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40 papers 100 to 500 followers EMS lit
By Merlin Curry MD, EMT-P
https://www.readbyqxmd.com/read/30066445/epinephrine-for-out-of-hospital-cardiac-arrest
#1
Kyle Kelson, Ian S deSouza
The original data supporting the use of epinephrine for cardiac arrest is rooted in a poorly controlled canine study1 from the 1960s. The Advanced Cardiac Life Support (ACLS) recommendation that it "may be reasonable" to use epinephrine in cardiac arrest continues in contemporary practice. Yet, when the ACLS guidelines2 are read carefully, they state that "for both survival to discharge and survival to discharge with good neurological outcome, there was no benefit" to receiving epinephrine...
July 31, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29587810/pre-hospital-extra-corporeal-cardiopulmonary-resuscitation
#2
REVIEW
Ben Singer, Joshua C Reynolds, David J Lockey, Ben O'Brien
Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extra-corporeal cardiopulmonary resuscitation (ECPR) is a novel use of an established technology that provides greater blood flow and oxygen delivery during cardiac arrest than closed chest compressions. Hospital-based ECPR is currently offered to selected OHCA patients in specialized centres. The interval between collapse and restoration of circulation is inversely associated with good clinical outcomes after ECPR...
March 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29573898/efficacy-of-prehospital-administration-of-tranexamic-acid-in-trauma-patients-a-meta-analysis-of-the-randomized-controlled-trials
#3
REVIEW
Ayman El-Menyar, Brijesh Sathian, Mohammed Asim, Rifat Latifi, Hassan Al-Thani
OBJECTIVE: Antifibrinolytic agent tranexamic acid (TXA) has a potential clinical benefit for in-hospital patients with severe bleeding but its effectiveness in pre-hospital settings remains unclear. We conducted a systematic review and meta-analysis to evaluate whether pre-hospital administration of TXA compared to placebo improve patients' outcomes? METHODS: PubMed, MEDLINE, Cochrane Library, WHO International Clinical Trials Registry Platform, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, clinicaltrials...
June 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29345513/no-benefit-in-neurologic-outcomes-of-survivors-of-out-of-hospital-cardiac-arrest-with-mechanical-compression-device
#4
Ryan Newberry, Ted Redman, Elliot Ross, Rachel Ely, Clayton Saidler, Allyson Arana, David Wampler, David Miramontes
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a major cause of death and morbidity in the United States. Quality cardiopulmonary resuscitation (CPR) has proven to be a key factor in improving survival. The aim of our study was to investigate the outcomes of OHCA when mechanical CPR (LUCAS 2 Chest Compression System™) was utilized compared to conventional CPR. Although controlled trials have not demonstrated a survival benefit to the routine use of mechanical CPR devices, there continues to be an interest for their use in OHCA...
May 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/25604325/tracheal-intubation-related-complications-in-the-prehospital-setting
#5
Emmanuel Caruana, François-Xavier Duchateau, Carole Cornaglia, Marie-Laure Devaud, Romain Pirracchio
BACKGROUND: Prehospital tracheal intubation (TI) is associated with morbidity and mortality, particularly in cases of difficult intubation. The goal of the present study was to describe factors associated with TI related complications in the prehospital setting. METHODS: This was a prospective cohort study including all patients intubated on scene in a prehospital emergency medical service over a 4 year period. TI related complications included oxygen desaturation, aspiration, vomiting, bronchospasm and/or laryngospasm, and mechanical complications (mainstem intubation, oesophageal intubation and airway lesion- that is, dental or laryngeal trauma caused by the laryngoscope)...
November 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27176727/prehospital-administration-of-tranexamic-acid-in-trauma-patients
#6
Arasch Wafaisade, Rolf Lefering, Bertil Bouillon, Andreas B Böhmer, Michael Gäßler, Matthias Ruppert
BACKGROUND: Evidence on prehospital administration of the antifibrinolytic tranexamic acid (TXA) in civilian trauma populations is scarce. The aim was to study whether prehospital TXA use in trauma patients was associated with improved outcomes. METHODS: The prehospital database of the ADAC (General German Automobile Club) Air Rescue Service was linked with the TraumaRegister of the German Trauma Society to reidentify patients documented in both registries. Primarily admitted trauma patients (2012 until 2014) who were treated with TXA during the prehospital phase were matched with patients who had not received prehospital TXA, applying propensity score-based matching...
May 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27894561/apneic-oxygenation-may-not-prevent-severe-hypoxemia-during-rapid-sequence-intubation-a-retrospective-helicopter-emergency-medical-service-study
#7
Sattha Riyapan, Jeffrey Lubin
OBJECTIVE: This study sought to determine the effectiveness of apneic oxygenation in preventing hypoxemia during prehospital rapid sequence intubation (RSI). METHODS: We performed a case-cohort study using a pre-existing database looking at intubation management by a single helicopter emergency medical service between July 2013 and June 2015. Apneic oxygenation using high-flow nasal cannula (15 L/min) was introduced to the standard RSI protocol in July 2014. Severe hypoxemia was defined as an incidence of oxygen saturation less than 90%...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/26270795/feasibility-of-remote-ischemic-peri-conditioning-during-air-medical-transport-of-stemi-patients
#8
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
https://www.readbyqxmd.com/read/26006743/endotracheal-intubation-versus-supraglottic-airway-placement-in-out-of-hospital-cardiac-arrest-a-meta-analysis
#9
REVIEW
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
https://www.readbyqxmd.com/read/27018764/relationship-between-time-to-rosc-and-survival-in-out-of-hospital-cardiac-arrest-ecpr-candidates-when-is-the-best-time-to-consider-transport-to-hospital
#10
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
https://www.readbyqxmd.com/read/7618776/emergency-medical-service-systems-research-problems-of-the-past-challenges-of-the-future
#11
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
https://www.readbyqxmd.com/read/26687513/technique-for-exchanging-the-king-laryngeal-tube-for-an-endotracheal-tube
#12
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
https://www.readbyqxmd.com/read/26550795/trial-of-continuous-or-interrupted-chest-compressions-during-cpr
#13
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/26574548/a-systematic-review-of-stroke-recognition-instruments-in-hospital-and-prehospital-settings
#14
REVIEW
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 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26475247/does-intubation-improve-outcomes-over-supraglottic-airways-in-adult-out-of-hospital-cardiac-arrest
#15
REVIEW
Jestin N Carlson, Henry E Wang
No abstract text is available yet for this article.
March 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26270634/procedures-performed-by-emergency-medical-services-in-the-united-states
#16
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
https://www.readbyqxmd.com/read/25077491/cardiocerebral-resuscitation-an-approach-to-improving-survival-of-patients-with-primary-cardiac-arrest
#17
REVIEW
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
https://www.readbyqxmd.com/read/19130982/recent-advances-in-cardiopulmonary-resuscitation-cardiocerebral-resuscitation
#18
REVIEW
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
https://www.readbyqxmd.com/read/24473409/paramedic-rapid-sequence-intubation-in-patients-with-non-traumatic-coma
#19
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
https://www.readbyqxmd.com/read/25465035/unplanned-urgent-and-emergency-care-what-are-the-roles-that-ems-plays-in-providing-for-older-people-with-dementia-an-integrative-review-of-policy-professional-recommendations-and-evidence
#20
REVIEW
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
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