Tanner Smida, James J Menegazzi, Remle P Crowe, David D Salcido, James Bardes, Brent Myers
Objective End tidal carbon dioxide (ETCO2 ) is often used to assess ventilation and perfusion during cardiac arrest resuscitation. However, few data exist on the relationship between ETCO2 values and mortality in the context of contemporary resuscitation practices. We aimed to explore the association between ETCO2 and mortality following out-of-hospital cardiac arrest (OHCA). Methods We used the 2018-2021 ESO annual datasets to query all non-traumatic OHCA patients with attempted resuscitation. Patients with documented DNR/POLST, EMS-witnessed arrest, ROSC after bystander CPR only, or < 2 documented ETCO2 values were excluded...
September 26, 2023: Prehospital Emergency Care
Sang Hoon Lee, Lauren C Riney, Brant Merkt, Shawn D McDonough, Jordan Baker, Stephanie Boyd, Yin Zhang, Gary L Geis
ObjectiveEmergency medical services (EMS) clinicians are expected to provide expert care to all patients, but face obstacles in maintaining skillsets required in the care of critically ill or injured children. The objectives of this study were to describe and assess the effectiveness of a pediatric-focused, simulation-based, procedural training program for EMS clinicians, delivered on-site by a pediatric simulation education team. We also describe a novel, remote, asynchronous performance outcome measurement system using first-person-view video review...
September 26, 2023: Prehospital Emergency Care
Ryuichi Nakayama, Naofumi Bunya, Shuji Uemura, Keigo Sawamoto, Eichi Narimatsu
BackgroundThe relationship among advanced airway management (AAM), ventilation, and oxygenation in patients with out-of-hospital cardiac arrest (OHCA) who achieve prehospital return of spontaneous circulation (ROSC) has not been validated. This study was designed to evaluate ventilation and oxygenation for each AAM technique (supraglottic devices [SGA] or endotracheal intubation [ETI]) using arterial blood gas (ABG) results immediately after hospital arrival.MethodsThis observational cohort study, using data from the Japanese Association for Acute Medicine OHCA Registry, included patients with OHCA with prehospital and hospital arrival ROSC between July 1, 2014, and December 31, 2019...
September 25, 2023: Prehospital Emergency Care
Sylvia Owusu-Ansah, Remle P Crowe, Sriram Ramgopal
Objective . Asthma represents one of the most common medical conditions among children encountered by emergency medical services (EMS). While care disparities for children with asthma have been observed in other healthcare settings, limited data exist characterizing disparities in prehospital care. We sought to characterize differences in prehospital treatment and transport of children with suspected asthma exacerbations by race and ethnicity, within the context of community socioeconomic status. Methods . We conducted a multi-agency retrospective study of EMS encounters in 2019 for children (2-17 years) with asthma and wheezing using a national prehospital database...
September 25, 2023: Prehospital Emergency Care
Willem Stassen, Craig Wylie, Wesley Craig, Ismaeel Ebrahim, Scott H Mahoney, Anthony E Pusateri, Sanjeev Rambharose, Candice van Koningsbruggen, Richard B Weiskopf, Lee A Wallis
<u>Introduction:</u> Globally, very few settings have undertaken prehospital randomized controlled trials. Given this lack of experience, there is a risk that such trials in these settings may result in protocol deviations, increased prehospital intervals, and increased cognitive load, leading to error. Ultimately, this may affect patient safety and mortality. The aim of this study was to assess the effect of trial-related procedures on simulated scene interval, self-reported cognitive load, medical errors, and time to action...
September 15, 2023: Prehospital Emergency Care
Emma R Wender, Catherine R Counts, Molly Van Dyke, Michael R Sayre, Charles Maynard, Nicholas J Johnson
INTRODUCTION: Shock after resuscitation from out-of-hospital cardiac arrest (OHCA) is often treated with vasopressors. We examined whether infusion of epinephrine versus norepinephrine was associated with prehospital rearrest and neurologically favorable survival among OHCA patients. METHODS: This retrospective study included OHCA cases in Seattle, Washington from 2014-2021 who had return of spontaneous circulation (ROSC) followed by vasopressor infusion. Our primary exposure was infusion of epinephrine or norepinephrine...
September 14, 2023: Prehospital Emergency Care
Christopher B Gage, Jonathan R Powell, Rebecca E Cash, Ashish R Panchal
No abstract text is available yet for this article.
September 13, 2023: Prehospital Emergency Care
(no author information available yet)
No abstract text is available yet for this article.
September 13, 2023: Prehospital Emergency Care
Louise Giaume, Adrien Jimenez, Romain Kedzierewicz, Daniel Jost, Marie Pery, Julien Trouvé, Guillaume Burlaton, Stéphane Travers, Bertrand Prunet, Marion Trousselard
BACKGROUND: Burnout among emergency health care professionals is well-described, especially during the COVID-19 pandemic. Prevention interventions, such as mindfulness focus on management of stress. OBJECTIVE: To evaluate the effects of the FIRECARE program (a mindfulness intervention, supplemented by heart coherence training and positive psychology workshops) on burnout, secondary stress, compassion fatigue, and mindfulness among advanced life supportt ambulance staff of the Paris Fire Brigade...
September 12, 2023: Prehospital Emergency Care
Mark X Cicero, Janette Baird, Linda Brown, Marc Auerbach, Kathleen Adelgais
BACKGROUND: Only 5-10% of emergency medical services (EMS) patients are children, and most pediatric encounters are low-acuity. EMS chart review has been used to identify adverse safety events (ASEs) in high-acuity and high-risk pediatric encounters. The objective of this work was to evaluate the frequency, type, and potential harm of ASEs in varied acuity pediatric EMS encounters. METHODS: This cross-sectional study evaluated pediatric (ages 0-18 years) prehospital records from 15 EMS agencies among three states (Colorado, Connecticut, and Rhode Island) between November 2019 and October 2021...
September 12, 2023: Prehospital Emergency Care
Gianfranco Sanson, Vittorio Antonaglia, Giovanni Buttignon, Giuseppe Davide Caggegi, Carlo Pegani, Alberto Peratoner
OBJECTIVES: Studies of out-of-hospital cardiac arrest generally document the presenting (pulseless electrical activity [PEA], ventricular fibrillation/tachycardia (VF/VT), asystole), and the final states (resuming stable spontaneous circulation [s-ROSC], being declared dead). Only a few studies described the transitions between clinical states during advanced life support (ALS). The aim of this study was to describe and analyze the dynamics of state transitions during ALS. METHODS: A retrospective analysis of 464 OHCA events was conducted...
September 11, 2023: Prehospital Emergency Care
Michael W Supples, Joseph S McIlwain, Anna C Snavely, Stephen Powell, James E Winslow, Jason P Stopyra, Simon A Mahler
BACKGROUND: Emergency medical services (EMS) clinicians demonstrate a high prevalence of chronic medical conditions that place them at risk for early mortality. Workplace health promotion programs improve health outcomes, but the availably of such programs for EMS clinicians has not been described. We investigate the availability, scope, and participation of workplace health promotion programs available to EMS clinicians in North Carolina (NC). METHODS: We administered an electronic survey based on the Centers for Disease Control and Prevention Worksite Health ScoreCard to key representatives of EMS agencies within NC that provide primarily transport-capable 9-1-1 response with ground ambulances...
September 5, 2023: Prehospital Emergency Care
Michael Kaduce, Jonathan R Powell, Lisa Collard, Christopher B Gage, Michael G Miller, Ashish R Panchal
BACKGROUND: Initial paramedic education must have sufficient rigor and appropriate resources to prepare graduates to provide lifesaving prehospital care. Despite required national paramedic accreditation, there is substantial variability in paramedic pass rates that may be related to program infrastructure and clinical support. Our objective was to evaluate US paramedic program resources and identify common deficiencies that may affect program completion. METHODS: We conducted a cross-sectional mixed methods analysis of the 2018 Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions annual report, focusing on program Resource Assessment Matrices (RAM)...
August 25, 2023: Prehospital Emergency Care
(no author information available yet)
No abstract text is available yet for this article.
August 24, 2023: Prehospital Emergency Care
Michael Redlener, Claire Kim, Michael Auten, Dennis Wang, Alexis Zebrowski
OBJECTIVES: This study aims to describe the civilian experience and perceptions of the patient coordination and management at the interface of the New York City (NYC) civilian and the military health systems during a large-scale public health emergency. METHODS: A qualitative study design was implemented with interviews conducted using a basic descriptive approach. Purposive sampling was used to recruit participants with experience working during the first wave of COVID-19 in NYC...
August 23, 2023: Prehospital Emergency Care
Angela B Clark, Alison M Coates, Tammie Choi, Ben Meadley, Kelly-Ann Bowles, Maxine P Bonham
Objectives Diet quality often changes as shift workers adjust to atypical work schedules, however, limited research exists examining the early effects of starting rotating shift work on diet and body composition. This study explored dietary behavior changes occurring in graduate paramedics during the first year of exposure to rotating shift work, and investigated dietary intake, diet quality and anthropometric changes over two years. Methods Participants from a graduate paramedic cohort in Melbourne, Australia were approached after two years of shift work for study inclusion...
August 18, 2023: Prehospital Emergency Care
Elizabeth M McCarthy, Kevin Burns, Kevin M Schuster, David C Cone
PURPOSE: Tourniquets are a mainstay of life-saving hemorrhage control. The US military has documented the safety and effectiveness of tourniquet use in combat settings. In civilian settings, events such as the Boston Marathon bombing and mass shootings show that tourniquets are necessary and life-saving entities that must be used correctly and whenever indicated. Much less research has been done on tourniquet use in civilian settings compared to military settings. The purpose of this study is to describe the prehospital use of tourniquets in a regional EMS system served by a single trauma center...
August 17, 2023: Prehospital Emergency Care
Tomer Talmy, Ithamar Greenstein, Sami Gendler, David Chayen, Irina Radomislensky, Alon Ahimor, Tomer Koler, Elon Glassberg, Ofer Almog
BACKGROUND: Prehospital traumatic cardiac arrest (TCA) is associated with a poor prognosis and requires urgent interventions to address its potentially reversible causes. Resuscitative efforts of TCA in the prehospital setting may entail significant resource allocation and impose added tolls on caregivers. The Israel Defense Forces Medical Corps (IDF-MC) instructs clinicians to perform a set protocol in the case of TCA, providing prompt oxygenation, chest decompression and volume resuscitation...
August 14, 2023: Prehospital Emergency Care
Romain Jouffroy, Papa Gueye
No abstract text is available yet for this article.
August 11, 2023: Prehospital Emergency Care
Benjamin Karfunkle, Hei Kit Chan, Benjamin Fisher, Joseph Gill, Carrie Bakunas, Richard Gordon, Sara Miller, Ryan Huebinger
OBJECTIVE: We sought to describe prehospital ultrasound (PHUS) use and trends in PHUS utilization over time using a national database. METHODS: Using the 2018 - 2021 National Emergency Medical Services Information System databases, we identified those EMS activations where PHUS was performed. We evaluated the association between year and number of PHUS exams performed using univariable and multivariable regression analysis. Analysis was performed on the overall group and various subgroups...
August 10, 2023: Prehospital Emergency Care
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