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https://www.readbyqxmd.com/read/29760676/helsinki-stroke-model-is-transferrable-with-real-world-resources-and-reduced-stroke-thrombolysis-delay-to-34-min-in-christchurch
#1
Teddy Y Wu, Erin Coleman, Sarah L Wright, Deborah F Mason, Jon Reimers, Roderick Duncan, Mary Griffiths, Michael Hurrell, David Dixon, James Weaver, Atte Meretoja, John N Fink
Background: Christchurch hospital is a tertiary hospital in New Zealand supported by five general neurologists with after-hours services provided mainly by onsite non-neurology medical residents. We assessed the transferrability and impact of the Helsinki Stroke model on stroke thrombolysis door-to-needle time (DNT) in Christchurch hospital. Methods: Key components of the Helsinki Stroke model were implemented first in 2015 with introduction of patient pre-notification and thrombolysis by the computed tomography (CT) suite, followed by implementation of direct transfer to CT on ambulance stretcher in May 2017...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29720290/effectiveness-of-a-home-based-missing-incident-prevention-program-for-community-dwelling-elderly-patients-with-dementia
#2
Wing Man Lau, Tak Yeung Chan, Sze Lok Szeto
ABSTRACTBackground:Getting lost is a recognized complication in patients with dementia. Preventive measures are lacking. This study aims to investigate the effectiveness of a home-based missing incident prevention program (HMIPP) in reducing missing incidents, time of searching, and caregivers' stress. METHODS: The design was a pre- and post-intervention study. Patients were recruited from a hospital-based Geriatric Memory Clinic. Inclusion criteria were as follows: aged 60 years or above, established dementia, and Modified Functional Ambulation Categories score VI or VII...
May 3, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29664833/effect-of-pre-hospital-red-blood-cell-transfusion-on-mortality-and-time-of-death-in-civilian-trauma-patients
#3
Marius Rehn, Anne Weaver, Karim Brohi, Sarah Eshelby, Laura Green, Jo Røislien, David J Lockey
BACKGROUND: Current management principles of haemorrhagic shock after trauma emphasize earlier transfusion therapy to prevent dilution of clotting factors and correct coagulopathy. London's air ambulance (LAA) was the first UK civilian pre-hospital service to routinely offer pre-hospital red blood cell (RBC) transfusion (phRTx). We investigated the effect of phRTx on mortality. METHODS: Retrospective trauma database study comparing mortality before-implementation with after-implementation of phRTx in exsanguinating trauma patients...
April 16, 2018: Shock
https://www.readbyqxmd.com/read/29622974/pre-hospital-and-hospital-delay-in-patients-with-non-st-elevation-acute-coronary-syndromes-in-tertiary-care
#4
G S Youssef, H H Kassem, O A Ameen, H S Al Taaban, H H Rizk
Background: Early presentation is desirable in all cases of acute prolonged chest pain. Causes of delayed presentation vary widely across geographic regions because of different patients' profile and different healthcare capabilities. Objectives: To detect causes of delay of Non-ST elevation acute coronary syndrome (NSTE-ACS) patients in our country. Methods: Patients admitted with NSTE-ACS were included. We recorded the time delay between the onsets of acute severe symptoms till their arrival to the hospital (Pre-hospital delay)...
September 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29622470/clinician-tasking-in-ambulance-control-improves-the-identification-of-major-trauma-patients-and-pre-hospital-critical-care-team-tasking
#5
Neil Sinclair, Paul A Swinton, Michael Donald, Lisa Curatolo, Peter Lindle, Steph Jones, Alasdair R Corfield
INTRODUCTION: Trauma remains the fourth leading cause of death in western countries and is the leading cause of death in the first four decades of life. NICE guidance in 2016 advocated the attendance of pre-hospital critical care trauma team (PHCCT) in the pre-hospital stage of the care of patients with major trauma. Previous publications support dispatch by clinicians who are also actively involved in the delivery of the PHCCT service; however there is a lack of objective outcome measures across the current reviewed evidence base...
March 30, 2018: Injury
https://www.readbyqxmd.com/read/29564472/should-pre-hospital-resuscitative-thoracotomy-be-reserved-only-for-penetrating-chest-trauma
#6
REVIEW
Edward J Nevins, Parisa L Moori, Jonathan Smith-Williams, Nicholas T E Bird, John V Taylor, Nikhil Misra
PURPOSE: The indications for pre-hospital resuscitative thoracotomy (PHRT) remain undefined. The aim of this paper is to explore the variation in practice for PHRT in the UK, and review the published literature. METHODS: MEDLINE and PUBMED search engines were used to identify all relevant articles and 22 UK Air Ambulance Services were sent an electronic questionnaire to assess their PHRT practice. RESULTS: Four European publications report PHRT survival rates of 9...
March 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29554641/pre-hospital-ambulance-care-of-patients-following-a-suspected-seizure-a-cross-sectional-study
#7
Jon M Dickson, Zahid B Asghar, A Niroshan Siriwardena
PURPOSE: We aimed to investigate the characteristics of patients presenting to the ambulance service with suspected seizures, the costs of managing these patients and the factors which predicted transport to hospital. METHODS: We employed a cross-sectional design using routine clinical data from a UK regional ambulance service. Logistic regression was used to identify predictors of transport to hospital from ambulance response times, demographics, clinical (physiological) findings and treatments...
March 8, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29485991/the-dead-and-the-dying-a-difficult-part-of-ems-transport-a-swiss-cross-sectional-study
#8
Rebecca Maria Hasler, Sandra Stucky, Heinz Bähler, Aristomenis K Exadaktylos, Frank Neff
OBJECTIVE: Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel. As there is little epidemiological data about these patients, this paper aims to describe this special population...
2018: PloS One
https://www.readbyqxmd.com/read/29430575/knowledge-and-attitude-of-singapore-schoolchildren-learning-cardiopulmonary-resuscitation-and-automated-external-defibrillator-skills
#9
Phek Hui Jade Kua, Alexander E White, Wai Yee Ng, Stephanie Fook-Chong, Eileen Kai Xin Ng, Yih Yng Ng, Marcus Eng Hock Ong
INTRODUCTION: Victims of out-of-hospital cardiac arrests require timely cardiopulmonary resuscitation (CPR) and early defibrillation. Persons making the call to emergency medical services will be asked to provide dispatcher-guided response until an ambulance arrives. Knowing what to expect in such circumstances should reduce both delay and confusion. METHODS: We conducted this study among schoolchildren aged 11-17 years using ten-item pre- and post-training surveys...
February 12, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/29423822/barriers-to-the-medication-error-reporting-process-within-the-irish-national-ambulance-service-a-focus-group-study
#10
Eamonn Byrne, Gerard Bury
BACKGROUND: Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring...
February 8, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29361856/catheterization-laboratory-activations-and-time-intervals-for-patients-with-pre-hospital-ecgs
#11
Josephine Muhrbeck, Jonas Persson, Claes Hofman-Bang
OBJECTIVE: The use of pre-hospital ECGs (PH-ECG) reduces time to reperfusion for patients with ST-segment elevation myocardial infarction (STEMI). The feasibility of reperfusion therapy within 60 minutes for hospitals with 24/7 PCI capability has been questioned, and current guidelines have set time targets to 90 minutes. Our primary objective was to investigate the proportion of false-positive catheterization laboratory activations by PH-ECG. Our secondary objective was to describe the time intervals from first medical contact to reperfusion and to establish the proportion of patients receiving reperfusion within 60 minutes...
April 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29218822/european-academy-of-neurology-and-european-stroke-organization-consensus-statement-and-practical-guidance-for-pre-hospital-management-of-stroke
#12
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
BACKGROUND AND PURPOSE: The reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving the chances of a favourable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. METHODS: The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions...
March 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29170314/17-exploring-ambulance-conveyances-to-the-emergency-department-a-descriptive-analysis-of-non-urgent-transports
#13
Jamie Miles, Colin O'Keeffe, Richard Jacques, Tony Stone, Suzanne Mason
OBJECTIVES: An NHS England report highlighted key issues in how patients were initially navigating access to healthcare. This has manifested in increased pressure on ambulance services and emergency departments (EDs) to provide high quality, safe and efficient services to manage this demand. This study aims to identify non-urgent conveyances by ambulance services to the ED that would be suitable for care at scene or an alternative response. DESIGN: A retrospective analysis of emergency department data linked to initial pre-hospital call data (either '111' or '999') in 2014 in Yorkshire and Humber...
December 2017: Emergency Medicine Journal: EMJ
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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