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https://www.readbyqxmd.com/read/29017646/-pre-hospital-therapeutic-hypothermia-for-survival-and-neuro-protection-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
Yan Zhuang, Linfeng Dai, Mingqi Cheng, Haidong Zhang, Ning Chang
OBJECTIVE: To assess the effectiveness of pre-hospital therapeutic hypothermia after out-of-hospital cardiac arrest (OHCA) for survival and neuro-protection. METHODS: Databases such as Medline, ScienceDirect, Embase, Highwire, Cochrane Library, CNKI and Wanfang digital database were searched from January 2000 to March 2017 to retrieve randomized controlled trials (RCTs) on pre-hospital therapeutic hypothermia after OHCA. Thereafter, the studies retrieved were screened based on predefined inclusion and exclusion criteria...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29017396/influence-of-awareness-and-availability-of-medical-alternatives-on-parents-seeking-paediatric-emergency-care
#2
Julia A Ellbrant, S Jonas Åkeson, Pia M Karlsland Åkeson
AIMS: Direct seeking of care at paediatric emergency departments may result from an inadequate awareness or a short supply of medical alternatives. We therefore evaluated the care-seeking patterns, availability of medical options and initial medical assessments - with overall reference to socioeconomic status - of parents at an urban paediatric emergency department in a Scandinavian country providing free paediatric healthcare. METHODS: The parents of children assessed by paediatric emergency department physicians at a Swedish university hospital over a 25-day winter period completed a questionnaire on recent medical contacts and their reasons for attendance...
October 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28993843/in-hospital-mortality-after-acute-stemi-in-patients-undergoing-primary-pci
#3
M Ali, S A Lange, T Wittlinger, G Lehnert, A G Rigopoulos, M Noutsias
BACKGROUND: Acute myocardial infarction (AMI) is the main cause of global and in-hospital mortality in patients with cardiovascular diseases. We aimed to examine the association between the coronary artery involved and the in-hospital mortality in patients who underwent primary percutaneous coronary intervention (pPCI) after ST segment elevation myocardial infarction (STEMI). METHODS: The in-hospital mortality of STEMI patients who underwent pPCI was assessed at the Department of Cardiology, Harzklinik Goslar, Germany, which has no access to immediate mechanical circulatory support (MCS), between 2013 and 2017...
October 9, 2017: Herz
https://www.readbyqxmd.com/read/28993097/prognostic-value-of-early-warning-scores-in-the-emergency-department-ed-and-acute-medical-unit-amu-a-narrative-review
#4
REVIEW
R S Nannan Panday, T C Minderhoud, N Alam, P W B Nanayakkara
BACKGROUND: A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). METHODS: A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28988805/prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#5
Jacqueline V Mclennan, Kevin C Mackway-Jones, Jason E Smith
BACKGROUND: The predominant cause of preventable trauma death is bleeding, and many of these patients need resuscitation with massive blood transfusion. In resource-constrained environments, early recognition of such patients can improve planning and reduce wastage of blood products. No existing decision rule is sufficiently reliable to predict those patients requiring massive blood transfusion. This study aims to produce a decision rule for use on arrival at hospital for patients sustaining battlefield trauma...
September 28, 2017: Injury
https://www.readbyqxmd.com/read/28974202/weaknesses-and-capacities-affecting-the-prehospital-emergency-care-for-victims-of-road-traffic-incidents-in-the-greater-kampala-metropolitan-area-a-cross-sectional-study
#6
Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati, Owais Raza
BACKGROUND: Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). METHODS: A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire...
October 3, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28970763/transitional-home-care-program-utilizing-the-integrated-practice-unit-concept-thc-ipu-effectiveness-in-improving-acute-hospital-utilization
#7
Lian Leng Low, Wei Yi Tay, Shu Yun Tan, Elian Hui San Chia, Rachel Marie Towle, Kheng Hock Lee
BACKGROUND: Organizing care into integrated practice units (IPUs) around conditions and patient segments has been proposed to increase value. We organized transitional care into an IPU (THC-IPU) for a patient segment of functionally dependent patients with limited community ambulation. METHODS: 1,166 eligible patients were approached for enrolment into THC-IPU. THC-IPU patients received a comprehensive assessment within two weeks of discharge; medication reconciliation; education using standardized action plans and a dedicated nurse case manager for up to 90 days after discharge...
August 14, 2017: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28968286/2017-military-supplement-hemoglobin-based-oxygen-carriers-current-state-of-the-art-and-novel-molecules
#8
Anirban Sen Gupta
In blood, the primary role of RBCs is to transport oxygen via highly regulated mechanisms involving hemoglobin (Hb). Hb is a tetrameric porphyrin protein comprising of two α- and two β-polypeptide chains, each containing an iron-containing heme group capable of binding one oxygen molecule. In military as well as civilian traumatic exsanguinating hemorrhage, rapid loss of RBCs can lead to sub-optimal tissue oxygenation and subsequent morbidity and mortality. In such cases, transfusion of whole blood or RBCs can significantly improve survival...
September 29, 2017: Shock
https://www.readbyqxmd.com/read/28964304/the-effect-of-pneumococcal-conjugate-vaccines-on-incidence-and-microbiology-associated-with-complicated-acute-otitis-media
#9
B B Laursen, C S Danstrup, S Hoffmann, N Nørskov-Lauritsen, A L B Christensen, T Ovesen
OBJECTIVES: The objectives of this study were to investigate the incidence of complicated acute otitis media (cAOM) as well as the associated microbiology before and after introduction of the 7- and 13-valent pneumococcal conjugate vaccines (PCV-7 and -13), respectively. CAOM comprises "heavy" AOM (AOM demanding hospitalization), mastodismus (M) and acute mastoiditis (AM). METHODS: A retrospective cohort study of the incidence and microbiology associated with cAOM during the non-PCV era, the PCV-7 and 13 eras, respectively...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28955423/variations-in-injury-characteristics-among-paediatric-patients-following-trauma-a-retrospective-descriptive-analysis-comparing-pre-hospital-and-in-hospital-deaths-at-kamuzu-central-hospital-lilongwe-malawi
#10
Laura Purcell, Charles E Mabedi, Jared Gallaher, Steven Mjuweni, Sean McLean, Bruce Cairns, Anthony Charles
BACKGROUND: Trauma is a major cause of paediatric mortality in sub-Saharan Africa. In absence of pre-hospital care, the injury mechanism and cause of death is difficult to characterise. Injury characteristics of pre-hospital deaths (PHD) versus in-hospital deaths (IHD) were compared. METHODS: Using our trauma surveillance database, a retrospective, descriptive analysis of children (<18 years) presenting to Kamuzu Central Hospital in Lilongwe, Malawi from 2008 to 2013 was performed...
June 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28954004/independent-early-predictors-of-mortality-in-polytrauma-patients-a-prospective-observational-longitudinal-study
#11
Luiz Guilherme V da Costa, Maria José C Carmona, Luiz M Malbouisson, Sandro Rizoli, Joel Avancini Rocha-Filho, Ricardo Galesso Cardoso, José Otávio C Auler-Junior
OBJECTIVES: Trauma is an important public health issue and associated with substantial socioeconomic impacts and major adverse clinical outcomes. No single study has previously investigated the predictors of mortality across all stages of care (pre-hospital, emergency room, surgical center and intensive care unit) in a general trauma population. This study was designed to identify early predictors of mortality in severely injured polytrauma patients across all stages of care to provide a better understanding of the physiologic changes and mechanisms by which to improve care in this population...
August 2017: Clinics
https://www.readbyqxmd.com/read/28948850/the-impact-of-airway-strategy-on-the-patient-outcome-after-out-of-hospital-cardiac-arrest-a-propensity-score-matched-analysis
#12
Patrick Sulzgruber, Philip Datler, Fritz Sterz, Michael Poppe, Elisabeth Lobmeyr, Markus Keferböck, Sebastian Zeiner, Alexander Nürnberger, Andreas Schober, Pia Hubner, Peter Stratil, Christian Wallmueller, Christoph Weiser, Alexandra-Maria Warenits, Andreas Zajicek, Florian Ettl, Ingrid Magnet, Thomas Uray, Christoph Testori, Raphael van Tulder
BACKGROUND: While guidelines mentioned supraglottic airway management in the case of out-of- hospital cardiac arrest, robust data of their impact on the patient outcome remain scare and results are inconclusive. METHODS: To assess the impact of the airway strategy on the patient outcome we prospectively enrolled 2224 individuals suffering cardiac arrest who were treated by the Viennese municipal emergency medical service. To control for potential confounders, propensity score matching was performed...
September 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28943123/prognostic-significance-of-spontaneous-shockable-rhythm-conversion-in-adult-out-of-hospital-cardiac-arrest-patients-with-initial-non-shockable-heart-rhythms-a-systematic-review-and-meta-analysis
#13
REVIEW
Shengyuan Luo, Yongshu Zhang, Wanwan Zhang, Ruiying Zheng, Jun Tao, Yan Xiong
BACKGROUND: There remains controversy over the prognostic significance of spontaneous shockable rhythm conversion in out-of-hospital cardiac arrest (OHCA) patients with initial non-shockable heart rhythms (pulseless electrical activity [PEA] or asystole). The aim of this study was to examine the association of shockable rhythm conversion with multiple OHCA outcomes, and to explore effect modifiers. METHODS: A dual-reviewer search was conducted in PubMed and EMBASE databases in March 2017...
September 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28941387/management-protocols-for-status-epilepticus-in-the-pediatric-emergency-room-systematic-review-article
#14
REVIEW
Cheuk C Au, Ricardo G Branco, Robert C Tasker
OBJECTIVE: This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department (ED) treatment of status epilepticus. SOURCES: Systematic search of national or regional guidelines (January 2000 to February 2017) contained within PubMed and Google Scholar databases, and article reference lists. The search keywords were status epilepticus, prolonged seizure, treatment, and guideline...
September 20, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28940249/protection-against-cold-a-survey-of-available-equipment-in-swedish-pre-hospital-services
#15
O Henriksson, U Björnstig, B-I Saveman, P J Lundgren
BACKGROUND: The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre-hospital services. METHODS: A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low-reading thermometers...
November 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28938903/metagenomic-characterization-of-ambulances-across-the-usa
#16
Niamh B O'Hara, Harry J Reed, Ebrahim Afshinnekoo, Donell Harvin, Nora Caplan, Gail Rosen, Brook Frye, Stephen Woloszynek, Rachid Ounit, Shawn Levy, Erin Butler, Christopher E Mason
BACKGROUND: Microbial communities in our built environments have great influence on human health and disease. A variety of built environments have been characterized using a metagenomics-based approach, including some healthcare settings. However, there has been no study to date that has used this approach in pre-hospital settings, such as ambulances, an important first point-of-contact between patients and hospitals. RESULTS: We sequenced 398 samples from 137 ambulances across the USA using shotgun sequencing...
September 22, 2017: Microbiome
https://www.readbyqxmd.com/read/28932302/predictive-value-of-tracheal-rapid-ultrasound-exam-performed-in-the-emergency-department-for-verification-of-tracheal-intubation
#17
Babak Masoumi, Reza Azizkhani, Gilava Hedayati Emam, Morteza Asgarzadeh, Behrouz Zargar Kharazi
BACKGROUND: Verification of the correct placement of the endotracheal tube (ETT) has been one of the most challenging issues of airway management in the field of emergency medicine. Early detection of oesophagal intubation through a reliable method is important for emergency physicians. AIM: The aim of this study was to assess the diagnostic accuracy of tracheal rapid ultrasound exam (TRUE) to assess endotracheal tube misplacement during emergency intubation. METHODS: This was an observational prospective study performed in the emergency department of the major tertiary referral hospital in the city...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28927951/definitive-airway-management-after-pre-hospital-supraglottic-airway-insertion-outcomes-and-a-management-algorithm-for-trauma-patients
#18
Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski, Scott P Zietlow, Brian D Kim, David S Morris
BACKGROUND: Prehospital airway management increasingly involves supraglottic airway insertion and a paucity of data evaluates outcomes in trauma populations. We aim to describe definitive airway management in traumatically injured patients who necessitated prehospital supraglottic airway insertion. METHODS: We performed a single institution retrospective review of multisystem injured patients (≥15years) that received prehospital supraglottic airway insertion during 2009 to 2016...
September 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28927190/outcomes-differ-by-first-documented-rhythm-after-witnessed-out-of-hospital-cardiac-arrest-in-children-an-observational-study-with-prospective-nationwide-population-based-cohort-database-in-japan
#19
Masahiko Hara, Kenichi Hayashi, Tetsuhisa Kitamura
Aims: To evaluate and compare outcomes and impacts of delay of time to cardiopulmonary resuscitation (CPR) by type of first documented rhythm in paediatric patients with out-of-hospital cardiac arrest (OHCA). Methods and results: We enrolled 3968 paediatric (aged <18 years) OHCA patients whose events were witnessed between 2005 and 2012 from a prospective nationwide population-based cohort database in Japan. We assessed and compared their neurologically favourable 1-month survival according to first documented rhythm: pulseless ventricular tachycardia/ventricular fibrillation (pVT/VF), pulseless electrical activity (PEA), or asystole...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28901626/acute-poisonings-during-pregnancy-and-in-other-non-pregnant-women-in-emergency-departments-of-four-government-hospitals-addis-ababa-ethiopia-2010-2015
#20
Mebrahtu Eyasu, Tolesa Dida, Yoseph Worku, Solomon Worku, Mensur Shafie
OBJECTIVE: To characterise acute poisonings in pregnant and non-pregnant women treated at emergency departments of government hospitals in Addis Ababa, Ethiopia, between 2010 and 2015. METHODS: All data for acutely poisoned women were retrospectively collected from patient medical charts at the emergency departments of Saint Paul's Hospital Millennium Medical College, Ras Desta Memorial Hospital, Yekatit 12 Hospital Medical College and Zewditu Memorial Hospital...
October 2017: Tropical Medicine & International Health: TM & IH
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