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Paramedic, cardiac, stroke

Brian Griffith, Patrick Kochanek, Cameron Dezfulian
Children and young adults tend to have reduced mortality and disability after acquired brain injuries such as trauma or stroke and across other disease processes seen in critical care medicine. However, after out-of-hospital cardiac arrest (OHCA), outcomes are remarkably similar across age groups. The consistent lack of witnessed arrests and a high incidence of asphyxial or respiratory etiology arrests among pediatric and young adult patients with OHCA account for a substantial portion of the difference in outcomes...
2017: F1000Research
N Bradai, C Andriantsifanetra, A Charlanes, C Scouarnec, C Cleophax, P Leprince, A Yelnik
INTRODUCTION: Possible admission to a PRM unit of a hemiplegic patient equipped with a left ventricular assistance device (LVAD) may constitute a cause for concern. We are reporting our observation on the subject. OBSERVATION: A 30-year-old hemiplegic patient presented with left hemiparesis secondary to a right middle cerebral artery (MCA) ischemic stroke having occurred during cardiopulmonary arrest. Persistence of major left ventricle dysfunction necessitated installation on 8 November 2011 of a mono-ventricular HEART-MATE II assistive device...
March 2014: Annals of Physical and Rehabilitation Medicine
Frederik H Verbrugge, Wilfried Mullens
Atrial fibrillation (AF) and heart failure (HF) are omnipresent cardiovascular disorders with a substantial impact on morbidity and mortality. As both share common risk factors, their pathophysiology is highly interrelated and a lot of patients present with both conditions. Surprisingly, despite their high prevalence, there is a paucity of evidence regarding the optimal combined management of AF and HF. The initial treatment for new-onset AF in the context of HF should focus on anticoagulation, rate control and prompt electrical cardioversion in case of hemodynamic instability...
May 2014: Heart Failure Reviews
Stephen W Borron, Robert Woolard, Susan Watts
A 40-year-old man with diabetes and seizure disorder was found at home unresponsive and "very hot to touch" by his father 40 minutes before emergency medical services arrival. His usual medications included topiramate, divalproex sodium, and rosiglitazone/metformin. Paramedics administered oxygen, intravenous fluids, and naloxone. They did not witness or report seizure activity. Upon emergency department arrival, the patient was unresponsive (Glasgow Coma Scale 3), hypotensive (94/50 mm Hg), and tachypneic (32 breaths per minute), with a heart rate of 60 beats per minute and elevated rectal temperature peaking at 43...
December 2013: American Journal of Emergency Medicine
(no author information available yet)
One of the longest running debates in cardiology is about the best reperfusion therapy for patients with evolving acute myocardial infarction (MI). Percutaneous transluminal coronary angioplasty (ANGIOPLASTY) is a surgical treatment to reopen a blocked coronary artery to restore blood flow. It is a type of percutaneous (through-the-skin) coronary intervention (PCI) also known as balloon angioplasty. When performed on patients with acute myocardial infarction, it is called primary angioplasty. Primary angioplasty is an alternative to thrombolysis, clot-dissolving drug therapy, for patients with acute MI associated with ST-segment elevation (STEMI), a change recorded with an electrocardiogram (ECG) during chest pain...
2004: Ontario Health Technology Assessment Series
Jean Petermans, Anja Velghe, Daniel Gillain, Xavier Boman, Nele Van Den Noortgate
A systematic review of the international literature concerning the organisation of the Geriatric Day Hospital (GDH) was performed. From 1987 till now, few papers were found describing the activity and the effectiveness of the GDH. All the studies comparing specific geriatric approaches to regular medicine demonstrate the efficiency of geriatric care, particularly the geriatric assessment. So, with a degree of evidence 1a, a better outcome is found for patients undergoing a geriatric assessment and intervention, compared to patients having no geriatric assessment at all...
September 2011: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Edward Durant, Karl A Sporer
OBJECTIVE: This cross-sectional study describes the characteristics of patients with an abnormal Glasgow Coma Scale (GCS) in the prehospital setting. METHODS: We reviewed existing prehospital care reports (PCRs) in the San Mateo County, California, emergency medical services (EMS) database from January 1 to December 31, 2007. Adults age 18 or greater with a documented GCS fit inclusion criteria. We excluded single and multisystem trauma patients, as well as patients in cardiac arrest, respiratory arrest, or listed as deceased from the study...
February 2011: Western Journal of Emergency Medicine
Henry E Wang, G K Balasubramani, Lawrence J Cook, Donald M Yealy, Judith R Lave
BACKGROUND: While prior studies describe the clinical presentation of patients requiring paramedic out-of-hospital endotracheal intubation (ETI), limited data characterize the underlying medical conditions or comorbidities. OBJECTIVE: To characterize the medical conditions and comorbidities of patients receiving successful paramedic out-of-hospital ETI. METHODS: We used Pennsylvania statewide emergency medical services (EMS) clinical data, including all successful ETIs performed during 2003-2005...
July 2011: Prehospital Emergency Care
S Silber
Acute myocardial infarction and its consequences (death, chronic ischemic coronary artery disease, heart failure) are still the number 1 causes of death and of cardiovascular diseases in Germany. In this context, patients with STEMI are at the highest risk. The first-line management of STEMI patients often determines if the outcome is life or death. This overview presents the current optimal evidence-based management of STEMI patients as a practice-oriented extract according to the latest ESC guidelines, fully published some weeks ago (http://www...
December 2010: Herz
Nicholas M Eschmann, Ronald G Pirrallo, Tom P Aufderheide, E Brooke Lerner
OBJECTIVE: To determine whether the number of advanced life support-trained personnel at the scene of an out-of-hospital cardiac arrest (OHCA) was associated with return of spontaneous circulation (ROSC) or survival to hospital discharge. METHODS: A retrospective database review using Utstein-style reporting definitions was conducted in Milwaukee County. All adult (>or= 18 years of age) OHCA cases of presumed cardiac etiology from January 1993 through December 2005 were eligible for inclusion in the study...
January 2010: Prehospital Emergency Care
Edo Y Birati, Nomi Malov, Yevgeni Kogan, Yigal Yanay, Mira Tamari, Mayera Elizur, David M Steinberg, Michal Golovner, Arie Roth
OBJECTIVES: The only large-scale report (1988) by the Israeli national ambulance service Magen David Adom (MDA) on the outcome of cardiac arrest victims who underwent cardiopulmonary resuscitation (CPR) by paramedics called for more frequent and more promptly initiated CPR and shorter time to arrival of paramedic care to improve survival. We report the 1987-2007 experience of resuscitation of out-of-hospital cardiac arrest victims who were 'SHL'-Telemedicine subscribers and who underwent CPR by SHL-Telemedicine mobile intensive care units (MICUs) personnel or under their instructions...
December 2008: Resuscitation
Wolfgang F Dick
It has been stated that the Franco-German Emergency Medical Services System (FGS) has considerable drawbacks compared to the Anglo-American Emergency Medical Services System (AAS): 1. The key differences between the AAS and the FGS are that in the AAS, the patients is brought to the doctor, while in the FGS, the doctor is brought to the patient. 2. In the FGS, patients with urgent conditions usually are evaluated and treated by general practitioners in their offices or at the patient's home; initially, very few approach an emergency department...
January 2003: Prehospital and Disaster Medicine
Michael Heim, Abraham Adunski, Aahron Chechick
Of 2776 intracapsular fractures of the proximal femur, 18% of the patients were treated nonoperatively. Included in the group of patients who were treated conservatively were children, patients with cardiac problems or mental problems, stroke, renal failure, multiple disseminated malignancies, and patients who chose nonoperative treatment. The medical treatment protocol can be divided into two stages: Initially, (1) nursing of a bedridden patient with emphasis on the prevention of complications; and (2) once partial bone union has occurred, the attempted rehabilitation to independent ambulation...
June 2002: Clinical Orthopaedics and related Research
D S Miles, P D Underwood, D J Nolan, M A Frey, R W Gotshall
The purpose of this study was to evaluate the cardiorespiratory demands inherent to the maintenance of continuous one- and two-man cardiopulmonary resuscitation (CPR) for 10 min. Ten male paramedics (X age = 26 yrs) certified to perform CPR participated. Each subject assumed the three possible roles for administering CPR: ventilator, compressor, and one-man technique. Cardiorespiratory responses were determined by impedance cardiography and open-circuit spirometry at 2 min intervals while performing CPR with a resuscitation manikin...
September 1984: Canadian Journal of Applied Sport Sciences. Journal Canadien des Sciences Appliquées Au Sport
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