Read by QxMD icon Read

prehospital fluid therapy

Michael A Smyth, Samantha J Brace-McDonnell, Gavin D Perkins
INTRODUCTION: Sepsis is a common and potentially life-threatening response to an infection. International treatment guidelines for sepsis advocate that treatment be initiated at the earliest possible opportunity. It is not yet clear if very early intervention by ambulance clinicians prior to arrival at hospital leads to improved clinical outcomes among sepsis patients. METHODA: We systematically searched the electronic databases MEDLINE, EMBASE, CINAHL, the Cochrane Library and PubMed up to June 2015...
July 2016: Western Journal of Emergency Medicine
Arasch Wafaisade, Rolf Lefering, Bertil Bouillon, Andreas B Böhmer, Michael Gäßler, Matthias Ruppert
BACKGROUND: Evidence on prehospital administration of the antifibrinolytic tranexamic acid (TXA) in civilian trauma populations is scarce. The aim was to study whether prehospital TXA use in trauma patients was associated with improved outcomes. METHODS: The prehospital database of the ADAC (General German Automobile Club) Air Rescue Service was linked with the TraumaRegister of the German Trauma Society to reidentify patients documented in both registries. Primarily admitted trauma patients (2012 until 2014) who were treated with TXA during the prehospital phase were matched with patients who had not received prehospital TXA, applying propensity score-based matching...
2016: Critical Care: the Official Journal of the Critical Care Forum
Arne Driessen, Matthias Fröhlich, Nadine Schäfer, Manuel Mutschler, Jerome M Defosse, Thomas Brockamp, Bertil Bouillon, Ewa K Stürmer, Rolf Lefering, Marc Maegele
BACKGROUND: Various studies have shown the deleterious effect of high volume resuscitation following severe trauma promoting coagulopathy by haemodilution, acidosis and hypothermia. As the optimal resuscitation strategy during prehospital trauma care is still discussed, we raised the question if the amount and kind of fluids administered changed over the recent years. Further, if less volume was administered, fewer patients should have arrived in coagulopathic depletion in the Emergency Department resulting in less blood product transfusions...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Hu Hang, Wang Jianan, Han Chunmao
BACKGROUND: On 5 July 2014, a suicide terrorist set a crowded bus on fire in Hangzhou, injuring 33 passengers. Among these, 19 adult victims with the most severe burns were triaged to our center. This is a single-center, descriptive study recording the prehospital response and in-hospital treatment of these patients. METHODS: Information on the attack, on-scene rescue, and patient triage was collected from public media, governmental, and hospital reports. Information on patient injury and our in-hospital procedures was collected from the emergency registry and patient records...
February 2016: Burns: Journal of the International Society for Burn Injuries
Dhuleep S Wijayatilake, Suyogi V Jigajinni, Peter B Sherren
PURPOSE OF REVIEW: Over many years, understanding of the pathophysiology in traumatic brain injury (TBI) has resulted in the development of core physiological targets and therapies to preserve cerebral oxygenation, and in doing so prevent secondary insult. The present review revisits the evidence for these targets and therapies. RECENT FINDINGS: Achieving oxygen, carbon dioxide, blood pressure, temperature and glucose targets remain a key goal of therapy in TBI, as does the role of effective prehospital care...
October 2015: Current Opinion in Anaesthesiology
Joachim Schnürle
Geriatric patients were more often treated in hospitals for Dehydration in the last years resembling a rising burden for Health systems. Elderly people are more vulnerable for Dehydration during Heat Waves especially when there are complicating factors like febrile episodes or multiple medications. In private care situations as in homes for elderly Strategies have to be implemented in Germany to prevent hospital admissions in the case of transient Dehydration. By this a rise of costs and a waste of resources should be diminished...
May 2015: Deutsche Medizinische Wochenschrift
B Landsleitner, J Keil
BACKGROUND: Since pediatric emergencies and burn injuries are rare in prehospital emergency medicine, emergency teams can hardly develop routine in emergency care. OBJECTIVES: How to effectively treat burn injuries and avoid common errors? MATERIALS AND METHODS: A simple and severity-based therapy concept based on the current literature using the example of a case report is presented. RESULTS: About 80% of burns and scalds in children are not severe cases-in these patients an effective analgesia by intranasal administration is important and further invasive treatments are generally not necessary...
June 2015: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Nizama Salihefendic, Muharem Zildzic, Sead Ahmetagic
Acute respiratory distress syndrome (ARDS) is a form of acute life threatening respiratory failure. In daily practice there is difficulty in diagnostic and therapeutic management of Acute respiratory distress syndrome (ARDS). We observed delay in diagnostic and therapeutic procedures in patients with clinical signs for the presence of severe respiratory disorders. Finding timely evidence of the presence the clinical signs of threatening ARDS and underlying diseases like influenza A/H1N1 during prehospital period in early stage of disease it is possible introduce early adequate treatment: high flow oxygen, fluid replacement and pharmacological and antiviral therapy...
February 2015: Medical Archives
Bijan S Kheirabadi, Krystal K Valdez-Delgado, Irasema B Terrazas, Nahir Miranda, Michael A Dubick
BACKGROUND: Reports of survival benefits of early transfusion of plasma with red blood cells (1:1 ratio) in trauma patients suggest that plasma may be a better fluid to replace Hextend for battlefield resuscitation. We studied possible advantages of prehospital resuscitation with plasma compared with Hextend or albumin in a model of uncontrolled hemorrhage. METHODS: Male New Zealand white rabbits (3.3 ± 0.1 kg) were anesthetized, instrumented, and subjected to a splenic injury with uncontrolled bleeding...
April 2015: Journal of Trauma and Acute Care Surgery
Bryan E Bledsoe
The evidence is quite clear that ITH in the prehospital setting is of dubious benefit. But what is the harm in continuing the practice? Well, prehospital ITH most likely takes away from more beneficial therapies such as high-quality CPR, rapid defibrillation, recognition of ST-segment elevation myocardial infarction (STEMI), and similar essential treatments. Several studies have shown prehospital ITH, in many cases, delays hospital transport. When the initial studies of ITH were released, I was immediately on the ITH bandwagon...
February 2015: EMS World
Scott A Goldberg, Dhanadol Rojanasarntikul, Andrew Jagoda
Traumatic brain injury (TBI) is an important cause of death and disability, particularly in younger populations. The prehospital evaluation and management of TBI is a vital link between insult and definitive care and can have dramatic implications for subsequent morbidity. Following a TBI the brain is at high risk for further ischemic injury, with prehospital interventions targeted at reducing this secondary injury while optimizing cerebral physiology. In the following chapter we discuss the prehospital assessment and management of the brain-injured patient...
2015: Handbook of Clinical Neurology
Matthias Heuer, Björn Hussmann, Rolf Lefering, Gernot M Kaiser, Christoph Eicker, Olaf Guckelberger, Sven Lendemans
PURPOSE: Severe bleeding after trauma frequently leads to a poor outcome. Prehospital fluid replacement therapy is considered an important primary treatment option. We conducted a retrospective matched pair analysis to assess the influence of prehospital fluid replacement volume on the clinical course of patients with solid abdominal organ trauma. METHODS: Data were analyzed from 51,425 patients in TraumaRegister DGU® of the German Trauma Society. Inclusion criteria were as follows: injury severity score ≥ 16 points, primary admission, age ≥ 16 years, no isolated brain injury, transfusion of at least one unit of packed red blood cells (pRBCs), and systolic blood pressure ≥ 20 mmHg at the accident site...
April 2015: Langenbeck's Archives of Surgery
Edward P Sloan, Max Koenigsberg, W Brad Weir, James M Clark, Robert O'Connor, Michael Olinger, Rita Cydulka
INTRODUCTION: Optimal emergent management of traumatic hemorrhagic shock patients requires a better understanding of treatment provided in the prehospital/Emergency Medical Services (EMS) and emergency department (ED) settings. Hypothesis/Problem Described in this research are the initial clinical status, airway management, fluid and blood infusions, and time course of severely-injured hemorrhagic shock patients in the EMS and ED settings from the diaspirin cross-linked hemoglobin (DCLHb) clinical trial...
February 2015: Prehospital and Disaster Medicine
Wan-Tsu W Chang, Neeraj Badjatia
Neurotrauma continues to be a significant cause of morbidity and mortality. Prevention of primary neurologic injury is a critical public health concern. Early and thorough assessment of the patient with neurotrauma with high index of suspicion of traumatic spinal cord injuries and traumatic vascular injuries requires a multidisciplinary approach involving prehospital providers, emergency physicians, neurosurgeons, and neurointensivists. Critical care management of the patient with neurotrauma is focused on the prevention of secondary injuries...
November 2014: Emergency Medicine Clinics of North America
Jaron Santelli, Julie M Sullivan, Ann Czarnik, John Bedolla
Heat illness spans a broad spectrum of disease, with outcomes ranging from benign rash to fatal heat stroke. Heat illness is broadly divided into 2 types: classic and exertional. Both types occur as a result of exposure to elevated temperature with inadequate thermoregulation; however, classic illness occurs without preceding physical activity. Treatment consists of rapid cooling, fluid replacement, and physiologic support. Other milder forms of heat illness include heat fatigue, heat syncope, heat edema, and heat rash...
August 2014: Emergency Medicine Practice
Markus Burkhardt, Alexander Kristen, Ulf Culemann, Daniel Koehler, Tina Histing, Joerg H Holstein, Antonius Pizanis, Tim Pohlemann
Until today the mortality of complex pelvic trauma remains unacceptably high. On the one hand this could be attributed to a biological limit of the survivable trauma load, on the other hand side an ongoing inadequate treatment might be conceivable too. For the management of multiple trauma patients with life-threatening pelvic fractures, there is ongoing international debate on the adequate therapeutic strategy, e.g. arterial embolization or pelvic packing, as well as aggressive or restrained volume therapy...
October 2014: Injury
R Leberle, A Ernstberger, M Loibl, J Merkl, M Bunz, M Creutzenberg, B Trabold
INTRODUCTION: Initial fluid resuscitation in trauma is still controversial. Hydroxyethyl starch (HES), a commonly used fluid for resuscitation in trauma patients, has potential nephrotoxic effects. Advancing age is a known risk factor for acute kidney injury (AKI) in trauma patients. Therefore, the objective of this study was to evaluate the impact of large volumes of HES 130/0.4 on renal function in trauma patients, with a particular focus on the significance of age. METHODS: A retrospective review of all patients admitted to the Trauma Centre of the University Hospital Regensburg from September 1, 2007 to December 31, 2012 was performed...
January 2015: Injury
B H Bester, Simpiwe Sobuwa
OBJECTIVE: To describe the use of intravenous (IV) therapy in the South African (SA) prehopsital setting, and to determine the proportion of prehopsital cannulations considered unnecessary when graded against the South African Triage Score (SATS) chart. METHODS: The study was conducted in the prehospital emergency medical care setting in the Western Cape Province, SA. Using a descriptive research design, we looked at the report forms of patients treated and transported by personnel currently employed in the public sector, serving the urban and rural areas stipulated by the municipal boundaries...
September 2014: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Hing Lung Ip, David S Liebeskind
Recent advances in ischemic stroke enable a seamless transition of the patient flow from the prehospital setting to definitive reperfusion, without the arbitrary separation of therapeutic phases of ischemia based on time alone. In 2013, the framework to understand and directly address the pathophysiology of cerebral blood flow that determines the timeline or evolution of ischemia in an individual case is given. This continuum of flow and the homeostasis of brain perfusion balanced by collaterals may be captured with serial imaging...
May 2014: Interventional Neurology
David Wampler, Victor A Convertino, Shannon Weeks, Michael Hernandez, Jacob Larrumbide, Craig Manifold
BACKGROUND: An impedance threshold device (ITD) intended for use in the spontaneously breathing patient has been shown to raise blood pressure in hypotensive patients. This device has not been evaluated in patients with hypotension secondary to trauma. This study focused on changes in key vital signs when the ITD was added to the paramedic treatment protocol for hypotensive patients with prehospital traumatic injury. METHODS: A 6-month prospective nonrandomized observational cohort study was conducted of 200 spontaneously breathing symptomatic adult patients with prehospital hypotension due to multiple causes; the patients of primary interest experienced a traumatic injury...
September 2014: Journal of Trauma and Acute Care Surgery
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"