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prehospital hypothermia

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https://www.readbyqxmd.com/read/28416582/relationship-between-oxygen-concentration-and-temperature-in-an-exothermic-warming-device
#1
Ben Brooks, Charles D Deakin
INTRODUCTION: Actively warming hypothermic patients or preventing hypothermia is critical in optimising outcomes in patients with traumatic injuries. Our aim was to investigate the effect of ambient oxygen concentration on the rate and change in temperature of the TechTrade Ready-Heat II exothermic (oxygen-activated) warming blanket, to evaluate safety and ascertain the risk of thermal injury. METHODS: A mannequin covered with an exothermic blanket was placed in a sealed oxygen tent...
April 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28352966/cold-blooded-evaluating-brain-temperature-by-mri-during-surface-cooling-of-human-subjects
#2
Eric J Curran, Daniel L Wolfson, Richard Watts, Kalev Freeman
BACKGROUND: Targeted temperature management (TTM) confers neurological and survival benefits for post-cardiac arrest patients with return of spontaneous circulation (ROSC) who remain comatose. Specialized equipment for induction of hypothermia is not available in the prehospital setting, and there are no reliable methods for emergency medical services personnel to initiate TTM. We hypothesized that the application of surface cooling elements to the neck will decrease brain temperature and act as initiators of TTM...
March 28, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#3
Michael W Hubble, Clark Tyson
Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28202085/should-capnography-be-used-as-a-guide-for-choosing-a-ventilation-strategy-in-circulatory-shock-caused-by-severe-hypothermia-observational-case-series-study
#4
Tomasz Darocha, Sylweriusz Kosiński, Anna Jarosz, Paweł Podsiadło, Mirosław Ziętkiewicz, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia can cause circulatory disturbances ranging from cardiac arrhythmias through circulatory shock to cardiac arrest. Severity of shock, pulmonary hypoperfusion and ventilation-perfusion mismatch are reflected by a discrepancy between measurements of CO2 levels in end-tidal air (EtCO2) and partial CO2 pressure in arterial blood (PaCO2). This disparity can pose a problem in the choice of an optimal ventilation strategy for accidental hypothermia victims, particularly in the prehospital period...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#5
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
March 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27912037/avalanche-accidents-causing-fatalities-are-they-any-different-in-the-summer
#6
Mathieu Pasquier, Olivier Hugli, Alexandre Kottmann, Frank Techel
Pasquier, Mathieu, Olivier Hugli, Alexandre Kottmann, and Frank Techel. Avalanche accidents causing fatalities: are they any different in the summer? High Alt Med Biol. 18:67-72, 2017. AIMS: This retrospective study investigated the epidemiology of summer avalanche accidents that occurred in Switzerland and caused at least one fatality between 1984 and 2014. Summer avalanche accidents were defined as those that occurred between June 1st and October 31st. RESULTS: Summer avalanches caused 21 (4%) of the 482 avalanches with at least one fatality occurring during the study period, and 40 (6%) of the 655 fatalities...
March 2017: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/27692660/therapeutic-hypothermia-to-protect-the-heart-against-acute-myocardial-infarction
#7
REVIEW
Matthias Kohlhauer, Alain Berdeaux, Bijan Ghaleh, Renaud Tissier
The cardioprotective effect of therapeutic hypothermia (32-34°C) has been well demonstrated in animal models of acute myocardial infarction. Beyond infarct size reduction, this protection was associated with prevention of the no-reflow phenomenon and long-term improvement in terms of left ventricular remodelling and performance. However, all these events were observed when hypothermia was induced during the ischaemic episode, and most benefits virtually vanished after reperfusion. This is consistent with clinical findings showing a lack of benefit from hypothermia in patients presenting acute myocardial infarction in most trials...
December 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27658332/prehospital-therapeutic-hypothermia-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis
#8
REVIEW
Chaoran Nie, Jiaxu Dong, Pengjiao Zhang, Xintong Liu, Fei Han
BACKGROUND: The effectiveness and safety of the infusion of ice-cold fluids for prehospital hypothermia in cardiac arrest victims are unclear. This study assessed its effects in adult victims of out-of-hospital cardiac arrest. METHODS: An online search of PubMed and Cochrane Library databases was performed. Cooling methods were limited to ice-cold fluid perfusion. Randomized controlled trials were included in this review. The main outcomes were body temperature at hospital arrival, survival to hospital discharge, neurological recovery, incidence of pulmonary edema, and the rate of rearrest...
November 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27559978/safety-and-feasibility-of-the-rhinochill-immediate-transnasal-evaporative-cooling-device-during-out-of-hospital-cardiopulmonary-resuscitation-a-single-center-observational-study
#9
Marie-Sophie Grave, Fritz Sterz, Alexander Nürnberger, Stergios Fykatas, Mathias Gatterbauer, Albert Friedrich Stättermayer, Andreas Zajicek, Reinhard Malzer, Dieter Sebald, Raphael van Tulder
We investigated feasibility and safety of the RhinoChill (RC) transnasal cooling system initiated before achieving a protected airway during cardiopulmonary resuscitation (CPR) in a prehospital setting.In out-of-hospital cardiac arrest (OHCA), transnasal evaporative cooling was initiated during CPR, before a protected airway was established and continued until either the patient was declared dead, standard institutional systemic cooling methods were implemented or cooling supply was empty. Patients were monitored throughout the hypothermia period until either death or hospital discharge...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27289919/prehospital-hypothermia-is-associated-with-increased-mortality
#10
J Shaw, B Taylor, K Thies
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27180033/neuroprotection-in-acute-stroke-targeting-excitotoxicity-oxidative-and-nitrosative-stress-and-inflammation
#11
REVIEW
Ángel Chamorro, Ulrich Dirnagl, Xabier Urra, Anna M Planas
Treatments for acute ischaemic stroke continue to evolve after the superior value of endovascular thrombectomy was confirmed over systemic thrombolysis. Unfortunately, numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischaemic stroke, making the search for new treatments imperative. Increased awareness of the relevance of rigorous preclinical testing, and appropriate selection of study participants, might overcome the barriers to progress in stroke research. Relevant areas of interest include the search for safe and effective treatment strategies that combine neuroprotection reperfusion, better use of advanced brain imaging for patient selection, and wider implementation of prehospital conducted clinical trials...
July 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27100929/elevated-admission-international-normalized-ratio-strongly-predicts-mortality-in-victims-of-abusive-head-trauma
#12
Christine M Leeper, Isam Nasr, Christine McKenna, Rachel P Berger, Barbara A Gaines
BACKGROUND: Victims of abusive head trauma have poor outcomes compared with other injured children. There is often a delay in diagnosis because these young patients are unable to communicate with health care providers. These critically injured patients would benefit from early identification and therapy. METHODS: We performed a retrospective review of our single hospital trauma registry from 2005 to 2014. All Level 1 pediatric (age 0-17 years) trauma patients who sustained abusive head trauma were included...
May 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27095272/a-recommended-early-goal-directed-management-guideline-for-the-prevention-of-hypothermia-related-transfusion-morbidity-and-mortality-in-severely-injured-trauma-patients
#13
REVIEW
Ryan Perlman, Jeannie Callum, Claude Laflamme, Homer Tien, Barto Nascimento, Andrew Beckett, Asim Alam
Hypothermia is present in up to two-thirds of patients with severe injury, although it is often disregarded during the initial resuscitation. Studies have revealed that hypothermia is associated with mortality in a large percentage of trauma cases when the patient's temperature is below 32 °C. Risk factors include the severity of injury, wet clothing, low transport unit temperature, use of anesthesia, and prolonged surgery. Fortunately, associated coagulation disorders have been shown to completely resolve with aggressive warming...
April 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27048395/prehospital-volume-resuscitation-did-evidence-defeat-the-crystalloid-dogma-an-analysis-of-the-traumaregister-dgu%C3%A2-2002-2012
#14
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...
April 6, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27029772/effects-of-prehospital-hypothermia-on-transfusion-requirements-and-outcomes-a-retrospective-observatory-trial
#15
Nora Klauke, Ingo Gräff, Andreas Fleischer, Olaf Boehm, Vera Guttenthaler, Georg Baumgarten, Patrick Meybohm, Maria Wittmann
OBJECTIVES: Prehospital hypothermia is defined as a core temperature <36.0 °C and has been shown to be an independent risk factor for early death in patients with trauma. In a retrospective study, a possible correlation between the body temperature at the time of admission to the emergency room and subsequent in-hospital transfusion requirements and the in-hospital mortality rate was explored. SETTING: This is a retrospective single-centre study at a primary care hospital in Germany...
March 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/27029051/is-hypothermia-indicated-during-cardiopulmonary-resuscitation-and-after-restoration-of-spontaneous-circulation
#16
Peter Stratil, Michael Holzer
PURPOSE OF REVIEW: Targeted temperature management (TTM) after cardiac arrest has become a standard therapy in postresuscitation care. However, many questions addressing the optimum treatment protocol remain unanswered. RECENT FINDINGS: The positive influence of intra-arrest cooling on survival and neurologic outcome, seen in animal studies, was not revealed in clinical trials so far. By contrast, the evidence of TTM after restoration of circulation is based on both experimental and clinical data...
June 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26985981/therapeutic-hypothermia-for-patients-with-out-of-hospital-cardiac-arrest-in-north-carolina
#17
Meena P Rao, Matthew E Dupre, Sean D Pokorney, Carolina M Hansen, Clark Tyson, Lisa Monk, David A Pearson, R Darrell Nelson, Brent Myers, James G Jollis, Christopher B Granger
INTRODUCTION: While therapeutic hypothermia has been the standard of care for patients who suffer out-of-hospital cardiac arrest (OHCA), recent trials have led to an advisory statement recommending a focus on targeted in-hospital temperature management and against initiation of prehospital hypothermia with rapid infusion of cooled saline. The aim of this study is to review the experience with therapeutic hypothermia in North Carolina. METHODS: We studied patients who suffered OHCA in North Carolina in 2012 captured in the CARES database as part of the Heart Rescue Project...
September 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26857732/preventing-and-managing-hypothermia-and-frostbite-injury
#18
REVIEW
Jessie Fudge
CONTEXT: Hypothermia and frostbite injuries occur in cold weather activities and sporting events. EVIDENCE ACQUISITION: A PubMed search was used to identify original research and review articles related to cold, frostbite, and hypothermia. Inclusion was based on their relevance to prevention and treatment of cold-related injuries in sports and outdoor activities. Dates of review articles were limited to those published after 2010. No date limit was set for the most recent consensus statements or original research...
March 2016: Sports Health
https://www.readbyqxmd.com/read/26838037/a-torso-model-comparison-of-temperature-preservation-devices-for-use-in-the-prehospital-environment
#19
COMPARATIVE STUDY
Michele Zasa, Neil Flowers, David Zideman, Timothy J Hodgetts, Tim Harris
BACKGROUND: Hypothermia is an independent predictor of increased morbidity and mortality in patients with trauma. Several strategies and products have been developed to minimise patients' heat loss in the prehospital arena, but there is little evidence to inform the clinician concerning their effectiveness. METHODS: We used a human torso model consisting of two 5.5-litre fluid bags to simultaneously compare four passive (space blanket, bubble wrap, Blizzard blanket, ambulance blanket) and one active (Ready-Heat II blanket) temperature preservation products...
June 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26713972/elevated-admission-inr-strongly-predicts-mortality-in-victims-of-abusive-head-trauma
#20
Christine Leeper, Isam Nasr, Christine McKenna, Rachel P Berger, Barbara A Gaines
BACKGROUND: Victims of abusive head trauma have poor outcomes compared to other injured children. There is often a delay in diagnosis as these young patients are unable to communicate with healthcare providers. These critically injured patients would benefit from early identification and therapy. METHODS: We performed a retrospective review of our single hospital trauma registry from 2005-2014. All level 1 pediatric (age 0-17) trauma patients who sustained abusive head trauma were included...
December 26, 2015: Journal of Trauma and Acute Care Surgery
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