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https://www.readbyqxmd.com/read/28719604/research-questions-in-pre-hospital-trauma-care
#1
David J Lockey
Noting that a variety of pre-hospital interventions can now be applied to treat traumatic injury, David J Lockey calls for research to determine which of these actually improve survival and reduce morbidity.
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28717775/impact-of-early-coronary-angiography-on-the-survival-to-discharge-after-out-of-hospital-cardiac-arrest
#2
Jikyoung Shin, Eunsil Ko, Won Chul Cha, Tae Rim Lee, Hee Yoon, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong, Jin-Ho Choi
OBJECTIVE: Acute myocardial infarction is a major cause of out-of-hospital cardiac arrest (OHCA). Coronary angiography (CAG) enables diagnostic confirmation of coronary artery disease and subsequent revascularization, which might improve the prognosis of OHCA survivors. Non-randomized data has shown a favorable impact of CAG on prognosis for this population. However, the optimal timing of CAG has been debated. METHODS: The clinical outcomes of 607 OHCA patients registered in CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance), a nationwide multicenter registry performed in 27 hospitals, were analyzed...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28716150/swedish-norwegian-co-operation-in-the-treatment-of-three-hypothermia-victims-a-case-report
#3
Anders Wetting Carlsen, Nils K Skjaervold, Nils Johan Berg, Øystein Karlsen, Eli Gunnarson, Alexander Wahba
BACKGROUND: Accidental hypothermia with cardiac arrest represents a challenge for pre-hospital rescuers as well as in-hospital staff. For pre-hospital personnel, the main focus is to get the patient to the correct destination without unnecessary delay. For in-hospital personnel early information is vital to assess the possibility for resuscitation with extracorporeal re-warming. The challenge is augmented when rescuers must cross national borders to reach and/or deliver the patients. We present a case where three adolescent boys suffered severe hypothermia after a canoeing accident in Sweden...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28715361/trauma-systems-around-the-world-a-systematic-overview
#4
Suzan Dijkink, Charlie Nederpelt, Pieta Krijnen, George C Velmahos, Inger B Schipper
BACKGROUND: Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally. METHODS: The literature review over the period 2000-2016 was conducted following the PRISMA guidelines. Pre-hospital care, acute hospital care and quality assurance were classified using the WHO Trauma System Maturity Index in four levels from I (least mature) to IV (most mature)...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715359/attempting-to-validate-the-over-under-triage-matrix-at-a-level-i-trauma-center
#5
James W Davis, Rachel C Dirks, Lawrence P Sue, Krista L Kaups
BACKGROUND: The Optimal Resources Document (ORD) mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the over/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different and Matrix does not discriminate the needs or outcomes of these different groups of patients...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28712527/clinical-presentation-to-the-emergency-department-predicts-subarachnoid-hemorrhage-associated-myocardial-injury
#6
Khalil M Yousef, Elizabeth Crago, Theodore F Lagattuta, Marilyn Hravnak
INTRODUCTION: Aneurysmal subarachnoid hemorrhage (aSAH) is frequently seen in emergency departments. Secondary injury, such as subarachnoid hemorrhage-associated myocardial injury (SAHMI), affects one third of survivors and contributes to poor outcomes. SAHMI is not attributed to ischemia from myocardial disease but can result in hypotension and arrhythmias. It is important that emergency nurses recognize which clinical presentation characteristics are predictive of SAHMI to initiate proper interventions...
July 13, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28707291/pre-hospital-cardiac-arrest-treated-successfully-with-automated-external-defibrillator
#7
Andrzej Cacko, Marcin Michalak, Eulalia Welk, Grzegorz Opolski, Marcin Grabowski
No abstract text is available yet for this article.
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28705570/la-pose-de-voie-veineuse-p%C3%A3-diatrique-par-les-%C3%A3-quipes-de-smur-adultes
#8
REVIEW
Frédéric Lemoine, Hugues Lefort, Sabine Lemoine, Benoît Frattini, Daniel Jost
Paediatric perfusion during pre-hospital care is a major issue in the event of life-threatening emergencies. Access, often restricted, to backup specialising in paediatrics, implies the existence of practices on protocols for the adult mobile emergency and intensive care service (Smur) in partnership with paediatricians. Paediatric perfusion practices were assessed in these teams. The results show the presence of a paediatric protocol in the adult Smur teams is not very common. Nursing practices seem to be evolving towards the recommendations, thanks to technological advances such as the use of the intraosseous device...
July 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28703047/assessment-of-people-who-have-been-tasered
#9
Matthew Peel
The use of Tasers® by the police is subject to intense scrutiny and controversy. With increasing numbers of police officers carrying Tasers, it is important that nurses in pre-hospital, emergency department and police custody settings understand how Tasers work, and the physiological effects. This article describes Tasers, their mechanisms and physiological effects, and explains how nurses should undertake assessment of people who have been subjected to Taser discharge.
July 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28701204/criteria-and-models-for-the-distribution-of-casualties-in-trauma-related-mass-casualty-incidents-a-systematic-literature-review-protocol
#10
Ali Ardalan, Mohammad Reza Khajehaminian, Sayed Mohsen Hosseini Boroujeni, Amir Nejati, Abbasali Keshtkar, Abbas Rahimi Foroushani, Omid Mahdi Ebadati E
BACKGROUND: One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to present models for the distribution of casualties, no systematic review has yet been conducted to evaluate the existing models on casualty distribution following mass casualty incidents...
July 12, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28697026/smartphone-based-mobile-thermal-imaging-technology-to-assess-limb-perfusion-and-tourniquet-effectiveness-under-normal-and-blackout-conditions
#11
Morgan R Barron, John P Kuckelman, John M McClellan, Michael J Derickson, Cody J Phillips, Shannon T Marko, Joshua P Smith, Matthew J Eckert, Matthew J Martin
BACKGROUND: Over the past decade there has been a resurgence of tourniquet use in civilian and military settings. Several key challenges include assessment of limb perfusion and adequacy of tourniquet placement, particularly in the austere or pre-hospital environments. We investigated the utility of thermal imaging to assess adequacy of tourniquet placement. METHODS: The FLIR ONE™ smartphone-based thermal imager was utilized. Ten swine underwent tourniquet placement with no associated hemorrhage (n=5) or with 40% hemorrhage (n=5)...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28694499/cystatin-d-cst5-an-ultra-early-inflammatory-biomarker-of-traumatic-brain-injury
#12
Lisa J Hill, Valentina Di Pietro, Jon Hazeldine, David Davies, Emma Tomman, Ann Logan, Antonio Belli
Traumatic brain injury (TBI) is set to become the leading cause of neurological disability across all age groups. Currently, no reliable biomarkers exist to help diagnose the severity of TBI to identify patients who are at risk of developing secondary injuries. Thus, the discovery of reliable biomarkers for the management of TBI would improve clinical interventions. Inflammatory markers are particularly suited for biomarker discovery as TBI leads to very early alterations in inflammatory proteins. Using the Proseek Multiplex Inflammation assay, we measured in patients that had suffered mild TBI (n = 10) or severe TBI (n = 10) with extra-cranial injury or extracranial injury only (EC) (n = 10), 92 inflammation-associated proteins in serum obtained: <1 hr (within 1-hour), 4-12 hr and 48-72 hr post injury...
July 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28693491/hypoxia-and-hypotension-in-patients-intubated-by-physician-staffed-helicopter-emergency-medical-services-a-prospective-observational-multi-centre-study
#13
Geir Arne Sunde, Mårten Sandberg, Richard Lyon, Knut Fredriksen, Brian Burns, Karl Ove Hufthammer, Jo Røislien, Akos Soti, Helena Jäntti, David Lockey, Jon-Kenneth Heltne, Stephen J M Sollid
BACKGROUND: The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Several studies describe the impact of pre-hospital hypoxia or hypotension on trauma patients, but few studies compare this in trauma and non-trauma patients...
July 11, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28688610/-materials-for-the-paediatric-resuscitation-trolley-or-backpack-expert-recommendations
#14
Jesús López-Herce Cid, Antonio Rodríguez Núñez, Ángel Carrillo Álvarez, Gonzalo Zeballos Serrato, Cecilia Martínez Fernández-Llamazares, Custodio Calvo Macías
Cardio-respiratory arrest (CPA) is infrequent in children, but it can occur in any place and at any time. This fact means that every health care facility must always have the staff and material ready to resuscitate a child. These recommendations are the consensus of experts of the Spanish Paediatric and Neonatal Resuscitation Group on the material and medication for paediatric and neonatal resuscitation and their distribution and use. CPR trolleys and backpacks must include the essential material to quickly and efficiently perform a paediatric CPR...
July 5, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28687082/experiences-of-inequitable-care-among-afghan-mothers-surviving-near-miss-morbidity-in-tehran-iran-a-qualitative-interview-study
#15
Soheila Mohammadi, Aje Carlbom, Robabeh Taheripanah, Birgitta Essén
BACKGROUND: Providing equitable maternal care to migrants is a seriously challenging task for hosting countries. Iran, the second-most accessed country for refugees from Afghanistan, has achieved maternal health improvement. However, Afghan women with near-miss morbidity faced pre-hospital delays and disparity in maternal care at hospitals. This study explores experiences of maternal care among Afghan women surviving near-miss morbidity to increase insight into healthcare improvements for migrants...
July 7, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28683821/stroke-awareness-among-dubai-emergency-medical-service-staff-and-impact-of-an-educational-intervention
#16
Fatima Shire, Zahra Kasim, Suhail Alrukn, Maria Khan
BACKGROUND: Emergency medical services (EMS) play a vital role in expediting hospital arrival in stroke patients. The objective of our study was to assess the level of awareness regarding pre-hospital identification and management of acute stroke among EMS Staff in Dubai and to evaluate the impact of an educational lecture on their knowledge. METHODS: Ours was a cross-sectional study with a pre-test and post-test design. The intervention was an educational lecture, based on the updated guidelines in pre-hospital care of acute stroke...
July 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28680866/the-effect-of-start-triage-education-on-knowledge-and-practice-of-emergency-medical-technicians-in-disasters
#17
Mahboub Pouraghaei, Jaafar Sadegh Tabrizi, Payman Moharamzadeh, Rozbeh Rajaei Ghafori, Farzad Rahmani, Baharak Najafi Mirfakhraei
Introduction: Pre-hospital triage is one of the most fundamental concepts in emergency management. Limited human resource changes triage to an inevitable solution in the management of disasters. The aim of this study was to evaluate the role of education of simple triage and rapid treatment (START) in the knowledge and practice of Emergency Medical Service (EMS) employees of Eastern Azerbaijan. Methods: This is a pre-and post-intervention study conducted on two hundred and five (205) of employees of EMS sector, in the disaster and emergency management center of Eastern Azerbaijan Province, 2015...
June 2017: Journal of Caring Sciences
https://www.readbyqxmd.com/read/28676296/contributing-factors-of-frequent-use-of-the-emergency-department-a-synthesis
#18
REVIEW
Timothy R Burns
INTRODUCTION: Overcrowding in emergency departments is an issue that has a negative impact worldwide. As attendance in emergency departments has increased, the ability to provide critical services to patients suffering from actual medical emergencies in a timely manner has decreased as these departments are many times at or over capacity. One patient population whose negative influence has been researched with regard to their impact on the overcrowding issue is that of the frequent user...
July 1, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28673321/open-chest-versus-closed-chest-cardiopulmonary-resuscitation-in-blunt-trauma-analysis-of-a-nationwide-trauma-registry
#19
Akira Endo, Atsushi Shiraishi, Yasuhiro Otomo, Makoto Tomita, Hiroki Matsui, Kiyoshi Murata
BACKGROUND: Although open-chest cardiopulmonary resuscitation (OCCPR) is often considered as the last salvage maneuver in critically injured patients, evidence on the effectiveness of OCCPR has been based only on the descriptive studies of limited numbers of cases or expert opinions. This study aimed to compare the effectiveness of OCCPR with that of closed-chest cardiopulmonary resuscitation (CCCPR) in an emergency department (ED). METHODS: A nationwide registry-based, retrospective cohort study was conducted...
July 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28670809/inaccurate-diagnosis-of-paediatric-anaphylaxis-in-three-australian-emergency-departments
#20
Hector Thomson, Robert Seith, Simon Craig
AIM: To determine the accuracy of emergency department (ED) paediatric anaphylaxis diagnosis, and to identify factors associated with misdiagnosis. METHODS: Retrospective chart review of children aged 0-18 years with allergic presentations to three Victorian EDs in 2014. Cases were included if an ED diagnosis of anaphylaxis was recorded, or the presentation met international consensus criteria for anaphylaxis. RESULTS: Of the 60 143 paediatric ED presentations during the study period, 1551 allergy-related presentations were identified and reviewed...
July 2017: Journal of Paediatrics and Child Health
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