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https://www.readbyqxmd.com/read/27920510/the-clock-in-the-box-a-brief-cognitive-screen-is-associated-with-failure-to-return-home-in-an-elderly-hospitalized-sample
#1
Colleen E Jackson, Laura J Grande, Kelly Doherty, Elizabeth Archambault, Brittany Kelly, Jane A Driver, William P Milberg, Regina McGlinchey, James L Rudolph
PURPOSE: Cognitive screening upon hospital admission can provide important information about the patient's ability to process information during the inpatient stay. The Clock-in-the-Box (CIB) is a rapidly administered cognitive screening measure which has been previously validated with cognitive screening and neuropsychological assessments. The purpose of this study is to demonstrate the predictive validity of the CIB for discharge location among a sample of older medical inpatients. PATIENTS AND METHODS: Hospitalized Veterans (N=218), aged 55 years and older, were recruited on the day after admission after they gave their consent...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27919173/carbon-monoxide-poisoning-during-camping-in-korea
#2
Youn-Jung Kim, Chang Hwan Sohn, Bum Jin Oh, Kyoung Soo Lim, Won Young Kim
OBJECTIVE: The aim of this study was to evaluate the epidemiology and characteristics of unintentional carbon monoxide (CO) poisoning during camping in Korea. METHODS: We performed a retrospective observational study on patients with unintentional camping-related CO poisoning who were admitted to the emergency department (ED) from 1 January 2010 to 31 December 2014. News reports about incidents of camping-related CO poisoning were collected using news search engines...
December 5, 2016: Inhalation Toxicology
https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#3
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918863/ems-providers-beliefs-regarding-spinal-precautions-for-pediatric-trauma-transport
#4
Cindy D Chang, Remle P Crowe, Melissa A Bentley, Alyssa R Janezic, Julie C Leonard
OBJECTIVE: Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. METHODS: We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors. RESULTS: We received 5,400 responses (17%)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918858/d10-in-the-treatment-of-prehospital-hypoglycemia-a-24-month-observational-cohort-study
#5
H Gene Hern, Matthew Kiefer, Derex Louie, Joseph Barger, Harrison J Alter
INTRODUCTION: Prehospital first responders historically have used an IV bolus of 50 mL of 50% dextrose solution (D50) for the treatment of hypoglycemia in the field. A local Emergency Medical Services (EMS) system recently approved a hypoglycemia treatment protocol of IV 10% dextrose solution (D10) due to occasional shortages and higher cost of D50. We use the experience of this EMS system to report the feasibility, safety, and efficacy of this approach. METHODS: Over the course of 104 weeks, paramedics treated 1,323 hypoglycemic patients with D10 and recorded patient demographics and clinical outcomes...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918852/anomaly-detection-outperforms-logistic-regression-in-predicting-outcomes-in-trauma-patients
#6
Zachary D W Dezman, Chen Gao, Shiming Yang, Peter Hu, Li Yao, Hsiao-Chi Li, Chein-I Chang, Colin Mackenzie
OBJECTIVE: Recent advancements in trauma resuscitation have shown a great benefit of early identification and control of hemorrhage, which is the most common cause of death in injured patients. We introduce a new analytical approach, anomaly detection (AD), as an alternative method to the traditional logistic regression (LR) method in predicting which injured patients receive transfusions, intensive care, and other interventions. METHODS: We abstracted routinely collected prehospital vital sign data from patient records (adult patients who survived more than 15 minutes after being directly admitted to a level 1 trauma center)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27916376/factors-predictive-of-complicated-appendicitis-in-children
#7
Xuan-Binh D Pham, Veronica F Sullins, Dennis Y Kim, Blake Range, Amy H Kaji, Christian M de Virgilio, Steven L Lee
BACKGROUND: The ability to predict whether a child has complicated appendicitis at initial presentation may influence clinical management. However, whether complicated appendicitis is associated with prehospital or inhospital factors is not clear. We also investigate whether hyponatremia may be a novel prehospital factor associated with complicated appendicitis. MATERIALS AND METHODS: A retrospective review of all pediatric patients (≤12 y) with appendicitis treated with appendectomy from 2000 to 2013 was performed...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27912037/avalanche-accidents-causing-fatalities-are-they-any-different-in-the-summer
#8
Mathieu Pasquier, Olivier Hugli, Alexandre Kottmann, Frank Techel
: Pasquier, Mathieu, Olivier Hugli, Alexandre Kottmann, and Frank Techel. Avalanche accidents causing fatalities: are they any different in the summer? High Alt Med Biol. 16:000-000, 2016. AIMS: This retrospective study investigated the epidemiology of summer avalanche accidents that occurred in Switzerland and caused at least one fatality between 1984 and 2014. Summer avalanche accidents were defined as those that occurred between June 1st and October 31st. RESULTS: Summer avalanches caused 21 (4%) of the 482 avalanches with at least one fatality occurring during the study period, and 40 (6%) of the 655 fatalities...
December 2, 2016: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/27908843/treatment-of-acute-coronary-syndrome-by-telemedically-supported-paramedics-compared-with-physician-based-treatment-a-prospective-interventional-multicenter-trial
#9
Jörg C Brokmann, Clemens Conrad, Rolf Rossaint, Sebastian Bergrath, Stefan K Beckers, Miriam Tamm, Michael Czaplik, Frederik Hirsch
BACKGROUND: Prehospital treatment of acute coronary syndrome (ACS) in German emergency medical services (EMSs) is reserved for EMS physicians due to legal issues. OBJECTIVE: The objective of this prospective, interventional, multicenter trial was to evaluate the quality of telemedically-delegated therapy and the possible complications in patients with ACS. METHODS: After approval by the ethics committee and trial registration, a one-year study phase was started in August 2012 with 5 ambulances, telemedically equipped and staffed with paramedics, in 4 German EMS districts...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27908332/prehospital-sepsis-care
#10
REVIEW
Jerrilyn Jones, Benjamin J Lawner
Prehospital care providers are tasked with the delivery of time-sensitive care, and emergency medical services (EMS) systems must match patients to appropriate clinical resources. Modern systems are uniquely positioned to recognize and treat patients with sepsis. Interventions such as administration of intravenous fluid and transporting patients to the appropriate level of definitive care are linked to improved patient outcomes. As EMS systems refine their protocols for the recognition and stabilization of patients with suspected or presumed sepsis, EMS providers need to be educated about the spectrum of sepsis-related presentations and treatment strategies need to be standardized...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906867/external-validation-of-the-air-medical-prehospital-triage-score-for-identifying-trauma-patients-likely-to-benefit-from-scene-helicopter-transport
#11
Joshua B Brown, Mark L Gestring, Francis X Guyette, Matthew R Rosengart, Nicole A Stassen, Raquel M Forsythe, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry
BACKGROUND: The Air Medical Prehospital Triage (AMPT) score was developed to identify injured patients who may benefit from scene helicopter emergency medical services (HEMS) transport. External validation using a different dataset is essential to ensure reliable performance. The study objective was to validate the effectiveness of the AMPT score to identify patients with a survival benefit from HEMS using the Pennsylvania Trauma Outcomes Study (PTOS) registry. METHODS: Patients age≥16years undergoing scene HEMS or ground EMS (GEMS) transport in the PTOS registry 2000-2013 were included...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27904259/profile-and-outcome-of-sudden-cardiac-arrests-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#12
Gautham Raja Pandian, Suma Mary Thampi, Nilanchal Chakraborty, Deepthi Kattula, Paul Prabhakar Abhilash Kundavaram
BACKGROUND: Sudden cardiac arrest (SCA) requiring cardiopulmonary resuscitation (CPR) is one of the common emergencies encountered in the emergency department (ED) of any hospital. Although several studies have reported the predictors of CPR outcome in general, there are limited data from the EDs in India. MATERIALS AND METHODS: This retrospective study included all patients above 18 years with SCA who were resuscitated in the ED of a tertiary care hospital with an annual census of 60,000 patients between August 2014 and July 2015...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27903839/the-effect-of-brain-tomography-findings-on-mortality-in-sniper-shot-head-injuries
#13
Çağdaş Can, M Bolatkale, A Sarıhan, Y Savran, A Ç Acara, M Bulut
OBJECTIVES: Penetrating gunshot head injuries have a poor prognosis and require prompt care. Brain CT is a routine component of the standard evaluation of head wounds and suspected brain injury. We aimed to investigate the effect of brain CT findings on mortality in gunshot head injury patients who were admitted to our emergency department (ED) from the Syrian Civil War. METHODS: The study group comprised patients who were admitted to the ED with gunshot brain injury...
November 30, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27903076/the-potential-of-optimizing-prehospital-triage-of-patients-with-suspected-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-t-and-copeptin
#14
Carsten Stengaard, Jacob T Sørensen, Søren A Ladefoged, Jens F Lassen, Martin B Rasmussnen, Claus Kjær Pedersen, Antoine Ayer, Hans Erik Bøtker, Christian J Terkelsen, Kristian Thygesen
PURPOSE: In patients with a suspected acute myocardial infarction (AMI), to evaluate the potential for early triage based on measurement of high-sensitivity cardiac troponin T (hs-cTnT) and copeptin in blood samples collected in the prehospital phase. MATERIALS AND METHODS: In this retrospective study, we measured hs-cTnT and copeptin in blood samples collected in the ambulance form 962 patients with suspected AMI. The diagnostic accuracy was estimated by receiver-operating characteristics curve area under the curve (AUC) for both biomarkers and a combined model...
December 1, 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/27902671/prehospital-transport-for-pediatric-trauma-a-comparison-of-private-transport-and-emergency-medical-services
#15
Yea-Chyi Lin, York Tien Lee, Jasmine Xun Yi Feng, Li Wei Chiang, Shireen Anne Nah
OBJECTIVES: We describe the demographics of pediatric patients with trauma transferred using private transport (PT) versus emergency medical services (EMS) and evaluate the potential impact on their treatment and outcome. METHODS: We accessed data from our national trauma registry, a prospectively collected database. Data were extracted on all patients with trauma admitted to our institution between January 2011 and June 2013, with injury severity score (ISS) higher than 8...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27899017/public-access-defibrillation-and-outcomes-after-pediatric-out-of-hospital-cardiac-arrest
#16
Tatsuma Fukuda, Naoko Ohashi-Fukuda, Hiroaki Kobayashi, Masataka Gunshin, Toshiki Sera, Yutaka Kondo, Naoki Yahagi
BACKGROUND: Use of automated external defibrillators (AEDs) has been recommended for pediatric out-of-hospital cardiac arrest (OHCA). However, there are no conclusive studies that elucidated the effectiveness of public-access defibrillation (PAD) in children. METHODS: This was a nationwide, population-based, propensity score-matched study of pediatric OHCA in Japan from 2011 to 2012, based on data from the All-Japan Utstein Registry. We included pediatric OHCA patients (aged 1-17 years) who received bystander cardiopulmonary resuscitation...
November 27, 2016: Resuscitation
https://www.readbyqxmd.com/read/27894562/todd-s-paresis-in-acute-mild-head-trauma
#17
Alan Cowley, David Wright, Thomas Breen, Richard Lyon
We present the case of an adult male who sustained Todd's paresis after a traumatically induced seizure in a patient with an isolated facial injury. The precipitating event was head trauma from a golf club. The patient had no previous history of seizures and went on to make a complete neurologic recovery with no cerebral pathology noted. A literature review suggests that Todd's paresis after trauma is very rare as opposed to occurring in the medical or long-term brain injury settings. Although the authors acknowledge that it may occur in trauma, the awareness within the prehospital setting is sufficiently rare for this case report to be of interest to prehospital clinicians; it is important prehospital clinicians are aware of this condition...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894561/apneic-oxygenation-may-not-prevent-severe-hypoxemia-during-rapid-sequence-intubation-a-retrospective-helicopter-emergency-medical-service-study
#18
Sattha Riyapan, Jeffrey Lubin
OBJECTIVE: This study sought to determine the effectiveness of apneic oxygenation in preventing hypoxemia during prehospital rapid sequence intubation (RSI). METHODS: We performed a case-cohort study using a pre-existing database looking at intubation management by a single helicopter emergency medical service between July 2013 and June 2015. Apneic oxygenation using high-flow nasal cannula (15 L/min) was introduced to the standard RSI protocol in July 2014. Severe hypoxemia was defined as an incidence of oxygen saturation less than 90%...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894558/helicopter-scene-response-for-stroke-patients-a-5-year-experience
#19
Andrew Hawk, Catherine Marco, Matt Huang, Bonnie Chow
OBJECTIVE: The purpose of this study was to examine the usefulness of an emergency medical service (EMS)-requested air medical helicopter response directly to the scene for a patient with clinical evidence of an ischemic cerebrovascular accident (CVA) and transport to a regional comprehensive CVA center. METHODS: CareFlight, an air medical critical care transportation service, is based in Dayton, OH. The 3 CareFlight helicopters are geographically located and provided transport to all CVA scene patients in this study...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894557/reporting-helicopter-emergency-medical-services-in-major-incidents-a-delphi-study
#20
Sabina Fattah, Anne Siri Johnsen, Stephen J M Sollid, Torben Wisborg, Marius Rehn, Ákos Sóti, Anatolij Truhlář, Andreas J Krüger, Björn Gunnarsson, Dan Gryth, David Ohlén, Espen Fevang, Geir Arne Sunde, Ivo Breitenmoser, Jouni Kurola, Jouni Nurmi, Knut Fredriksen, Leif Rognås, Peter Temesvari, Søren Mikkelsen, Vidar Magnusson, Wolfgang Voelckel
OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences. This type of database presently exists for major incident reporting at www.majorincidentreporting.net. This study aimed to develop a HEMS-specific major incident template. METHODS: This Delphi study included 17 prehospital critical care physicians with current or previous HEMS experience...
November 2016: Air Medical Journal
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