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https://www.readbyqxmd.com/read/29453473/prehospital-events-in-st-elevation-myocardial-infarction-undergoing-primary-angioplasty
#1
Sachin Dhungel, Rabi Malla, Chandramani Adhikari, Arun Maskey, Rajeeb Rajbhandari, Ranjit Sharma, Deewakar Sharma, Man Bhadhur Kc, Ajay Adhikari, Binaya Rauniyar, Dipak Limbu, Milan Gautam
INTRODUCTION: Pre-hospital delay includes time from onset of symptoms of myocardial infarction till arrival to emergency room of the hospital. This defines time from symptom onset to first medical contact and first medical contact to emergency room. This study aims to study the prehospital events and determining factors in patients undergoing primary angioplasty. METHODS: This was a cross sectional study in Shahid Gangalal National Heart Centre for three months...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29452732/efficacy-of-pre-hospital-rapid-sequence-intubation-in-paediatric-traumatic-brain-injury-a-9-year-observational-study
#2
Stefan Heschl, Ben Meadley, Emily Andrew, Warwick Butt, Stephen Bernard, Karen Smith
INTRODUCTION: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29452599/feasibility-and-acceptability-of-pre-operative-physical-activity-to-improve-patient-outcomes-after-major-cancer-surgery-study-protocol-for-a-pilot-randomised-controlled-trial-pepa-trial
#3
Daniel Steffens, Jane Young, Paula R Beckenkamp, James Ratcliffe, Freya Rubie, Nabila Ansari, Neil Pillinger, Michael Solomon
BACKGROUND: There is a need for evidence of the effectiveness of pre-operative exercise for patients undergoing major cancer surgery; however, recruitment to such trials can be challenging. The PrE-operative Physical Activity (PEPA) Trial will establish the feasibility and acceptability of a pre-operative exercise programme aimed to improve patient outcomes after cytoreductive surgery and pelvic exenteration. The secondary aim is to obtain pilot data on the likely difference in key outcomes (post-operative complications, length of hospital stay, post-operative functional capacity and quality of life) to inform the sample size calculation for the substantive randomised clinical trial...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29447789/comprehensive-electrocardiogram-to-device-time-for-primary-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction-a-report-from-the-american-heart-association-mission-lifeline-program
#4
Jay S Shavadia, William French, Anne S Hellkamp, Laine Thomas, Eric R Bates, Steven V Manoukian, Michael C Kontos, Robert Suter, Timothy D Henry, Harold L Dauerman, Matthew T Roe
BACKGROUND: Assessing hospital-related network-level primary percutaneous coronary intervention (PCI) performance for ST-segment elevation myocardial infarction (STEMI) is challenging due to differential time-to-treatment metrics based on location of diagnostic electrocardiogram (ECG) for STEMI. METHODS: STEMI patients undergoing primary PCI at 588 PCI-capable hospitals in AHA Mission: Lifeline (2008-2013) were categorized by initial STEMI identification location: PCI-capable hospitals (Group 1); pre-hospital setting (Group 2); and non-PCI-capable hospitals (Group 3)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29443860/a-novel-rat-model-of-extremity-trauma-for-pre-hospital-pain-management-research
#5
Lusha Xiang, Harold G Klemcke, Nathan A Wienandt, Kathy L Ryan, Carmen Hinojosa-Laborde
BACKGROUND: Pain management is important in pre-hospital care of patients with extremity trauma (ET). The goal of this study was to establish a rat model of ET for pre-hospital pain research, and validate it using pain behaviors and analgesics. METHODS: Rats were anesthetized using isoflurane and ET was induced in one hindlimb via clamping retrofemoral tissues for 30 sec, followed by closed fibula fracture. Rats regained consciousness after ET. Pain responses in the injured hindlimb to thermal hyperalgesia (paw withdrawal latency, PWL), mechanical allodynia (paw withdrawal pressure, PWP), and weight bearing (WB) were determined before and 90 minutes after ET...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29441123/circulation-first-the-time-has-come-to-question-the-sequencing-of-care-in-the-abcs-of-trauma-an-american-association-for-the-surgery-of-trauma-multicenter-trial
#6
Paula Ferrada, Rachael A Callcut, David J Skarupa, Therese M Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M Nygaard, Martin A Schreiber, Toby Enniss, Michelle McNutt, Herb Phelan, Kira Smith, Forrest O Moore, Irene Tabas, Joseph Dubose
Background: The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence. Methods: This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29437308/presenteeism-among-emergency-health-care-staff
#7
Marta Sánchez-Zaballos, María Baldonedo-Mosteiro, Mª Pilar Mosteiro-Díaz
OBJECTIVES: To estimate the prevalence of presenteeism among different categories of hospital and pre-hospital emergency health care professionals in the Principality of Asturias, Spain, and to define the sociodemographic characteristics and workplace factors associated with presenteeism in all categories. MATERIAL AND METHODS: Cross-sectional descriptive study carried out during the last half of 2014 and first half of 2015. A self-administered questionnaire was used to collecta data on sociodemographic and work-related variables and perception of work as stressful...
February 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29433441/ambulance-use-is-not-associated-with-patient-acuity-after-road-traffic-collisions-a-cross-sectional-study-from-addis-ababa-ethiopia
#8
Yonas Abebe, Tolesa Dida, Engida Yisma, David M Silvestri
BACKGROUND: Africa accounts for one sixth of global road traffic deaths-most in the pre-hospital setting. Ambulance transport is expensive relative to other modes of pre-hospital transport, but has advantages in time-sensitive, high-acuity scenarios. Many countries, including Ethiopia, are expanding ambulance fleets, but clinical characteristics of patients using ambulances remain ill-defined. METHODS: This is a cross-sectional study of 662 road traffic collisions (RTC) patients arriving to a single trauma referral center in Addis Ababa, Ethiopia, over 7 months...
February 13, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29432317/the-outcomes-of-early-surgical-intervention-in-geriatric-proximal-femur-fractures-among-patients-receiving-direct-oral-anticoagulation
#9
Nathan A Franklin, Ashley Ali, Richard K Hurley, Hassan R Mir, Michael J Beltran
OBJECTIVE: Evaluate the pre-hospital use of Direct Oral Anticoagulant (DOAC) agents on the outcomes of early surgical fixation of a geriatric hip fracture. DESIGN: Case-Control. SETTING: Two academic level 1 trauma centers. INTERVENTION: Early (<48h) surgical fixation of a geriatric proximal femur fracture. PATIENTS: 19 patients receiving Pradaxa (Dabigatran), Eliquis (Apixaban), or Xarelto (Rivaroxaban) who underwent surgery between 2010 and 2015 and 74 control patients...
February 9, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29425977/survival-after-out-of-hospital-cardiac-arrest-in-nursing-homes-a-nationwide-study
#10
Marianne Pape, Shahzleen Rajan, Steen Møller Hansen, Rikke Nørmark Mortensen, Signe Riddersholm, Fredrik Folke, Lena Karlsson, Freddy Lippert, Lars Køber, Gunnar Gislason, Helle Søholm, Mads Wissenberg, Thomas A Gerds, Christian Torp-Pedersen, Kristian Kragholm
BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents. METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014...
February 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29423822/barriers-to-the-medication-error-reporting-process-within-the-irish-national-ambulance-service-a-focus-group-study
#11
Eamonn Byrne, Gerard Bury
BACKGROUND: Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring...
February 8, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29421694/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-resuscitative-thoracotomy-in-select-patients-with-hemorrhagic-shock-early-results-from-the-american-association-for-the-surgery-of-trauma-aortic-occlusion-in-resuscitation-for-trauma-and-acute-care
#12
Megan Brenner, Kenji Inaba, Alberto Aiolfi, Joseph DuBose, Timothy Fabian, Tiffany Bee, John B Holcomb, Laura Moore, David Skarupa, Thomas M Scalea
BACKGROUND: Aortic occlusion (AO) is a potentially valuable tool for early resuscitation in patients nearing extremis or in arrest from severe hemorrhage. STUDY DESIGN: AAST AORTA registry identified trauma patients without penetrating thoracic injury undergoing AO at the level of the descending thoracic aorta (RT or Zone 1 REBOA) in the Emergency Department (ED). Survival outcomes relative to the timing of CPR need and admission hemodynamic status were examined...
February 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29421664/epidemiology-and-outcome-of-paediatric-out-of-hospital-cardiac-arrests-a-paediatric-sub-study-of-the-pan-asian-resuscitation-outcomes-study-paros
#13
Lai Peng Tham, Win Wah, Rachel Phillips, Nur Shahidah, Yih Yng Ng, Sang Do Shin, Tatsuya Nishiuchi, Kwanhathai Darin Wong, Patrick Chow-In Ko, Nalinas Khunklai, Ghulam Yasin Naroo, Marcus Eng Hock Ong
BACKGROUND: The Pan Asian Resuscitation Outcomes Study (PAROS) is a retrospective study of out- of-hospital cardiac arrest(OHCA), collaborating with EMS agencies and academic centers in Japan, South Korea, Malaysia, Singapore, Taiwan, Thailand and UAE-Dubai. The objectives of this study is to describe the characteristics and outcomes, and to find factors associated with survival after paediatric OHCA. METHODS: We studied all children less than 17 years of age with OHCA conveyed by EMS and non-EMS transports from January 2009 to December 2012...
February 5, 2018: Resuscitation
https://www.readbyqxmd.com/read/29421015/duration-of-ischemia-and-treatment-effects-of-pre-versus-in-hospital-ticagrelor-in-patients-with-st-segment-elevation-myocardial-infarction-insights-from-the-atlantic-study
#14
Akshay Bagai, Shaun G Goodman, Warren J Cantor, Eric Vicaut, Leonardo Bolognese, Angel Cequier, Mohamed Chettibi, Christopher J Hammett, Kurt Huber, Magnus Janzon, Frédéric Lapostolle, Jens Flensted Lassen, Béla Merkely, Robert F Storey, Jurriën M Ten Berg, Uwe Zeymer, Abdourahmane Diallo, Christian W Hamm, Anne Tsatsaris, Jad El Khoury, Arnoud W Van't Hof, Gilles Montalescot
BACKGROUND: Among patients with STEMI in the ATLANTIC study, pre-hospital administration of ticagrelor improved post-PCI ST-segment resolution and 30-day stent thrombosis. We investigated whether this clinical benefit with pre-hospital ticagrelor differs by ischemic duration. METHODS: In a post hoc analysis we compared absence of ST-segment resolution post-PCI and stent thrombosis at 30 days between randomized treatment groups (pre- versus in-hospital ticagrelor) stratified by symptom onset to first medical contact (FMC) duration [≤1 hour (n = 773), >1 to ≤3 hours (n = 772), and >3 hours (n = 311)], examining the interaction between randomized treatment strategy and duration of symptom onset to FMC for each outcome...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29420761/chinese-military-evaluation-of-a-portable-near-infrared-detector-of-traumatic-intracranial-hematomas
#15
Chun-Yang Liang, Yang Yang, Chun-Sen Shen, Hai-Jiang Wang, Nai-Ming Liu, Zhi-Wen Wang, Feng-Lei Zhu, Ru-Xiang Xu
Introduction: 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. As pre-hospital care is the weakest part of Chinese emergency care, there is an urgent need for a capability to detect brain hematomas early. In China, in addition to preventing injuries and diseases in military staff and in enhancing the military armed forces during war, military medicine participates in actions such as emergency public health crises, natural disasters, emerging conflicts, and anti-terrorist campaigns during peacetime...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29415232/maternal-antibiotic-exposure-during-pregnancy-and-hospitalization-with-infection-in-offspring-a-population-based-cohort-study
#16
Jessica Eden Miller, Chunsen Wu, Lars Henning Pedersen, Nicholas de Klerk, Jørn Olsen, David P Burgner
Background: The early life microbiome contributes to immune development. Antibiotics during pregnancy alter the microbiome and may influence disease risks in the offspring. We investigated the relationship between maternal antibiotic exposure before and during pregnancy, and risk of childhood hospitalization with infection. Methods: We used population-based Danish national databases for pregnancies between 1995 and 2009. Infants were followed from birth until their first infection-related hospitalization, death, 14th birthday, emigration or end-2009...
February 4, 2018: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29412043/acute-crisis-care-for-patients-with-mental-health-crises-initial-assessment-of-an-innovative-prehospital-alternative-destination-program-in-north-carolina
#17
Jamie O Creed, Julianne M Cyr, Hillary Owino, Shannen E Box, Mia Ives-Rublee, Brian B Sheitman, Beat D Steiner, Jefferson G Williams, Michael W Bachman, Jose G Cabanas, J Brent Myers, Seth W Glickman
OBJECTIVE: Emergency Departments (ED) are overburdened with patients experiencing acute mental health crises. Pre-hospital transport by Emergency Medical Services (EMS) to community mental health and substance abuse treatment facilities could reduce ED utilization and costs. Our objective was to describe characteristics, treatment, and outcomes of acute mental health crises patients who were transported by EMS to an acute crisis unit at WakeBrook, a North Carolina community mental health center...
February 7, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29411358/optimisation-of-the-dosage-of-tranexamic-acid-in-trauma-patients-with-population-pharmacokinetic-analysis
#18
S Grassin-Delyle, O M Theusinger, R Albrecht, S Mueller, D R Spahn, S Urien, P Stein
Tranexamic acid is used both pre-hospital and in-hospital as an antifibrinolytic drug to treat or prevent hyperfibrinolysis in trauma patients; dosing, however, remains empirical. We aimed to measure plasma levels of tranexamic acid in patients receiving pre-hospital anti-hyperfibrinolytic therapy and to build a population pharmacokinetic model to propose an optimised dosing regimen. Seventy-three trauma patients were enrolled and each received tranexamic acid 1 g intravenously pre-hospital. A blood sample was drawn after arrival in the emergency department, and we measured the plasma tranexamic acid concentration using liquid chromatography-mass spectrometry, and modelled the data using non-linear mixed effect modelling...
February 7, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29409525/pre-hospital-transthoracic-echocardiography-for-early-identification-of-non-st-elevation-myocardial-infarction-in-patients-with-acute-coronary-syndrome
#19
Ingo Bergmann, Benedikt Büttner, Elena Teut, Claudius Jacobshagen, José Hinz, Michael Quintel, Ashham Mansur, Markus Roessler
BACKGROUND: Non-ST elevation myocardial infarction (NSTEMI) is a common manifestation of acute coronary syndrome (ACS), but delayed diagnosis can increase mortality. In this proof of principle study, the emergency physician performed transthoracic echocardiography (TTE) on scene to determine whether NSTEMI could be correctly diagnosed pre-hospitalization. This could expedite admission to the appropriate facility and reduce the delay until initiation of correct therapy. METHODS: Pre-hospital TTE was performed on scene by the emergency physician in patients presenting with ACS but without ST-elevation in the initial 12-lead electrocardiography (ECG) (NSTE-ACS)...
February 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29402334/developing-prehospital-clinical-practice-guidelines-for-resource-limited-settings-why-re-invent-the-wheel
#20
Michael McCaul, Ben de Waal, Peter Hodkinson, Jennifer L Pigoga, Taryn Young, Lee A Wallis
OBJECTIVES: Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, the volume of literature is not matched by research into alternative methods of CPG development using existing CPG documents-a specific issue for guideline development groups in low- and middle-income countries. We report on how we developed a context specific prehospital CPG using an alternative guideline development method. Difficulties experienced and lessons learnt in applying existing global guidelines' recommendations to a national context are highlighted...
February 5, 2018: BMC Research Notes
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