11,422 results match your criteria Prehospital Emergency Care [Journal]


Identification of thoracic injuries by emergency medical services providers among trauma patients.

Injury 2018 Dec 6. Epub 2018 Dec 6.

Department of Traumatology, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Surgery, Diakonessenhuis Utrecht/Zeist/Doorn, Utrecht, the Netherlands. Electronic address:

Introduction: Severe thoracic injuries are time sensitive and adequate triage to a facility with a high-level of trauma care is crucial. The emergency medical services (EMS) providers are required to identify patients with a severe thoracic injury to transport the patient to the right hospital. However, identifying these patients on-scene is difficult. Read More

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December 2018

Evaluation of new quality indicators for the TraumaRegister DGU using the systematic QUALIFY methodology.

Eur J Trauma Emerg Surg 2018 Dec 14. Epub 2018 Dec 14.

Department for Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Armed Forces Hospital Ulm, HEMS "Christoph 22", Oberer Eselsberg 40, 89081, Ulm, Germany.

Background: The TraumaRegister DGU (TR-DGU) of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie, DGU) enables the participating hospitals to perform quality management. For that purpose, nine so-called audit filters have existed, since its foundation, which, inter alia, is listed in the Annual Report. The objective of this study effort is a revision of these quality indicators with the aim of developing pertinent new and reliable quality indicators for the management of severely injured patients. Read More

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December 2018
1 Read

Optimal Scene Time to Achieve Favorable Outcomes in Out-of-hospital Cardiac Arrest: How Long Is Too Long?

Cureus 2018 Oct 9;10(10):e3434. Epub 2018 Oct 9.

Internal Medicine, Brookdale University Hospital Medical Center, New York, USA.

Background Despite advances in resuscitation science and public health, out-of-hospital cardiac arrest (OOHCA) cases have an average survival rate of only 12% nationwide, compared to 24.8% of cases occurring in hospital. Many factors, including resuscitation interventions, contribute to positive patient outcomes and have, therefore, been studied in attempts to optimize emergency medical services (EMS) protocols to achieve higher rates of return of spontaneous circulation (ROSC) in the field. Read More

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October 2018

Gender Differences in the Quality of EMS Care Nationwide for Chest Pain and Out-of- Hospital Cardiac Arrest.

Womens Health Issues 2018 Nov 24. Epub 2018 Nov 24.

Milken Institute School of Public Health, George Washington University, Washington, DC. Electronic address:

Background: We sought to determine whether gender disparities exist in the prehospital management of chest pain (CP) or out-of-hospital cardiac arrest (OHCA) among patients who accessed the emergency medical services (EMS) system.

Methods: We obtained 2010-2013 data from the National Emergency Medical Services Information System and identified all EMS activations for CP or OHCA by adults 40 years of age or older. We selected American Heart Association medications and procedures to manage cardiovascular events. Read More

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November 2018

Pre-hospital Transport Times and Outcomes After Different Reperfusion Strategies for ST-Elevation Myocardial Infarction.

Am J Cardiol 2018 Oct 21. Epub 2018 Oct 21.

Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan.

This study evaluated prehospital transport times and clinical outcomes after different reperfusion strategies for ST-elevation myocardial infarction in a real-world setting. We consecutively enrolled 27,205 patients who underwent percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction in Michigan from 2010 to 2016. Primary PCI was performed in 25,927 patients (95%), whereas 1,278 (5%) were treated with a pharmacoinvasive strategy. Read More

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October 2018

A multicentre, randomized, controlled open-label trial to compare an Accelerated Rule-Out protocol using combined prehospital copeptin and in-hospital high sensitive troponin with standard rule-out in patients suspected of acute Myocardial Infarction - the AROMI trial.

Trials 2018 Dec 12;19(1):683. Epub 2018 Dec 12.

Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.

Background: Suspicion of acute myocardial infarction (AMI) is among the most common reasons for admission to hospital in Denmark. Owing to this suspicion, an estimated 50,000 patients are admitted every year. Only 15-20% are finally diagnosed with AMI, whereas 40% are discharged after rule-out of AMI and without initiation of any treatment or need for further admission. Read More

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December 2018

Health Information Exchange in Emergency Medical Services.

Appl Clin Inform 2018 Oct 12;9(4):884-891. Epub 2018 Dec 12.

The Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States.

Background:  The Office of the National Coordinator for Health Information Technology has outlined the benefits of health information exchange in emergency medical services (EMSs) according to the model-, , , -developed in collaboration with the California Emergency Medical Services Authority.

Objective:  This scoping review aims to identify and characterize progress toward the adoption of prehospital health information exchange, as reported in the peer-reviewed literature.

Methods:  A structured review of literature in MEDLINE-indexed journals was conducted using the "Electronic Health Records" topic-specific query, the "Emergency Medical Services" Medical Subject Headings descriptor, and a prehospital identifier. Read More

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October 2018
3 Reads

Prehospital Double Sequential Defibrillation: A Matched Case-Control Study.

Acad Emerg Med 2018 Dec 10. Epub 2018 Dec 10.

Department of Emergency Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.

Study Objectives: The goal of our study is to determine if prehospital double sequential defibrillation (DSD) is associated with improved survival to hospital admission in the setting of refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT).

Methods: This project is a matched case-control study derived from prospectively collected Quality Assurance/Quality Improvement (QA/QI) data obtained from the San Antonio Fire Department out-of-hospital cardiac arrest database between JAN 2013 and DEC 2015. The cases were defined as out-of-hospital cardiac arrest (OHCA) patients with refractory VF/pVT that survived to hospital admission. Read More

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December 2018
3 Reads

[Prehospital Emergency Management of Pregnant Women - Obstetric Emergencies Series, Part 1].

Z Geburtshilfe Neonatol 2018 Dec 10;222(6):237-244. Epub 2018 Dec 10.

Institut für Rettungs- und Notfallmedizin, Universitätsklinikum Schleswig Holstein.

Maternal emergencies during pregnancy are characterized by a concomitant threat to 2 patients. These emergencies can occur during or even before a hospital stay. Due to the rarity of the latter cases, sustainable methods of knowledge transfer should be implemented so emergency teams have sufficient obstetrical information to provide emergency care during pregnancy. Read More

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December 2018

Global emergency care clinical practice guidelines: A landscape analysis.

Afr J Emerg Med 2018 Dec 24;8(4):158-163. Epub 2018 Oct 24.

Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, South Africa.

Introduction: An adaptive guideline development method, as opposed to a guideline development, is dependent on access to existing high-quality up-to-date clinical practice guidelines (CPGs). We described the characteristics and quality of CPGs relevant to prehospital care worldwide, in order to strengthen guideline development in low-resource settings for emergency care.

Methods: We conducted a descriptive study of a database of international CPGs relevant to emergency care produced by the African Federation for Emergency Medicine (AFEM) CPG project in 2016. Read More

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December 2018

A descriptive analysis of endotracheal intubation in a South African Helicopter Emergency Medical Service.

Afr J Emerg Med 2018 Dec 26;8(4):140-144. Epub 2018 Jul 26.

Department of Emergency Medical Care, University of Johannesburg, South Africa.

Introduction: Helicopter Emergency Medical Services (HEMS) exists to supplement the operations of ground-based emergency care providers, mainly in high acuity cases. One of the important procedures frequently carried out by HEMS personnel is endotracheal intubation. Several HEMS providers exist in South Africa, with a mix of advanced life support personnel, however intubation success rates and adverse events have not been described in any local HEMS operation. Read More

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December 2018

Evaluation of volume status in a prehospital setting by ultrasonographic measurement of inferior vena cava and aorta diameters.

Turk J Emerg Med 2018 Dec 7;18(4):152-157. Epub 2018 Sep 7.

Lithuanian University of Health Sciences, Department of Emergency Medicine, Kaunas, Lithuania.

Objectives: The aim of this study was to evaluate the utility of ultrasonographic measurement of the diameter of the inferior vena cava (IVCD) and abdominal aorta (AAD) for assessing volume status.

Material And Methods: This was a prospective, observational study. A total of 23 volunteers participated in the study. Read More

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December 2018

Feasibility of prehospital freeze-dried plasma administration in a UK Helicopter Emergency Medical Service.

Eur J Emerg Med 2018 Dec 7. Epub 2018 Dec 7.

Kent, Surrey and Sussex Air Ambulance Trust, Redhill Aerodrome, Redhill.

Background: Early transfusion of patients with major traumatic haemorrhage may improve survival. This study aims to establish the feasibility of freeze-dried plasma transfusion in a Helicopter Emergency Medical Service in the UK.

Patients And Methods: A retrospective observational study of major trauma patients attended by Kent, Surrey and Sussex Helicopter Emergency Medical Service and transfused freeze-dried plasma since it was introduced in April 2014. Read More

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December 2018

Emergency medical systems education may improve knowledge of pre-hospital stroke triage protocols.

J Neurointerv Surg 2018 Dec 7. Epub 2018 Dec 7.

Department of Diagnostic Imaging, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA.

Background: Following the results of randomized clinical trials supporting the use of mechanical thrombectomy (MT) with tissue plasminogen activator for emergent large vessel occlusion (ELVO), our state Stroke Task Force convened to: update legislation to recognize differences between Primary Stroke Centers (PSCs) and Comprehensive Stroke Centers (CSCs); and update Emergency Medical Services (EMS) protocols to triage direct transport of suspected ELVO patients to CSCs.

Purpose: We developed a single-session training curriculum for EMS personnel focused on the Los Angeles Motor Scale (LAMS) score, its use to correctly triage patients as CSC-appropriate in the field, and our state-wide EMS stroke protocol. We assessed the effect of our training on EMS knowledge. Read More

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December 2018

Incidence of Anaphylaxis Recorded During 1 Year by the Municipal Emergency Service of Madrid (SAMUR-PC).

J Investig Allergol Clin Immunol 2018 Dec;28(6):438-440

Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.

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December 2018

Prehospital ketamine administration to pediatric trauma patients with head injuries in combat theaters.

Am J Emerg Med 2018 Oct 22. Epub 2018 Oct 22.

Brooke Army Medical Center, JBSA-Fort Sam Houston, TX, United States of America; 59(th) Medical Wing, JBSA-Lackland, TX, United States of America; US Army Institute of Surgical Research, JBSA-Fort Sam Houston, TX, United States of America.

Background: Head injuries frequently occur in combat. Tactical Combat Casualty Care (TCCC) guidelines recommend pre-hospital use of ketamine for analgesia. Yet the use of this medication in patients with head injuries remains controversial, particularly among pediatric patients. Read More

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October 2018
3 Reads

Impact of Social Media on Community Consultation in Exception From Informed Consent Clinical Trials.

J Surg Res 2019 Feb 4;234:65-71. Epub 2018 Oct 4.

The University of Texas McGovern Medical School at Houston, Houston, Texas.

Background: Exception from informed consent (EFIC) allows clinician scientists to perform much needed emergency research. Obtaining this exception, however, requires many meetings with community groups for consultation, which can make the process time-consuming and expensive. We aim to determine the impact of using social media in lieu of some community meetings in an effort to obtain an EFIC. Read More

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February 2019

Establishment of trauma treatment teams within a regional severe trauma treatment system in China: study protocol for a national cluster-randomised trial.

BMJ Open 2018 Dec 4;8(12):e023347. Epub 2018 Dec 4.

Department of Orthopedic and Traumatology, Peking University People's Hospital, Beijing, China.

Introduction: The implementation of first aid processes for patients with trauma in China faces significant challenges. These challenges include long response times of prehospital first aid services, lack of information exchange between prehospital first aid services and in-hospital emergency services, lack of a professional rescue team in the majority of hospitals, and lack of standardised training for prehospital and in-hospital emergency personnel. The purpose of the trial is to guide the establishment of an urban trauma treatment system in China, highlight the construction of a trauma treatment system tailored to the Chinese context and improve levels of medical treatment by selecting approximately 100 counties across China as pilots to establish a regional trauma treatment system. Read More

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December 2018
3 Reads

Trajectories of early secondary insults correlate to outcomes of traumatic brain injury: results from a large, single centre, observational study.

BMC Emerg Med 2018 Dec 5;18(1):52. Epub 2018 Dec 5.

School of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy.

Background: Secondary insults (SI), such as hypotension, hypoxia, and intracranial hypertension frequently occur after traumatic brain injury (TBI), and have a strong impact on patients' clinical outcomes. The aim of this study is to examine the trajectories of SI from the early phase of injury in the prehospital setting to hospital admission in a cohort of TBI patients.

Methods: This is a retrospective, observational, single centre study on consecutive patients admitted from 1997 to 2016 to the Neuro Intensive Care Unit (NICU) at San Gerardo Hospital, in Monza, Italy. Read More

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December 2018
1 Read

Emergency medical services oxygen equipment: a fomite for transmission of MRSA?

Emerg Med J 2018 Dec 1. Epub 2018 Dec 1.

Objectives: The primary purpose of this study was to determine if methicillin-resistant (MRSA) was present on the surface of oxygen cylinders and regulators used in the prehospital setting and secondarily to assess other surfaces for MRSA within the ambulance compartment, as a comparison.

Methods: On 17 March 2018, the surface of oxygen cylinders and regulators located in ambulances at an emergency medical services (EMS) station in North Alabama (n=9) and at an offsite oxygen cylinder storage area (n=70) were swabbed using sterile cotton-tipped applicators saturated in an 0.9% NaCl solution. Read More

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December 2018
1 Read

Prehospital Tranexamic Acid Administration During Aeromedical Transport After Injury.

J Surg Res 2019 Jan 21;233:132-138. Epub 2018 Aug 21.

Division of Trauma, Department of Surgery, Section of General Surgery, University of Cincinnati, Cincinnati, Ohio. Electronic address:

Background: Tranexamic acid (TXA) has been shown to reduce mortality in the treatment of traumatic hemorrhage. This effect seems most profound when given early after injury. We hypothesized that extending a protocol for TXA administration into the prehospital aeromedical setting would improve outcomes while maintaining a similar safety profile to TXA dosed in the emergency department (ED). Read More

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January 2019
1 Read

Autistic Man Falling Through The Cracks. Advanced patient transport and the "pop-up" recovery ward.

Prehosp Emerg Care 2018 Dec 3:1-4. Epub 2018 Dec 3.

b University of Sydney, Faculty of Medicine and Health, School of Rural Health (Dubbo/Orange) , Dubbo , 2830 Australia.

The Royal Flying Doctor Service was tasked to relocate a 19 year-old autistic patient with severe social anxiety, agoraphobia and morbid obesity from one residential location to another. The retrieval team was confronted with two main challenges: 1. Continuous risk elevation in an elective patient transportation as distinct from other urgent prehospital transfers of mental health patients. Read More

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December 2018

The Speech Arm Vision Eyes (SAVE) scale predicts large vessel occlusion stroke as well as more complicated scales.

J Neurointerv Surg 2018 Dec 4. Epub 2018 Dec 4.

Department of Neurology, University of California, San Francisco, San Francisco, California, USA.

Introduction: The Speech Arm Vision Eyes (SAVE) scale, a 4-item clinical scale emphasizing binary scoring and avoidance of nuanced examination distinctions, predicts LVOs with similar characteristics as more complex scales.

Methods: Receiver operating characteristic analyses of the prospective STOPStroke study assessed the ability of the SAVE scale and other published scales to predict LVO. We identified scale thresholds with positive likelihood ratios with 95% confidence intervals of ≥5. Read More

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December 2018

Evolution of ST-Elevation Acute Myocardial Infarction Prevalence by Gender Assessed Age Pyramid Analysis-The Piramyd Study.

J Clin Med 2018 Dec 3;7(12). Epub 2018 Dec 3.

SAMU 93, UF Recherche-Enseignement-Qualité Avicenne Hospital-APHP, 93000 Bobigny, France.

Introduction: Recent studies reported a decrease in the incidence of acute myocardial infarction. This favorable evolution does not extend to young women. The interaction between gender, risk factors and myocardial infarction incidence remains controversial. Read More

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December 2018

Commentary on "Prehospital Airway Management in Iraq and Afghanistan: A Descriptive Analysis".

Authors:
G Richard Holt

South Med J 2018 Dec;111(12):714-715

From the Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center, San Antonio.

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December 2018

Prehospital Airway Management in Iraq and Afghanistan: A Descriptive Analysis.

South Med J 2018 Dec;111(12):707-713

From the US Army Institute of Surgical Research, Joint Base San Antonio-Fort Sam Houston, Texas, the 59th Medical Wing, Joint Base San Antonio-Lackland Air Force Base, Texas, the San Antonio Military Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, the Madigan Army Medical Center, Joint Base Lewis McChord, Washington, and the Army Medical Department Center and School Health Readiness Center of Excellence, Joint Base San Antonio-Fort Sam Houston, Texas.

Objectives: Airway failures are the second leading cause of potentially preventable death on the battlefield. Improvements in airway management depend on identifying current challenges. We sought to build on previously reported data on prehospital, combat airway management. Read More

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December 2018
5 Reads

Evaluation of emotional excitation during standardized endotracheal intubation in simulated conditions.

Ann Intensive Care 2018 Dec 4;8(1):117. Epub 2018 Dec 4.

Department of Intensive Care Medicine, University Hospital of Brest - La Cavale Blanche, Boulevard Tanguy Prigent, 29609, Brest Cedex, France.

Objective: To assess how stressful conditions in endotracheal intubation could induct emotional excitation in a population of acute care physicians.

Materials And Methods: Two situations were randomly tested: one in standard and easy intubation conditions the other under difficult conditions presumed to induce stress (monitoring alarms, manikin lying on the floor, difficult intubation). Emotional excitation was assessed using several physiological (cardiac patterns, electrodermal activity and eye-tracking) and psycho-cognitive patterns. Read More

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December 2018

Methodology of a Cross-sectional Study Evaluating the Impact of a Novel Mobile Care Team on the Prevalence of Ambulatory Care Sensitive Conditions Presenting to Emergency Medical Services.

Cureus 2018 Sep 26;10(9):e3369. Epub 2018 Sep 26.

Emergency Medicine, Dalhousie University, Halifax, CAN.

Introduction Hospitalization due to ambulatory care sensitive conditions (ACSC) is often used as a proxy measure for access to primary care. The prevalence of ACSC has not been measured in the prehospital setting. Emergency medical services (EMS) are being used by patients who lack access to primary care for ACSC. Read More

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September 2018
3 Reads

Intravenous Hydroxocobalamin Versus Hextend Versus Control for Class III Hemorrhage Resuscitation in a Prehospital Swine Model.

Mil Med 2018 Nov;183(11-12):e721-e729

CREST Research Program, Department of Emergency Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX.

Background: Hydroxyethyl starch (Hextend) has been used for hemorrhagic shock resuscitation, however, hydroxyethyl starch may be associated with adverse outcomes.

Objective: To compare systolic blood pressure (sBP) in animals that had 30% of their blood volume removed and treated with intravenous hydroxocobalamin, hydroxyethyl starch, or no fluid.

Methods: Twenty-eight swine (45-55 kg) were anesthetized and instrumented with continuous femoral and pulmonary artery pressure monitoring. Read More

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November 2018
1 Read

To what extent are GCS and AVPU equivalent to each other when assessing the level of consciousness of children with head injury? A cross-sectional study of UK hospital admissions.

BMJ Open 2018 Nov 28;8(11):e023216. Epub 2018 Nov 28.

Division of Population Medicine, Cardiff University, Cardiff, UK.

Objective: To evaluate utility and equivalence of Glasgow Coma Scale (GCS) and the Alert, Voice, Pain, Unresponsive (AVPU) scale in children with head injury.

Design: Cross sectional study.

Setting: UK hospital admissions: September 2009-February 2010. Read More

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November 2018
3 Reads

Impact of time to repair on outcomes in patients with lower extremity arterial injuries.

J Vasc Surg 2018 Nov 26. Epub 2018 Nov 26.

Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md.

Background: Six hours has long been considered the threshold of ischemia after peripheral artery injury. However, there is a paucity of evidence regarding the impact of operative delays on morbidity and mortality in patients with lower extremity arterial injuries.

Methods: We analyzed the records of 3,441,259 injured patients entered into the National Trauma Data Bank Research Dataset from 2012 to 2015. Read More

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November 2018
3 Reads

Assessing Infrastructure to Care for Pediatric Patients in the Prehospital Setting.

Pediatr Emerg Care 2018 Nov 26. Epub 2018 Nov 26.

Data Coordinating Center, Department of Pediatrics, University of Utah, Salt Lake City, UT.

Objectives: Pediatric patients represent a small proportion of emergency medical services (EMS) calls, challenging providers in maintaining skills in treating children. Having structural capacity to appropriately diagnose and treat pediatric patients is critical. Our study measured the availability of off-line and on-line medical direction and recommended pediatric equipment at EMS agencies. Read More

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November 2018

[Erratum to: Performance of prehospital emergency anesthesia and airway management : An online survey].

Anaesthesist 2018 Nov 28. Epub 2018 Nov 28.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln (AöR), Köln, Deutschland.

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November 2018

Overall risk index for patient transfers in total assistance mode executed by emergency medical technician-paramedics in real work situations.

Appl Ergon 2019 Jan 3;74:177-185. Epub 2018 Sep 3.

Université Laval, Département de Kinésiologie, 2300 rue de la Terrasse, Québec Québec, G1V 0A6, Canada; Centre for interdisciplinary research in rehabilitation and social integration (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC, Canada. Electronic address:

Few studies have quantified the risk of musculoskeletal disorders during patient transfers in total assistance mode in real-life prehospital emergency care situations. An index to assess the overall risk of patient transfers was created; it makes it possible to quantify risk based on the patient's position and the height of the patient's location. An analysis of 71 transfers executed by paramedics in actual work situations showed that moving a patient from the ground was characterized by acute sagittal flexions and axial rotations, respectively, 42% and 12% of the time. Read More

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January 2019

Association between the reported intensity of an acute symptom at first prehospital assessment and the subsequent outcome: a study on patients with acute chest pain and presumed acute coronary syndrome.

BMC Cardiovasc Disord 2018 Nov 28;18(1):216. Epub 2018 Nov 28.

PreHospen - Centre for Prehospital Research, University of Borås, Borås, Sweden.

Background: To decrease the morbidity burden of cardiovascular disease and to avoid the development of potentially preventable complications, early assessment and treatment of acute coronary syndrome (ACS) are important. The aim of this study has therefore been to explore the possible association between patients' estimated intensity of chest pain when first seen by the ambulance crew in suspected ACS, and the subsequent outcome before and after arrival in hospital.

Methods: Data was collected both prospectively and retrospectively. Read More

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November 2018

Emergency medical services provider perspectives on pediatric calls: A qualitative study.

Prehosp Emerg Care 2018 Nov 27:1-26. Epub 2018 Nov 27.

a Allina Health Emergency Medical Services , 167 Grand Avenue, St. Paul , Minnesota , USA.

Objective: Previous research indicates that 9-1-1 response to incidents involving children is particularly distressing for emergency medical services (EMS) clinicians. This qualitative study was conducted to increase understanding about the difficulties of responding to pediatric calls and to obtain information about how organizations can better support EMS providers in managing potentially difficult calls.

Methods: Paramedics and emergency medical technicians from a single US ambulance service were invited to participate in focus groups about responding to 9-1-1 calls involving pediatric patients. Read More

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November 2018

Out-of-hospital cardiac arrest at place of residence is associated with worse outcomes in patients admitted to intensive care: a post-hoc analysis of the Targeted Temperature Management trial.

Minerva Anestesiol 2018 Nov 22. Epub 2018 Nov 22.

Department of Clinical Sciences, Center for Cardiac Arrest, Faculty of Medicine, Lund University, Lund, Sweden.

Background: The majority of out-of-hospital cardiac arrests (OHCAs) occur at place residence, which is associated with worse outcomes in unselected prehospital populations. Our aim was to investigate whether location of arrest was associated with outcome in a selected group of initial survivors admitted to intensive care.

Methods: This is a post-hoc analysis of the Targeted Temperature Management after cardiac arrest trial (TTM trial), a multicenter controlled trial, randomizing 950 OHCA patients to an intervention of 33°C or 36°C. Read More

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November 2018

Analysis of data for comorbidity and survival in out-of-hospital cardiac arrest.

Data Brief 2018 Dec 6;21:1541-1551. Epub 2018 Nov 6.

Faculty of Caring Science,Work Life and Social Welfare, University of Borås, Sweden.

The data presented in this article is supplementary to the research article titled "Comorbidity and survival in out-of-hospital cardiac arrest" (Hirlekar et al., 2018). The data contains information of how Charlson Comorbidity Index (CCI) is calculated and coded from ICD-10 codes. Read More

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December 2018
4 Reads

Effectiveness of implementation strategies for the improvement of guideline and protocol adherence in emergency care: a systematic review.

BMJ Open 2018 Nov 25;8(11):e017572. Epub 2018 Nov 25.

Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium.

Objective: Guideline and protocol adherence in prehospital and in-hospital emergency departments (EDs) is suboptimal. Therefore, the objective of this systematic review was to identify effective strategies for improving guideline and protocol adherence in prehospital and ED settings.

Design: Systematic review. Read More

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November 2018
1 Read

Application of the emergency medical services trigger tool to measure adverse events in prehospital emergency care: a time series analysis.

BMC Emerg Med 2018 Nov 26;18(1):47. Epub 2018 Nov 26.

Department: Improvement Capability, Institution: Institute for Healthcare Improvement, Cambridge, USA.

Background: Emergency Care has previously been identified as an area of significant concern regarding the prevalence of Adverse Events (AEs). However, the majority of this focus has been on the in-hospital setting, with little understanding of the identification and incidence of AEs in the prehospital environment.

Method: The early development and testing of Emergency Medical Services (EMS) specific triggers for the identification of AEs and Harm has been previously described. Read More

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November 2018

Prognostic value of lactate in prehospital care as a predictor of early mortality.

Am J Emerg Med 2018 Nov 19. Epub 2018 Nov 19.

Emergency Department, Valladolid University Clinic, SACYL, Spain.

Background: Prehospital Emergency Medical Services must attend to patients with complex physiopathological situations with little data and in the shortest possible time. The objective of this work was to study lactic acid values and their usefulness in the prehospital setting to help in clinical decision-making.

Study Design: We conducted a longitudinal prospective, observational study on patients over 18 years of age who, after being evaluated by the Advanced Life Support Unit, were taken to the hospital between April and June 2018. Read More

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November 2018

The safety and efficacy of on-site paramedic and allied health treatment interventions targeting the reduction of emergency department visits by long-term care patients: systematic review protocol.

Syst Rev 2018 Nov 23;7(1):206. Epub 2018 Nov 23.

Department of Emergency Medicine, University of Ottawa at The Ottawa Hospital, 1053 Carling Ave, Ottawa, Ontario, K1Y 4E9, Canada.

Background: Older adults are more likely to access the emergency department, which suffers from overcrowding and congestion, for conditions that could potentially be treated in other settings. Older adults living in long-term care centers have access to healthcare resources in their residence, and several programs have been created with the intent of treating medical conditions on-site. The aim of this study is to identify and systematically review programs and interventions at long-term care centers that aim to treat patients on-site, avoiding unscheduled transportation to the emergency department. Read More

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November 2018

Epidemiology of cardiovascular disease in China: current features and implications.

Nat Rev Cardiol 2018 Nov 22. Epub 2018 Nov 22.

Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.

Cardiovascular disease (CVD) is the leading cause of death in China. To develop effective and timely strategies to cope with the challenges of CVD epidemics, we need to understand the current epidemiological features of the major types of CVD and the implications of these features for the prevention and treatment of CVD. In this Review, we summarize eight important features of the epidemiology of CVD in China. Read More

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November 2018
10 Reads

Longitudinal emergency medical services experience within a postgraduate year 2 pharmacy residency in emergency medicine.

Am J Health Syst Pharm 2018 Dec;75(23):1864-1866

Department of Emergency MedicineNebraska MedicineOmaha, NE.

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December 2018
3 Reads

Cerebral Blood Flow in Polytrauma: Transcranial Doppler Analysis in a Nonhuman Primate Shock Model.

J Surg Res 2018 Dec 5;232:146-153. Epub 2018 Jul 5.

Naval Medical Research Unit San Antonio, San Antonio, Texas. Electronic address:

Background: In combat-related trauma, resuscitation goals are to attenuate tissue hypoxia and maintain circulation. During hemorrhagic shock, compensatory and autoregulatory mechanisms are activated to preserve cerebral blood flow. Transcranial Doppler (TCD) ultrasonography may be an ideal noninvasive modality to monitor cerebral hemodynamics. Read More

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December 2018
2 Reads

Longer prehospital time was not associated with mortality in major trauma. A retrospective cohort study.

Prehosp Emerg Care 2018 Nov 21:1-24. Epub 2018 Nov 21.

f Monash University , Department: School of Public Health and Preventive Medicine, Monash Universit , Melbourne , 3800 Australia.

Objective: To determine the association between prehospital time and outcomes in adult major trauma patients, transported by ambulance paramedics.

Methods: A retrospective cohort study of major trauma patients (Injury Severity Score >15) attended by St John Ambulance paramedics in Perth, Western Australia, who were transported to hospital between 1st January 2013 and 31st December 2016. Inverse probability of treatment weighting (IPTW) using the propensity score was performed to limit selection bias and confounding. Read More

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November 2018
3 Reads

Outcomes and emergency medical services resource utilization among patients with syncope arriving to the emergency department by ambulance.

CJEM 2018 Nov 21:1-6. Epub 2018 Nov 21.

†Ottawa Hospital Research Institute,Ottawa, ON.

CLINICIAN'S CAPSULEWhat is known about the topic?A majority of syncope patients are transported to the emergency department by emergency medical services (EMS), yet only a small proportion are admitted or suffer serious adverse events (SAE).What did this study ask?What proportion of EMS syncope patient transports are at low risk (i.e. Read More

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November 2018
3 Reads