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Prehospital collection

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128 papers 25 to 100 followers
https://www.readbyqxmd.com/read/27879534/physician-provided-prehospital-critical-care-effect-on-patient-physiology-dynamics-and-on-scene-time
#1
Bjørn O Reid, Marius Rehn, Oddvar Uleberg, Andreas J Krüger
INTRODUCTION: Improved physiologic status can be seen as a surrogate measure of improved outcome and a field-friendly prognostic model such as the Mainz Emergency Evaluation Score (MEES) could quantify the effect on physiological response. We aim to examine the dynamic physiological profile as measured by this score on patients managed by physician-manned helicopter emergency medical services and how this profile was related to on-scene time expenditure and critical care interventions...
November 22, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/23087028/severe-sepsis-in-pre-hospital-emergency-care-analysis-of-incidence-care-and-outcome
#2
Christopher W Seymour, Thomas D Rea, Jeremy M Kahn, Allan J Walkey, Donald M Yealy, Derek C Angus
RATIONALE: Severe sepsis is common and highly morbid, yet the epidemiology of severe sepsis at the frontier of the health care system-pre-hospital emergency care-is unknown. OBJECTIVES: We examined the epidemiology of pre-hospital severe sepsis among emergency medical services (EMS) encounters, relative to acute myocardial infarction and stroke. METHODS: Retrospective study using a community-based cohort of all nonarrest, nontrauma King County EMS encounters from 2000 to 2009 who were transported to a hospital...
December 15, 2012: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/26719078/severe-sepsis-and-septic-shock-in-pre-hospital-emergency-medicine-survey-results-of-medical-directors-of-emergency-medical-services-concerning-antibiotics-blood-cultures-and-algorithms
#3
Sebastian Casu, David Häske
Delayed antibiotic treatment for patients in severe sepsis and septic shock decreases the probability of survival. In this survey, medical directors of different emergency medical services (EMS) in Germany were asked if they are prepared for pre-hospital sepsis therapy with antibiotics or special algorithms to evaluate the individual preparations of the different rescue areas for the treatment of patients with this infectious disease. The objective of the survey was to obtain a general picture of the current status of the EMS with respect to rapid antibiotic treatment for sepsis...
June 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27836253/bi-manual-proximal-external-aortic-compression-after-major-abdominal-pelvic-trauma-and-during-ambulance-transfer-a-simulation-study
#4
M J Douma, D O'Dochartaigh, P G Brindley
BACKGROUND: Applying manual pressure after hemorrhage is intuitive, cost-free, and logistically-simple. When direct abdominal-pelvic compression fails, clinicians can attempt indirect proximal-external-aortic-compression (PEAC), while expediting transfer and definitive rescue. This study quantifies the sustainability of simulated bi-manual PEAC both immediately on scene and during subsequent ambulance transfer. The goal is to understand when bi-manual PEAC might be clinically-useful, and when to prioritize compression-devices or endovascular-occlusion...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/27814743/prehospital-fibrinolysis-versus-primary-percutaneous-coronary-intervention-in-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
Vincent Roule, Pierre Ardouin, Katrien Blanchart, Adrien Lemaitre, Julien Wain-Hobson, Damien Legallois, Joachim Alexandre, Rémi Sabatier, Paul Milliez, Farzin Beygui
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy in patients with ST-elevation myocardial infarction (STEMI), but its benefit over prehospital fibrinolysis (FL) is not clear. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials in which outcomes of patients with STEMI managed with FL early in the prehospital setting versus PPCI were compared. RESULTS: Compared with PPCI, FL was consistently associated with similar rates of short-term (30-90 days) death (relative risk [RR] 0...
November 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27692683/the-effect-of-combined-out-of-hospital-hypotension-and-hypoxia-on-mortality-in-major-traumatic-brain-injury
#6
Daniel W Spaite, Chengcheng Hu, Bentley J Bobrow, Vatsal Chikani, Bruce Barnhart, Joshua B Gaither, Kurt R Denninghoff, P David Adelson, Samuel M Keim, Chad Viscusi, Terry Mullins, Duane Sherrill
STUDY OBJECTIVE: Survival is significantly reduced by either hypotension or hypoxia during the out-of-hospital management of major traumatic brain injury. However, only a handful of small studies have investigated the influence of the combination of both hypotension and hypoxia occurring together. In patients with major traumatic brain injury, we evaluate the associations between mortality and out-of-hospital hypotension and hypoxia separately and in combination. METHODS: All moderate or severe traumatic brain injury cases in the preimplementation cohort of the Excellence in Prehospital Injury Care study (a statewide, before/after, controlled study of the effect of implementing the out-of-hospital traumatic brain injury treatment guidelines) from January 1, 2007, to March 31, 2014, were evaluated (exclusions: <10 years, out-of-hospital oxygen saturation ≤10%, and out-of-hospital systolic blood pressure <40 or >200 mm Hg)...
September 27, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27650943/physician-staffed-helicopter-emergency-medical-systems-can-provide-advanced-trauma-life-support-in-mountainous-and-remote-areas
#7
Julia Ausserer, Elizabeth Moritz, Matthias Stroehle, Hermann Brugger, Giacomo Strapazzon, Simon Rauch, Peter Mair
INTRODUCTION: In remote and mountainous areas, helicopter emergency medical systems (HEMS) are used to expedite evacuation and provide pre-hospital advanced trauma life support (ATLS) in major trauma victims. Aim of the study was to investigate feasibility of ATLS in HEMS mountain rescue missions and its influence on patient condition at hospital admission. PATIENTS: 58 major trauma victims (Injury Severity Score ≥16), evacuated by physician staffed HEMS from remote and mountainous areas in the State of Tyrol, Austria between 1...
September 8, 2016: Injury
https://www.readbyqxmd.com/read/27637440/the-effect-of-prehospital-intubation-on-treatment-times-in-patients-with-suspected-traumatic-brain-injury
#8
Joshua D Lansom, Kate Curtis, Helen Goldsmith, Alex Tzannes
OBJECTIVE: This study examines whether, in patients requiring intubation with moderate to severe traumatic brain injury (TBI), prehospital intubation compared with emergency department intubation leads to a reduction in treatment times and time to a computed tomographic (CT) scan. METHODS: A retrospective cohort study compared adult patients with a Glasgow Coma Score of less than 14 with a suspected TBI who underwent intubation, either prehospital or on arrival to the emergency department...
September 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27629235/ten-year-maturation-period-in-a-level-i-trauma-center-a-cohort-comparison-study
#9
A M K Harmsen, G F Giannakopoulos, M Terra, E S M de Lange de Klerk, F W Bloemers
PURPOSE: Many changes have been made to improve trauma care. Improved trauma team response and usage of a hybrid resuscitation room are examples of how this trauma center has developed. The aim was to assess how the outcome of the trauma population was influenced by the maturation. METHODS: A cohort comparison, between June 2004-July 2005 and 2014, was performed. All adult trauma patients with an Injury Severity Score (ISS) >15 were included. Variables collected were: patient demographics, mechanism of trauma, total prehospital time, pre- and inhospital trauma scores, vital signs, blood values and interventions, and physician staffed helicopter emergency medical services (P-HEMS) involvement and outcome...
September 15, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27565859/association-between-prehospital-physician-involvement-and-survival-after-out-of-hospital-cardiac-arrest-a-danish-nationwide-observational-study
#10
Annika Hamilton, Jacob Steinmetz, Mads Wissenberg, Christian Torp-Pedersen, Freddy K Lippert, Lars Hove, Nicolai Lohse
AIM: Sudden out-of-hospital cardiac arrest (OHCA) is an important public health problem. While several interventions are known to improve survival, the impact of physician-delivered advanced cardiac life support for OHCA is unclear. We aimed to assess the association between prehospital physician involvement and 30-day survival. METHODS: Observational study including persons registered with first-time OHCA of any cause in the Danish Cardiac Arrest Registry during 2005-2012...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/27567923/prehospital-intubation-for-isolated-severe-blunt-traumatic-brain-injury-worse-outcomes-and-higher-mortality
#11
Tobias Haltmeier, Elizabeth Benjamin, Stefano Siboni, Evren Dilektasli, Kenji Inaba, Demetrios Demetriades
PURPOSE: Prehospital endotracheal intubation (ETI) for traumatic brain injury (TBI) is a controversial issue. The aim of this study was to investigate the effect of prehospital ETI in patients with TBI. METHODS: Cohort-matched study using the US National Trauma Data Bank (NTDB) 2008-2012. Patients with isolated severe blunt TBI (AIS head ≥3, AIS chest/abdomen <3) and a field GCS ≤8 were extracted from NTDB. A 1:1 matching of patients with and without prehospital ETI was performed...
August 27, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27586097/prehospital-transportation-decisions-for-patients-sustaining-major-trauma-in-road-traffic-crashes-in-sweden
#12
Stefan Candefjord, Ruben Buendia, Eva-Corina Caragounis, Bengt Arne Sjöqvist, Helen Fagerlind
OBJECTIVE: The objective of this study was to evaluate the proportion and characteristics of patients sustaining major trauma in road traffic crashes (RTCs) who could benefit from direct transportation to a trauma center (TC). METHODS: Currently, there is no national classification of TC in Sweden. In this study, 7 university hospitals (UHs) in Sweden were selected to represent a TC level I or level II. These UHs have similar capabilities as the definition for level I and level II TC in the United States...
September 2016: Traffic Injury Prevention
https://www.readbyqxmd.com/read/27566790/transtracheal-jet-ventilation-in-the-can-t-intubate-can-t-oxygenate-emergency-a-systematic-review
#13
REVIEW
L V Duggan, B Ballantyne Scott, J A Law, I R Morris, M F Murphy, D E Griesdale
BACKGROUND: Transtracheal jet ventilation (TTJV) is recommended in several airway guidelines as a potentially life-saving procedure during the 'Can't Intubate Can't Oxygenate' (CICO) emergency. Some studies have questioned its effectiveness. METHODS: Our goal was to determine the complication rates of TTJV in the CICO emergency compared with the emergency setting where CICO is not described (non-CICO emergency) or elective surgical setting. Several databases of published and unpublished literature were searched systematically for studies describing TTJV in human subjects...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27075015/pediatric-pre-hospital-emergencies-in-belgium-a-2-year-national-descriptive-study
#14
Pierre Demaret, Frédéric Lebrun, Philippe Devos, Caroline Champagne, Roland Lemaire, Isabelle Loeckx, Marie Messens, André Mulder
UNLABELLED: This study aims to describe the pediatric physician-staffed EMS missions at a national level and to compare the pediatric and the adult EMS missions. Using a national database, we analyzed 254,812 interventions including 15,294 (6 %) pediatric emergencies. Less children than adults received an intravenous infusion (52.7 versus 77.1 %, p < 0.001), but the intra-osseous access was used more frequently in children (1.3 versus 0.8 %, p < 0.001). More children than adults benefited from a therapeutic immobilization (16...
July 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27550497/reduced-mortality-by-physician-staffed-hems-dispatch-for-adult-blunt-trauma-patients-in-korea
#15
Kyoungwon Jung, Yo Huh, John Cj Lee, Younghwan Kim, Jonghwan Moon, Seok Hwa Youn, Jiyoung Kim, Tea Youn Kim, Juryang Kim, Hyoju Kim
The aim of this study was to investigate the efficiency of domestic physician-staffed helicopter emergency medical service (HEMS) for the transport of patients with severe trauma to a hospital. The study included patients with blunt trauma who were transported to our hospital by physician-staffed HEMS (Group P; n = 100) or nonphysician-staffed HEMS (Group NP; n = 80). Basic patient characteristics, transport time, treatment procedures, and medical treatment outcomes assessed using the Trauma and Injury Severity Score (TRISS) were compared between groups...
October 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27503061/the-role-of-prehospital-advanced-airway-management-on-outcomes-for-out-of-hospital-cardiac-arrest-patients-a-meta-analysis
#16
Seungmin Jeong, Ki Ok Ahn, Sang Do Shin
OBJECTIVE: The objective of this meta-analysis was to compare the benefits of prehospital advanced airway management (AAM) and basic airway management (BAM) for out-of-hospital cardiac arrest (OHCA) patients. METHODS: Two investigators performed a systematic review of PubMed, EMBASE, and the Cochrane Database to identify all peer-reviewed articles relevant to this meta-analysis. We included all articles describing emergency medical system-treated nontraumatic OHCAs; specifically, all articles that described intervention of the prehospital AAM type were considered...
July 19, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27484298/characteristics-and-outcomes-of-blood-product-transfusion-during-critical-care-transport
#17
Jorge Mena-Munoz, Udayan Srivastava, Christian Martin-Gill, Brian Suffoletto, Clifton W Callaway, Francis X Guyette
BACKGROUND: Civilian out-of-hospital transfusions have not been adequately studied. This study seeks to characterize patients receiving out-of-hospital blood product transfusion during critical care transport. STUDY DESIGN AND METHODS: We studied patients transported by a regional critical care air-medical service who received blood products during transport. This service carries two units of uncrossmatched packed Red Blood Cells (pRBCs) on every transport in addition to blood obtained from referring facilities...
September 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27436374/five-year-retrospective-review-of-physician-and-non-physician-performed-ultrasound-in-a-canadian-critical-care-helicopter-emergency-medical-service
#18
Domhnall O'Dochartaigh, Matthew Douma, Mark MacKenzie
OBJECTIVE: To describe the use of prehospital ultrasonography (PHUS) to support interventions, when used by physician and non-physician air medical crew (AMC), in a Canadian helicopter emergency medical service (HEMS). METHODS: A retrospective review was conducted of consecutive patients who underwent ultrasound examination during HEMS care from January 1, 2009 through March 10, 2014. An a priori created data form was used to record patient demographics, type of ultrasound scan performed, ultrasound findings, location of scan, type of interventions supported by PHUS, factors that affected PHUS completion, and quality indicator(s)...
July 19, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27273615/the-success-of-battlefield-surgical-airway-insertion-in-severely-injured-military-patients-a-uk-perspective
#19
Tony Kyle, S le Clerc, A Thomas, I Greaves, V Whittaker, J E Smith
BACKGROUND: The insertion of a surgical airway in the presence of severe airway compromise is an uncommon occurrence in everyday civilian practice. In conflict, the requirement for insertion of a surgical airway is more common. Recent military operations in Afghanistan resulted in large numbers of severely injured patients, and a significant proportion required definitive airway management through the insertion of a surgical airway. OBJECTIVE: To examine the procedural success and survival rate to discharge from a military hospital over an 8-year period...
December 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27275669/emergency-cricothyrotomy-performed-by-surgical-airway-naive-medical-personnel-a-randomized-crossover-study-in-cadavers-comparing-three-commonly-used-techniques
#20
Frédéric Heymans, Georg Feigl, Stephan Graber, Delphine S Courvoisier, Kerstin M Weber, Pavel Dulguerov
BACKGROUND: When conventional approaches to obtain effective ventilation and return of effective spontaneous breathing fail, surgical airway is the last rescue option. Most physicians have a limited lifetime experience with cricothyrotomy, and it is unclear what method should be taught for this lifesaving procedure. The aim of this study is to compare the performance of medical personnel, naive to surgical airway techniques, in establishing an emergency surgical airway in cadavers using three commonly used cricothyrotomy techniques...
August 2016: Anesthesiology
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