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33 papers 100 to 500 followers EMS lit
By Merlin Curry MD, EMT-P
Christian Martin-Gill, Max Wayne, Francis X Guyette, Oladipupo Olafiranye, Catalin Toma
Remote ischemic peri-conditioning (RIPC) has gained interest as a means of reducing ischemic injury in patients with acute ST-elevation myocardial infarction (STEMI) who are undergoing emergent primary percutaneous coronary intervention (pPCI). We aimed to evaluate the feasibility, process, and patient-related factors related to the delivery of RIPC during air medical transport of STEMI patients to tertiary pPCI centers. We performed a retrospective review of procedural outcomes of a cohort of STEMI patients who received RIPC as part of a clinical protocol in a multi-state air medical service over 16 months (March 2013 to June 2014)...
2016: Prehospital Emergency Care
Justin L Benoit, Ryan B Gerecht, Michael T Steuerwald, Jason T McMullan
OBJECTIVE: Overall survival from out-of-hospital cardiac arrest (OHCA) is less than 10%. After initial bag-valve mask ventilation, 80% of patients receive an advanced airway, either by endotracheal intubation (ETI) or placement of a supraglottic airway (SGA). The objective of this meta-analysis was to compare patient outcomes for these two advanced airway methods in OHCA patients treated by Emergency Medical Services (EMS). METHODS: A dual-reviewer search was conducted in PubMed, Scopus, and the Cochrane Database to identify all relevant peer-reviewed articles for inclusion in the meta-analysis...
August 2015: Resuscitation
Brian Grunau, Joshua Reynolds, Frank Scheuermeyer, Robert Stenstom, Dion Stub, Sarah Pennington, Sheldon Cheskes, Krishnan Ramanathan, Jim Christenson
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR) may improve outcomes for refractory out-of-hospital cardiac arrest (OHCA). Transport of intra-arrest patients to hospital however, may decrease CPR quality, potentially reducing survival for those who would have achieved return-of-spontaneous-circulation (ROSC) with further on-scene resuscitation. We examined time-to-ROSC and patient outcomes for the optimal time to consider transport. METHODS: From a prospective registry of consecutive adult non-traumatic OHCA's, we identified a hypothetical ECPR-eligible cohort of EMS-treated patients with age ≤ 65, witnessed arrest, and bystander CPR or EMS arrival < 10 minutes...
September 2016: Prehospital Emergency Care
D W Spaite, E A Criss, T D Valenzuela, J Guisto
Out-of-hospital emergency care was designed around the concept of a system of interrelated events that combine to offer a patient the best care possible outside the hospital. However, in contrast to the actual operations of emergency medical service (EMS) systems, research has not typically used systems-based models as the method for evaluation. In this discussion we outline the weaknesses of component-based research models in EMS evaluation and attempt to provide a "systems-analysis" framework that can be used for future research...
August 1995: Annals of Emergency Medicine
Lauren Klein, Glenn Paetow, Rebecca Kornas, Rob Reardon
No abstract text is available yet for this article.
March 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Graham Nichol, Brian Leroux, Henry Wang, Clifton W Callaway, George Sopko, Myron Weisfeldt, Ian Stiell, Laurie J Morrison, Tom P Aufderheide, Sheldon Cheskes, Jim Christenson, Peter Kudenchuk, Christian Vaillancourt, Thomas D Rea, Ahamed H Idris, Riccardo Colella, Marshal Isaacs, Ron Straight, Shannon Stephens, Joe Richardson, Joe Condle, Robert H Schmicker, Debra Egan, Susanne May, Joseph P Ornato
BACKGROUND: During cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest, the interruption of manual chest compressions for rescue breathing reduces blood flow and possibly survival. We assessed whether outcomes after continuous compressions with positive-pressure ventilation differed from those after compressions that were interrupted for ventilations at a ratio of 30 compressions to two ventilations. METHODS: This cluster-randomized trial with crossover included 114 emergency medical service (EMS) agencies...
December 3, 2015: New England Journal of Medicine
Matthew Rudd, Deborah Buck, Gary A Ford, Christopher I Price
BACKGROUND: We undertook a systematic review of all published stroke identification instruments to describe their performance characteristics when used prospectively in any clinical setting. METHODS: A search strategy was applied to Medline and Embase for material published prior to 10 August 2015. Two authors independently screened titles, and abstracts as necessary. Data including clinical setting, reported sensitivity, specificity, positive predictive value, negative predictive value were extracted independently by two reviewers...
November 16, 2015: Emergency Medicine Journal: EMJ
Jestin N Carlson, Henry E Wang
No abstract text is available yet for this article.
March 2016: Annals of Emergency Medicine
Jestin N Carlson, Christopher Karns, N Clay Mann, Karen E Jacobson, Mengtao Dai, Caroline Colleran, Henry E Wang
Emergency medical services (EMS) must provide a wide range of care for patients in the out-of-hospital setting. Although previous work has detailed that EMS providers rarely perform certain procedures, (e.g., endotracheal intubation) there are limited data detailing the frequency of procedures across the breadth of EMS providers' scope of practice. We sought to characterize procedures performed by EMS in the United States. We conducted an analysis of the 2011 National Emergency Medical Services Information System (NEMSIS) research data set, encompassing EMS emergency response data from 40 states and two territories...
2016: Prehospital Emergency Care
Gordon A Ewy, Bentley J Bobrow
Out-of-hospital cardiac arrest (OHCA) is a major public health problem. In the United States, OHCA accounts for more premature deaths than any other cause. For over a half-century, the national "Guidelines" for resuscitation have recommended the same initial treatment of primary and secondary cardiac arrests. Using this approach, the overall survival of patients with OHCA, while quite variable, was generally very poor. One reason is that the etiologies of cardiac arrests are not all the same. The vast majority of nontraumatic OHCA in adults are due to a "primary" cardiac arrest, rather than secondary to respiratory arrest...
January 2016: Journal of Intensive Care Medicine
Gordon A Ewy, Karl B Kern
Cardiocerebral resuscitation (CCR) is a new approach for resuscitation of patients with cardiac arrest. It is composed of 3 components: 1) continuous chest compressions for bystander resuscitation; 2) a new emergency medical services (EMS) algorithm; and 3) aggressive post-resuscitation care. The first 2 components of CCR were first instituted in 2003 in Tucson, Arizona; in 2004 in the Rock and Walworth counties of Wisconsin; and in 2005 in the Phoenix, Arizona, metropolitan area. The CCR method has been shown to dramatically improve survival in the subset of patients most likely to survive: those with witnessed arrest and shockable rhythm on arrival of EMS...
January 13, 2009: Journal of the American College of Cardiology
S A Bernard, K Smith, R Porter, C Jones, A Gailey, B Cresswell, D Cudini, S Hill, B Moore, T St Clair
INTRODUCTION: Pre-hospital intubation by paramedics is widely used in comatose patients prior to transportation to hospital, but the optimal technique for intubation is uncertain. One approach is paramedic rapid sequence intubation (RSI), which may improve outcomes in adult patients with traumatic brain injury. However, many patients present to emergency medical services with coma of non-traumatic cause and the role of paramedic RSI in these patients remains uncertain. METHODS: The electronic Victorian Ambulance Clinical Information System was searched for the term 'suxamethonium' between 2008 and 2011...
January 2015: Emergency Medicine Journal: EMJ
Marina Buswell, Philip Lumbard, Larissa Prothero, Caroline Lee, Steven Martin, Jane Fleming, Claire Goodman
OBJECTIVE: To synthesise the existing literature on the roles that emergency medical services (EMS) play in unplanned, urgent and emergency care for older people with dementia (OPWD), to define these roles, understand the strength of current research and to identify where the focus of future research should lie. DESIGN: An integrative review of the synthesised reports, briefings, professional recommendations and evidence. English-language articles were included if they made any reference to the role of EMS in the urgent or emergency care of OPWD...
January 2016: Emergency Medicine Journal: EMJ
Prachi Sanghavi, Anupam B Jena, Joseph P Newhouse, Alan M Zaslavsky
IMPORTANCE: Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited. OBJECTIVE: To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest. DESIGN, SETTING, AND PARTICIPANTS: Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases)...
February 2015: JAMA Internal Medicine
Jonathan L Burstein
No abstract text is available yet for this article.
January 2006: Annals of Emergency Medicine
Matthew E Prekker, Laura C Feemster, Catherine L Hough, David Carlbom, Kristina Crothers, David H Au, Thomas D Rea, Christopher W Seymour
OBJECTIVES: Patients with respiratory distress often seek emergency medical care and are transported by emergency medical services (EMS). EMS encounters with patients in respiratory distress have not been well described. The study objective was to characterize the epidemiology of prehospital respiratory distress and subsequent patient outcomes. METHODS: This was a population-based cohort study of noninjured adults transported by EMS to any of 16 hospitals between 2002 and 2006...
May 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Martin Ebinger, Benjamin Winter, Matthias Wendt, Joachim E Weber, Carolin Waldschmidt, Michal Rozanski, Alexander Kunz, Peter Koch, Philipp A Kellner, Daniel Gierhake, Kersten Villringer, Jochen B Fiebach, Ulrike Grittner, Andreas Hartmann, Bruno-Marcel Mackert, Matthias Endres, Heinrich J Audebert
IMPORTANCE: Time to thrombolysis is crucial for outcome in acute ischemic stroke. OBJECTIVE: To determine if starting thrombolysis in a specialized ambulance reduces delays. DESIGN, SETTING, AND PARTICIPANTS: In the Prehospital Acute Neurological Treatment and Optimization of Medical care in Stroke Study (PHANTOM-S), conducted in Berlin, Germany, we randomly assigned weeks with and without availability of the Stroke Emergency Mobile (STEMO) from May 1, 2011, to January 31, 2013...
April 23, 2014: JAMA: the Journal of the American Medical Association
Stephen A Bernard, Vina Nguyen, Peter Cameron, Kevin Masci, Mark Fitzgerald, David J Cooper, Tony Walker, B Paramed Std, Paul Myles, Lynne Murray, David, Taylor, Karen Smith, Ian Patrick, John Edington, Andrew Bacon, Jeffrey V Rosenfeld, Rodney Judson
OBJECTIVE: To determine whether paramedic rapid sequence intubation in patients with severe traumatic brain injury (TBI) improves neurologic outcomes at 6 months compared with intubation in the hospital. BACKGROUND: Severe TBI is associated with a high rate of mortality and long-term morbidity. Comatose patients with TBI routinely undergo endo-tracheal intubation to protect the airway, prevent hypoxia, and control ventilation. In many places, paramedics perform intubation prior to hospital arrival...
December 2010: Annals of Surgery
Hans Morten Lossius, Jo Røislien, David J Lockey
INTRODUCTION: Pre-hospital airway management is a controversial subject, but there is general agreement that a small number of seriously ill or injured patients require urgent emergency tracheal intubation (ETI) and ventilation. Many European emergency medical services (EMS) systems provide physicians to care for these patients while other systems rely on paramedics (or, rarely, nurses). The ETI success rate is an important measure of provider and EMS system success and a marker of patient safety...
February 11, 2012: Critical Care: the Official Journal of the Critical Care Forum
Chelsea C White, Robert M Domeier, Michael G Millin
Field spinal immobilization using a backboard and cervical collar has been standard practice for patients with suspected spine injury since the 1960s. The backboard has been a component of field spinal immobilization despite lack of efficacy evidence. While the backboard is a useful spinal protection tool during extrication, use of backboards is not without risk, as they have been shown to cause respiratory compromise, pain, and pressure sores. Backboards also alter a patient's physical exam, resulting in unnecessary radiographs...
April 2014: Prehospital Emergency Care
2014-08-12 17:36:53
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