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https://www.readbyqxmd.com/read/28326162/trauma-informed-care-for-children-in-the-ambulance-international-survey-among-pre-hospital-providers
#1
Eva Alisic, Mark P Tyler, Melita J Giummarra, Rahim Kassam-Adams, Juul Gouweloos, Markus A Landolt, Nancy Kassam-Adams
Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28324353/the-fast-d-protocol-a-simple-method-to-rule-out-traumatic-vascular-injuries-of-the-lower-extremities
#2
Miguel Angel Montorfano, Lisandro Miguel Montorfano, Federico Perez Quirante, Federico Rodríguez, Leonardo Vera, Luca Neri
BACKGROUND: The aim of this study is to assess the accuracy of a Fast Doppler protocol for the examination of an injured lower limb, namely 2-Point Fast Doppler (2PFD), in order to rapidly triage arterial lesions after penetrating trauma. METHODS: The presence of flow and the aspects of the Doppler waveform of the dorsalis pedis artery (DPA) and posterior tibial artery (PTA) of the injured lower limb (2PFD) were evaluated immediately before the execution of a standardized Color Duplex Doppler (SD) evaluation in 149 limbs of 140 patients with gunshot penetrating injuries...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28321571/effect-of-causes-of-surgical-delay-on-early-and-late-mortality-in-patients-with-proximal-hip-fracture
#3
Yong-Han Cha, Yong-Chan Ha, Jun-Il Yoo, Yeon-Seung Min, Young-Kyun Lee, Kyung-Hoi Koo
INTRODUCTION: The purpose of this study was to investigate the reasons for delayed surgery in patients with proximal hip fracture and to compare differences in mortality between delayed surgery cases and non-delayed surgery cases. In addition, we evaluated causal factors for delayed surgery that affected differences in mortality. METHODS: From 2003 to 2013, 1290 patients (1290 hips) with unilateral femoral neck or intertrochanteric fractures who underwent surgery were categorized into Group Ia (402 patients, early surgery group) and Group Ib (888 patients, delayed surgery group)...
March 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28317095/evaluating-helicopter-emergency-medical-missions-a-reliability-study-of-the-hems-benefit-and-naca-scores
#4
L Raatiniemi, J Liisanantti, M Tommila, S Moilanen, P Ohtonen, M Martikainen, V Voipio, J Reitala, T Iirola
BACKGROUND: The benefits of the Helicopter Emergency Medical Service (HEMS) and dispatch accuracy are continuously debated, and a widely accepted score to measure the benefits of the mission is lacking. The HEMS Benefit Score (HBS) has been used in Finnish helicopter emergency medical services, but studies are lacking. The National Advisory Committee for Aeronautics (NACA) score is widely used to measure the severity of illness or injury in the pre-hospital setting, but it has many critics due to its subjectivity...
March 19, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28314465/data-capture-and-communication-during-transfers-to-definitive-care-in-an-inclusive-trauma-system
#5
Nori L Bradley, Naisan Garraway, Nathaniel Bell, Nasira Lakha, S Morad Hameed
INTRODUCTION: Background trauma survivors in rural areas transferred to urban centers have higher mortality than trauma patients admitted directly to urban centers. Transfer data in trauma registries is important for injury control. Prehospital and early physiologic data may reflect processes of pre-hospital care. British Columbia currently has no standardized process for trauma patient data transfer. PATIENTS AND METHODS: We performed a retrospective data analysis for major trauma patients (ISS>15) transferred to a Level I trauma center over a 1year period (n=243)...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#6
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28301629/antidote-availability-in-the-municipality-of-campinas-s%C3%A3-o-paulo-brazil
#7
Luciane Cristina Rodrigues Fernandes, Taís Freire Galvão, Adriana Safioti Toledo Ricardi, Eduardo Mello De Capitani, Stephen Hyslop, Fábio Bucaretchi
CONTEXT AND OBJECTIVE: The lack of availability of antidotes in emergency services is a worldwide concern. The aim of the present study was to evaluate the availability of antidotes used for treating poisoning in Campinas (SP). DESIGN AND SETTING: This was a cross-sectional study of emergency services in Campinas, conducted in 2010-2012. METHODS: The availability, amount in stock, place of storage and access time for 26 antidotal treatments was investigated...
March 13, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28295147/a-prospective-randomised-trial-of-pre-oxygenation-strategies-available-in-the-pre-hospital-environment
#8
C J Groombridge, E Ley, M Miller, T Konig
Pre-oxygenation before tracheal intubation aims to increase safe apnoea duration by denitrogenation of the functional residual capacity of the lungs, and increasing oxygen stores at the onset of apnoea. Pre-oxygenation options in the pre-hospital environment are limited due to oxygen availability and equipment portability. The aim of this study was to evaluate the effectiveness of strategies available in this setting. This was a prospective, randomised, crossover study of 30 healthy volunteers who underwent 3-min periods of pre-oxygenation by tidal volume breathing with a non-rebreather mask, a bag-valve-mask and a portable ventilator...
March 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28287909/clinical-evaluation-of-a-microwave-based-device-for-detection-of-traumatic-intracranial-hemorrhage
#9
Johan Ljungqvist, Stefan Candefjord, Mikael Persson, Lars Jönsson, Thomas Skoglund, Mikael Elam
Traumatic brain injury (TBI) is the leading cause of death and disability among young persons. A key to improve outcome for patients with TBI is to reduce the time from injury to definitive care by achieving high triage accuracy. Microwave technology (MWT) allows for a portable device to be used in the pre-hospital setting for detection of intracranial hematomas at the scene of injury, thereby enhancing early triage and allowing for more adequate early care. MWT has previously been evaluated for medical applications including the ability to differentiate between hemorrhagic and ischemic stroke...
March 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28286822/ability-of-ultrasonography-in-detection-of-different-extremity-bone-fractures-a-case-series-study
#10
Farzad Bozorgi, Massoud Shayesteh Azar, Seyed Hossein Montazer, Aroona Chabra, Seyed Farshad Heidari, Alireza Khalilian
INTRODUCTION: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. METHODS: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28282553/challenges-in-the-treatment-of-convulsive-status-epilepticus
#11
REVIEW
Gaetano Zaccara, Gianfranco Giannasi, Roberto Oggioni, Eleonora Rosati, Luciana Tramacere, Pasquale Palumbo
Convulsive status epilepticus (CSE) is a medical emergency associated with high mortality and morbidity. The most recent definition of CSE is a convulsive seizure lasting more than 5min or consecutive seizures without recovery of consciousness. In adults, for the treatment of the early stages of CSE, diazepam, lorazepam or midazolam are the most common treatments, although the choice of agent seems less important than rapid treatment. Midazolam, when administered intramuscularly (best evidence), buccally, or nasally, is effective and safe in the pre-hospital setting...
February 28, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28281731/current-patterns-of-antithrombotic-and-revascularization-therapy-in-patients-hospitalised-for-acute-coronary-syndromes-data-from-the-polish-subset-of-the-epicor-study
#12
Izabela Wojtkowska, Janina Stępińska, Małgorzata Stępień-Wojno, Mateusz Sobota, Jerzy Kopaczewski, Zygfryd Reszka, Michał Kurzelewski, Jesus Medina
BACKGROUND: Cardiovascular disease is the leading cause of mortality and morbidity in developed countries, including Poland. Antithrombotic drugs play a crucial role in the management of acute coronary syndromes (ACS). Recent clinical trials have demonstrated the efficacy and safety profiles of new antiplatelet and anticoagulant agents, which may be used as add-on therapy or replacements for older drugs. The EPICOR: (long-t E: rm follow-u P: of antithrombotic management patterns I: n acute COR: onary syndrome patients) is a prospective international observational study (NCT01171404) designed to describe the use of antithrombotic management strategies for the treatment of ACS during the acute phase and over a follow-up period of up to 2 years from the index event...
March 10, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28279553/portable-near-infrared-rapid-detection-of-intracranial-hemorrhage-in-chinese-population
#13
Long Xu, Xiaogang Tao, Weiming Liu, Yanong Li, Jun Ma, Te Lu, Bo Han, Baiyun Liu, Yuanli Zhao, Jingsheng Li, Jizong Zhao
BACKGROUND: Secondary brain injury is the main cause of mortality from traumatic brain injury (TBI). One hallmark of TBI is intracranial hemorrhage, which occurs in 40-50% of severe TBI cases. Early identification of intracranial hematomas in TBI patients allows early surgical evacuation, and can reduce the case-fatality rate of TBI. Since pre-hospital care is the weakest part of Chinese emergency care, there is an urgent need for a capability to detect brain hematomas early. The purpose of this observational study was to evaluate the performance of a near infrared (NIR) based, device to screen for traumatic intracranial hematomas in Chinese population...
March 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28279094/pre-hospital-assessment-of-a-child-under-one-year-old-with-fever
#14
Ann Wilkinson
Parents often bring children with a fever to primary and emergency care settings. This article uses a case study to explore the assessment of children with a fever in pre-hospital settings using the three-minute toolkit, National Institute for Health and Care Excellence fever guidelines and the baby check score. It also highlights some educational resources for parents, designed to help them recognise when to seek clinical advice for their children.
March 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28275084/reduction-in-time-to-treatment-in-prehospital-telemedicine-evaluation-and-thrombolysis
#15
Ather Taqui, Russell Cerejo, Ahmed Itrat, Farren B S Briggs, Andrew P Reimer, Stacey Winners, Natalie Organek, Andrew B Buletko, Lila Sheikhi, Sung-Min Cho, Maureen Buttrick, Megan M Donohue, Zeshaun Khawaja, Dolora Wisco, Jennifer A Frontera, Andrew N Russman, Fredric M Hustey, Damon M Kralovic, Peter Rasmussen, Ken Uchino, Muhammad S Hussain
OBJECTIVE: To compare the times to evaluation and thrombolytic treatment of patients treated with a telemedicine-enabled mobile stroke treatment unit (MSTU) vs those among patients brought to the emergency department (ED) via a traditional ambulance. METHODS: We implemented a MSTU with telemedicine at our institution starting July 18, 2014. A vascular neurologist evaluated each patient via telemedicine and a neuroradiologist and vascular neurologist remotely assessed images obtained by the MSTU CT...
March 8, 2017: Neurology
https://www.readbyqxmd.com/read/28272851/the-effect-of-emergency-medical-services-response-on-outcome-of-trauma-laparotomy-at-a-level-1-trauma-centre-in-south-africa
#16
S Chowdhury, P H Navsaria, S Edu, A J Nicol
BACKGROUND: Due to resource constrained pre-hospital emergency medical services (EMSs) there is a significant delay in injured patients arriving at Groote Schuur Hospital Trauma Centre (GSHTC). The aim of the study was to examine the effectiveness of EMSs in transferring trauma patients to GSHTC. The effect of any delay to laparotomy from injury was noted. METHOD: A prospective audit of patients presented directly from the scene to GSHTC following abdominal trauma over a four-month period was performed...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28264690/presentations-to-an-urban-emergency-department-in-bern-switzerland-associated-with-acute-recreational-drug-toxicity
#17
Evangelia Liakoni, Sabine Müller, Adrian Stoller, Meret Ricklin, Matthias E Liechti, Aristomenis K Exadaktylos
BACKGROUND: Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. METHODS: Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28262729/abo-blood-types-associated-with-the-risk-of-venous-thromboembolism-in-han-chinese-people-a-hospital-based-study-of-200-000-patients
#18
Xuefeng Sun, Jun Feng, Wei Wu, Min Peng, Juhong Shi
ABO blood types are putatively associated with the risk of venous thromboembolism (VTE), but it is not proved in Chinese people. A large population of Han Chinese patients discharged from Peking Union Medical College Hospital between January 2010 and June 2016 were retrospectively analyzed in a case-control study. A total of 1412 VTE patients were identified from 200,660 discharged Han Chinese patients, including 600 patients with deep vein thrombosis (DVT), 441 patients with pulmonary embolism, and 371 patients with both DVT and pulmonary embolism...
March 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28249588/the-difficult-medical-emergency-call-a-register-based-study-of-predictors-and-outcomes
#19
Thea Palsgaard Møller, Thora Majlund Kjærulff, Søren Viereck, Doris Østergaard, Fredrik Folke, Annette Kjær Ersbøll, Freddy K Lippert
BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data...
March 1, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28245880/pre-hospital-ct-diagnosis-of-subarachnoid-hemorrhage
#20
Maren Ranhoff Hov, Annette Ryen, Katrine Finsnes, Janne Storflor, Thomas Lindner, Jostein Gleditsch, Christian Georg Lund
BACKGROUND: Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better. CASE PRESENTATION: The Norwegian Acute Stroke Pre-hospital Project (NASPP) has developed a Mobile Stroke Unit (MSU) model, which is staffed with anesthesiologists also trained in pre-hospital clinical assessment of acute stroke patients and interpretation of computerized tomography (CT)...
February 28, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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