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https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#1
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29622008/factors-associated-with-internal-medicine-physician-job-attitudes-in-the-veterans-health-administration
#2
David C Mohr, Jennifer L Eaton, Mark Meterko, Kelly L Stolzmann, Joseph D Restuccia
BACKGROUND: US healthcare organizations increasingly use physician satisfaction and attitudes as a key performance indicator. Further, many health care organizations also have an academically oriented mission. Physician involvement in research and teaching may lead to more positive workplace attitudes, with subsequent decreases in turnover and beneficial impact on patient care. This article aimed to understand the influence of time spent on academic activities and perceived quality of care in relation to job attitudes among internal medicine physicians in the Veterans Health Administration (VHA)...
April 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29607637/erratum-correction-of-author-order-reduced-mortality-by-physician-staffed-hems-dispatch-for-adult-blunt-trauma-patients-in-korea
#3
Yo Huh, John Cj Lee, Younghwan Kim, Jonghwan Moon, Seok Hwa Youn, Jiyoung Kim, Tea Youn Kim, Juryang Kim, Hyoju Kim, Kyoungwon Jung
This corrects the article on p. 1656 in vol. 31, PMID: 27550497.
April 2, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29569383/inter-disciplinary-cooperation-in-a-physician-staffed-emergency-medical-system
#4
B O Reid, M Rehn, O Uleberg, L E N Pleym, A J Krüger
BACKGROUND: On-scene management of pre-hospital emergencies is often inter-disciplinary, involving ground-emergency medical services (EMS), police- and fire services, and in Norway general practitioners on-call. This can also be supplemented by physician-staffed EMS (P-EMS), utilizing helicopters or rapid response vehicles. We hypothesized that P-EMS cooperates extensively with other emergency services, and therefore the primary aim of this study was to investigate the fraction of inter-disciplinary cooperation between P-EMS and other emergency services...
March 22, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29486493/effect-of-a-pediatric-early-warning-system-on-all-cause-mortality-in-hospitalized-pediatric-patients-the-epoch-randomized-clinical-trial
#5
Christopher S Parshuram, Karen Dryden-Palmer, Catherine Farrell, Ronald Gottesman, Martin Gray, James S Hutchison, Mark Helfaer, Elizabeth A Hunt, Ari R Joffe, Jacques Lacroix, Michael Alice Moga, Vinay Nadkarni, Nelly Ninis, Patricia C Parkin, David Wensley, Andrew R Willan, George A Tomlinson
Importance: There is limited evidence that the use of severity of illness scores in pediatric patients can facilitate timely admission to the intensive care unit or improve patient outcomes. Objective: To determine the effect of the Bedside Paediatric Early Warning System (BedsidePEWS) on all-cause hospital mortality and late admission to the intensive care unit (ICU), cardiac arrest, and ICU resource use. Design, Setting, and Participants: A multicenter cluster randomized trial of 21 hospitals located in 7 countries (Belgium, Canada, England, Ireland, Italy, New Zealand, and the Netherlands) that provided inpatient pediatric care for infants (gestational age ≥37 weeks) to teenagers (aged ≤18 years)...
February 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29478577/should-helicopters-transport-patients-who-become-sick-after-a-chemical-biological-radiological-nuclear-and-explosive-attack
#6
Youichi Yanagawa, Kouhei Ishikawa, Ikuto Takeuchi, Hiroki Nagasawa, Kei Jitsuiki, Hiromichi Ohsaka, Kazuhiko Omori
The local fire department executed a training simulation for chemical and explosive incidents at a large sports facility. In this training simulation, a physician-staffed helicopter arrived at the request of the fire department and landed just outside the cold zone in the parking area. The doctor and nurse of the helicopter were escorted to a red area in the cold zone, which was selected based on the results of postdecontamination triage. After the patients had been treated, they were air medically evacuated to the base hospital...
March 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29469616/prehospital-echocardiography-during-resuscitation-impacts-treatment-in-a-physician-staffed-helicopter-emergency-medical-service-an-observational-study
#7
Rein Ketelaars, Christian Beekers, Geert-Jan Van Geffen, Gert Jan Scheffer, Nico Hoogerwerf
BACKGROUND: Patients in cardiac arrest must receive algorithm-based management such as basic life support and advanced (cardiac) life support. International guidelines dictate diagnosing and treating any factor that may have caused the arrest or may be complicating the resuscitation. Ultrasound may be of potential value in this process and can be used in a prehospital setting. The objective is to evaluate the use of prehospital ultrasound during traumatic and non-traumatic CPR and determine its impact on prehospital treatment decisions in a Dutch helicopter emergency medical service (HEMS)...
February 22, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29463437/prehospital-quick-sequential-organ-failure-assessment-as-a-tool-to-predict-in-hospital-mortality
#8
Kyohei Miyamoto, Naoaki Shibata, Tsuyoshi Nakashima, Seiya Kato
OBJECTIVE: This study aimed to evaluate the predictive ability of quick sequential organ failure assessment (qSOFA) score for in-hospital mortality among patients transported by physician-staffed helicopters. METHODS: We conducted a single-center, retrospective observational study using the physician-staffed helicopter registry data between 2003 and 2016. We calculated the qSOFA scores based on the patients' vital signs, which were measured on the scene. The tool's discriminatory ability was determined using the area under the curve of the receiver operating characteristic...
February 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29381489/abdominal-prehospital-ultrasound-impacts-treatment-decisions-in-a-dutch-helicopter-emergency-medical-service
#9
Rein Ketelaars, Jasper J M Holtslag, Nico Hoogerwerf
OBJECTIVE: The aim of this study was to determine the impact of abdominal prehospital ultrasound (PHUS) on patient care in a Dutch physician-staffed Helicopter Emergency Medical Service (HEMS) and to determine its diagnostic performance. PATIENTS AND METHODS: We carried out a retrospective analysis of abdominal ultrasound (US) examinations performed by the HEMS of Nijmegen, the Netherlands, from January 2007 until December 2016. Data including patient demographics, type of incident, abdominal US findings, impact on treatment decisions, and the physicians' narrative report were retrieved from the HEMS database and analyzed...
January 29, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29284700/an-ngo-implemented-community-clinic-health-worker-approach-to-providing-long-term-care-for-hypertension-in-a-remote-region-of-southern-india
#10
Sujatha Sankaran, Prema S Ravi, Yichen Ethel Wu, Sharan Shanabogue, Sangeetha Ashok, Kaylan Agnew, Margaret C Fang, Raman A Khanna, Madhavi Dandu, James D Harrison
Poor blood pressure control results in tremendous morbidity and mortality in India where the leading cause of death among adults is from coronary heart disease. Despite having little formal education, community health workers (CHWs) are integral to successful public health interventions in India and other low- and middle-income countries that have a shortage of trained health professionals. Training CHWs to screen for and manage chronic hypertension, with support from trained clinicians, offers an excellent opportunity for effecting systemwide change in hypertension-related burden of disease...
December 28, 2017: Global Health, Science and Practice
https://www.readbyqxmd.com/read/29230501/-development-of-ground-based-physician-staffed-emergency-missions-in-the-city-of-leipzig-from-2003-to-2013
#11
K Bader, M Bernhard, A Gries, M Kaul, R Schröder, A Ramshorn-Zimmer
BACKGROUND: The annual number of physician-based emergency missions reported is continuously increasing. Data from large cities concerning this development over long periods is sparse. MATERIAL AND METHODS: In this retrospective study the charts of all ground-based physician-staffed emergency missions in the city of Leipzig for the first quarters of 2003 and 2013 were analyzed. Patient characteristics, injury and illness severities, mission location, hospital admission rate, as well as emergency interventions were collated...
March 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29223696/key-players-in-key-roles-the-baystate-patient-progress-initiative-to-improve-emergency-department-efficiency-and-productivity
#12
Niels K Rathlev, Jacqualyn Anderson, Joseph Schmidt, Joeli Hettler, Lynn Garreffi, Molly Gray, Douglas Neal, Paul Visintainer
BACKGROUND: The percentage of patients who leave the emergency department without being seen by a provider is a measure of efficiency and presents risk-management concerns. The number of patients actually "seen" by a provider is a measure of productivity. The opening of our new emergency department in December 2012, resulted in increases in both demand and the percentage of patients who left without being seen. Operational nursing leadership managed ED patient flow, but the structure was loosely organized on an ad hoc basis...
December 6, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29189297/are-on-scene-blood-transfusions-by-a-helicopter-emergency-medical-service-useful-and-safe-a-multicentre-case-control-study
#13
Joost H Peters, Pascal S H Smulders, Xavier R J Moors, Stef J M Bouman, Claartje M E M Meijs, Nico Hoogerwerf, Michael J R Edwards
INTRODUCTION: In the prehospital setting, crystalloid fluids are frequently used, but only erythrocytes are capable of transporting oxygen to tissues. The aim of this study was to establish the efficacy and safety of the prehospital use of uncross matched type O rhesus-negative packed red blood cells (URBC) by the Dutch physician-staffed helicopter emergency medical service. We hypothesized that prehospital URBC transfusions are safe and more effective with respect to survival than resuscitations with crystalloids...
November 17, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29174280/physician-staffing-needs-in-critical-care-departments
#14
V Gómez Tello, J Ruiz Moreno, M Weiss, E González Marín, P Merino de Cos, N Franco Garrobo, A Alonso Ovies, J C Montejo González, T Iber, G Marx, V Córcoles González, F Gordo Vidal, E Palencia Herrejón, J Roca Guiseris
Departments of Critical Care Medicine are characterized by high medical assistance costs and great complexity. Published recommendations on determining the needs of medical staff in the DCCM are based on low levels of evidence and attribute excessive significance to the structural/welfare approach (physician-to-beds ratio), thus generating incomplete and minimalistic information. The Spanish Society of Intensive Care Medicine and Coronary Units established a Technical Committee of experts, the purpose of which was to draft recommendations regarding requirements for medical professionals in the ICU...
January 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29037168/locating-helicopter-emergency-medical-service-bases-to-optimise-population-coverage-versus-average-response-time
#15
Alan A Garner, Pieter L van den Berg
BACKGROUND: New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate optimal HEMS base locations within NSW using advanced mathematical modelling techniques. METHODS: We used high resolution census population data for NSW from 2011 which divides the state into areas containing 200-800 people...
October 16, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28975883/prehospital-interventions-before-and-after-implementation-of-a-physician-staffed-helicopter
#16
Asger Sonne, Sandra Wulffeld, Jacob Steinmetz, Lars S Rasmussen, Rasmus Hesselfeldt
INTRODUCTION: Implementation of a physician-staffed helicopter emergency medical service (HEMS) in eastern Denmark was associated with increased survival for severely injured patients. This study aimed to assess the potential impact of advanced prehospital interventions by comparing the proportion of patients who received those interventions before and after the HEMS implementation. METHODS: A post-hoc analysis of a prospective before-after study. We included trauma patients with Injury Severity Scores above three who had been admitted to seven emergency departments or one level 1 trauma centre in the course of a five-month period before and a 12-month period after the HEMS implementation...
October 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#17
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28864437/organizational-factors-associated-with-perceived-quality-of-patient-care-in-closed-intensive-care-units
#18
Nathalie McIntosh, Eva Oppel, David Mohr, Mark Meterko
BACKGROUND: Improving patient care quality in intensive care units is increasingly important as intensive care unit services account for a growing proportion of hospital services. Organizational factors associated with quality of patient care in such units have been identified; however, most were examined in isolation, making it difficult to assess the relative importance of each. Furthermore, though most intensive care units now use a closed model, little research has been done in this specific context...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28828300/generalizable-items-and-modular-structure-for-computerised-physician-staffing-calculation-on-intensive-care-units
#19
REVIEW
Manfred Weiss, Gernot Marx, Thomas Iber
Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28739239/acute-coronary-syndrome-evacuated-by-a-helicopter-from-the-scene
#20
Hiromichi Ohsaka, Kazuhio Omori, Ikuto Takeuchi, Kei Jitsuiki, Toshihiko Yoshizawa, Kouhei Ishikawa, Kikuo Isoda, Satoru Suwa, Youichi Yanagawa
OBJECTIVE: The purpose of this study was to investigate the safety of evacuating patients using a physician-staffed helicopter (Dr. Heli). METHODS: We retrospectively investigated all of the patients with acute coronary syndrome (ACS) who were transported by a Dr. Heli between April 2004 and March 2016. The scene group included subjects evacuated from the scene by the Dr. Heli. The interhospital group included subjects transported to a nearby medical facility by a ground ambulance and then transported to our hospital by a Dr...
July 2017: Air Medical Journal
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