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https://www.readbyqxmd.com/read/29111768/differences-in-symptoms-first-medical-contact-and-pre-hospital-delay-times-between-patients-with-st-and-non-st-elevation-myocardial-infarction
#1
Karin H Ängerud, Sofia Sederholm Lawesson, Rose-Marie Isaksson, Ingela Thylén, Eva Swahn
AIM: In ST-elevation myocardial infarction, time to reperfusion is crucial for the prognosis. Symptom presentation in myocardial infarction influences pre-hospital delay times but studies about differences in symptoms between patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction are sparse and inconclusive. The aim was to compare symptoms, first medical contact and pre-hospital delay times in patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29100549/low-sensitivity-of-qsofa-sirs-criteria-and-sepsis-definition-to-identify-infected-patients-at-risk-of-complication-in-the-prehospital-setting-and-at-the-emergency-department-triage
#2
Selin Tusgul, Pierre-Nicolas Carron, Bertrand Yersin, Thierry Calandra, Fabrice Dami
BACKGROUND: Sepsis is defined as life-threatening organ dysfunction caused by a host response to infection. The quick SOFA (qSOFA) score has been recently proposed as a new bedside clinical score to identify patients with suspected infection at risk of complication (intensive care unit (ICU) admission, in-hospital mortality). The aim of this study was to measure the sensitivity of the qSOFA score, SIRS criteria and sepsis definitions to identify the most serious sepsis cases in the prehospital setting and at the emergency department (ED) triage...
November 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29067785/pre-hospital-transfusion-of-red-blood-cells-in-civilian-trauma-patients
#3
M Rehn, A E Weaver, S Eshelby, J Røislien, D J Lockey
INTRODUCTION: The current management of severely injured patients includes damage control resuscitation strategies that minimise the use of crystalloids and emphasise earlier transfusion of red blood cells (RBC) to prevent coagulopathy. In 2012, London's air ambulance (LAA) became the first UK civilian pre-hospital service to routinely carry RBC to the trauma scene. OBJECTIVE: To investigate the effect of pre-hospital RBC transfusion (phRTx) on overall blood product consumption...
October 24, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28974202/weaknesses-and-capacities-affecting-the-prehospital-emergency-care-for-victims-of-road-traffic-incidents-in-the-greater-kampala-metropolitan-area-a-cross-sectional-study
#4
Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati, Owais Raza
BACKGROUND: Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). METHODS: A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire...
October 3, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28940249/protection-against-cold-a-survey-of-available-equipment-in-swedish-pre-hospital-services
#5
O Henriksson, U Björnstig, B-I Saveman, P J Lundgren
BACKGROUND: The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre-hospital services. METHODS: A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low-reading thermometers...
November 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28894773/the-pattern-of-pre-hospital-medical-service-delivery-in-iran-a-cross-sectional-study
#6
Mashyaneh Haddadi, Mohammad Sarvar, Hamid Soori, Elaheh Ainy
INTRODUCTION: Pre-hospital emergency systems provide service by Franco-German and Anglo American models. This study was carried out to compare the Iranian emergency medical service (EMS) with the two models regarding timing and equipment. METHODS: In this cross sectional study, response time, scene time, and transport time to hospital as well as ambulance equipment of five hundred thousand Tehran EMS recorded missions, during one year, were compared with Franco-German and Anglo American models, trying to determine the pattern of EMS delivery in Iran...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28893214/a-mixed-methods-study-on-evaluating-the-performance-of-a-multi-strategy-national-health-program-to-reduce-maternal-and-child-health-disparities-in-haryana-india
#7
Madhu Gupta, Hans Bosma, Federica Angeli, Manmeet Kaur, Venkatesan Chakrapani, Monica Rana, Onno C P van Schayck
BACKGROUND: A multi pronged community based strategy, known as National Rural Health Mission (NRHM), was implemented from 2005-06 to 2012-13 in India to curtail maternal and child health (MCH) disparities between poor and rich, rural and urban areas, and boys and girls,. This study aimed to determine the degree to which MCH plans of NRHM implemented, and resulted in improving the MCH outcomes and reducing the inequalities. METHODS: An explanatory sequential mixed methods study was conducted, first to assess the degree of implementation of MCH plans by estimating the budget utilization rates of each MCH plan, and the effectiveness of these plans by comparing demographic health surveys data conducted post (2012-13), during (2007-08) and pre- (2002-04) NRHM implementation period, in the quantitative study...
September 11, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28841272/a-coproduced-patient-and-public-event-an-approach-to-developing-and-prioritizing-ambulance-performance-measures
#8
Andy Irving, Janette Turner, Maggie Marsh, Andrea Broadway-Parkinson, Dan Fall, Joanne Coster, A Niroshan Siriwardena
BACKGROUND: Patient and public involvement (PPI) is recognized as an important component of high-quality health services research. PPI is integral to the Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) programme. The PPI event described in detail in this article focusses on the process of involving patients and public representatives in identifying, prioritizing and refining a set of outcome measures that can be used to support ambulance service performance measurement. OBJECTIVE: To obtain public feedback on little known, complex aspects of ambulance service performance measurement...
August 25, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28841252/prioritizing-novel-and-existing-ambulance-performance-measures-through-expert-and-lay-consensus-a-three-stage-multimethod-consensus-study
#9
Joanne E Coster, Andy D Irving, Janette K Turner, Viet-Hai Phung, Aloysius N Siriwardena
BACKGROUND: Current ambulance quality and performance measures, such as response times, do not reflect the wider scope of care that services now provide. Using a three-stage consensus process, we aimed to identify new ways of measuring ambulance service quality and performance that represent service provider and public perspectives. DESIGN: A multistakeholder consensus event, modified Delphi study, and patient and public consensus workshop. SETTING AND PARTICIPANTS: Representatives from ambulance services, patient and public involvement (PPI) groups, emergency care clinical academics, commissioners and policymakers...
August 25, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28834559/improving-the-prehospital-safety-of-steroid-dependent-patients-in-northern-england-a-hospital-initiated-ambulance-service-registration-pathway
#10
LETTER
Anna L Mitchell, Kerri Devine, Vikram Lal, Paul Galloway, Matthew House, Katherine White, Julie Watson, Steve Parry, Margaret Miller, Margaret Morris, R Andy James, Petros Perros, Simon H S Pearce, Richard Quinton
No abstract text is available yet for this article.
August 23, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28827263/effect-of-national-implementation-of-utstein-recommendation-from-the-global-resuscitation-alliance-on-ten-steps-to-improve-outcomes-from-out-of-hospital-cardiac-arrest-a-ten-year-observational-study-in-korea
#11
Young Taek Kim, Sang Do Shin, Sung Ok Hong, Ki Ok Ahn, Young Sun Ro, Kyoung Jun Song, Ki Jeong Hong
OBJECTIVES: The Utstein ten-step implementation strategy (UTIS) proposed by the Global Resuscitation Alliance, a bundle of community cardiopulmonary resuscitation (CPR) programs to improve outcomes after out-of-hospital cardiac arrests (OHCAs), has been developed. However, it is not documented whether UTIS programs are associated with better outcomes or not. The study aimed to test the association between the UTIS programme and better outcomes after OHCA. METHODS: The study was a before- and after-intervention study...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28792986/-implementation-of-the-mobile-emergency-medical-service-in-brazil-action-strategies-and-structural-dimension
#12
Gisele O'Dwyer, Mariana Teixeira Konder, Luciano Pereira Reciputti, Cesar Macedo, Monica Guimarães Macau Lopes
The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service...
August 7, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28774567/minnesota-heart-safe-communities-are-community-based-initiatives-increasing-pre-ambulance-cpr-and-aed-use
#13
Lori L Boland, Michelle B Formanek, Kim K Harkins, Carol L Frazee, Jonathan W Kamrud, Andrew C Stevens, Charles J Lick, Demetris Yannopoulos
AIM: Implementation research that describes how successfully resuscitation guidelines are translated into practice are lacking. We examined whether recent community-based initiatives being conducted as part of the Minnesota Heart Safe (HS) Communities program increase the delivery of CPR and use of automated external defibrillators (AED) by bystanders and first responders prior to ambulance arrival. METHODS: Non-EMS witnessed out-of-hospital cardiac arrests (OHCA) with presumed cardiac etiology treated by a single ambulance service in 2013-2015 were studied...
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28771639/utilisation-of-prehospital-emergency-medical-services-for-hyperglycaemia-a-community-based-observational-study
#14
Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Arul Earnest, Karen Smith, Georgia Soldatos, Helena Teede, Sophia Zoungas
AIMS: This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport. MATERIALS AND METHODS: A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#15
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28701153/cost-effectiveness-of-an-ambulance-based-referral-system-for-emergency-obstetrical-and-neonatal-care-in-rural-ethiopia
#16
Sandro Accorsi, Edgardo Somigliana, Hagos Solomon, Tsegaye Ademe, Jofrey Woldegebriel, Biadgo Almaz, Mohammed Zemedu, Fabio Manenti, Akalu Tibebe, Pasquale Farese, Aberra Seifu, Serena Menozzi, Giovanni Putoto
BACKGROUND: To estimate the cost-effectiveness of an ambulance-based referral system an dedicated to emergency obstetrics and neonatal care (EmONC) in remote sub-Saharan settings. METHODS: In this prospective study performed in Oromiya Region (Ethiopia), all obstetrical cases referred to the hospital with the ambulance were consecutively evaluated during a three-months period. The health professionals who managed the referred cases were requested to identify those that could be considered as undoubtedly effective...
July 12, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28624593/double-sequential-defibrillation-therapy-for-out-of-hospital-cardiac-arrests-the-london-experience
#17
Amber C Emmerson, Mark Whitbread, Rachael T Fothergill
BACKGROUND: Despite advances in treatment for out-of-hospital cardiac arrest (OHCA), a subgroup of patients remain in refractory ventricular fibrillation (RVF) during resuscitation. Recent evidence suggests that double sequential defibrillation (DSD), where two shocks are delivered to the patient in quick succession, may provide an effective therapy for RVF. This study describes the characteristics and survival outcomes of OHCA patients treated by ambulance clinicians using a local DSD protocol in an attempt to resolve RVF...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28501815/can-the-prehospital-national-early-warning-score-identify-patients-most-at-risk-from-subsequent-deterioration
#18
Joanna Shaw, Rachael T Fothergill, Sophie Clark, Fionna Moore
INTRODUCTION: The National Early Warning Score (NEWS) aids the early recognition of those at risk of becoming critically ill. NEWS has been recommended for use by ambulance services, but very little work has been undertaken to date to determine its suitability. This paper examines whether a prehospital NEWS derived from ambulance service clinical observations is associated with the hospital ED disposition. METHODS: Prehospital NEWS was retrospectively calculated from the ambulance service clinical records of 287 patients who were treated by the ambulance service and transported to hospital...
August 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28301629/antidote-availability-in-the-municipality-of-campinas-s%C3%A3-o-paulo-brazil
#19
Luciane Cristina Rodrigues Fernandes, Taís Freire Galvão, Adriana Safioti Toledo Ricardi, Eduardo Mello De Capitani, Stephen Hyslop, Fábio Bucaretchi
CONTEXT AND OBJECTIVE: The lack of availability of antidotes in emergency services is a worldwide concern. The aim of the present study was to evaluate the availability of antidotes used for treating poisoning in Campinas (SP). DESIGN AND SETTING: This was a cross-sectional study of emergency services in Campinas, conducted in 2010-2012. METHODS: The availability, amount in stock, place of storage and access time for 26 antidotal treatments was investigated...
January 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28280651/prehospital-systolic-hypertension-and-outcomes-in-patients-with-spontaneous-intracerebral-hemorrhage
#20
Stacy Hatcher, Connie Chen, Prasanthi Govindarajan
BACKGROUND: It is well known that hematoma volume and expansion is associated with poor outcomes in patients with spontaneous intracerebral hemorrhage (sICH). The factors associated with hematoma volume and possible expansion include the use of anticoagulant medications, autoimmune or bacterial diseases that reduce platelet production, and genetic defects of Von Willebrand factor causing inhibition or reduction of platelet aggregation. However, little is known about the role of elevated systolic blood pressure (SBP) on hematoma volume and its ultimate role on sICH when identified in the prehospital setting...
January 26, 2017: Curēus
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