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Prehospital collection

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217 papers 25 to 100 followers
Dag Ståle Nystøyl, Steinar Hunskaar, Hans Johan Breidablik, Øyvind Østerås, Erik Zakariassen
OBJECTIVE: To examine handling of cancelled helicopter emergency medical services (HEMS) missions with a persisting medical indication. DESIGN: Retrospective observational study. SETTING AND SUBJECTS: Cancelled HEMS missions with persisting medical indication within Sogn og Fjordane county in Norway during the period of 2010-2013. Both primary and secondary missions were included. MAIN OUTCOME MEASURES: Primary care involvement, treatment and cooperation within the prehospital system...
October 8, 2018: Scandinavian Journal of Primary Health Care
José-Gabriel Sato Folatre, Per Arnell, Mari Henning, Kristina Josefsson, Gabriel Skallsjö, Sven-Erik Ricksten
In 2016, physician staffed helicopter emergency medical service (VGR HEMS) became the first Swedish prehospital service to routinely carry and transfuse red blood cells. In this report we describe our implementation and present our results, with preliminary analysis of our data. Out of 1 336 patients a total of 34 patients (2,5 %) were transfused without any adverse events. Our demography is predominantly male and the most common mechanism of injury is trauma. Amongst the most common interventions were endotracheal intubation, thoracostomy and CPR...
October 2, 2018: Läkartidningen
Prashanth Nandhabalan, Nicholas Ioannou, Christopher Meadows, Duncan Wyncoll
Despite timely intervention, there exists a small subgroup of patients with septic shock who develop progressive multi-organ failure. Seemingly refractory to conventional therapy, they exhibit a very high mortality. Such patients are often poorly represented in large clinical trials. Consequently, good evidence for effective treatment strategies is lacking. In this article, we describe a pragmatic, multi-faceted approach to managing patients with refractory septic shock based on our experience of toxin-mediated sepsis in a specialist referral centre...
September 19, 2018: Critical Care: the Official Journal of the Critical Care Forum
Scott Munro, Mark Joy, Richard de Coverly, Mark Salmon, Julia Williams, Richard M Lyon
BACKGROUND: Helicopter Emergency Medical Services (HEMS) are a scarce resource that can provide advanced emergency medical care to unwell or injured patients. Accurate tasking of HEMS is required to incidents where advanced pre-hospital clinical care is needed. We sought to evaluate any association between non-clinically trained dispatchers, following a bespoke algorithm, compared with HEMS paramedic dispatchers with respect to incidents requiring a critical HEMS intervention. METHODS: Retrospective analysis of prospectively collected data from two 12-month periods was performed (Period one: 1st April 2014 - 1st April 2015; Period two: 1st April 2016 - 1st April 2017)...
September 25, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Yuki Enomoto, Asuka Tsuchiya, Yusuke Tsutsumi, Hitoshi Kikuchi, Koji Ishigami, Junpei Osone, Masahito Togo, Susumu Yasuda, Yoshiaki Inoue
OBJECTIVES: The effectiveness of Japanese helicopter emergency medical services (HEMS) and interventions at the scene is not clear as regard children. For effective use of HEMS at the clinical scene, we need to clarify the characteristics of pediatric patients cared for by HEMS. Therefore, the objective of this study was to describe the characteristics of pediatric scene flights and to describe the procedures performed on the patients. METHODS: This was a retrospective cohort study based on the database for children aged younger than 18 years who were cared for by physician-staffed HEMS of Ibaraki prefecture, in Japan...
September 11, 2018: Pediatric Emergency Care
Makoto Aoki, Toshikazu Abe, Daizoh Saitoh, Shuichi Hagiwara, Kiyohiro Oshima
OBJECTIVES: To evaluate the possible association of vasopressor use with mortality in traumatic hemorrhagic shock patients. DESIGN: Retrospective cohort study. SETTING: Traumatic hemorrhagic shock patients at 260 emergency hospitals in Japan between 2004 and 2015. PATIENTS: Three-thousand five-hundred fifty-one traumatic hemorrhagic shock patients who had systolic hypotension (< 90 mm Hg) on arrival at the emergency department and a blood transfusion received within the first 24 hours...
September 7, 2018: Critical Care Medicine
Patryk Rzońca, Robert Gałązkowski, Mariusz Panczyk, Joanna Gotlib
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a significant clinical challenge for emergency medical systems worldwide. The first step towards ensuring patient survival is achieving return of spontaneous circulation (ROSC). The purpose of the study was to analyze the cases of OHCA to which HEMS teams were dispatched. MATERIAL AND METHODS We performed a retrospective analysis of all HEMS calls in Poland for cases of OHCA between 1 January 2011 and 31 December 2016. Data were obtained from medical records maintained by the Polish HEMS...
August 31, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Craig Prentice, Jeyasankar Jeyanathan, Richard De Coverly, Julia Williams, Richard Lyon
OBJECTIVES: The aim of this study is to describe the demographics of reported traumatic cardiac arrest (TCA) victims, prehospital resuscitation and survival to hospital rate. SETTING: Helicopter Emergency Medical Service (HEMS) in south-east England, covering a resident population of 4.5 million and a transient population of up to 8 million people. PARTICIPANTS: Patients reported on the initial 999 call to be in suspected traumatic cardiac arrest between 1 July 2016 and 31 December 2016 within the trust's geographical region were identified...
September 5, 2018: BMJ Open
Joachim Juelsgaard, Leif Rognås, Lars Knudsen, Troels Martin Hansen, Mads Rasmussen
BACKGROUND: Hypoxia and hypotension may be associated with secondary brain injury and negative outcomes in patients with traumatic and non-traumatic intracranial pathology. Guidelines exist only for the prehospital management of patients with severe traumatic brain injury (TBI). In patients with non-traumatic intracranial pathology, TBI guideline recommendations may be applied to assess whether hypoxia and hypotension should be avoided during prehospital treatment. The main study objective was to assess the extent to which Danish Helicopter Emergency Medical Service (HEMS) critical care teams adhere to the prehospital TBI guideline recommendations for the management of patients with a clinical diagnosis of non-traumatic intracranial pathology or isolated TBI...
August 22, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Daniel Kornhall, Robert Näslund, Cecilia Klingberg, Regina Schiborr, Mikael Gellerfors
BACKGROUND: Physician-staffed helicopter emergency services (HEMS) can provide benefit through the delivery of specialist competence and equipment to the prehospital scene and through expedient transport of critically ill patients to specialist care. This paper describes the integration of such a system in a rural Swedish county. METHODS: This is a retrospective database study recording the outcomes of every emergency call centre dispatch request as well as the clinical and operational data from all completed missions during this service's first year in operation...
August 29, 2018: BMC Emergency Medicine
Julian Thompson, Marius Rehn, Stephen J M Sollid
BACKGROUND: Helicopter EMS (HEMS) teams may perform a variety of clinical, managerial and transport functions during major incident management. Despite national and international variations in HEMS systems, the rapid delivery of HEMS personnel with advanced skills in major incident management and clinical scene leadership has been crucial to the delivery of an effective medical response at previous incidents. This document outlines the Best Practice Advice of the European HEMS and Air Ambulance Committee (EHAC) Medical Working Group on how HEMS and Pre Hospital Critical Care teams may maximise the positive impact of their resources in the event of Major Incidents...
August 15, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Christina Sebastian, Kevin Collopy, Thomas V Clancy, Elizabeth Acquista
Our medical center's regional helicopter emergency medical service (HEMS) serves southeastern North Carolina. Judicious HEMS use is vital to ensure that the resource is available for critically injured patients and to reduce morbidity and mortality by providing timely access to definitive care. We reviewed HEMS use, clinical outcomes, and overtriage rates. The data included airlifted trauma patients from January 2004 to December 2012. Of 1210 total patients, 733 were flown directly from the scene (FS) and 477 from referring hospitals (FH)...
June 1, 2018: American Surgeon
Henrik Langdalen, Eirik B Abrahamsen, Stephen J M Sollid, Leif Inge K Sørskår, Håkon B Abrahamsen
BACKGROUND: Inadequate non-technical skills (NTSs) among employees in the Norwegian prehospital emergency medical services (EMSs) are a risk for patient and operational safety. Simulation-based training and assessment is promising with respect to improving NTSs. The frequency of simulation-based training in and assessment of NTSs among crewmembers in the Norwegian helicopter emergency medical service (HEMS) has gained increased attention over recent years, whereas there has been much less focus on the Norwegian ground emergency medical service (GEMS)...
July 3, 2018: BMC Health Services Research
Joshua Schiller, Jane E McCormack, Victor Tarsia, Mark J Shapiro, Adam J Singer, Henry C Thode, Mark C Henry
OBJECTIVES: Despite conflicting evidence regarding its efficacy, helicopter transportation of trauma victims is widespread. We determined the effect of adding a second helicopter to a countywide emergency medicine system on trauma-related mortality. METHODS: A before-and-after trial design was used to compare hospital mortality before and after introducing a second helicopter to the eastern end of Suffolk County, New York, in 2001 aimed at reducing transport times to the regional trauma center...
October 2009: Prehospital Emergency Care
Iscander M Maissan, Leonie A Verbaan, Marco van den Berg, Robert Jan Houmes, Robert Jan Stolker, Dennis den Hartog
OBJECTIVE: After severe (primary) brain injury, Dutch physician-based helicopter emergency medical services start therapy to lower the intracranial pressure (ICP) on scene to stop or delay secondary brain injury. In some cases, helicopter transportation to the nearest level 1 trauma center is indicated. During transportation, the head-down position may counteract the ICP-lowering strategies because of venous blood pooling in the head. To examine this theory, we measured the optic nerve sheath diameter (ONSD) during helicopter transport in healthy volunteers...
July 2018: Air Medical Journal
B L S Borger van der Burg, Thijs T C F van Dongen, J J Morrison, P P A Hedeman Joosten, J J DuBose, T M Hörer, R Hoencamp
BACKGROUND: Circulatory collapse is a leading cause of mortality among traumatic major exsanguination and in ruptured aortic aneurysm patients. Approximately 40% of patients die before hemorrhage control is achieved. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct designed to sustain the circulation until definitive surgical or endovascular repair. A systematic review was conducted for the current clinical use of REBOA in patients with hemodynamic instability and to discuss its potential role in improving prehospital and in-hospital outcome...
August 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Xilin Chen, Mark L Gestring, Matthew R Rosengart, Andrew B Peitzman, Timothy R Billiar, Jason L Sperry, Joshua B Brown
BACKGROUND: Trauma is a time sensitive disease. Helicopter emergency medical services (HEMS) have shown benefit over ground emergency medical services (GEMS), which may be related to reduced prehospital time. The distance at which this time benefit emerges depends on many factors that can vary across regions. Our objective was to determine the threshold distance at which HEMS has shorter prehospital time than GEMS under different conditions. METHODS: Patients in the Pennsylvania trauma registry 2000 to 2013 were included...
July 2018: Journal of Trauma and Acute Care Surgery
Chris Evans, David O Quinlan, Paul T Engels, Jonathan Sherbino
Resuscitation of traumatic cardiac arrest is typically considered futile. Recent evidence suggests that traumatic cardiac arrest is survivable. In this article key principles in managing traumatic cardiac arrest are discussed, including the importance of rapidly seeking prognostic information, such as signs of life and point-of-care ultrasonography evidence of cardiac contractility, to inform the decision to proceed with resuscitative efforts. In addition, a rationale for deprioritizing chest compressions, steps to quickly reverse dysfunctional ventilation, techniques for temporary control of hemorrhage, and the importance of blood resuscitation are discussed...
February 2018: Emergency Medicine Clinics of North America
Damien Di Rocco, Mathieu Pasquier, Eric Albrecht, Pierre-Nicolas Carron, Fabrice Dami
BACKGROUND: Helicopter emergency medical services (HEMS) are popular rescue systems despite inconsistent evidence in the scientific literature to support their use for primary interventions, as well as for inter-facility transfer (IFT). There is little research about IFT by HEMS, hence questions remain about the appropriateness of this method of transport. The aim of this study was to describe a case-mix of operational and medical characteristics for IFT activity of a sole HEMS base, and identify indicators of over-triage...
May 16, 2018: BMC Emergency Medicine
Maryse C Cnossen, Ruben van der Brande, Hester F Lingsma, Suzanne Polinder, Fiona Lecky, Andrew I R Maas
The first hour following traumatic brain injury (TBI) is considered crucial to prevent death and disability. It is, however, not established yet how the prehospital care should be organized to optimize recovery during the first hour. The objective of the current study was to examine variation in prehospital trauma care across Europe aiming to inform comparative effectiveness analyses on care for neurotrauma patients. A survey on prehospital trauma care was sent to 68 neurotrauma centers from 20 European countries participating in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study...
July 24, 2018: Journal of Neurotrauma
2018-05-17 05:22:11
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