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Prehospital collection

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225 papers 25 to 100 followers
Lars Mommers, Sean Keogh
Prehospital emergency medical services often operate in the most challenging and austere environments. Checklist use for complex tasks in these circumstances is useful but must make task completion simpler, faster and more effective. The SPEEDBOMB checklist for Prehospital Rapid Sequence Induction (PRSI) management rapidly addresses critical steps in the RSI process, is designed to improve checklist compliance and patient safety, and is adaptable for local circumstances.
April 2015: Emergency Medicine Australasia: EMA
J E Griggs, J Jeyanathan, M Joy, M Q Russell, N Durge, D Bootland, S Dunn, E D Sausmarez, G Wareham, A Weaver, R M Lyon
BACKGROUND: Major haemorrhage is a leading cause of mortality following major trauma. Increasingly, Helicopter Emergency Medical Services (HEMS) in the United Kingdom provide pre-hospital transfusion with blood products, although the evidence to support this is equivocal. This study compares mortality for patients with suspected traumatic haemorrhage transfused with pre-hospital packed red blood cells (PRBC) compared to crystalloid. METHODS: A single centre retrospective observational cohort study between 1 January 2010 and 1 February 2015...
November 20, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Yohei Hirano, Toshikazu Abe, Hiroshi Tanaka
PURPOSE: The beneficial effect of the presence of an emergency physician in prehospital major trauma care is controversial. The aim in this study is to assess whether an emergency physician on scene can improve survival outcome of critical trauma patients. METHODS: This retrospective cohort study was conducted by using nationwide trauma registry data between 2004 and 2013 in Japan. Severe trauma patients (injury severity score (ISS) ≥ 16) who were transported directly to the hospital from the injury site were included in our analysis...
November 9, 2018: American Journal of Emergency Medicine
Chase Krook, Domhnall O'Dochartaigh, Doug Martin, Zoë Piggott, Ryan Deedo, Sarah Painter, Gennifer van Werkhoven, Darcy McKay, Dennis Nesdoly, J N Armstrong
CLINICIAN'S CAPSULE What is known about the topic? Emerging evidence regarding prehospital blood transfusions for patients in hemorrhagic shock is positive. What did this study ask? Describe the implementation and stewardship of a prehospital blood transfusion program, as well as basic demographics and blood traceability. What did this study find? We provided blood transfusion to 274 mainly male trauma patients, and just 1.2% of units were wasted. Why does this study matter to clinicians? Implementation of a similar program at other prehospital organizations can be sustainably achieved...
November 8, 2018: CJEM
Jing Wang, Yun Fang, Subhashini Ramesh, Asma Zakaria, Maryann T Putman, Dan Dinescu, James Paik, Romergryko G Geocadin, Pouya Tahsili-Fahadan, Laith R Altaweel
BACKGROUND/OBJECTIVE: Prompt treatment of acute intracranial hypertension is vital to preserving neurological function and frequently includes administration of 23.4% NaCl. However, 23.4% NaCl administration requires central venous catheterization that can delay treatment. Intraosseous catheterization is an alternative route of venous access that may result in more rapid administration of 23.4% NaCl. METHODS: Single-center retrospective analysis of 76 consecutive patients, between January 2015 and January 2018, with clinical signs of intracranial hypertension received 23...
November 5, 2018: Neurocritical Care
Charlotte Cordonnier, Andrew Demchuk, Wendy Ziai, Craig S Anderson
Acute spontaneous intracerebral haemorrhage is a life-threatening illness of global importance, with a poor prognosis and few proven treatments. As a heterogeneous disease, certain clinical and imaging features help identify the cause, prognosis, and how to manage the disease. Survival and recovery from intracerebral haemorrhage are related to the site, mass effect, and intracranial pressure from the underlying haematoma, and by subsequent cerebral oedema from perihaematomal neurotoxicity or inflammation and complications from prolonged neurological dysfunction...
October 6, 2018: Lancet
Angharad Jones, Michael John Donald, Jan O Jansen
BACKGROUND: Helicopter emergency medical services (HEMS) are a useful means of reducing inequity of access to specialist emergency care. The aim of this study was to evaluate the variations in HEMS provision across Europe, in order to inform the further development of emergency care systems. METHODS: This is a survey of primary HEMS in the 32 countries of the European Economic Area and Switzerland. Information was gathered through internet searches (May to September 2016), and by emailing service providers, requesting verification and completion of data (September 2016 to July 2017)...
December 2018: Emergency Medicine Journal: EMJ
Torgrim Soeyland, Alan Garner, Sam Vidler, Cristian Humberto Gutierrez, Arnold Foster, Jane Kitcher
BACKGROUND: Prehospital medical teams are commonly required to administer a range of medications for urgent stabilisation and treatment. The safe preparation of medications during resuscitation requires attention, time and resources, and can be a source of medication error. In our two road and HEMS (Helicopter Emergency Medical Service) prehospital services, medication errors are mitigated by predrawing commonly used medications to set concentrations daily (Hunter Retrieval Service, HRS) or second-daily (CareFlight Sydney, CFS)...
October 20, 2018: Emergency Medicine Journal: EMJ
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...
December 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
2018-07-11 20:39:28
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