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https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#1
Stefan Heschl, Emily Andrew, Anthony de Wit, Stephen Bernard, Marcus Kennedy, Karen Smith
OBJECTIVE: The optimal volume and type of intravenous fluid for the treatment of blood loss in the prehospital setting is controversial. The use of red cell concentrates (RCCs) may be associated with improved outcomes; however, the administration of blood products is limited to physicians in many jurisdictions. We sought to describe the characteristics of RCC transfusions in a paramedic-staffed helicopter emergency medical system in Victoria, Australia. METHODS: We performed a retrospective analysis of all cases where paramedics consulted the responsible physician for approval of RCC transfusion between July 2011 and December 2015 in Victoria, Australia...
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29142380/epidemiological-study-of-patients-of-road-traffic-injuries-attending-emergency-department-of-a-trauma-center-in-new-delhi
#2
Puneet Misra, Anindo Majumdar, Mahesh Chandra Misra, Shashi Kant, Sanjeev Kumar Gupta, Amit Gupta, Subodh Kumar
Background and Aims: There is paucity of data regarding some of the lesser known contextual and epidemiological factors with respect to road traffic injuries (RTIs). The objective was to study the epidemiological profile of RTI victims attending an emergency department of a tertiary care trauma center. Methods: The present study was a hospital-based cross-sectional study conducted in the emergency department of a tertiary care trauma center in New Delhi. All patients of RTI attending the emergency department during the designated data collection days were included in the study...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29132593/the-impact-of-helicopter-emergency-medical-service-night-operations-in-south-east-england
#3
Leigh Curtis, Mark Salmon, Richard M Lyon
OBJECTIVE: This study sought to assess the impact of a helicopter emergency medical service (HEMS) capable of night operations. METHODS: This is a retrospective case review of all night HEMS missions attended by a charity air ambulance service in South East England over a 2-year period (October 1, 2013, to October 1, 2015). RESULTS: During the 2-year trial period, the HEMS service undertook a total of 5,004 missions and attended to 3,728 patients...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29123835/ambulance-dispatches-to-schools-during-a-5-year-period-in-fukui-prefecture
#4
Yoshikazu Takinami, Shinji Maeda
Aim: To determine the characteristics and trends of medical emergencies during school activities by analyzing information provided by fire departments. Methods: During a 5-year period from January 2009 to December 2013, all nine fire departments in Fukui Prefecture handled 850 emergencies at schools. We investigated the 850 cases with the age range of 0-63 years. Results: It was found that 21.5% of ambulance dispatches to schools were on weekends and there were more dispatches for non-faculty members of all age groups on weekends than on weekdays...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29108472/maternal-and-fetal-outcomes-of-emergency-obstetric-referrals-to-a-nigerian-teaching-hospital
#5
Godwin O Akaba, Bissallah A Ekele
Our study sought to determine the maternal and fetal outcomes of emergency obstetric referrals to a Nigerian teaching hospital as well as assess reasons for these referrals. We enrolled women referred or who presented themselves to the emergency obstetric unit for management of complications of pregnancy, labour, delivery or the puerperium. The majority presented late, their mean duration of stay at the referring facility being 22.25 h. Only nine (7.3%) were transported by ambulance. Severe pre-eclampsia and eclampsia (in 33, 26...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/29100219/healthcare-utilization-by-frail-community-dwelling-older-veterans-a-1-year-follow-up-study
#6
Miriam Zylberglait Lisigurski, Yolin A Bueno, Chandana Karanam, Allen D Andrade, Sisir Akkineni, Victor Cevallos, Jorge G Ruiz
OBJECTIVES: Frailty is a prevalent clinical syndrome associated with a high risk of adverse health outcomes, including disability, morbidity, and mortality, that has become a major challenge for the healthcare system. The aim of this prospective study was to determine the level of healthcare utilization in prefrail and frail community-dwelling older military veterans. METHODS: We studied a cohort of community-dwelling older veterans aged 65 years and older 1 year at the Miami Veterans Affairs Medical Center to determine their levels of healthcare utilization...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29077228/air-ambulance-delivery-and-administration-of-4-factor-prothrombin-complex-concentrate-is-feasible-and-decreases-time-to-anticoagulation-reversal
#7
Claire Vines, Stephanie J Tesseneer, Robert D Cox, Damon A Darsey, Kristin Carbrey, Michael A Puskarich
OBJECTIVES: To evaluate the feasibility, safety, and preliminary efficacy of four-factor prothrombin complex concentrate (4-factor PCC) administration by an air ambulance service prior to or during transfer of patients with warfarin-associated major hemorrhage to a tertiary care center for definitive management (interventional arm) compared to patients receiving 4-factor PCC following transfer by air ambulance or ground without 4-factor PCC treatment (conventional arm). METHODS: Retrospective chart review of patients presenting to a large academic medical center...
October 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29069141/intra-arterial-fibrinolysis-for-the-management-of-acute-ischemia-on-a-below-knee-amputation-stump-case-report
#8
Breno Boueri Affonso, Joaquim Maurício da Motta Leal, Rafael Noronha Cavalcante, Priscila Mina Falsarella, Francisco Leonardo Galastri, Rodolfo Souza Cardoso, Felipe Nasser
Preservation of the knee joint has enormous advantages in terms of mobility and rehabilitation of an amputee. Any cause of breakdown requiring revision to an above-knee amputation is a major setback because it reduces the patient's rehabilitative potential. We report a case of intra-arterial thrombolysis use to save a below-knee amputation stump with acute ischemia. A 56-year-old man who sought the emergency department with 1-day history of acute pain on his right below-knee stump. The angiography confirmed popliteal artery occlusion...
October 23, 2017: Einstein
https://www.readbyqxmd.com/read/29055616/sizing-capacity-levels-in-emergency-medical-services-dispatch-centers-using-the-newsvendor-approach
#9
Gorkem Sariyer
BACKGROUND: The increased volume in demand worldwide in the present day has led to the need for the establishment of effective ambulance services. As call centers have become the primary contact point between patients and emergency service providers, the planning of the call center has become a key task for administrators. OBJECTIVES: The aim of this study is to apply a widely used operations management method, the newsvendor model, for optimizing the capacity level in EMS call centers with a minimum cost in order to efficiently meet the calls arriving...
October 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29055613/which-transfers-can-we-avoid-multi-state-analysis-of-factors-associated-with-discharge-home-without-procedure-after-ed-to-ed-transfer-for-traumatic-injury
#10
Laura N Medford-Davis, Daniel N Holena, David Karp, Michael J Kallan, M Kit Delgado
OBJECTIVE: Among injured patients transferred from one emergency department (ED) to another, we determined factors associated with being discharged from the second ED without procedures, or admission or observation. METHODS: We analyzed all patients with injury diagnosis codes transferred between two EDs in the 2011 Healthcare Utilization Project State Emergency Department and State Inpatient Databases for 6 states. Multivariable hierarchical logistic regression evaluated the association between patient (demographics and clinical characteristics) and hospital factors, and discharge from the second ED without coded procedures...
October 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29032474/discrepancy-between-the-initial-assessment-of-injury-severity-and-post-hoc-determination-of-injury-severity-in-patients-with-apparently-mild-traumatic-brain-injury-a-retrospective-multicenter-cohort-analysis
#11
S M Bossers, K M Pol, E P A Oude Ophuis, B Jacobs, M C Visser, S A Loer, C Boer, J van der Naalt, P Schober
PURPOSE: Traumatic brain injury (TBI) is a major cause of trauma-related visits to emergency departments (ED). Determination of monitoring requirements of patients with apparently mild TBI is challenging. Patients may turn out to be more severely injured than initially assumed, and failure to identify these patients constitutes a serious threat to patient safety. We, therefore, aimed to identify clinical risk factors for more severe injuries in patients with apparently mild TBI. METHODS: In a retrospective cohort analysis performed at two level I trauma centers, 808 patients aged ≥ 16 presenting to the ED with head trauma and a Glasgow Coma Scale (GCS) score 13-15 who received a head CT scan were studied...
October 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29026470/major-determinants-of-maternal-near-miss-and-mortality-at-the-maternity-teaching-hospital-erbil-city-iraq
#12
Vian Sabri Akrawi, Tariq Salman Al-Hadithi, Namir Ghanim Al-Tawil
OBJECTIVES: To find out the major determinants of maternal near-miss (NM)and maternal deaths (MDs) in Erbil city, Iraq, by comparative analysis of maternal NMs and MDs. METHODS: We conducted a hospital-based cross-sectional study in the Maternity Teaching Hospital in Erbil city from 1 June to 31 December 2013. All MDs and NMs that occurred in the hospital during the study period were included in the study. Systematic identification of all eligible women was done...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29016592/availability-of-life-support-equipment-and-its-utilization-by-ambulance-drivers
#13
Rija Acharya, Angur Badhu, Tara Shah, Sharmila Shrestha
BACKGROUND: An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers. METHODS: Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28988163/high-sensitivity-c-reactive-protein-as-a-predictor-of-inhospital-mortality-in-patients-with-cardiovascular-disease-at-an-emergency-department-a-retrospective-cohort-study
#14
Ryo Yoshinaga, Yasufumi Doi, Katsuhiko Ayukawa, Shizukiyo Ishikawa
OBJECTIVE: We investigated whether serum high-sensitivity C reactive protein (hs-CRP) levels measured in an emergency department (ED) are associated with inhospital mortality in patients with cardiovascular disease (CVD). DESIGN: A retrospective cohort study. SETTING: ED of a teaching hospital in Japan. PARTICIPANTS: 12 211 patients with CVD aged ≥18 years who presented to the ED by an ambulance between 1 February 2006 and 30 September 2014 were evaluated...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28822215/family-emergency-plan-and-preparedness-among-medical-practitioners-in-zaria-nigeria
#15
Jerry Godfrey Makama, Istifanus Anekoson Joshua, Elizabeth Jerry Makama
BACKGROUND: There has been an increase in the incidence of disasters in many parts of the world. Similarly, Nigeria has witnessed a recent increase of man-made disaster events such as plane crash, fire incidents, flood, and building collapse, including bomb blast orchestrated by terrorists that often create emergency situations. Therefore, the aim of the study was to evaluate family emergency plan and preparedness among medical practitioners in Zaria. METHODS: This was a cross-sectional descriptive study (May-July, 2013) of medical practitioners in Zaria, Nigeria...
2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#16
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28710197/cervical-shock-a-complication-of-incomplete-abortion
#17
Julian David Birch, Divyansh Gulati, Sachin Mandalia
A case of a 37-year-old female primagravida who attended the emergency department (ED) via ambulance in hypotensive shock. She was 10 weeks pregnant, but had an inevitable miscarriage confirmed in the local Early Pregnancy Unit 3 weeks previously. She was hypotension (90/60 mm Hg), bradycardic (45 bpm) and was peripherally shut down. A provisional diagnosis of haemorrhagic shock was made, but despite intravenous fluid challenges, she appeared to be deteriorating, so a major haemorrhage protocol was activated...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28661949/an-overview-of-stroke-infrastructure-network-and-nursing-services-in-contemporary-greece
#18
Dimitrios Theofanidis, Antigoni Fountouki
This article describes the provision of stroke services in Greece and addresses the possible effects of the hospital rotation system. Unique to Greece is a centrally administered rotation system for hospital 24-hour on-call systems in the major cities. This means that a hospital may admit new patients only during specific 24-hour periods every 3 to 5 days. All Greek city hospitals must conform to this rotation basis for emergency and scheduled admissions. Patients with stroke arrive to designated rotation on-call hospital via ambulance or taxi or by private means and are first seen in the accident and emergency department where they are given priority attention accordingly and allocated to a neurology ward, medical ward, or stroke bay if the hospital has one...
August 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28661710/use-of-hemostatic-nasal-plugs-in-emergency-medical-services-in-the-netherlands-a-prospective-study-of-33-cases
#19
Ruben Te Grotenhuis, Pierre M van Grunsven, Wim M J M Heutz, Edward C T H Tan
BACKGROUND: Epistaxis is a common medical emergency with possible life-threatening complications. In the prehospital setting, epistaxis can be treated with nasal tampons. HemCon® Nasal Plug is a nasal tampon impregnated with oxidized cellulose, which has hemostatic properties. OBJECTIVE: The objective of this study was to determine the effectiveness and usability of HemCon Nasal Plugs in the treatment of severe epistaxis in the prehospital setting. METHODS: From June 2012 to December 2014, all ambulances of two emergency medical services in the Netherlands were equipped with HemCon Nasal Plugs...
June 29, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28648856/presentations-for-hypoglycemia-associated-with-diabetes-mellitus-to-emergency-departments-in-a-canadian-province-a-database-and-epidemiological-analysis
#20
Chris J Alexiu, Anderson Chuck, Susan E Jelinski, Brian H Rowe
AIMS: The prevalence of diabetes mellitus was reportedly 9% in 2014, making it one of the most common global chronic conditions. Hypoglycemia is an important complication of diabetes treatment. The objective of this study was to quantify and characterize hypoglycemia presentations associated with type 1 or 2 diabetes made to emergency departments (EDs) by adults in a Canadian province. METHODS: A retrospective cohort study was conducted using reliable administrative data from Alberta for a five-year period (2010/11-2014/15)...
March 11, 2017: Diabetes Research and Clinical Practice
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