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https://www.readbyqxmd.com/read/28433250/public-private-implementation-of-integrated-emergency-response-services-case-study-of-gvk-emergency-management-and-research-institute-in-karnataka-india
#1
Veena M Sriram, Gopalkrishna Gururaj, Adnan A Hyder
BACKGROUND: Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public-private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru...
April 19, 2017: Surgery
https://www.readbyqxmd.com/read/28431508/association-between-cardiopulmonary-resuscitation-duration-and-one-month-neurological-outcomes-for-out-of-hospital-cardiac-arrest-a-prospective-cohort-study
#2
Masahiro Kashiura, Yuichi Hamabe, Akiko Akashi, Atsushi Sakurai, Yoshio Tahara, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura
BACKGROUND: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. METHODS: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan...
April 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#3
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28416852/-first-aid-system-for-trauma-development-and-status
#4
D K Chen, W C Lin, P Zhang, S J Kuang, W Huang, T B Wang
With the great progress of the economy, the level of industrialization has been increasing year by year, which leads to an increase in accidental trauma accidents. Chinese annual death of trauma is already more than 400 000, which makes trauma the fifth most common cause of death, following malignant tumor, heart, brain and respiratory diseases. Trauma is the leading cause of the death of young adults. At the same time, trauma has become a serious social problem in peace time. Trauma throws great treats on human health and life...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#5
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28413515/outcome-of-out-of-hospital-cardiac-arrest-after-fibrinolysis-with-reteplase-in-comparison-to-the-return-of-spontaneous-circulation-after-cardiac-arrest-score-in-a-geographic-region-without-emergency-coronary-intervention
#6
Thomas Luiz, Alexander Wilhelms, Christian Madler, Gregor Pollach, Bernd Haaff, Joachim Grüttner, Tim Viergutz
Coronary occlusion and pulmonary embolism are responsible for the majority of cases of out-of-hospital cardiac arrest (OHCA). Despite previous favourable results of pre-hospital fibrinolysis in cases of OHCA, the benefit could not be confirmed in a large controlled study using the fibrinolytic tenecteplase. For reteplase (r-PA), there are hardly any data regarding pre-hospital fibrinolysis during ongoing resuscitation. The present study reported results using r-PA therapy in a German physician-supported Emergency Medical Services system...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28410590/early-predictors-of-poor-outcome-after-out-of-hospital-cardiac-arrest
#7
Louise Martinell, Niklas Nielsen, Johan Herlitz, Thomas Karlsson, Janneke Horn, Matt P Wise, Johan Undén, Christian Rylander
BACKGROUND: Early identification of predictors for a poor long-term outcome in patients who survive the initial phase of out-of-hospital cardiac arrest (OHCA) may facilitate future clinical research, the process of care and information provided to relatives. The aim of this study was to determine the association between variables available from the patient's history and status at intensive care admission with outcome in unconscious survivors of OHCA. METHODS: Using the cohort of the Target Temperature Management trial, we performed a post hoc analysis of 933 unconscious patients with OHCA of presumed cardiac cause who had a complete 6-month follow-up...
April 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28403866/erratum-to-pre-hospital-management-of-mass-casualty-civilian-shootings-a-systematic-literature-review
#8
Conor D A Turner, David J Lockey, Marius Rehn
No abstract text is available yet for this article.
April 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28403713/correction
#9
(no author information available yet)
In March's Emergency Nurse, the article on pre-hospital assessment of a child under one year old with fever advised the administration of glucose if children are 'very unwell or unconscious'. This should read 'check blood glucose'. We apologise for the error and any inconvenience it has caused. A corrected version is available online here .
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28401417/effect-of-a-comprehensive-health-education-program-on-pre-hospital-delay-intentions-in-high-risk-stroke-population-and-caregivers
#10
Li Yang, Qiuli Zhao, Xuemei Zhu, Xiaoying Shen, Yulan Zhu, Liu Yang, Wei Gao, Minghui Li
OBJECTIVE: Many factors influence pre-hospital delays in the event of stroke. This study aimed to develop and evaluate a comprehensive educational program for decreasing pre-hospital delays in high-risk stroke population. METHODS: We enrolled 220 high-risk stroke population and caregivers from six urban communities in Harbin from May 2013 to May 2015, and randomly divided them into intervention and control groups. We implemented a comprehensive educational program (intervention group), comprising public lectures, instructional brochures, case videos, simulations, and role-playing from May 2013 to May 2015...
April 11, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28400222/self-reported-health-and-safety-awareness-improves-prediction-of-level-of-care-needs-in-veterans-discharged-from-a-post-acute-unit
#11
Julija Stelmokas, Linas A Bieliauskas, Katherine A Kitchen Andren, Robert Hogikyan, Neil B Alexander
OBJECTIVES: Evaluate the differential value of a self-reported health and safety awareness measure relative to other medical, psychosocial, and cognitive factors in predicting level of care (LOC) needs following hospital discharge. DESIGN: Retrospective medical record review. SETTING: Community Living Center Post-Acute Care (CLC-PAC) unit at a Veterans Affairs (VA) hospital. PARTICIPANTS: 175 Veterans admitted to the VA hospital or directly to the CLC-PAC from home...
April 8, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28400033/pre-hospital-policies-for-the-care-of-patients-with-acute-coronary-syndromes-in-india-a-policy-document-analysis
#12
Amisha Patel, Dorairaj Prabhakaran, Mark Berendsen, P P Mohanan, Mark D Huffman
BACKGROUND AND OBJECTIVE: Ischemic heart disease is the leading cause of death in India. In high-income countries, pre-hospital systems of care have been developed to manage acute manifestations of ischemic heart disease, such as acute coronary syndrome (ACS). However, it is unknown whether guidelines, policies, regulations, or laws exist to guide pre-hospital ACS care in India. We undertook a nation-wide document analysis to address this gap in knowledge. METHODS AND RESULTS: From November 2014 to May 2016, we searched for publicly available emergency care guidelines and legislation addressing pre-hospital ACS care in all 29 Indian states and 7 Union Territories via Internet search and direct correspondence...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28397461/analytical-and-clinical-validation-of-a-point-of-care-cardiac-troponin-t-test-with-an-improved-detection-limit
#13
Carsten Jungbauer, Julian Hupf, Evangelos Giannitsis, Johann Frick, Anna Slagman, Christoph Ehret, Nicolas Herbert, Christine Jung, Rainer Zerback, Thomas Bertsch, Michael Christ
BACKGROUND: The point-of-care test Roche CARDIAC POC Troponin T (PoC TnT) is an improved assay which has been developed for the Roche cobas h 232 system. METHODS: We performed a multicentre evaluation (four sites) to assess the analytical performance of the PoC TnT assay and to compare it with the central laboratory Elecsys® troponin T high sensitive (lab cTnT-hs) assay. RESULTS: The relative mean differences found in method comparisons of PoC TnT vs...
April 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28395658/the-hospital-of-tomorrow-in-10-points
#14
REVIEW
Jean-Louis Vincent, Jacques Creteur
Technology has advanced rapidly in recent years and is continuing to do so, with associated changes in multiple areas, including hospital structure and function. Here we describe in 10 points our vision of some of the ways in which we see our hospitals, particularly those in developed countries, evolving in the future, including increased specialization, greater use of telemedicine and robots, the changing place of the intensive care unit, improved pre-hospital and post-hospital management, and improved end-of-life care...
April 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28392075/pre-hospital-thoracotomy-and-the-evolution-of-pre-hospital-critical-care-for-victims-of-trauma
#15
EDITORIAL
D J Lockey, K Brohi
No abstract text is available yet for this article.
March 30, 2017: Injury
https://www.readbyqxmd.com/read/28383466/relative-device-stability-of-anterior-vs-axillary-needle-decompression-for-tension-pneumothorax-during-casualty-movement-preliminary-analysis-of-a-human-cadaver-model
#16
Matthew L Leatherman, Jenny M Held, Laura M Fluke, Christian S McEvoy, Kenji Inaba, Daniel Grabo, Matthew J Martin, Angela S Earley, Robert L Ricca, Travis M Polk
BACKGROUND: Tension pneumothorax (tPTX) remains a significant cause of potentially preventable death in military and civilian settings. The current pre-hospital standard of care for tPTX is immediate decompression with a 14 gauge 8cm angiocatheter (14G AC); however, failure rates may be as high as 17-60%. Alternative devices, such as 10G AC, modified Veress needle (mVN) and laparoscopic trocar (LT), have shown to be potentially more effective in animal models; however, little is known about the relative insertional safety or mechanical stability during casualty movement...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28381298/ticagrelor-versus-clopidogrel-in-real-world-patients-with-st-elevation-myocardial-infarction-1-year-results-by-propensity-score-analysis
#17
Matteo Vercellino, Federico Ariel Sànchez, Valentina Boasi, Dino Perri, Chiara Tacchi, Gioel Gabrio Secco, Stefano Cattunar, Gianfranco Pistis, Giovanni Mascelli
BACKGROUND: European guidelines recommend the use of ticagrelor versus clopidogrel in patients with ST elevation myocardial infarction (STEMI). This recommendation is based on inconclusive results and subanalyses from clinical trials. Few data are available on the effects of ticagrelor in a real-world population. METHODS: To compare the effects of ticagrelor and clopidogrel in a real-world STEMI population, we conducted a pre-post case-control study examining all patients with STEMI included in the Cardio-STEMI Sanremo registry between February 2011 and June 2013...
April 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28378954/pre-hospital-and-retrieval-medicine-clinical-governance-and-workforce-models
#18
Marcus Kennedy, Mark Elcock, Daniel Ellis, Gary Tall
Pre-hospital and retrieval medicine (PHARM) has developed significantly in the past decade. This perspective article proposes that PHARM should develop with a clear focus on contemporary health governance principles, and that its workforce and models of care adopt modern interdisciplinary approaches. Many of the older systems of managing clinical standards, and outdated cultural approaches to professional 'turf', workforce and scope of practice have little place in high-performance organisations. This paper calls us to attention with a recommendation that best and safest systems of care, structured to optimise patient outcomes and system performance should be our goal...
April 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28378268/carbon-dioxide-poisoning-a-literature-review-of-an-often-forgotten-cause-of-intoxication-in-the-emergency-department
#19
REVIEW
Kris Permentier, Steven Vercammen, Sylvia Soetaert, Christian Schellemans
The goal of this article was to provide an overview of the literature available on carbon dioxide intoxication. Articles were included based on their focus on medical or physiological effects of carbon dioxide. Studies related to decompression sickness were excluded. Mechanisms of carbon dioxide poising (both as an asphyxiant and as a toxicant) were described. Our review suggested that precautions are needed when handling dry ice or while working in confined spaces. Pre-hospital responders also need to pay attention for the possible diagnosis of CO2 intoxication for their own safety...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28365630/thrombolysis-and-thrombectomy-for-acute-ischaemic-stroke
#20
Salwa El Tawil, Keith W Muir
The likelihood of disability-free recovery after acute ischemic stroke is significantly improved by reperfusion either by intravenous thrombolytic drug treatment or with endovascular mechanical thrombectomy in selected cases. The use of intravenous thrombolysis is limited by the short treatment window and you need to assess individual balance of benefit and risk of symptomatic intracranial haemorrhage. Benefit is greater for shorter onset-to-reperfusion time intervals, requiring optimisation of pre-hospital and in-hospital pathways...
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
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