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https://www.readbyqxmd.com/read/27918864/comparison-of-emergency-medical-services-and-trauma-care-systems-among-pan-asian-countries-an-international-multicenter-population-based-survey
#1
Kyong Min Sun, Kyoung Jun Song, Sang Do Shin, Hideharu Tanaka, Goh E Shaun, Wen-Chu Chiang, Kentaro Kajino, Sabariah Faizah Jamaluddin, Akio Kimura, Young Sun Ro, Dae Han Wi, Ju Ok Park, Sung Woo Moon, Young Hee Jung, Min Jung Kim, James F Holmes
OBJECTIVE: Knowledge on the current trauma systems in Asian countries is limited. The objective of this study was to describe the emergency medical services (EMS) and trauma care systems among countries participating in the Pan-Asian Trauma Outcomes Study (PATOS) Clinical Research Network. METHODS: The PATOS network consists of 33 participating sites from 14 countries. Standardized data was collected from each site using an EMS survey form and included general information (population, population density, urbanization, EMS service fee, etc...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27886997/using-stable-free-radicals-to-obtain-unique-and-clinically-useful-data-in-vivo-in-human-subjects
#2
Harold M Swartz
This paper attempts to: (1) provide a critical overview of the challenges and opportunities to extend electron paramagnetic resonance (EPR) into practical applications in human subjects, based on EPR measurements made in vivo; (2) summarize the clinical applications of EPR for improving treatments in cancer, wound healing and diabetic care, emphasizing EPR's unique capability to measure tissue oxygen repeatedly and with particular sensitivity to hypoxia and (3) summarize the capabilities of in vivo EPR to measure radiation dose for triage and medical guidance after a large-scale radiation exposure...
November 24, 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/27833674/alternative-destination-transport-the-role-of-paramedics-in-optimal-use-of-the-emergency-department
#3
Michael M Neeki, Fanglong Dong, Leigh Avera, Tan Than, Rodney Borger, Joe Powell, Reza Vaezazizi, Richard Pitts
INTRODUCTION: Alternative destination transportation by emergency medical services (EMS) is a subject of hot debate between those favoring all patients being evaluated by an emergency physician (EP) and those recognizing the need to reduce emergency department (ED) crowding. This study aimed to determine whether paramedics could accurately assess a patient's acuity level to determine the need to transport to an ED. METHODS: We performed a prospective double-blinded analysis of responses recorded by paramedics and EPs of arriving patients' acuity level in a large Level II trauma center between April 2015 and November 2015...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27797986/ambulance-smartphone-tool-for-field-triage-of-ruptured-aortic-aneurysms-filtr-study-protocol-for-a-prospective-observational-validation-of-diagnostic-accuracy
#4
Thomas L Lewis, Rachael T Fothergill, Alan Karthikesalingam
INTRODUCTION: Rupture of an abdominal aortic aneurysm (rAAA) carries a considerable mortality rate and is often fatal. rAAA can be treated through open or endovascular surgical intervention and it is possible that more rapid access to definitive intervention might be a key aspect of improving mortality for rAAA. Diagnosis is not always straightforward with up to 42% of rAAA initially misdiagnosed, introducing potentially harmful delay. There is a need for an effective clinical decision support tool for accurate prehospital diagnosis and triage to enable transfer to an appropriate centre...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27793995/identifying-patients-at-risk-for-pre-hospital-sudden-cardiac-arrest-at-the-early-phase-of-myocardial-infarction-the-e-must-study
#5
Nicole Karam, Sophie Bataille, Eloi Marijon, Olivier Giovanetti, Muriel Tafflet, Dominique Savary, Hakim Benamer, Christophe Caussin, Philippe Garot, Jean-Michel Juliard, Virginie Pires, Thévy Boche, François Dupas, Gaelle Lebail, Lionel Lamhaut, François-Xavier Laborne, Hugues Lefort, Mireille B Mapouata, Frédéric Lapostolle, Christian Spaulding, Jean-Philippe Empana, Xavier Jouven, Yves Lambert
BACKGROUND: -In-hospital mortality of ST-Segment Elevation Myocardial Infarction (STEMI) has decreased drastically. In contrast pre-hospital mortality by Sudden Cardiac Arrest (SCA) remains high and difficult to reduce. Identification of the STEMI patients at higher risk for pre-hospital SCA could facilitate rapid triage and intervention in the field. METHODS: - Using a prospective population-based study evaluating all STEMI patients managed by Emergency Medical Services (EMS) in the Greater Paris Area (11...
October 28, 2016: Circulation
https://www.readbyqxmd.com/read/27789231/triage-damned-triage%C3%A2-and-statistics-sorting-out-redundancy-and-duplication-within-an-emergency-department-presenting-problem-code-set-to-enhance-research-capacity
#6
Saartje Berendsen Russell, Michael M Dinh, Nerida Bell
BACKGROUND: Having a robust Emergency Department Presenting Problem Code Set (EDPPCS) is important for collecting and analysing data around Emergency Department (ED) activity, funding, bio-surveillance and research. This paper analyses the clinical utilisation of the current EDPPCS using two years worth of ED data collected as part of the larger state-wide Demand for Emergency Services Trends in Years 2010-2014 (DESTINY) project. This project proposes potential improvements in the current EDPPCS including a reduction in duplication and redundant clinical terms...
October 24, 2016: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/27786390/diagnosis-based-emergency-department-alcohol-harm-surveillance-what-can-it-tell-us-about-acute-alcohol-harms-at-the-population-level
#7
Genevieve Whitlam, Michael Dinh, Craig Rodgers, David J Muscatello, Rhydwyn McGuire, Therese Ryan, Sarah Thackway
INTRODUCTION AND AIMS: Acute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms. DESIGN AND METHODS: We selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the 'alcohol syndrome') in the New South Wales, Australia, automatic syndromic surveillance system...
November 2016: Drug and Alcohol Review
https://www.readbyqxmd.com/read/27757716/simedis-a-discrete-event-simulation-model-for-testing-responses-to-mass-casualty-incidents
#8
Michel Debacker, Filip Van Utterbeeck, Christophe Ullrich, Erwin Dhondt, Ives Hubloue
It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS)...
December 2016: Journal of Medical Systems
https://www.readbyqxmd.com/read/27733926/wearable-multimodal-vitals-acquisition-unit-for-intelligent-field-triage
#9
Christoph Beck, Julius Georgiou
In this Letter, the authors describe the characterisation design and development of the authors' wearable, multimodal vitals acquisition unit for intelligent field triage. The unit is able to record the standard electrocardiogram, blood oxygen and body temperature parameters and also has the unique capability to record up to eight custom designed acoustic streams for heart and lung sound auscultation. These acquisition channels are highly synchronised to fully maintain the time correlation of the signals. The unit is a key component enabling systematic and intelligent field triage to continuously acquire vital patient information...
September 2016: Healthcare Technology Letters
https://www.readbyqxmd.com/read/27732713/evaluation-of-rural-vs-urban-trauma-patients-served-by-9-1-1-emergency-medical-services
#10
Craig D Newgard, Rongwei Fu, Eileen Bulger, Jerris R Hedges, N Clay Mann, Dagan A Wright, David P Lehrfeld, Carol Shields, Gregory Hoskins, Craig Warden, Lynn Wittwer, Jennifer N B Cook, Michael Verkest, William Conway, Stephanie Somerville, Matthew Hansen
Importance: Despite a large rural US population, there are potential differences between rural and urban regions in the processes and outcomes following trauma. Objectives: To describe and evaluate rural vs urban processes of care, injury severity, and mortality among injured patients served by 9-1-1 emergency medical services (EMS). Design, Setting, and Participants: This was a preplanned secondary analysis of a prospective cohort enrolled from January 1 through December 31, 2011, and followed up through hospitalization...
October 12, 2016: JAMA Surgery
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
#11
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...
October 6, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27636529/do-ems-providers-accurately-ascertain-anticoagulant-and-antiplatelet-use-in-older-adults-with-head-trauma
#12
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...
September 16, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27635947/nrasq61r-mutation-specific-immunohistochemistry-also-identifies-the-hrasq61r-mutation-in-medullary-thyroid-cancer-and-may-have-a-role-in-triaging-genetic-testing-for-men2
#13
Jessica Reagh, Martyn Bullock, Juliana Andrici, John Turchini, Loretta Sioson, Adele Clarkson, Nicole Watson, Amy Sheen, Grace Lim, Leigh Delbridge, Stan Sidhu, Mark Sywak, Ahmad Aniss, Phillip Shepherd, Daniel Ng, Paul Oei, Michael Field, Diana Learoyd, Bruce G Robinson, Roderick J Clifton-Bligh, Anthony J Gill
A quarter of patients with medullary thyroid carcinoma (MTC) have germline mutations in the RET proto-oncogene indicating MEN2. Therefore genetic testing is recommended for all patients presenting with MTC. Approximately 40% of MTCs have somatic RET mutations. Somatic mutations in the RAS genes are the next most common driver mutations and appear to be mutually exclusive with germline RET mutation. The single most common somatic RAS mutation is HRASQ61R (c.182A>G), reported in 4.6% to 11% of all MTCs. Mutation-specific immunohistochemistry (IHC) initially developed to identify the NRASQ61R mutation in melanoma (clone SP174) has proven highly sensitive and specific...
September 15, 2016: American Journal of Surgical Pathology
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
#14
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/27613217/grace-under-fire-the-army-nurses-of-pearl-harbor-1941
#15
Gwyneth R Milbrath
OBJECTIVE: Much has been written about the military events of December 7, 1941; however, little has been documented about the nurses' work and experience at Pearl Harbor, Hawaii. The aerial assault on Pearl Harbor was the first time in US history that Army nurses had been on the front line of battle. Nurses quickly triaged and stabilized those who could be saved, and provided compassion and comfort to those who were dying, in an environment where the nurses were unsure of their own survival...
October 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27610475/contrast-enhanced-dual-energy-spectral-mammogram-an-emerging-addendum-in-breast-imaging
#16
Kalpana D Kariyappa, Francis Gnanaprakasam, Subhapradha Anand, Murali Krishnaswami, Madan Ramachandran
OBJECTIVE: To assess the role of contrast-enhanced dual-energy spectral mammogram (CEDM) as a problem-solving tool in equivocal cases. METHODS: 44 consenting females with equivocal findings on full-field digital mammogram underwent CEDM. All the images were interpreted by two radiologists independently. Confidence of presence was plotted on a three-point Likert scale and probability of cancer was assigned on Breast Imaging Reporting and Data System scoring. Histopathology was taken as the gold standard...
November 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27538946/process-evaluation-for-complex-interventions-in-health-services-research-analysing-context-text-trajectories-and-disruptions
#17
Jamie Murdoch
BACKGROUND: Process evaluations assess the implementation and sustainability of complex healthcare interventions within clinical trials, with well-established theoretical models available for evaluating intervention delivery within specific contexts. However, there is a need to translate conceptualisations of context into analytical tools which enable the dynamic relationship between context and intervention implementation to be captured and understood. METHODS: In this paper I propose an alternative approach to the design, implementation and analysis of process evaluations for complex health interventions through a consideration of trial protocols as textual documents, distributed and enacted at multiple contextual levels...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27531062/development-of-mass-casualty-life-support-cbrne-mcls-cbrne-in-japan
#18
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/27521365/field-validation-of-the-reebov-antigen-rapid-test-for-point-of-care-diagnosis-of-ebola-virus-infection
#19
Matthew L Boisen, Robert W Cross, Jessica N Hartnett, Augustine Goba, Mambu Momoh, Mohamed Fullah, Michael Gbakie, Sidiki Safa, Mbalu Fonnie, Francis Baimba, Veronica J Koroma, Joan B Geisbert, Stephanie McCormick, Diana K S Nelson, Molly M Millett, Darin Oottamasathien, Abby B Jones, Ha Pham, Bethany L Brown, Jeffrey G Shaffer, John S Schieffelin, Brima Kargbo, Momoh Gbetuwa, Sahr M Gevao, Russell B Wilson, Kelly R Pitts, Thomas W Geisbert, Luis M Branco, Sheik H Khan, Donald S Grant, Robert F Garry
BACKGROUND:  The 2013-2016 West African Ebola virus disease (EVD) epidemic is the largest recorded. Triage on the basis of clinical signs had limited success, and the time to diagnosis by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) could exceed 5 days. Here we describe the development and field validation of the ReEBOV Antigen Rapid Test (ReEBOV RDT) to aid triage of individuals with suspected EVD. METHODS:  Samples from patients with suspected EVD were submitted to Kenema Government Hospital, Sierra Leone, for Lassa fever and EVD screening throughout 2014...
October 15, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27507550/understanding-the-experience-of-miscarriage-in-the-emergency-department
#20
Kate MacWilliams, Jean Hughes, Megan Aston, Simon Field, Faith Wight Moffatt
INTRODUCTION: Up to 20% of pregnancies end in miscarriage, which can be a significant life event for women with psychological implications. Because the only preventative measure for a miscarriage is risk factor modification, the treatment focuses on confirming the miscarriage has occurred and medical management of symptoms. Although women experiencing a miscarriage are frequently directed to seek medical care in emergency departments, the patients are often triaged as nonemergent patients unless they are unstable, which exposes women to potentially prolonged wait times...
November 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
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