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H W Wietske Ham, L Lisette Schoonhoven, M Marieke J Schuurmans, L Luke P H Leenen
OBJECTIVES: To explore the influence of risk factors present at Emergency Department admission on pressure ulcer development in trauma patients with suspected spinal injury, admitted to the hospital for evaluation and treatment of acute traumatic injuries. DESIGN: Prospective cohort study setting level one trauma center in the Netherlands participants adult trauma patients transported to the Emergency Department on a backboard, with extrication collar and headblocks and admitted to the hospital for treatment or evaluation of their injuries...
July 19, 2016: International Emergency Nursing
Esa Soppi, Ansa Iivanainen, Leila Sikanen, Elina Jouppila-Kupiainen
The relationship between the efficacy of resuscitation and the mattresses and backboards used in acute care units, has been studied previously. However, few reports focus on the relative efficacy of resuscitation when using mattresses with different modes of function. This study examines the performance of different support surfaces during experimental cardiopulmonary resuscitation (CPR). The surfaces included a hard surface, a higher specification foam mattress, a dynamic, alternating pressure mattress, and a dynamic, reactive minimum pressure air mattress system...
February 2016: Heliyon
Şaban Akkuş, Şeref Kerem Çorbacıoğlu, Yunsur Çevik, Emine Akıncı, Hüseyin Uzunosmanoğlu
PURPOSE: The purpose of the study is to investigate whether spinal immobilization with a long backboard (LBB) and semirigid cervical collar (CC) at 20° instead of 0° conserve pulmonary functions, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. METHODOLOGY: The study included 56 adult healthy volunteers. Volunteers were randomly divided into 2 groups, and those in the first group (group 1) had LBBs and CCs applied at 0° (n=30), whereas volunteers in the second group (group 2) had LBBs and CCs applied at 20° (n=26)...
July 1, 2016: American Journal of Emergency Medicine
Ahmet Bulent Yazici, Mine Gul, Esra Yazici, Gazanfer Kemal Gul
Sports and physical activity are widely recommended, both as guidelines and in clinical practice, because of their broad range of positive effects on health, depression, anxiety, and psychological well-being. While several studies have examined the anti-depressive and anxiolytic effects of physical activity in clinical populations, and fewer studies have focused on the nonclinical populations, the relationship between tennis and well-being has not been clearly investigated. This study was carried out with 76 student volunteers from Kocaeli University (Turkey) who had chosen tennis lessons as their University...
May 18, 2016: Mental Illness
Matthew J Douma, Domhnall O'Dochartaigh, Peter G Brindley
BACKGROUND: Minimizing haemorrhage using direct pressure is intuitive and widely taught. In contrast, this study examines the use of indirect-pressure, specifically external aortic compression (EAC). Indirect pressure has great potential for temporizing bleeds not amenable to direct tamponade i.e. abdominal-pelvic, junctional, and multi-site trauma. However, it is currently unclear how to optimize this technique. METHODS: We designed a model of central vessel compression using the Malbrain intra-abdominal pressure monitor and digital weigh scale...
September 2016: Injury
Chris P Yang, Elizabeth A Hunt, Nicole Shilkofski, Robert Dudas, Chinyere Egbuta, Jamie M Schwartz
OBJECTIVES: Children transferred from community hospitals lacking specialized pediatric care are more seriously ill than those presenting to pediatric centers. Pediatric consultation and adherence to management guidelines improve outcomes. The aims of the study were (1) to assess whether telemedicine consultation in critical situations is feasible and (2) to compare the impact of pediatric critical care medicine (PCCM) consultation via telemedicine versus telephone on community hospital adherence to resuscitation guidelines through a randomized controlled telemedicine trial...
March 3, 2016: Pediatric Emergency Care
A Y Lee, S Elojeimy, K M Kanal, K F Linnau, M L Gunn
AIM: To assess the effect of trauma backboards on the radiation dose at computed tomography (CT) when using automatic tube current modulation (ATCM). MATERIALS AND METHODS: An anthropomorphic phantom was scanned with two commercially available CT systems (GE LightSpeed16 Pro and Siemens Definition AS+) without and with backboards. Tube current-time product (mAs), and CTDIvol (mGy) were recorded for each examination. Thermoluminescent dosimeters were used to measure skin entrance dose in the pelvis and breast...
May 2016: Clinical Radiology
Jing Nong Liang, David A Brown
OBJECTIVE: Successful execution of upright locomotion requires coordinated interaction between controllers for locomotion and posture. Our earlier research supported this model in the non-impaired and found impaired interaction in the post-stroke nervous system during locomotion. In this study, we sought to examine the role of the Ia afferent spinal loop, via the H-reflex response, under postural influence during a locomotor task. We tested the hypothesis that the ability to increase stretch reflex gain in response to postural loads during locomotion would be reduced post-stroke...
2015: PloS One
Gabriel Putzer, Anna Fiala, Patrick Braun, Sabrina Neururer, Karin Biechl, Bernhard Keilig, Werner Ploner, Ernst Fop, Peter Paal
BACKGROUND: Chest compression quality is decisive for overall outcome after cardiac arrest. Chest compression depth may decrease when cardiopulmonary resuscitation (CPR) is performed on a mattress, and the use of a backboard does not necessarily improve compression depth. Mechanical chest compression devices may overcome this problem. OBJECTIVES: We sought to investigate the effectiveness of manual chest compressions both with and without a backboard compared to mechanical CPR performed on surfaces of different softness...
April 2016: Journal of Emergency Medicine
A Ala, S Shams-Vahdati, A Taghizadieh, S H Miri, N Kazemi, S R Hodjati, M Jalilzadeh-Binazar
INTRODUCTION: According to Advanced Trauma Life Support (ATLS) for trauma patients, a cervical collar should be applied initially. Patients on backboards with a cervical collar mostly complain of dyspnea and tend to take the collar off or roll themselves off the backboard. The purpose of this study is to investigate the effect of collar removal on lung volumes and dyspnea in patients with GCS 15. METHOD: In a physiological study, 50 trauma patients with a GCS of 15 were enrolled...
September 3, 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jonathan DeShaw, Salam Rahmatalla
This work presents a predictive model to evaluate discomfort associated with supine humans during transportation, where whole-body vibration and repeated shock are predominant. The proposed model consists of two parts: (i) static discomfort resulting from body posture, joint limits and ambient discomfort; and (ii) dynamic discomfort resulting from the relative motion between the body segments as a result of transmitted vibration. Twelve supine subjects were exposed to single and 3D random vibrations and 3D shocks mixed with vibrations...
April 2016: Ergonomics
Joshua Bucher, Frank Dos Santos, Danny Frazier, Mark A Merlin
INTRODUCTION: The goal of this study was to compare application of the Kendrick Extrication Device (KED) versus rapid extrication (RE) by emergency medical service personnel. Our primary endpoints were movement of head, time to extrication and patient comfort by a visual analogue scale. METHODS: We used 23 subjects in two scenarios for this study. The emergency medical services (EMS) providers were composed of one basic emergency medical technician (EMT), one advanced EMT...
May 2015: Western Journal of Emergency Medicine
Kevin T Collopy, Sean M Kivlehan, Scott R Snyder
Evidence-based medicine will continually change the paradigm in which emergency medicine is practiced. Fifteen years ago tourniquets were a last resort and often considered a guaranteed way to lose a limb; today they are a gold standard in hemorrhage control. Believing in, and having practiced, medicine we later learn to be false doesn't make someone a bad provider, nor does it make them wrong. It simply means emergency medicine and EMS will continue to develop as a profession, and our body of evidence will continue to grow as we learn more about prehospital care...
March 2015: EMS World
Robert P Olympia, Kaylee Hollern, Caitlin Armstrong, Pelumi Adedayo, Jennifer Dunnick, Jessica Hartley, Bhavin Doshi
OBJECTIVE: To determine the compliance of US camps with guidelines for health and safety practices as set forth by the American Academy of Pediatrics and the US Department of Homeland Security. METHODS: An electronic questionnaire was distributed to US camps during the summer of 2012 as identified by 3 online summer camp directories. RESULTS: Analysis was performed on 433 completed questionnaires. Fourteen percent of camps were considered medically related...
March 2015: Pediatric Emergency Care
Nancy J Sullivan, Jordan Duval-Arnould, Marida Twilley, Sarah P Smith, Deborah Aksamit, Pam Boone-Guercio, Pamela R Jeffries, Elizabeth A Hunt
BACKGROUND: Traditional American Heart Association (AHA) cardiopulmonary resuscitation (CPR) curriculum focuses on teams of two performing quality chest compressions with rescuers on their knees but does not include training specific to In-Hospital Cardiac Arrests (IHCA), i.e. patient in hospital bed with large resuscitation teams and sophisticated technology available. DESIGN: A randomized controlled trial was conducted with the primary goal of evaluating the effectiveness and ideal frequency of in-situ training on time elapsed from call for help to; (1) initiation of chest compressions and (2) successful defibrillation in IHCA...
January 2015: Resuscitation
Nancy M Tofil, Dawn Taylor Peterson, Julie Turner Wheeler, Amber Youngblood, J Lynn Zinkan, Diego Lara, Brett Jakaitis, Julia Niebauer, Marjorie Lee White
BACKGROUND: Repeated exposure to pediatric emergency scenarios improves technical skills, but it is unclear whether repeated exposure to specific cases affects medical decision making in varied cases. OBJECTIVE: We sought to determine whether repeated exposure to 1 scenario would translate to improved performance and decision making in varied scenarios. METHODS: Senior pediatrics residents participated in 3 scenarios with scripted debriefing...
June 2014: Journal of Graduate Medical Education
Wietske Ham, Lisette Schoonhoven, Marieke J Schuurmans, Luke P H Leenen
BACKGROUND: To protect the (possibly) injured spine, trauma patients are immobilized on backboard or vacuum mattress, with a cervical collar, lateral headblocks, and straps. Several studies identified pressure ulcer (PU) development from these devices. The aim of this literature study was to gain insight into the occurrence and development of PUs, the risk factors, and the possible interventions to prevent PUs related to spinal immobilization with devices in adult trauma patients. METHODS: We systematically searched PubMed (MEDLINE), EMBASE, Cochrane, and CINAHL for the period 1970 to September 2011...
April 2014: Journal of Trauma and Acute Care Surgery
Marko Sainio, Heidi Hellevuo, Heini Huhtala, Sanna Hoppu, Joar Eilevstjønn, Jyrki Tenhunen, Klaus T Olkkola
AIM: Implementation of chest compression (CC) feedback devices with a single force and deflection sensor (FDS) may improve the quality of CPR. However, CC depth may be overestimated if the patient is on a compliant surface. We have measured the true CC depth during in-hospital CPR using two FDSs on different bed and mattress types. METHODS: This prospective observational study was conducted at Tampere University Hospital between August 2011 and September 2012. During in-hospital CPR one FDS was placed between the rescuer's hand and the patient's chest, with the second attached to the backboard between the patient's back and the mattress...
June 2014: Resuscitation
Chelsea C White, Robert M Domeier, Michael G Millin
Field spinal immobilization using a backboard and cervical collar has been standard practice for patients with suspected spine injury since the 1960s. The backboard has been a component of field spinal immobilization despite lack of efficacy evidence. While the backboard is a useful spinal protection tool during extrication, use of backboards is not without risk, as they have been shown to cause respiratory compromise, pain, and pressure sores. Backboards also alter a patient's physical exam, resulting in unnecessary radiographs...
April 2014: Prehospital Emergency Care
James F Morrissey, Elsie R Kusel, Karl A Sporer
INTRODUCTION: Prehospital spine immobilization has long been applied to victims of trauma in the United States and up to 5 million patients per year are immobilized mostly with a cervical collar and a backboard. OBJECTIVE: The training of paramedics and emergency medical technicians on the principals of spine motion restriction (SMR) will decrease the use of backboards. METHODS: The training for SMR emphasized the need to immobilize those patients with a significant potential for an unstable cervical spine fracture and to use alternative methods of maintaining spine precautions for those with lower risk...
July 2014: Prehospital Emergency Care
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