010-clinical-practice-advisory-from-the-american-academy-of-emergency-medicine
#12
William J Meurer, Bradley Barth, Michael Abraham, Jerome R Hoffman, Gary M Vilke, Gerard DeMers
BACKGROUND: Stroke treatment is a continuum that begins with the rapid identification of symptoms and treatment with transition to successful rehabilitation. Therapies for acute ischemic stroke (AIS) may vary based on anatomic location, interval from symptom onset, and coexisting health conditions. Successful therapy requires a seamless systematic approach with coordination from prehospital environment through acute management at medical facilities to disposition and long-term care of the patient...
May 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29533448/prehospital-medicine-and-the-future-will-ecmo-ever-play-a-role
#13
David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29533432/feasibility-and-proposed-training-pathway-for-austere-application-of-resuscitative-balloon-occlusion-of-the-aorta
#14
Elliot M Ross, Theodore T Redman
BACKGROUND: Noncompressible junctional and truncal hemorrhage remains a significant cause of combat casualty death. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective treatment for many junctional and noncompressible hemorrhages. The current hospital standard for time of placement of REBOA is approximately 6 minutes. This study examined the training process and the ability of nonsurgical physicians to apply REBOA therapy in an austere field environment. METHODS: This was a skill acquisition and feasibility study...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29516125/medical-speciality-medication-or-skills-key-factors-of-prehospital-joint-reduction-a-prospective-multicenter-cohort-study
#15
Georg Siebenbürger, Christian Zeckey, Julian Fürmetz, Wolfgang Böcker, Tobias Helfen
PURPOSE: Joint dislocations occur frequently in prehospital settings. The medical specialities of emergency physicians are heterogeneous. Decision making and the success rates of reduction attempt can vary greatly. The aim of this prospective multicentre study was to identify the factors most crucial for achieving successful prehospital reduction. METHODS: Study was conducted from 05/2012-05/2015 investigating cases of shoulder, patella and ankle joint dislocations in 16 emergency physician rescue stations...
March 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29509045/abdominopelvic-injuries-due-to-road-traffic-accidents-characteristics-in-a-registry-of-162-695-victims
#16
Tristan Monchal, Amina Ndiaye, Blandine Gadegbeku, Etienne Javouhey, Olivier Monneuse
OBJECTIVE: Road traffic accidents (RTAs) are the first cause of abdominopelvic injuries (APIs). The objective of this study was to describe the characteristics and severity of APIs due to traffic accidents in a large French trauma registry and to identify risk factors for API. METHODS: All victims from the French Rhône registry of victims of RTAs were analyzed from 1996 to 2013. This registry contained data that were issued over a 20-year period from 245 medical departments, from prehospital care until re-adaptation, and forensic medicine departments...
July 4, 2018: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29489441/targeted-applications-of-unmanned-aerial-vehicles-drones-in-telemedicine
#17
Kunj Bhatt, Ali Pourmand, Neal Sikka
INTRODUCTION: Advances in technology have revolutionized the medical field and changed the way healthcare is delivered. Unmanned aerial vehicles (UAVs) are the next wave of technological advancements that have the potential to make a huge splash in clinical medicine. UAVs, originally developed for military use, are making their way into the public and private sector. Because they can be flown autonomously and can reach almost any geographical location, the significance of UAVs are becoming increasingly apparent in the medical field...
February 28, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29485427/how-hemorrhage-control-became-common-sense
#18
Alan James Hawk
BACKGROUND: Just over 200 years ago, surgeons were puzzled that the use of the tourniquet to control hemorrhage as common sense during surgery was a relatively recent development. Within the last 20 years, much progress has been made to controlling hemorrhage in the prehospital context. Then, as now, it was surprising that progress on something that appeared obvious had occurred only recently, begging the question how controlling blood loss was common sense in a surgical context, but not for emergency treatment...
July 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29466560/comparison-of-military-and-civilian-methods-for-determining-potentially-preventable-deaths-a-systematic-review
#19
Jud C Janak, Jonathan A Sosnov, Joan M Bares, Zsolt T Stockinger, Harold R Montgomery, Russ S Kotwal, Frank K Butler, Stacy A Shackelford, Jennifer M Gurney, Mary Ann Spott, Louis N Finelli, Edward L Mazuchowski, David J Smith
Importance: Military and civilian trauma experts initiated a collaborative effort to develop an integrated learning trauma system to reduce preventable morbidity and mortality. Because the Department of Defense does not currently have recommended guidelines and standard operating procedures to perform military preventable death reviews in a consistent manner, these performance improvement processes must be developed. Objectives: To compare military and civilian preventable death determination methods to understand the existing best practices for evaluating preventable death...
April 1, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29409085/-point-of-care-sonography-in-emergency-and-intensive-care-medicine
#20
Caroline Busche, Hans-Jörg Busch, Guido Michels
The use of Point-of-care ultrasonography (POC Ultrasonography) is getting more and more important in the bedside care of patients, especially in emergency- and intensive care units. In addition to the focused sonography of the heart, lungs and abdomen, the POC Ultrasonography recently includes also cases in prehospital care. Increasingly special applications in intensive care, e.g. the assessment of weaning from mechanical ventilation or evaluation of the hemodynamics of a patient by means of sonographic control, gain meaning...
February 2018: Deutsche Medizinische Wochenschrift
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