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https://www.readbyqxmd.com/read/28653554/the-role-of-simulation-to-support-donation-after-circulatory-death-with-extracorporeal-membrane-oxygenation-dcd-ecmo
#1
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Maciej Sip, Sebastian Stefaniak, Tomasz Kłosiewicz, Łukasz Gąsiorowski, Marek Karczewski, Tomasz Małkiewicz, Małgorzata Ładzińska, Marcin Zieliński, Aleksander Pawlak, Bartłomiej Perek, Michael Czekajlo, Marek Jemielity
Maintaining the viability of organs from donors after circulatory death (DCD) for transplantation is a complicated procedure, from a time perspective in the absence of appropriate organizational capabilities, that makes such transplantation cases difficult and not yet widespread in Poland. We present the procedural preparation for Poland's first case of organ (kidney) transplantation from a DCD donor in which perfusion was supported by extracorporeal membrane oxygenation (ECMO). Because this organizational model is complex and expensive, we used advanced high-fidelity medical simulation to prepare for the real-life implementation...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28649936/berlin-prehospital-or-usual-delivery-of-acute-stroke-care-study-protocol
#2
Martin Ebinger, Peter Harmel, Christian H Nolte, Ulrike Grittner, Bob Siegerink, Heinrich J Audebert
Rationale Prehospital stroke care in specialized ambulances increases thrombolysis rates, reduces alarm-to-treatment times, and improves the prehospital triage. Preliminary analyses suggest cost-effectiveness. However, scientific proof of better functional outcome compared to usual care is still lacking. Aim To prove better functional outcomes after deployment of the Stroke Emergency Mobile compared to regular ambulances. Sample size estimates A sample size of 686 patients will be required in each arm (Stroke Emergency Mobile group vs...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28648808/are-characteristics-of-hospitals-associated-with-outcome-after-cardiac-arrest-insights-from-the-great-paris-registry
#3
Richard Chocron, Wulfran Bougouin, Frankie Beganton, Philippe Juvin, Thomas Loeb, Frédéric Adnet, Eric Lecarpentier, Lionel Lamhaut, Daniel Jost, Eloi Marijon, Alain Cariou, Xavier Jouven, Florence Dumas
PURPOSE: As post-cardiac arrest care may influence patients' outcome, characteristics of receiving hospitals should be integrated in the evaluation of survival. We aimed at assessing the influence of care level center on patients' survival at hospital discharge using a regional registry of out-of-hospital cardiac arrest patients (OHCA). METHODS: We retrospectively analysed a Utstein and in-hospital data prospectively collected for all non-traumatic OHCA patients, in whom a successful return of spontaneous circulation (ROSC) had been obtained, from a large metropolitan area (Great Paris)...
June 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28646851/development-of-an-education-campaign-to-reduce-delays-in-pre-hospital-response-to-stroke
#4
Caterina Caminiti, Peter Schulz, Barbara Marcomini, Elisa Iezzi, Silvia Riva, Umberto Scoditti, Andrea Zini, Giovanni Malferrari, Maria Luisa Zedde, Donata Guidetti, Enrico Montanari, Mario Baratti, Licia Denti
BACKGROUND: Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness. METHODS: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28646584/prehospital-advanced-cardiac-life-support-for-out-of-hospital-cardiac-arrest-a-cohort-study
#5
Alexis Cournoyer, Eric Notebaert, Massimiliano Iseppon, Sylvie Cossette, Luc Londei-Leduc, Yoan Lamarche, Judy Morris, Éric Piette, Raoul Daoust, Jean-Marc Chauny, Catalina Sokoloff, Yiorgos Alexandros Cavayas, Jean Paquet, André Denault
OBJECTIVES: Out-of-hospital advanced cardiac life support (ACLS) has not consistently shown a positive impact on survival. Extracorporeal cardiopulmonary resuscitation (E-CPR) could render prolonged on-site resuscitation (ACLS or basic cardiac life support [BCLS]) undesirable in selected cases. The objectives of this study were to evaluate, in patients suffering from out-of-hospital cardiac arrest (OHCA) and in a subgroup of potential E-CPR candidates, the association between the addition of prehospital ACLS to BCLS and survival to hospital discharge, prehospital return of spontaneous circulation (ROSC) and delay from call to hospital arrival...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28639537/prehospital-identification-of-trauma-patients-requiring-transfusion-results-of-a-retrospective-study-evaluating-the-use-of-the-trauma-induced-coagulopathy-clinical-score-ticcs-in-33-385-patients-from-the-traumaregister-dgu-%C3%A2
#6
Martin Tonglet, Rolf Lefering, Jean Marc Minon, Alexandre Ghuysen, Vincenzo D'Orio, Frank Hildebrand, Hans-Christoph Pape, Klemens Horst
BACKGROUND: Identifying trauma patients that need emergent blood product transfusion is crucial. The Trauma Induced Coagulopathy Clinical Score (TICCS) is an easy-to-measure score developed to meet this medical need. We hypothesized that TICCS would assist in identifying patients that need a transfusion in a large cohort of severe trauma patients from the TraumaRegister DGU(®) (TR-DGU). MATERIALS AND METHODS: A total of 33,385 severe trauma patients were extracted from the TR-DGU for retrospective analysis...
June 22, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28637583/the-revised-trauma-score-plus-serum-albumin-level-improves-the-prediction-of-mortality-in-trauma-patients
#7
Seong Chun Kim, Dong Hoon Kim, Tae Yun Kim, Changwoo Kang, Soo Hoon Lee, Jin Hee Jeong, Yong Joo Park, Sang Bong Lee, Daesung Lim
INTRODUCTION: The Revised Trauma Score (RTS) is used worldwide in prehospital practice and in the emergency department (ED) settings to triage trauma patients. The main purpose of this study was to evaluate the value of the RTS plus serum albumin (RTS-A) and to compare it with other existing trauma scores as well as to compare the predictive performance of the Trauma and Injury Severity Score with the RTS-A (TRISS-A) with the original TRISS. METHODS: This was a single center, trauma registry based observational cohort study...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28636456/healthcare-system-in-indonesia
#8
Suryanto, Virginia Plummer, Malcolm Boyle
The cultural diversity, its archipelago, and the major religion being Muslim have all influenced the development of the healthcare in Indonesia. The authors' objective is to describe the evolution of the healthcare system in Indonesia. Community-based health service, called puskesmas, is the key of the healthcare service in the country. The World Health Organization estimated that 64% of all deaths in Indonesia are caused by noncommunicable diseases, which might relate to the mostly unorganized prehospital care system...
June 21, 2017: Hospital Topics
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#9
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28628603/field-and-en-route-resuscitative-endovascular-occlusion-of-the-aorta-a-feasible-military-reality
#10
Viktor A Reva, Tal M Hörer, Andrey I Makhnovskiy, Mikhail V Sokhranov, Igor M Samokhvalov, Joseph J DuBose
BACKGROUND: Severe noncompressible torso hemorrhage remains a leading cause of potentially preventable death in modern military conflicts. Resuscitative endovascular occlusion of the aorta (REBOA) has demonstrated potential as an effective adjunct to the treatment of noncompressible torso hemorrhage in the civilian early hospital and even prehospital settings-but the application of this technology for military prehospital use has not been well described. We aimed to assess the feasibility of both field and en route prehospital REBOA in the military exercise setting, simulating a modern armed conflict...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28627230/relationship-between-community-hospital-versus-pre-hospital-location-of-randomisation-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-insights-from-the-stream-study
#11
Robert C Welsh, Patrick Goldstein, Peter Sinnaeve, Miodrag C Ostojic, Yinggan Zheng, Thierry Danays, Cynthia M Westerhout, Frans Van de Werf, Paul W Armstrong
AIMS: The STREAM study randomly assigned ST-elevation myocardial infarction (STEMI) patients to receive a pharmacoinvasive versus primary percutaneous coronary intervention reperfusion strategy. We assessed whether there was an association between outcomes based on randomisation at a community hospital versus a prehospital location. METHODS/RESULTS: Community hospital patients (358/1866 (19.2%)) were compared to prehospital patients and their outcomes categorised into pharmacoinvasive according to their treatment assignment...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28626877/factors-associated-with-the-difficulty-in-hospital-acceptance-among-elderly-emergency-patients-a-population-based-study-in-osaka-city-japan
#12
Tasuku Matsuyama, Tetsuhisa Kitamura, Yusuke Katayama, Kosuke Kiyohara, Sumito Hayashida, Takashi Kawamura, Taku Iwami, Bon Ohta
AIM: We aimed to investigate prehospital factors associated with difficulty in hospital acceptance among elderly emergency patients. METHODS: We reviewed ambulance records in Osaka City from January 2013 through December 2014, and enrolled all elderly emergency patients aged ≥65 years who were transported by on-scene emergency medical service personnel to a hospital that the personnel had selected. The definition of difficulty in hospital acceptance was to the requirement for ≥4 phone calls to hospitals by emergency medical service personnel before receiving a decision from the destination hospitals...
June 18, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28622155/triad-ix-can-a-patient-testimonial-safely-help-ensure-prehospital-appropriate-critical-versus-end-of-life-care
#13
Ferdinando Mirarchi, Christopher Cammarata, Timothy E Cooney, Kristin Juhasz, Stanley A Terman
OBJECTIVE: The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM). METHODS: Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM...
June 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28622075/meaningful-interventions-in-prehospital-and-retrieval-medicine
#14
Cliff Reid, Brian Burns
No abstract text is available yet for this article.
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28622074/disparities-in-feedback-provision-to-emergency-medical-services-professionals
#15
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/28622071/survival-in-out-of-hospital-rapid-sequence-intubation-of-non-traumatic-brain-pathologies
#16
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28616642/-identification-of-common-locations-of-out-of-hospital-cardiac-arrests-in-a%C3%A2-german-metropolis
#17
C Hanefeld, F Rosbund, A Kloppe, C Kloppe
BACKGROUND: Most patients who suffer a sudden cardiac arrest initially have a shockable rhythm. Fast defibrillation and correctly performed cardiopulmonary resuscitation (CPR) are key factors for patient survival. These can be carried out by bystanders if an automated external defibrillator (AED) is available even in the absence of emergency services. AIM: The place and time of CPRs in a German city were investigated and the strategic placement of emergency medical services and AEDs necessary were evaluated...
June 14, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28616613/comparison-of-the-airway-access-skills-of-prehospital-staff-in-moving-and-stationary-ambulance-simulation-a-randomized-crossover-study
#18
Onur Karaca, Basak Bayram, Nese Colak Oray, Asli Acerer, Zeynep Sofuoglu
OBJECTIVES: We aimed to compare the procedural success and intervention durations regarding various airway access skills in moving and stationary ambulance simulations. MATERIAL AND METHODS: An ambulance simulator was used to simulate the moving ambulance environment, and a standard manikin was used for airway simulation. The study included 38 paramedics and paramedic students. In stationary and moving environments, a classical endotracheal intubation with a stylet, an intubation with a gum elastic bougie (GEB), a laryngeal mask airway (LMA), and a laryngeal tube (LT) were applied randomly...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28615900/predictors-of-outcome-in-children-with-status-epilepticus-during-resuscitation-in-pediatric-emergency-department-a-retrospective-observational-study
#19
Indumathy Santhanam, Sangeetha Yoganathan, V Akila Sivakumar, Rubini Ramakrishnamurugan, Sharada Sathish, Murali Thandavarayan
OBJECTIVES: To study the clinical profile and predictors of outcome in children with status epilepticus (SE) during resuscitation in pediatric emergency department. MATERIALS AND METHODS: This retrospective study was carried out in a tertiary care teaching hospital. Admission and resuscitation data of children, aged between 1 month and 12 years, treated for SE, between September 2013 and August 2014, were extracted using a standard data collection form. Our SE management protocol had employed a modified pediatric assessment triangle to recognize and treat acute respiratory failure, cardiovascular dysfunction (CD), and subtle SE until all parameters resolved...
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28615177/direct-transport-to-a-percutaneous-cardiac-intervention-center-and-outcomes-in-patients-with-out-of-hospital-cardiac-arrest
#20
Kristian Kragholm, Carolina Malta Hansen, Matthew E Dupre, Ying Xian, Benjamin Strauss, Clark Tyson, Lisa Monk, Claire Corbett, Christopher B Fordyce, David A Pearson, Emil L Fosbøl, James G Jollis, Benjamin S Abella, Bryan McNally, Christopher B Granger
BACKGROUND: Practice guidelines recommend regional systems of care for out-of-hospital cardiac arrest. However, whether emergency medical services should bypass nonpercutaneous cardiac intervention (non-PCI) facilities and transport out-of-hospital cardiac arrest patients directly to PCI centers despite longer transport time remains unknown. METHODS AND RESULTS: Using the Cardiac Arrest Registry to Enhance Survival with geocoding of arrest location, we identified out-of-hospital cardiac arrest patients with prehospital return of spontaneous circulation and evaluated the association between direct transport to a PCI center and outcomes in North Carolina during 2012 to 2014...
June 2017: Circulation. Cardiovascular Quality and Outcomes
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