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Prehospital Airway

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https://www.readbyqxmd.com/read/27879534/physician-provided-prehospital-critical-care-effect-on-patient-physiology-dynamics-and-on-scene-time
#1
Bjørn O Reid, Marius Rehn, Oddvar Uleberg, Andreas J Krüger
INTRODUCTION: Improved physiologic status can be seen as a surrogate measure of improved outcome and a field-friendly prognostic model such as the Mainz Emergency Evaluation Score (MEES) could quantify the effect on physiological response. We aim to examine the dynamic physiological profile as measured by this score on patients managed by physician-manned helicopter emergency medical services and how this profile was related to on-scene time expenditure and critical care interventions...
November 22, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27870588/assessment-of-paramedic-performance-on-difficult-airway-simulation
#2
Ashish R Panchal, Geoffrey Finnegan, David P Way, Thomas Terndrup
OBJECTIVE: Airway management is a common, important intervention for critically ill patients in the United States. A key element of prehospital airway management is endotracheal intubation (ETI). Prehospital ETI success rates have been shown to be as low as 77% compared to in-hospital rates of 95%. Given these rates, the use of backup airway devices is a necessary precaution for patient safety. The extent to which paramedics integrate backup airway use into their airway algorithm is unknown...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27775982/evaluating-pre-burn-center-intubation-practices-an-update
#3
Anthony R Cai, Erica I Hodgman, Puneet B Kumar, Alvand J Sehat, Alexander L Eastman, Steven E Wolf
A significant proportion of patients appeared to arrive at our American Burn Association-verified burn center intubated without clear benefit. The current study aims to evaluate regional prehospital intubation practices and their outcomes. All consecutive admissions from November 2012 to June 2014 were reviewed for data points associated with intubation. Demographics and outcomes for patients who were intubated before arrival or within 24 hours of admission were compared using χ, Fisher's exact test, and the Kruskal-Wallis test as appropriate...
October 17, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27742522/use-and-implementation-of-standard-operating-procedures-and-checklists-in-prehospital-emergency-medicine-a-literature-review
#4
Chulin Chen, Ting Kan, Shuang Li, Chen Qiu, Li Gui
OBJECTIVES: This review aimed to analyze published literature to introduce the use and implementation of standard operating procedures (SOPs) and checklists in prehospital emergency medicine and their impact on guideline adherence and patient outcome. METHODS: An English literature search was carried out using the Cochrane Library, MEDLINE, EMBASE, Springer, Elsevier, and ProQuest databases. Original articles describing the use and implementation of SOPs or checklists in prehospital emergency medicine were included...
September 28, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27724976/prehospital-treatment-with-continuous-positive-airway-pressure-in-patients-with-acute-respiratory-failure-a-regional-observational-study
#5
Vibe Maria Laden Nielsen, Jacob Madsen, Anette Aasen, Anne Pernille Toft-Petersen, Kenneth Lübcke, Bodil Steen Rasmussen, Erika Frischknecht Christensen
BACKGROUND: Patients with acute respiratory failure are at risk of deterioration during prehospital transport. Ventilatory support with continuous positive airway pressure (CPAP) can be initiated in the prehospital setting. The objective of the study is to evaluate adherence to treatment and effectiveness of CPAP as an addition to standard care. METHODS: In North Denmark Region, patients with acute respiratory failure, whom paramedics assessed as suffering from acute cardiopulmonary oedema, acute exacerbation of chronic obstructive pulmonary disease or asthma were treated with CPAP using 100 % O2 from 1 March 2014 to 3 May 2015...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27700196/pediatric-blunt-neck-trauma-causing-esophageal-and-complete-tracheal-transection
#6
Benjamin Nicholson, Harinder Dhindsa, Louis Seay
BACKGROUND: Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources. CASE SUMMARY: The case presented here involves a clothesline injury to a pediatric patient that resulted in complete tracheal transection and partial esophageal transection...
October 4, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27694275/effect-of-cricoid-pressure-on-laryngeal-view-during-prehospital-tracheal-intubation-a-propensity-based-analysis
#7
Emmanuel Caruana, Sylvie Chevret, Romain Pirracchio
BACKGROUND: The benefit of cricoid pressure during tracheal intubation is still debated and, due to its potential negative impact on laryngeal views, its routine use is questioned. The goal of this study was to estimate its impact on laryngeal view. METHODS: All patients intubated in the prehospital setting were included. Three different propensity score (PS) models were used and compared in terms of the balance achieved between those patients who received cricoid pressure and those who did not...
September 30, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27690714/can-ems-providers-provide-appropriate-tidal-volumes-in-a-simulated-adult-sized-patient-with-a-pediatric-sized-bag-valve-mask
#8
Jeffrey Siegler, Melissa Kroll, Susan Wojcik, Hawnwan Philip Moy
INTRODUCTION: In the prehospital setting, Emergency Medical Services (EMS) professionals rely on providing positive pressure ventilation with a bag-valve-mask (BVM). Multiple emergency medicine and critical care studies have shown that lung-protective ventilation protocols reduce morbidity and mortality. Our primary objective was to determine if a group of EMS professionals could provide ventilations with a smaller BVM that would be sufficient to ventilate patients. Secondary objectives included 1) if the pediatric bag provided volumes similar to lung-protective ventilation in the hospital setting and 2) compare volumes provided to the patient depending on the type of airway (mask, King tube, and intubation)...
October 3, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27650719/tracheal-malplacement-of-the-king-lt-airway-may-be-an-important-cause-of-prehospital-device-failure
#9
Brian E Driver, David Plummer, William Heegaard, Robert F Reardon
BACKGROUND: The King LT airway (King Systems, Noblesville, IN) is a popular extraglottic device that is widely used in the prehospital setting. We report a case of tracheal malplacement of the King airway with a severe kink in the distal tube. CASE REPORT: A 51-year-old unhelmeted motorcyclist collided with a freeway median and was obtunded when paramedics arrived. After bag mask ventilation, a King airway was placed uneventfully and the patient was transported to the emergency department...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27646281/collective-review-of-the-status-of-rapid-sequence-intubation-drugs-of-choice-in-trauma-in-low-and-middle-income-settings-prehospital-emergency-department-and-operating-room-setting
#10
Leressè Pillay, Timothy Hardcastle
INTRODUCTION: Establishing a definitive airway in order to ensure adequate ventilation and oxygenation is an important aspect of resuscitation of the polytrauma patient . AIM: To review the relevant literature that compares the different drugs used for rapid sequence intubation (RSI) of trauma patients, specifically reviewing: premedication, induction agents and neuromuscular blocking agents across the prehospital, emergency department and operating room setting, and to present the best practices based on the reviewed evidence...
September 19, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27637440/the-effect-of-prehospital-intubation-on-treatment-times-in-patients-with-suspected-traumatic-brain-injury
#11
Joshua D Lansom, Kate Curtis, Helen Goldsmith, Alex Tzannes
OBJECTIVE: This study examines whether, in patients requiring intubation with moderate to severe traumatic brain injury (TBI), prehospital intubation compared with emergency department intubation leads to a reduction in treatment times and time to a computed tomographic (CT) scan. METHODS: A retrospective cohort study compared adult patients with a Glasgow Coma Score of less than 14 with a suspected TBI who underwent intubation, either prehospital or on arrival to the emergency department...
September 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27592723/2016-emergency-medical-services-annotated-literature-in-review
#12
Jose V Nable, Benjamin J Lawner, William J Brady
In the daily practice of emergency medicine, physicians constantly interact with components of emergency medical services systems. The provision of high-quality care in the prehospital setting requires emergency physicians to remain abreast of recent literature that may inform the care of patients prior to their arrival at the emergency department. This literature review will examine some recent trends in the prehospital literature. In addition, the review will highlight important areas of clinical practice which represent some of the many intersections between emergency medicine and emergency medical services such as cardiac arrest and airway management...
July 19, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27571279/advanced-prehospital-airway-management-in-patients-with-traumatic-brain-injury
#13
François-Xavier Duchateau, Matthew Beardmore, Tobias Gauss, Sebastian Pease
No abstract text is available yet for this article.
October 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27559978/safety-and-feasibility-of-the-rhinochill-immediate-transnasal-evaporative-cooling-device-during-out-of-hospital-cardiopulmonary-resuscitation-a-single-center-observational-study
#14
Marie-Sophie Grave, Fritz Sterz, Alexander Nürnberger, Stergios Fykatas, Mathias Gatterbauer, Albert Friedrich Stättermayer, Andreas Zajicek, Reinhard Malzer, Dieter Sebald, Raphael van Tulder
We investigated feasibility and safety of the RhinoChill (RC) transnasal cooling system initiated before achieving a protected airway during cardiopulmonary resuscitation (CPR) in a prehospital setting.In out-of-hospital cardiac arrest (OHCA), transnasal evaporative cooling was initiated during CPR, before a protected airway was established and continued until either the patient was declared dead, standard institutional systemic cooling methods were implemented or cooling supply was empty. Patients were monitored throughout the hypothermia period until either death or hospital discharge...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27530816/creation-and-validation-of-a-novel-mobile-simulation-laboratory-for-high-fidelity-prehospital-difficult-airway-simulation
#15
Jason J Bischof, Ashish R Panchal, Geoffrey I Finnegan, Thomas E Terndrup
UNLABELLED: Introduction Endotracheal intubation (ETI) is a complex clinical skill complicated by the inherent challenge of providing care in the prehospital setting. Literature reports a low success rate of prehospital ETI attempts, partly due to the care environment and partly to the lack of consistent standardized training opportunities of prehospital providers in ETI. Hypothesis/Problem The availability of a mobile simulation laboratory (MSL) to study clinically critical interventions is needed in the prehospital setting to enhance instruction and maintain proficiency...
October 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27517801/prehospital-ketamine-is-a-safe-and-effective-treatment-for-excited-delirium-in-a-community-hospital-based-ems-system
#16
Thomas R Scaggs, David M Glass, Megan Gleason Hutchcraft, William B Weir
Excited delirium syndrome (ExDS) is defined by marked agitation and confusion with sympathomimetic surge and incessant physical struggle, despite futility, which may lead to profound pathophysiologic changes and sudden death. Severe metabolic derangements, including lactic acidosis, rhabdomyolysis, and hyperthermia, occur. The pathophysiology of excited delirium is a subject of ongoing basic science and clinical research. Positive associations with ExDS include male gender, mental health disorders, and substance abuse (especially sympathomimetics)...
October 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27503061/the-role-of-prehospital-advanced-airway-management-on-outcomes-for-out-of-hospital-cardiac-arrest-patients-a-meta-analysis
#17
Seungmin Jeong, Ki Ok Ahn, Sang Do Shin
OBJECTIVE: The objective of this meta-analysis was to compare the benefits of prehospital advanced airway management (AAM) and basic airway management (BAM) for out-of-hospital cardiac arrest (OHCA) patients. METHODS: Two investigators performed a systematic review of PubMed, EMBASE, and the Cochrane Database to identify all peer-reviewed articles relevant to this meta-analysis. We included all articles describing emergency medical system-treated nontraumatic OHCAs; specifically, all articles that described intervention of the prehospital AAM type were considered...
July 19, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27492275/emergency-medical-service-providers-perspectives-towards-management-of-the-morbidly-obese
#18
John J Cienki
OBJECTIVE: Obesity is a growing epidemic in the United States with increasing burden to the health care system. Management and transport of the morbidly obese (MO) pose challenges for Emergency Medical Services (EMS) providers. Though equipment and resources are being directed to the transport of the obese, little research exists to guide these efforts. To address this, the author of this study sought to assess EMS providers' perspectives on the challenges of caring for MO patients. METHODS: An anonymous, web-based survey was distributed to all active providers of prehospital transport of a large, urban, fire-based EMS system to evaluate the challenges of MO patients...
October 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27436455/barriers-and-facilitators-to-recognition-and-reporting-of-child-abuse-by-prehospital-providers
#19
Gunjan Kamdar Tiyyagura, Marcie Gawel, Aimee Alphonso, Jeannette Koziel, Kyle Bilodeau, Kirsten Bechtel
BACKGROUND: Prehospital care providers are in a unique position to provide initial unadulterated information about the scene where a child is abusively injured or neglected. However, they receive minimal training with respect to detection of Child Abuse and Neglect (CAN) and make few reports of suspected CAN to child protective services. AIMS: To explore barriers and facilitators to the recognition and reporting of CAN by prehospital care providers. DESIGN/METHODS: Twenty-eight prehospital care providers participated in a simulated case of infant abusive head trauma prior to participating in one-on-one semi-structured qualitative debriefs...
July 19, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27331580/the-effects-of-pediatric-advanced-life-support-guidelines-on-pediatric-trauma-airway-management
#20
Jana Sperka, Sheila J Hanson, Raymond G Hoffmann, Mahua Dasgupta, Michael T Meyer
OBJECTIVE: Recent Pediatric Advanced Life Support (PALS) guidelines have deemphasized the use of advanced airways in short transport. It is unclear if guideline recommendations have altered practice. We sought to determine if a temporal change exists in the number of prehospital pediatric trauma intubations since the 2005 PALS guidelines update. METHODS: This is an institutional review board-approved, retrospective, single-center study. Reviewed all pediatric trauma activations where patients younger than 19 years were intubated at the scene, en route or at the level 1 trauma center during 2006 to 2011...
August 2016: Pediatric Emergency Care
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