Publications by authors named "Kevin T Collopy"

68 Publications

Patient Care Alterations After Point-of-Care Laboratory Testing During Critical Care Transport.

Air Med J 2022 Jul-Aug;41(4):370-375. Epub 2022 May 23.

Department of General Surgery, Novant Health New Hanover Regional Medical Center, Wilmington, NC.

Objective: Point-of-care laboratory testing (POCT) is associated with a reduced time to testing results and critical decision making within emergency departments. POCT is an essential clinical assessment tool because laboratory data are used to support timely critical decisions regarding acute medical conditions onditions ; however, there is currently limited research to support the use of POCT in the critical care transport environment. Few studies have evaluated the changes in patient care that occur after POCT during critical care transport. This study aims to contribute to the limited data available correlating prehospital POCT and changes in patient care.

Methods: After institutional review board approval, a retrospective review of patients transported by a critical care transport team between October 1, 2013 and September 31, 2015 was completed. During the study period, 11,454 patients were transported, and 632 (5.51%) received POCT testing.

Results: Patient care changes were noted in 244 (38.6%) patient tests. The most frequent patient care alterations were ventilator settings (10.9%), electrolyte changes (10.4%), and unit bed upgrades (7.1%). POCT most frequently altered care for patients with post-cardiac arrest syndrome (64.7%), sepsis/septic shock (61.8%), diabetic ketoacidosis (54.5%), or pneumonia (49.3%).

Conclusion: Patient care alterations occurred in 38.6% of patients undergoing POCT. Patient care was most frequently changed when patients were diagnosed with post-arrest, sepsis/septic shock, diabetic ketoacidosis, and pneumonia.
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http://dx.doi.org/10.1016/j.amj.2022.04.008DOI Listing
June 2022

Talladega EMS: Behind the Scenes at NASCAR's Most Fabled Superspeedway.

Authors:
Kevin T Collopy

EMS World 2017 Jan;46(1):18-26

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January 2017

Busting top trauma myths. Exploring best practices for prehospital trauma care.

EMS World 2015 Mar;44(3):38-45

Evidence-based medicine will continually change the paradigm in which emergency medicine is practiced. Fifteen years ago tourniquets were a last resort and often considered a guaranteed way to lose a limb; today they are a gold standard in hemorrhage control. Believing in, and having practiced, medicine we later learn to be false doesn't make someone a bad provider, nor does it make them wrong. It simply means emergency medicine and EMS will continue to develop as a profession, and our body of evidence will continue to grow as we learn more about prehospital care. As we prepare to retire MAST, backboards and lidocaine, and realize the golden hour as a concept rather than a definitive 60 minutes, it's important to keep a critical eye out for the next intervention that truly will help patients during their prehospital care.
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March 2015

Surgical cricothyrotomies in prehospital care. Surgical airway placement is indicated when you cannot intubate or ventilate.

EMS World 2015 Jan;44(1):42-9

Managing the airway does not mean intubation, it means managing the airway. Allowing a patient to breathe on their own with appropriate positioning, bag-valve ventilation and blind insertion devices are all airway management options. The surgical cricothyrotomy is a rare and life-saving procedure when managing patients who are in a "can't intubate, can't ventilate" situation. These patients will die without aggressive and rapid intervention. While not all surgical cricothyrotomies provide a definitive airway, the needle cricothyrotomy is an ineffective means for ventilation and its use is discouraged. Understand the techniques used in your program and that are within your scope of practice as an EMS provider. Provide your patient the best opportunity for survival by knowing your program's surgical airway procedure thoroughly, and practice it regularly.
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January 2015

Aortic dissections and aneurysms. Prehospital care of these rare but life-threatening emergencies.

EMS World 2014 Sep;43(9):43-9

Aortic dissections and aneurysms are seen with low frequency and have high risk for deterioration during prehospital care. It is essential to include both dissections and aneurysms in your differential diagnoses whenever evaluating patients with chest or abdominal complaints. Often a good history is the best indication of one of these grave vascular emergencies. Consider thoracic aortic dissection in your differential diagnosis for any patient who complains of chest pain and aortic aneurysm in patients who have any sort of abdominal discomfort or syncope with an unknown etiology. When either is suspected transport rapidly to a facility with cardiothoracic and vascular surgery capability, and provide care that prepares you to manage the patient quickly should a rupture occur.
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September 2014

Critical transport decisions. In time-sensitive emergencies, every moment counts--choose wisely.

EMS World 2014 Jun;43(6):42-7

Time-sensitive emergencies require early recognition and rapid transport to a facility properly equipped to manage the patient's needs. When managing STEMI, cardiac arrest, suspected stroke, trauma or a severe sepsis patient, use your resources smartly. Manage the patient using all of your capabilities on scene and know the destination best prepared to manage the patient upon ED arrival. When it makes sense to extend transport time to take a patient to a proper facility, it is OK to do so. Considering air medical transport for patients as ground transports exceed 30 minutes is reasonable as long as the flight team provides transport more rapidly or brings additional care that will improve patient outcomes.
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June 2014

Preventing back injuries in EMS. What's the best approach to avoiding harm to providers?

EMS World 2014 May;43(5):23-4, 26-31

Reducing back injuries requires a holistic approach and investment by all interested parties, from front-line staff to leadership and supporting agencies. As a provider, take the time to ensure you are lifting and moving equipment and patients in a manner that protects both the patient and you.
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May 2014

What's the point of point-of-care testing? Understanding the potential of this evolving capability.

EMS World 2014 Feb;43(2):34-42

Point-of-care testing is a rapidly evolving yet complex field. As your POCT program grows, take the time to understand the regulations, as they are important to ensuring patient safety. The regualtions established CLIA are designed to ensure consistent and reliable laboratory results that can accurately impact patient care. When beginning your look into POCY, first identify what labs can directly impact your patient care, then look for a device that meets your needs.
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February 2014

Prehospital childbirth fetal complications. Part 2: what can go wrong, and how can you tell?

EMS World 2013 Nov;42(11):50-7

Public Safety Training Center, Emergency Care Program, Santa Rosa Junior College, CA, USA.

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November 2013

Prehospital childbirth without complications. Part 1: Babies are delivered everyday--just not by EMS providers.

EMS World 2013 Oct;42(10):34-40

Public Safety Training Center, Santa Rosa Junior College, CA, USA.

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October 2013

Hyperglycemia and what to do about it.

EMS World 2013 Sep;42(9):68-77

Vitalink/Airlink, Wilmington, NC, USA.

Diabetes mellitus is on incredibly complex disease and impacts millions of Americans. The pancreas and insulin are both key to normal glucose metabolism and glucose control.Nearly any body stressor that alters a patient's metabolism can impair normal insulin function and trigger hyperglycemia. It is prudent to check blood sugar in all patients with suspected serious illness, whether or not they have diabetic histories. Hyperglycemia can affect any patient and is a predictor of increased mortality if not treated early. Diabetic ketoacidosis has a more rapid onset than a hyperosmolar hyperglycemic state and often presents with a comparatively lower blood sugar and the presence of acidosis. HHS does not present with profound acidosis and has a slower onset, yet more profound dehydration and a higher blood sugar. Do not underestimate the need for early prehospital intervention with hyperglycemia. Early and aggressive IV fluid administration can improve patient outcomes and speed recovery.
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September 2013

Case studies in hypoglycemia. When is it safe to leave these patients at home?

EMS World 2013 Aug;42(8):54-61

Public Safety Training Center, Emergency Care Program at Santa Rosa Junior College, CA, USA.

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August 2013

An EMS guide to chronic pain.

EMS World 2013 Jul;42(7):59-63

Vitalink/Airlink, Wilmington, NC, USA.

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July 2013
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