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https://www.readbyqxmd.com/read/29224237/major-haemorrhage-fatalities-in-the-australian-national-coronial-database
#1
Jacob S Gipson, Erica M Wood, Merrole F Cole-Sinclair, Zoe McQuilten, Neil Waters, Noel W Woodford
OBJECTIVE: The aim of the study is to describe the epidemiology of major bleeding fatalities. METHODS: A case series analysis of Australia's National Coronial Information System was conducted. Keywords were used to search for closed cases of major haemorrhage in the state of Victoria for the period 1 January 2009 to 31 December 2011. Coroners' findings, autopsy reports and police reports of cases were reviewed. Demographic data were extracted, and cases were assigned to a clinical bleeding context...
December 10, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29218822/european-academy-of-neurology-european-stroke-organisation-consensus-statement-and-practical-guidance-for-pre-hospital-management-of-stroke
#2
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
Reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving chances of a favorable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations...
December 7, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29214444/the-respiratory-rate-a-neglected-triage-tool-for-pre-hospital-identification-of-trauma-patients
#3
John D Yonge, Phillip Kemp Bohan, Justin J Watson, Christopher R Connelly, Lynn Eastes, Martin A Schreiber
BACKGROUND: Under-triaged trauma patients have worse clinical outcomes. We evaluated the capability of four pre-hospital variables to identify this population at the lowest level trauma activation (level 3). METHODS: A retrospective review of adult trauma activations from 2004 to 2014 was completed. Pre-hospital vital signs and Glasgow Coma Scale were converted to categorical variables. Patients were under-triaged based on meeting current level 1 or 2 criteria, or requiring a pre-defined critical intervention...
December 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29207756/intravenous-fluid-administration-and-the-survival-of-pre-hospital-resuscitated-out-of-hospital-cardiac-arrest-patients-in-thailand
#4
Phichet Nongchang, Wongsa Laohasiri Wong, Somsak Pitaksanurat, Pairoj Boonsirik Amchai
Introduction: Out of Hospital Cardiac Arrest (OHCA) is a leading cause of death worldwide. The Emergency Medical Service (EMS) provides early care to critical OHCA patients. Pre hospital intervention has been improving OHCA survival rate, however it is still unclear for the recommendation of routine infusion of Intravenous (IV) fluids during cardiac arrest resuscitation. Aim: This study aimed to determine whether IV fluid administration was associated with increasing survival of resuscitated OHCA patients and to assess the survival rate of resuscitated OHCA patients...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29198733/virtual-medicine-utilization-of-the-advanced-cardiac-imaging-patient-avatar-for-procedural-planning-and-facilitation
#5
REVIEW
Jerold S Shinbane, Leslie A Saxon
Advances in imaging technology have led to a paradigm shift from planning of cardiovascular procedures and surgeries requiring the actual patient in a "brick and mortar" hospital to utilization of the digitalized patient in the virtual hospital. Cardiovascular computed tomographic angiography (CCTA) and cardiovascular magnetic resonance (CMR) digitalized 3-D patient representation of individual patient anatomy and physiology serves as an avatar allowing for virtual delineation of the most optimal approaches to cardiovascular procedures and surgeries prior to actual hospitalization...
November 16, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29193548/rephill-protocol-for-a-randomised-controlled-trial-of-pre-hospital-blood-product-resuscitation-for-trauma
#6
I M Smith, N Crombie, J R Bishop, A McLaughlin, D N Naumann, M Herbert, J M Hancox, G Slinn, N Ives, M Grant, G D Perkins, H Doughty, M J Midwinter
OBJECTIVES: To describe the 'Resuscitation with Pre-HospItaL bLood products' trial (RePHILL) - a multi-centre randomised controlled trial of pre-hospital blood product (PHBP) administration vs standard care for traumatic haemorrhage. BACKGROUND: PHBP are increasingly used for pre-hospital trauma resuscitation despite a lack of robust evidence demonstrating superiority over crystalloids. Provision of PHBP carries additional logistical and regulatory implications, and requires a sustainable supply of universal blood components...
November 28, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29191378/patients-with-head-trauma-a-study-on-initial-prehospital-assessment-and-care
#7
Rebecka Rubenson Wahlin, Veronica Lindström, Sari Ponzer, Veronica Vicente
BACKGROUND: Best evidence guidelines are intended to standardise assessment and treatment of patients with head trauma and improve outcomes for TBI patients. The primary aim was to explore pre-hospital emergency care nurses' (PECNs') documented assessment and care of patients with head trauma and the secondary aim to study gender differences in the documented care and interventions given by the PECNs. METHODS: A retrospective observational study was conducted by evaluating 2750 prehospital medical records...
November 27, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29190808/the-validity-of-linear-and-non-linear-heart-rate-metrics-as-workload-indicators-of-emergency-physicians
#8
Frederick Schneider, Jan Martin, Alexander Hapfelmeier, Denis Jordan, Gerhard Schneider, Christian M Schulz
BACKGROUND: It has been shown that linear and non-linear heart rate variability (HRV) metrics are suitable to assess workload of anesthetists administering anesthesia. In pre-hospital emergency care, these parameters have not yet been evaluated. We hypothesized that heart rate (HR) and HRV metrics discriminate between differing workload levels of an emergency physician. METHODS: Electrocardiograms were obtained from 13 emergency physicians. Mean HR, ten linear and seven non-linear HRV metrics were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/29190257/the-trauma-center-is-too-late-major-limb-trauma-without-a-pre-hospital-tourniquet-has-increased-death-from-hemorrhagic-shock
#9
Michelle H Scerbo, John B Holcomb, Ethan Taub, Keith Gates, Joseph D Love, Charles E Wade, Bryan A Cotton
BACKGROUND: To date, no civilian studies have demonstrated that pre-hospital (PH) tourniquets improve survival. We hypothesized that late, trauma center (TC) tourniquet use would increase death from hemorrhagic shock compared to early (PH) placement. METHODS: All patients arriving to a Level 1, urban TC between October 2008 and January 2016 with a tourniquet placed before (T-PH) or after arrival to the TC (T-TC) were evaluated. Cases were assigned the following designations: indicated (absolute indication [vascular injury requiring repair/ligation, operation within 2 hours for extremity injury, or traumatic amputation] or relative indication [major musculoskeletal/soft tissue injury requiring operation 2-8 hours after arrival, documented large blood loss]) or non-indicated...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29186485/indications-and-practical-approach-to-non-invasive-ventilation-in-acute-heart-failure
#10
Josep Masip, W Frank Peacock, Susanna Price, Louise Cullen, F Javier Martin-Sanchez, Petar Seferovic, Alan S Maisel, Oscar Miro, Gerasimos Filippatos, Christiaan Vrints, Michael Christ, Martin Cowie, Elke Platz, John McMurray, Salvatore DiSomma, Uwe Zeymer, Hector Bueno, Chris P Gale, Maddalena Lettino, Mucio Tavares, Frank Ruschitzka, Alexandre Mebazaa, Veli-Pekka Harjola, Christian Mueller
In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure...
November 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29183635/hypothermia-indices-among-severely-injured-trauma-patients-undergoing-urgent-surgery-a-single-centred-retrospective-quality-review-and-analysis
#11
A Alam, Rafael Olarte, Jeannie Callum, Arsham Fatahi, B Nascimento, Claude Laflamme, Robert Cohen, Avery B Nathens, Homer Tien
BACKGROUND: Hypothermia (<36°C) exacerbates trauma-induced coagulopathy and worsens morbidity and mortality among severely injured trauma patients; there is a paucity of published data describing how well trauma centres adhere to standards regarding measurement of temperature, and best practices for preventing and treating hypothermia. METHODS: We completed a retrospective quality audit of all severely injured trauma patients (Injury Severity Score (ISS≥20)) who had urgent surgery at Sunnybrook Health Sciences Centre (SHSC) between 2010 and 2014...
November 23, 2017: Injury
https://www.readbyqxmd.com/read/29181655/the-organisation-of-the-acute-ischemic-stroke-management-key-notes-of-the-italian-neurological-society-and-of-the-italian-stroke-organization
#12
E Agostoni, A Carolei, G Micieli, L Provinciali, D Toni, Simone Vidale
The main aim of acute ischemic stroke treatment is the as much possible prompt, safe and effective arterial recanalisation, in order to restore reperfusion into the ischemic brain area. The procedures obtaining this result are rapidly evolving and in the last years, we observed new evidences that affirmed the therapeutical benefit of the concomitant treatment using endovenous thrombolysis and mechanical thrombectomy in selected patients with ischemic stroke. However, all treatments are time-sensitive and the main limitation for their application is represented by the time...
November 27, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/29177178/factors-affecting-the-location-of-road-emergency-bases-in-iran-using-analytical-hierarchy-process-ahp
#13
Mohammadkarim Bahadori, Ahmad Hajebrahimi, Khalil Alimohammadzadeh, Ramin Ravangard, Seyed Mojtaba Hosseini
Objective: To identify and prioritize factors affecting the location of road emergency bases in Iran using Analytical Hierarchy Process (AHP). Methods: This was a mixed method (quantitative-qualitative) study conducted in 2016. The participants in this study included the professionals and experts in the field of pre-hospital and road emergency services issues working in the Health Deputy of Iran Ministry of Health and Medical Education, which were selected using purposive sampling method...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29172657/effects-of-targeted-temperature-management-on-mortality-and-neurological-outcome-a-systematic-review-and-meta-analysis
#14
Dylan Stanger, Vesna Mihajlovic, Joel Singer, Sameer Desai, Rami El-Sayegh, Graham C Wong
AIMS: The purpose of this study was to conduct a systematic review, and where applicable meta-analyses, examining the evidence underpinning the use of targeted temperature management following resuscitation from cardiac arrest. METHODS AND RESULTS: Multiple databases were searched for publications between January 2000-February 2016. Nine Population, Intervention, Comparison, Outcome questions were developed and meta-analyses were performed when appropriate. Reviewers extracted study data and performed quality assessments using Grading of Recommendations, Assessment, Development and Evaluation methodology, the Cochrane Risk Bias Tool, and the National Institute of Health Study Quality Assessment Tool...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29170791/trauma-induced-coagulopathy-upon-emergency-room-arrival-still-a-significant-problem-despite-increased-awareness-and-management
#15
Matthias Fröhlich, Manuel Mutschler, Michael Caspers, Ulrike Nienaber, Vera Jäcker, Arne Driessen, Bertil Bouillon, Marc Maegele
PURPOSE: Over the last decade, the pivotal role of trauma-induced coagulopathy has been described and principal drivers have been identified. We hypothesized that the increased knowledge on coagulopathy of trauma would translate into a more cautious treatment, and therefore, into a reduced overall incidence rate of coagulopathy upon ER admission. PATIENTS AND METHODS: Between 2002 and 2013, 61,212 trauma patients derived from the TraumaRegister DGU® had a full record of coagulation parameters and were assessed for the presence of coagulopathy...
November 23, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29170351/54%C3%A2-paediatric-traumatic-cardiac-arrest-in-england-and-wales-a-10-year-epidemiological-study
#16
James Vassallo, Melanie Webster, Edward Barnard, Marisol Fragoso Iniguez, Mark Lyttle, Jason Smith
INTRODUCTION: Traumatic cardiac arrest (TCA) has traditionally been described as futile, with poor outcomes. Reported survival rates vary widely, with higher rates observed from mechanisms leading to a respiratory cause of traumatic cardiac arrest (e.g., drowning and hanging). Currently there is little evidence regarding outcomes following TCA in children. The primary aim of our study was to describe 30 day survival following TCA. Secondary aims were to provide an analysis of injury patterns (severe haemorrhage or traumatic brain injury), describe the functional outcome at discharge and to report the association between survival and interventions performed...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170331/34%C3%A2-a-systematic-literature-review-of-the-pre-hospital-lessons-identified-following-mass-casualty-deliberate-bombing-incidents
#17
Thomas Cooke, Adam Chesters, Gareth Grier
BACKGROUND: Since the end of World War II, there has been an emergence of explosives used amongst civilian populations resulting in mass-casualty incidents. The development of pre-hospital medical systems, worldwide, has resulted in an increased response at these incidents. However, information about the pre-hospital medical response is sparse and not collated. This review aimed to collect and appraise the literature on the pre-hospital management of mass-casualty bombing incidents. The primary objective was to identify and discuss the common themes highlighted as problems in the pre-hospital medical response...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170314/17%C3%A2-exploring-ambulance-conveyances-to-the-emergency-department-a-descriptive-analysis-of-non-urgent-transports
#18
Jamie Miles, Colin O'Keeffe, Richard Jacques, Tony Stone, Suzanne Mason
OBJECTIVES: An NHS England report highlighted key issues in how patients were initially navigating access to healthcare. This has manifested in increased pressure on ambulance services and emergency departments (EDs) to provide high quality, safe and efficient services to manage this demand. This study aims to identify non-urgent conveyances by ambulance services to the ED that would be suitable for care at scene or an alternative response. DESIGN: A retrospective analysis of emergency department data linked to initial pre-hospital call data (either '111' or '999') in 2014 in Yorkshire and Humber...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170311/14%C3%A2-prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#19
Jackie Mclennan, Jason Smith, Kevin Mackway-Jones
BACKGROUND: The predominant cause of preventable death from trauma is bleeding. Many patients need resuscitation with massive blood transfusion (MBT). In some theatres of military operation there is limited blood product availability and walking donor panels can be required. This study aimed to produce a tool to predict the need for MBT using information available on patient arrival at the ED for patients sustaining battlefield trauma. METHODS: A retrospective database analysis was undertaken using the UK Joint Theatre Trauma Registry (JTTR) to provide derivation and validation datasets...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29162534/nano-and-micro-materials-in-the-treatment-of-internal-bleeding-and-uncontrolled-haemorrhage
#20
REVIEW
Elizabeth Gaston, John F Fraser, Zhi Ping Xu, Hang T Ta
Internal bleeding is defined as the loss of blood that occurs inside of a body cavity. After a traumatic injury, haemorrhage accounts for over 35% of pre-hospital deaths and 40% of deaths within the first 24hours. Coagulopathy, a disorder in which the blood is not able to properly form clots, typically develops after traumatic injury and results in a higher rate of mortality. The current methods to treat internal bleeding and coagulopathy are inadequate due to the requirement of extensive medical equipment that is typically not available at the site of injury...
November 18, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
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