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Field triage guidelines

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https://www.readbyqxmd.com/read/28489471/effect-of-the-2011-revisions-to-the-field-triage-guidelines-on-under-and-over-triage-rates-for-pediatric-trauma-patients
#1
E Brooke Lerner, Jeremy T Cushman, Amy L Drendel, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: In 2011, revised Field Triage Guidelines were released jointly by the Centers for Disease Control and Prevention (CDC) and the American College of Surgeons - Committee on Trauma (ACS-COT). It is unknown how the modifications will affect the number of injured children identified by EMS providers as needing transport to a trauma center. OBJECTIVE: To determine the change in under- and over-triage rates when the 2011 Field Triage Guidelines are compared to the 2006 and 1999 versions...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28459301/role-of-guideline-adherence-in-improving-field-triage
#2
Craig D Newgard, Rongwei Fu, E Brooke Lerner, Mohamud Daya, Jonathan Jui, Lynn Wittwer, Terri A Schmidt, Dana Zive, Eileen M Bulger, Ritu Sahni, Craig Warden, Nathan Kuppermann
OBJECTIVE: To compare the sensitivity of current field triage practices for identifying high-risk trauma patients to strict guideline adherence, including changes in triage specificity, ambulance transport patterns, and trauma center volumes. METHODS: This was a pre-planned secondary analysis of an out-of-hospital prospective cohort of injured children and adults transported by 44 EMS agencies to 28 trauma and non-trauma hospitals in 7 Northwest U.S. counties from January 1, 2011 through December 31, 2011...
May 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28422541/evaluation-of-the-implementation-of-the-trauma-triage-and-destination-plan-on-the-field-triage-of-injured-patients-in-north-carolina
#3
Jane H Brice, Frances S Shofer, Christopher Cowden, E Brooke Lerner, Matthew Psioda, Meredith Arasaratanam, N Clay Mann, Antonio R Fernandez, Anna Waller, Chailee Moss, Michael Mian
OBJECTIVE: Timely triage and appropriate destination decision making for injured patients are central challenges faced by emergency medical services (EMS) systems. In 2010, North Carolina (NC) adopted a statewide Trauma Triage and Destination Plan (TTDP) based on the CDC's Field Triage Guidelines to better address these challenges. We sought to characterize the implementation of these guidelines by quantifying their effect on multiple metrics of patient care. METHODS: We employed a retrospective pre-post study design utilizing a statewide EMS medical record database...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28322534/indicators-for-monitoring-screening-programs-with-primary-hpv-test
#4
Manuel Zorzi, Paolo Giorgi Rossi
BACKGROUND: following scientific evidence produced in numerous studies, as well as national and international guidelines, organized cervical cancer screening programs in Italy have gradually introduced the HPV test as primary screening test, replacing cytology. As public health interventions, screening programs must ensure equity, improvement in quality of life, and adequate information for the population involved with regards to benefits and possible risks; therefore, it is essential for quality to be constantly checked at every phase of the project...
January 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/28238499/out-of-hospital-triage-of-older-adults-with-head-injury-a-retrospective-study-of-the-effect-of-adding-anticoagulation-or-antiplatelet-medication-use-as-a-criterion
#5
Daniel K Nishijima, Samuel D Gaona, Trent Waechter, Ric Maloney, Troy Bair, Adam Blitz, Andrew R Elms, Roel D Farrales, Calvin Howard, James Montoya, Jeneita M Bell, Mark Faul, David R Vinson, Hernando Garzon, James F Holmes, Dustin W Ballard
STUDY OBJECTIVE: Field triage guidelines recommend that emergency medical services (EMS) providers consider transport of head-injured older adults with anticoagulation use to trauma centers. However, the triage patterns and the incidence of intracranial hemorrhage or neurosurgery in these patients are unknown. Our objective is to describe the characteristics and outcomes of older adults with head trauma who are transported by EMS, particularly for patients who do not meet physiologic, anatomic, or mechanism-of-injury (steps 1 to 3) field triage criteria but are receiving anticoagulant or antiplatelet medications...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27992953/age-related-disparities-in-trauma-center-access-for-severe-head-injuries-following-the-release-of-the-updated-field-triage-guidelines
#6
Thomas J Flottemesch, Susan Raetzman, Kevin C Heslin, Katie Fingar, Rosanna Coffey, Marguerite Barrett, Ernest Moy
OBJECTIVE: In 2006, the American College of Surgeons' Committee on Trauma and the Centers for Disease Control and Prevention released field triage guidelines with special consideration for older adults. Additional considerations for direct transport to a Level I or II trauma center (TC) were added in 2011, reflecting perceived undertriage to TCs for older adults. We examined whether age-based disparities in TC care for severe head injury decreased following introduction of the 2011 revisions...
April 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27928226/achieving-timely-percutaneous-reperfusion-for-rural-st-elevation-myocardial-infarction-patients-by-direct-transport-to-an-urban-pci-hospital
#7
Charles-Lwanga K Bennin, Saif Ibrahim, Farah Al-Saffar, Lyndon C Box, Joel A Strom
BACKGROUNDS: ST-elevation myocardial infarction (STEMI) guidelines recommend reperfusion by primary percutaneous coronary intervention (PCI) ≤ 90 min from time of first medical contact (FMC). This strategy is challenging in rural areas lacking a nearby PCI-capable hospital. Recommended reperfusion times can be achieved for STEMI patients presenting in rural areas without a nearby PCI-capable hospital by ground transportation to a central PCI-capable hospital by use of protocol-driven emergency medical service (EMS) STEMI field triage protocol...
October 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27710155/ability-of-the-physiologic-criteria-of-the-field-triage-guidelines-to-identify-children-who-need-the-resources-of-a-trauma-center
#8
E Brooke Lerner, Amy L Drendel, Jeremy T Cushman, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: There is limited research on how well the American College of Surgeons/Center for Disease Control and Prevention Guidelines for Field Triage of Injured Patients assist EMS providers in identifying children who need the resources of a trauma center. OBJECTIVE: To determine the accuracy of the Physiologic Criteria (Step 1) of the Field Triage Guidelines in identifying injured children who need the resources of a trauma center. METHODS: EMS providers who transported injured children 15 years and younger to pediatric trauma centers in 3 mid-sized cities were interviewed regarding patient demographics and the presence or absence of each of the Field Triage Guidelines criteria...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27636529/do-ems-providers-accurately-ascertain-anticoagulant-and-antiplatelet-use-in-older-adults-with-head-trauma
#9
Daniel K Nishijima, Samuel Gaona, Trent Waechter, Ric Maloney, Troy Bair, Adam Blitz, Andrew R Elms, Roel D Farrales, Calvin Howard, James Montoya, Jeneita M Bell, Victor C Coronado, David E Sugerman, Dustin W Ballard, Kevin E Mackey, David R Vinson, James F Holmes
OBJECTIVE: Prehospital provider assessment of the use of anticoagulant or antiplatelet medications in older adults with head trauma is important. These patients are at increased risk for traumatic intracranial hemorrhage and therefore field triage guidelines recommend transporting these patients to centers capable of rapid evaluation and treatment. Our objective was to evaluate EMS ascertainment of anticoagulant and antiplatelet medication use in older adults with head trauma. METHODS: A retrospective study of older adults with head trauma was conducted throughout Sacramento County...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27633781/accidental-hypothermia-an-update-the-content-of-this-review-is-endorsed-by-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#10
REVIEW
Peter Paal, Les Gordon, Giacomo Strapazzon, Monika Brodmann Maeder, Gabriel Putzer, Beat Walpoth, Michael Wanscher, Doug Brown, Michael Holzer, Gregor Broessner, Hermann Brugger
BACKGROUND: This paper provides an up-to-date review of the management and outcome of accidental hypothermia patients with and without cardiac arrest. METHODS: The authors reviewed the relevant literature in their specialist field. Summaries were merged, discussed and approved to produce this narrative review. RESULTS: The hospital use of minimally-invasive rewarming for non-arrested, otherwise healthy, patients with primary hypothermia and stable vital signs has the potential to substantially decrease morbidity and mortality for these patients...
September 15, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27531062/development-of-mass-casualty-life-support-cbrne-mcls-cbrne-in-japan
#11
Hideaki Anan, Yasuhiro Otomo, Hisayoshi Kondo, Masato Homma, Yuichi Koido, Kazuma Morino, Kenichi Oshiro, Kiyokazu Harikae, Osamu Akasaka
This report outlines the need for the development of an advanced course in mass-casualty life support (MCLS) and introduces the course content. The current problems with education on disasters involving chemical agents, biological agents, radiation/nuclear attacks, or explosives (CBRNE) in Japan are presented. This newly developed "MCLS-CBRNE" program was created by a Ministry of Health, Labour, and Welfare (Tokyo, Japan) research group based on these circumstances. Modifications were then made after a trial course...
October 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27100748/a-proposed-field-emergency-donor-panel-questionnaire-and-triage-tool
#12
Heidi Doughty, Patrick Thompson, Andrew P Cap, Philip C Spinella, Elon Glassberg, Håkon Skogrand Eliassen, Marc De Pasquale, Geir Strandenes
BACKGROUND: The provision of transfusion support to isolated military or civilian projects may require the use of an emergency donor panel (EDP) for immediate warm fresh whole blood (WFWB). The aim of this short discussion article is to raise and resolve some of the practical aspects for the nonspecialist faced with the emergency collection of WFWB whole blood in the austere medical environment (AME). METHODS AND RESULTS: A proposed field EDP questionnaire and triage tool (QTT) is presented...
April 2016: Transfusion
https://www.readbyqxmd.com/read/27094925/endometrial-biomarkers-for-the-non-invasive-diagnosis-of-endometriosis
#13
REVIEW
Devashana Gupta, M Louise Hull, Ian Fraser, Laura Miller, Patrick M M Bossuyt, Neil Johnson, Vicki Nisenblat
BACKGROUND: About 10% of reproductive-aged women suffer from endometriosis, which is a costly, chronic disease that causes pelvic pain and subfertility. Laparoscopy is the gold standard diagnostic test for endometriosis, but it is expensive and carries surgical risks. Currently, there are no non-invasive tests available in clinical practice that accurately diagnose endometriosis. This is the first diagnostic test accuracy review of endometrial biomarkers for endometriosis that utilises Cochrane methodologies, providing an update on the rapidly expanding literature in this field...
April 20, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26774173/termination-of-resuscitation-in-the-prehospital-setting-a-comparison-of-decisions-in-clinical-practice-vs-recommendations-of-a-termination-rule
#14
COMPARATIVE STUDY
Dominique V M Verhaert, Judith L Bonnes, Joris Nas, Wessel Keuper, Pierre M van Grunsven, Joep L R M Smeets, Menko Jan de Boer, Marc A Brouwer
BACKGROUND: Of the proposed algorithms that provide guidance for in-field termination of resuscitation (TOR) decisions, the guidelines for cardiopulmonary resuscitation (CPR) refer to the basic and advanced life support (ALS)-TOR rules. To assess the potential consequences of implementation of the ALS-TOR rule, we performed a case-by-case evaluation of our in-field termination decisions and assessed the corresponding recommendations of the ALS-TOR rule. METHODS: Cohort of non-traumatic out-of-hospital cardiac arrest (OHCA)-patients who were resuscitated by the ALS-practising emergency medical service (EMS) in the Nijmegen area (2008-2011)...
March 2016: Resuscitation
https://www.readbyqxmd.com/read/26712244/prospective-validation-of-the-national-field-triage-guidelines-for-identifying-seriously-injured-persons
#15
MULTICENTER STUDY
Craig D Newgard, Rongwei Fu, Dana Zive, Tom Rea, Susan Malveau, Mohamud Daya, Jonathan Jui, Denise E Griffiths, Lynn Wittwer, Ritu Sahni, K Dean Gubler, Jonathan Chin, Pat Klotz, Stephanie Somerville, Tina Beeler, T J Bishop, Tara N Garland, Eileen Bulger
BACKGROUND: The national field trauma triage guidelines have been widely implemented in US trauma systems, but never prospectively validated. We sought to prospectively validate the guidelines, as applied by out-of-hospital providers, for identifying high-risk trauma patients. STUDY DESIGN: This was an out-of-hospital prospective cohort study from January 1, 2011 through December 31, 2011 with 44 Emergency Medical Services agencies in 7 counties in 2 states. We enrolled injured patients transported to 28 acute care hospitals, including 7 major trauma centers (Level I and II trauma hospitals) and 21 nontrauma hospitals...
February 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26543836/a-triage-model-for-chemical-warfare-casualties
#16
REVIEW
Mohammad Ali Khoshnevis, Yunes Panahi, Mostafa Ghanei, Hojat Borna, Amirhossein Sahebkar, Jafar Aslani
CONTEXT: The main objectives of triage are securing patient safety during the process of emergency diagnosis and treatment, and reduction of waiting time for medical services and transport. To date, there is no triage system for nerve agent victims. EVIDENCE ACQUISITION: This systematic review proposes a new triage system for patients exposed to nerve agents. Information regarding clinical signs and symptoms of intoxication with nerve agents, primary treatments, and classification of patients were extracted from the literature...
August 2015: Trauma Monthly
https://www.readbyqxmd.com/read/26513859/-the-value-of-surgical-experience-gained-during-the-great-patriotic-war-for-the-modern-military-surgery
#17
N A Efimenko, L M Samokhvalov
The surgical experience gained during the Great Patriotic War (1941-1945) is a basis of the modern Russian military surgery, which allows providing any options for surgical care to the wounded. The article describes the main achievements of the military surgeons in our country during the Great Patriotic War, which helped the Soviet (Russian) military field surgery to achieve a leading position in the world of military medicine. The role of the united martial medical doctrine, three editions of "Guidelines for the military surgery", the qualified surgical assistance as a mean that helped to deliver surgical care to the wounded, the introduction of specialized medical care, technology development of medical triage, as well as the origins of the tactics of a multi-stage surgical treatment of combat trauma and special treatment of minimally wounded during the war...
May 2015: Voenno-medit︠s︡inskiĭ Zhurnal
https://www.readbyqxmd.com/read/26477345/improving-early-identification-of-the-high-risk-elderly-trauma-patient-by-emergency-medical-services
#18
MULTICENTER STUDY
Craig D Newgard, James F Holmes, Jason S Haukoos, Eileen M Bulger, Kristan Staudenmayer, Lynn Wittwer, Eric Stecker, Mengtao Dai, Renee Y Hsia
STUDY OBJECTIVE: We sought to (1) define the high-risk elderly trauma patient based on prognostic differences associated with different injury patterns and (2) derive alternative field trauma triage guidelines that mesh with national field triage guidelines to improve identification of high-risk elderly patients. METHODS: This was a retrospective cohort study of injured adults ≥65 years transported by 94 EMS agencies to 122 hospitals in 7 regions from 1/1/2006 through 12/31/2008...
January 2016: Injury
https://www.readbyqxmd.com/read/26415807/mass-casualty-incident-primary-triage-methods-in-china
#19
REVIEW
Jin-Hong Chen, Jun Yang, Yu Yang, Jing-Chen Zheng
OBJECTIVE: To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China. DATA SOURCES: Chinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014). The English literature was searched by PubMed (MEDLINE) (1950 to June 2014). We also searched Official Websites of Chinese Central Government's (http://www.gov.cn/), National Health and Family Planning Commission of China (http://www...
October 5, 2015: Chinese Medical Journal
https://www.readbyqxmd.com/read/26253883/impact-of-age-on-the-clinical-outcomes-of-major-trauma
#20
REVIEW
F Hildebrand, H-C Pape, K Horst, H Andruszkow, P Kobbe, T-P Simon, G Marx, T Schürholz
PURPOSE: In view of demographic changes over the past few decades, the average age of trauma patients is progressively increasing. We therefore aimed to summarize the specific characteristics of geriatric trauma and to identify potential fields for further research to improve the care of elderly trauma patients. METHODS: Review of the literature. RESULTS: Due to the diverse risk factors (e.g., pre-existing conditions, limited physiological reserve), geriatric patients are prone to developing severe complications, even after less severe trauma...
June 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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