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https://www.readbyqxmd.com/read/28004310/high-body-mass-index-and-use-of-fentanyl-iontophoretic-transdermal-system-in-postoperative-pain-management-results-of-a-pooled-analysis-of-six-phase-3-3b-trials
#1
Eugene R Viscusi, Li Ding, J Bradley Phipps, Loretta M Itri, Philip R Schauer
INTRODUCTION: Postoperative pain management can be challenging in patients with a high body mass index (BMI) especially as a result of poor venous access and delayed ambulation that can result in serious complications. Fentanyl iontophoretic transdermal system (ITS) is a needle-free, patient-controlled analgesic method available for use in acute postoperative pain. The primary objective of these analyses was to determine if there were any differences between patients with high BMI (>40 kg/m(2)) and lower BMIs (<30 kg/m(2) and 35-40 kg/m(2)) in terms of efficacy or safety...
December 21, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27940625/effect-of-the-number-of-request-calls-on-the-time-from-call-to-hospital-arrival-a-cross-sectional-study-of-an-ambulance-record-database-in-nara-prefecture-japan
#2
Nao Hanaki, Kazuto Yamashita, Susumu Kunisawa, Yuichi Imanaka
OBJECTIVES: In Japan, ambulance staff sometimes must make request calls to find hospitals that can accept patients because of an inadequate information sharing system. This study aimed to quantify effects of the number of request calls on the time interval between an emergency call and hospital arrival. DESIGN AND SETTING: A cross-sectional study of an ambulance records database in Nara prefecture, Japan. CASES: A total of 43 663 patients (50% women; 31...
December 9, 2016: BMJ Open
https://www.readbyqxmd.com/read/27938469/the-birth-and-growth-of-the-national-ambulance-service-in-ghana
#3
Ahmed Zakariah, Barclay T Stewart, Edmund Boateng, Christiana Achena, Gavin Tansley, Charles Mock
: Introduction This study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified. METHODS: Data routinely collected by the Ghana NAS from 2004-2014 were described, including: patient demographics, reason for the call, response location, target destination, and ti1mes of service...
December 12, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27919173/carbon-monoxide-poisoning-during-camping-in-korea
#4
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 2016: Inhalation Toxicology
https://www.readbyqxmd.com/read/27897380/lived-experience-of-involuntary-transport-under-mental-health-legislation
#5
Joanne Bradbury, Marie Hutchinson, John Hurley, Helen Stasa
Police have historically been responsible for transporting people during a mental health crisis in Australia. A major change to the New South Wales (NSW) Mental Health Act (MHA) in 2007 expanded the range of coercive transportation agencies to include NSW Ambulance (paramedics) and NSW Health (mental health nurses). Anecdotal reports, however, describe a lack of clarity around how these changes should be implemented in practice. This research aims to explore this lack of clarity through qualitative analysis of interviews with people with the lived experience of involuntary transport under the MHA...
November 29, 2016: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/27890031/a-national-assessment-of-the-health-and-safety-of-emergency-medical-services-professionals
#6
Melissa A Bentley, Roger Levine
OBJECTIVES: The objectives were to assess changes in (1) health and physical fitness, (2) the prevalence of selected health problems, (3) risk behaviors, (4) ambulance safety issues, and (5) the preparedness of Emergency Medical Services (EMS) professionals. In addition, the incidence of patient-initiated violence directed toward EMS personnel and associated factors were assessed. METHODS: Data were obtained from a sample of nationally certified EMS professionals via annual questionnaires between 1999 and 2008...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27852453/current-use-and-outcomes-of-helicopter-transport-in-pediatric-trauma-a-review-of-18-291-transports
#7
Brian R Englum, Kristy L Rialon, Jina Kim, Mark L Shapiro, John E Scarborough, Henry E Rice, Obinna O Adibe, Elisabeth T Tracy
PURPOSE: The role of helicopter emergency medical services (HEMS) in pediatric trauma remains controversial. We examined its use in pediatric trauma and its effectiveness in children with moderate/severe injuries. METHODS: All blunt/penetrating trauma patients ≤18years old in the National Trauma Data Bank were evaluated for use of HEMS and in-hospital mortality. In a comparative effectiveness study, only patients treated at level I/II pediatric centers with injury severity score (ISS)≥9 were included...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27842598/exploratory-analysis-of-real-personal-emergency-response-call-conversations-considerations-for-personal-emergency-response-spoken-dialogue-systems
#8
Victoria Young, Elizabeth Rochon, Alex Mihailidis
BACKGROUND: The purpose of this study was to derive data from real, recorded, personal emergency response call conversations to help improve the artificial intelligence and decision making capability of a spoken dialogue system in a smart personal emergency response system. The main study objectives were to: develop a model of personal emergency response; determine categories for the model's features; identify and calculate measures from call conversations (verbal ability, conversational structure, timing); and examine conversational patterns and relationships between measures and model features applicable for improving the system's ability to automatically identify call model categories and predict a target response...
November 14, 2016: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/27833678/telehealth-enabled-emergency-medical-services-program-reduces-ambulance-transport-to-urban-emergency-departments
#9
James R Langabeer, Michael Gonzalez, Diaa Alqusairi, Tiffany Champagne-Langabeer, Adria Jackson, Jennifer Mikhail, David Persse
INTRODUCTION: Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system's capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27747560/the-epidemiology-of-pre-hospital-potential-spinal-cord-injuries-in-victoria-australia-a-six-year-retrospective-cohort-study
#10
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27737641/dispatch-guideline-adherence-and-response-interval-a-study-of-emergency-medical-calls-in-norway
#11
Eirin N Ellensen, Torben Wisborg, Steinar Hunskaar, Erik Zakariassen
BACKGROUND: The Emergency Medical Communication Centre (EMCC) operators in Norway report using the Norwegian Index for Medical Emergency Assistance (Index), a criteria-based dispatch guideline, in about 75 % of medical emergency calls. The main purpose of a dispatch guideline is to assist the operator in securing a correct response as quickly as possible. The effect of using the guideline on EMCC response interval is as yet unknown. We wanted to ascertain an objective measure of guideline adherence, and explore a possible effect on emergency medical dispatch (EMD) response interval...
October 13, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27733928/health-and-rescue-services-management-system-during-a-crisis-event
#12
Efthyvoulos Kyriacou, Iolie Nicolaidou, George Hadjichristofi, Stelios Kyprianou, Synesios Christou, Riana Constantinou
Τhe performance of rescuers and personnel handling major emergencies or crisis events can be significantly improved through continuous training and through technology support. The work done in order to create a system has been discussed which can support both resources and victims during a crisis or major emergency event. More specifically, the system supports real-time management of firefighter teams, rescue teams, health services, and victims during a major disaster. It can be deployed in an ad hoc manner in the disaster area, as a stand-alone infrastructure (using its own telecommunications and power)...
September 2016: Healthcare Technology Letters
https://www.readbyqxmd.com/read/27732713/evaluation-of-rural-vs-urban-trauma-patients-served-by-9-1-1-emergency-medical-services
#13
Craig D Newgard, Rongwei Fu, Eileen Bulger, Jerris R Hedges, N Clay Mann, Dagan A Wright, David P Lehrfeld, Carol Shields, Gregory Hoskins, Craig Warden, Lynn Wittwer, Jennifer N B Cook, Michael Verkest, William Conway, Stephanie Somerville, Matthew Hansen
Importance: Despite a large rural US population, there are potential differences between rural and urban regions in the processes and outcomes following trauma. Objectives: To describe and evaluate rural vs urban processes of care, injury severity, and mortality among injured patients served by 9-1-1 emergency medical services (EMS). Design, Setting, and Participants: This was a preplanned secondary analysis of a prospective cohort enrolled from January 1 through December 31, 2011, and followed up through hospitalization...
October 12, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27726972/emergency-nursing-workload-and-patient-dependency-in-the-ambulance-bay-a-prospective-study
#14
Wayne Varndell, Elizabeth Ryan, Alison Jeffers, Nadya Marquez-Hunt
AIM: The purpose of this prospective observational study was to characterise patients occupying the ambulance bay and to determine the ensuing nursing workload. BACKGROUND: The number of patients presenting to ED by ambulance is increasing. During periods of peak demand and access block in the ED, patients with ongoing care needs, requiring continual assessment and symptom management by emergency nurses can remain in the ambulance bay for extended periods of time...
October 7, 2016: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/27630459/epidemiology-of-traumatic-cardiac-arrest-in-patients-presenting-to-emergency-department-at-a-level-1-trauma-center
#15
Sanjeev Bhoi, Prakash Ranjan Mishra, Kapil Dev Soni, Upendra Baitha, Tej Prakash Sinha
INTRODUCTION: There is a paucity of literature on prehospital care and epidemiology of traumatic cardiac arrest (TCA) in India. This study highlights the profile and characteristics of TCA. METHODS: A retrospective cohort study was conducted to study epidemiological profile of TCA patients ≥1 year presenting to a level 1 trauma center of India. RESULTS: One thousand sixty-one patients were recruited in the study. The median age (interquartile range) was 32 (23-45) years (male:female ratio of 5...
August 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27614946/electrocardiographic-indicators-of-acute-coronary-syndrome-are-more-common-in-patients-with-ambulance-transport-compared-to-those-who-self-transport-to-the-emergency-department-journal-of-electrocardiology
#16
Jessica K Zègre-Hemsey, David Pickham, Michele M Pelter
INTRODUCTION: The American Heart Association recommends individuals with symptoms suggestive of acute coronary syndrome (ACS) activate the Emergency Medical Services' (EMS) 911 system for ambulance transport to the emergency department (ED), which enables treatment to begin prior to hospital arrival. Despite this recommendation, the majority of patients with symptoms suspicious of ACS continue to self-transport to the ED. The IMMEDIATE AIM study was a prospective study that enrolled individuals who presented to the ED with ischemic symptoms...
November 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27596837/when-chronic-conditions-become-emergencies-a-report-from-regional-queensland
#17
Linton R Harriss, Fintan Thompson, Arindam Dey, Jane Mills, Kerrianne Watt, Robyn McDermott
OBJECTIVE: To describe chronic conditions and injuries as a proportion of total emergency presentations to a large public hospital in regional Queensland, and to investigate differences in presentation rates associated with Indigenous status. DESIGN: Cross-sectional analysis using Emergency Department Information System data between 1 July 2012 and 30 June 2014. SETTING: Regional Queensland, Australia. PARTICIPANTS: A total of 95 238 emergency presentations were generated by 50 083 local residents living in the 10 statistical local areas (SLAs) immediately around the hospital...
December 2016: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/27547282/geospatial-and-clinical-analyses-on-pediatric-related-road-traffic-injury-in-malaysia
#18
Nik Hisamuddin Rahman, Ruslan Rainis, Syed Hatim Noor, Sharifah Mastura Syed Mohamad
BACKGROUND: The main aim of this study is to utilize the geographical information system (GIS) software and perform the spatial analysis in relation to clinical data for road traffic injury (RTI) pediatric cases attending the emergency department. METHODS: The study sample included pediatric patients (age less than 18 years) with road-related injuries within a district in Malaysia who attended emergency departments of two tertiary hospitals within the district. In addition to injury, pre-hospital care and outcome data, the coordinate of the locations were obtained by the ambulance paramedics by using portable handheld GPS unit brand Garmin(®) model GPS 72 H...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27546753/crossing-the-handover-chasm-clinicians-perceptions-of-barriers-to-the-early-detection-and-timely-management-of-severe-sepsis-and-septic-shock
#19
Claudia T Matthaeus-Kraemer, Daniel O Thomas-Rueddel, Daniel Schwarzkopf, Hendrik Rueddel, Bernhard Poidinger, Konrad Reinhart, Frank Bloos
PURPOSE: The purpose was to identify barriers to the early detection and timely management of severe sepsis throughout the emergency department (ED), general ward (GW), intermediate care unit (IMC), and the intensive care unit (ICU). MATERIALS AND METHODS: Five multicenter focus group discussions with 29 clinicians were conducted. Discussions were based on a moderation guide were recorded and transcribed. Qualitative analysis was performed according to the principles of the concept mapping method and the framework approach...
July 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27531051/muscle-redox-disturbances-and-oxidative-stress-as-pathomechanisms-and-therapeutic-targets-in-early-onset-myopathies
#20
Maryline Moulin, Ana Ferreiro
Because of their contractile activity and their high oxygen consumption and metabolic rate, skeletal muscles continually produce moderate levels of reactive oxygen and nitrogen species (ROS/RNS), which increase during exercise and are buffered by multiple antioxidant systems to maintain redox homeostasis. Imbalance between ROS/RNS production and elimination results in oxidative stress (OxS), which has been implicated in aging and in numerous human diseases, including cancer, diabetes or age-related muscle loss (sarcopenia)...
August 12, 2016: Seminars in Cell & Developmental Biology
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