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prehospital hypothermia

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https://www.readbyqxmd.com/read/28490655/practice-guideline-summary-reducing-brain-injury-following-cardiopulmonary-resuscitation-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#1
Romergryko G Geocadin, Eelco Wijdicks, Melissa J Armstrong, Maxwell Damian, Stephan A Mayer, Joseph P Ornato, Alejandro Rabinstein, José I Suarez, Michel T Torbey, Richard M Dubinsky, Jason Lazarou
OBJECTIVE: To assess the evidence and make evidence-based recommendations for acute interventions to reduce brain injury in adult patients who are comatose after successful cardiopulmonary resuscitation. METHODS: Published literature from 1966 to August 29, 2016, was reviewed with evidence-based classification of relevant articles. RESULTS AND RECOMMENDATIONS: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32-34°C for 24 hours) is highly likely to be effective in improving functional neurologic outcome and survival compared with non-TH and should be offered (Level A)...
May 10, 2017: Neurology
https://www.readbyqxmd.com/read/28486266/pediatric-drowning-a-standard-operating-procedure-to-aid-the-prehospital-management-of-pediatric-cardiac-arrest-resulting-from-submersion
#2
Rebecca R Best, Benjamin H L Harris, Jason L Walsh, Timothy Manfield
OBJECTIVES: Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. METHODS: A literature review on the management of pediatric drowning was conducted...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28483389/battlefield-trauma-induced-hypothermia-transitioning-the-preferred-method-of-casualty-rewarming
#3
REVIEW
Brad L Bennett, John B Holcomb
For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an overview of trauma-induced hypothermia (TIH); 2) highlight the Department of Defense strategy for the implementation of a hypothermia clinical management program for battlefield (prehospital) casualties; 3) highlight the research and development of the Hypothermia Prevention and Management Kit (HPMK) as the preferred field rewarming system for battlefield TIH; and 4) emphasize how the HPMK can be easily transitioned to the civilian sector for active rewarming of both accidental and TIH patients...
May 5, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28465012/mild-induced-hypothermia-and-survival-after-out-of-hospital-cardiac-arrest-in-a-swedish-urban-area
#4
Louise Martinell, Johan Herlitz, Thomas Karlsson, Niklas Nielsen, Christian Rylander
BACKGROUND: Mild induced hypothermia (MIH) was introduced for post cardiac arrest care in Sweden in 2003, based on two clinical trials. This retrospective study evaluated its association with 30-day survival after out-of-hospital cardiac arrest (OHCA) in a Swedish community from 2003 to 2015. METHODS: Out of 3680 patients with OHCA, 1100 were hospitalized after return of spontaneous circulation and 871 patients who remained unconscious were included in the analysis...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28438222/hypothermia-in-trauma-victims-at-first-arrival-of-ambulance-personnel-an-observational-study-with-assessment-of-risk-factors
#5
Frédéric Lapostolle, James Couvreur, François Xavier Koch, Dominique Savary, Armelle Alhéritière, Michel Galinski, Jean-Luc Sebbah, Karim Tazarourte, Frédéric Adnet
BACKGROUND: Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. METHODS: This was an ancillary analysis of data recorded in the HypoTraum study, a prospective multicenter study conducted by the emergency medical services (EMS) of 8 hospitals in France. Inclusion criteria were: trauma victim, age over 18 years, and victim receiving prehospital care from an EMS team and transported to hospital by the EMS team in a medically equipped mobile intensive care unit...
April 24, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28435902/emergency-medical-service-personnel-need-to-improve-knowledge-and-attitude-regarding-prehospital-sepsis-care
#6
Joongmin Park, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Hee Yoon, Tae Rim Lee, Won Chul Cha, Min Seob Sim
OBJECTIVE: We aimed to evaluate the knowledge and attitudes of emergency medical service (EMS) personnel pertaining to sepsis. We also compared EMS personnel's knowledge of sepsis and their intention to engage in prehospital sepsis management. METHODS: The survey was conducted during education conferences for EMS personnel in December 2013 and January 2015 in Seoul, Korea. The questionnaire composed of 10 questions relevant to sepsis, was distributed on-scene, and was retrieved by investigators after the conference...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28416582/relationship-between-oxygen-concentration-and-temperature-in-an-exothermic-warming-device
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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