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Prehospital Emergency Care

Colleen J Bressler, Megan M Letson, David Kline, Tara McCarthy, James Davis, Julie C Leonard
OBJECTIVE: The objective of this study was to determine if neighborhood rates of pediatric Emergency Medical Services (EMS) encounters correlate with rates of child maltreatment reporting and if there are neighborhood-level risk factors for EMS encountering children with maltreatment reports. METHODS: We conducted a retrospective cohort study using the electronic medical records of children ages <18 years who had Columbus Division of Fire EMS encounters between 2011-2015...
January 31, 2019: Prehospital Emergency Care
Zar Popal, Sebastiaan M Bossers, Maartje Terra, Patrick Schober, Marcel A de Leeuw, Frank W Bloemers, Georgios F Giannakopoulos
No abstract text is available yet for this article.
January 29, 2019: Prehospital Emergency Care
Robert L Dickson, Remle P Crowe, Casey Patrick, Kevin Crocker, Michael Aiken, Andrew Adams, Guy R Gleisberg, Tyler Nichols, Christopher Mason, Ashish R Panchal
INTRODUCTION: Emergency Medical Services (EMS) providers may identify and preferentially transport patients experiencing large vessel occlusion (LVO) stroke to appropriate treatment centers. The Rapid Arterial oCclusion Evaluation (RACE) scale was created for prehospital LVO detection, yet few studies have evaluated its function in real-world EMS settings. Our objective was to assess the prehospital performance of the RACE scale for detecting LVO stroke following implementation at a large suburban/rural agency in the United States...
January 22, 2019: Prehospital Emergency Care
Bronson Du, Michelle Boileau, Kayla Wierts, Sue Hignett, Steven Fischer, Amin Yazdani
BACKGROUND: Emergency medical services (EMS) personnel face a disproportionally high risk for fatality and injury due to the nature of their work; and current ambulance and EMS equipment design standards do not adequately safeguard EMS personnel from sacrificing personal safety for patient care, a known human factors and ergonomic (HFE) design challenge. Despite the desire to include HFE interventions or considerations into a standard, the effectiveness of existing HFE interventions for EMS is unclear...
January 14, 2019: Prehospital Emergency Care
(no author information available yet)
No abstract text is available yet for this article.
January 11, 2019: Prehospital Emergency Care
Tiffany Champagne-Langabeer, James R Langabeer, Kirk E Roberts, Joshua S Gross, Guy R Gleisberg, Michael G Gonzalez, David Persse
INTRODUCTION: Telehealth has been used nominally for trauma, neurological, and cardiovascular incidents in prehospital emergency medical services (EMS). Yet, much less is known about the use of telehealth for low-acuity, primary care. We examine the development of one telehealth program, and its impact on unnecessary ambulance transports. OBJECTIVE: To describe the development and impact of a large-scale telehealth program on ambulance transports. METHODS: We describe the patient characteristics and results from a cohort of patients in Houston, Texas who received a prehospital telehealth consultation from an emergency medicine physician...
January 9, 2019: Prehospital Emergency Care
Gina Agarwal, Ricardo Angeles, Melissa Pirrie, Brent McLeod, Francine Marzanek, Jenna Parascandalo, Lehana Thabane
OBJECTIVE: Older adults account for 38-48% of emergency medical service (EMS) calls, have more chronic diseases, and those with low income have lower quality of life. Mobile integrated health and community paramedicine may help address these health inequalities and reduce EMS calls. This study examines the effectiveness of the Community Paramedicine at Clinic (CP@clinic) program in decreasing EMS calls and improving health outcomes in low-income older adults. METHODS: This was an open-label, pragmatic, cluster-randomized controlled trial conducted within subsidized public housing buildings for older adults in five paramedic services across Ontario, Canada...
January 9, 2019: Prehospital Emergency Care
Maria J Mandt, Kari Hayes, Fred Severyn, Kathleen Adelgais
OBJECTIVE: Needle thoracostomy is a life-saving procedure. Advanced Trauma Life Support guidelines recommend insertion of a 5 cm, 14-gauge needle for pneumothorax decompression. High-risk complications can arise if utilizing an inappropriate needle size. No study exist evaluating appropriate needle length in pediatric patients. Utilizing computed tomography (CT), we determined the needle length required to access the pleural cavity in children matched to Broselow™ Pediatric Emergency Tape color...
January 9, 2019: Prehospital Emergency Care
Jennifer N Fishe, Sean Lynch
OBJECTIVES: Pediatric behavioral health disorders and related emergency department visits are increasing, but effects on emergency medical services (EMS) are unknown. This study's objective was to describe the statewide epidemiology of pediatric behavioral health-related EMS encounters in Florida, including mental health and substance use. METHODS: This analysis is a retrospective study of pediatric behavioral health-related EMS encounters from Florida's statewide EMS Tracking and Reporting Systems Database from 2011-2016...
January 7, 2019: Prehospital Emergency Care
S Pruyn, J Frey, B Baker, M Brodeur, C Graichen, H Long, H Zheng, M W Dailey
OBJECTIVE: Naloxone is an opioid receptor antagonist that reverses life-threatening effects of opioid overdose. Since the 1970's, naloxone products have been developed as injectable solutions, and more recently as nasal sprays. Naloxone products have saved many lives in emergency settings. These products are routinely carried by public safety first-responders including fire fighters (FF), law enforcement officers (LEO) and emergency medical services (EMS). Now, they are also distributed through community access programs to the public...
December 30, 2018: Prehospital Emergency Care
Steven G Schauer, Jason F Naylor, Adrianna Long, Alejandra Mora, Tuan D Le, Joseph K Maddry, Michael D April
BACKGROUND: Women served in both combat and non-combat units in the recent conflicts in Iraq and Afghanistan. Moreover, the recent conflicts lacked traditional separation of civilians from combatants carrying additional risk for injury to local civilians. There is a relative paucity of data specific to this topic. We compare injury patterns and interventions performed in the prehospital, combat setting among females versus males. METHODS: This is a secondary analysis of previously published data from the Department of Defense Trauma Registry...
December 27, 2018: Prehospital Emergency Care
Joanne Coster, Alicia O'Cathain, Richard Jacques, Annabel Crum, Niroshan Siriwardena, Janette Turner
Objectives Emergency ambulance services do not transport all patients to hospital. International literature reports non-transport rates ranging from 3.7%-93.7%. In 2017, 38% of the 11 million calls received by ambulance services in England were attended by ambulance but not transported to an Emergency Department (ED). A further 10% received clinical advice over the telephone. Little is known about what happens to patients following a non-transport decision. We aimed to investigate what happens to patients following an emergency ambulance telephone call that resulted in a non-transport decision, using a linked routine data-set...
December 24, 2018: Prehospital Emergency Care
Annisa Dewi Utami Rakun, John Carson Allen, Nur Shahidah, Yih Yng Ng, Benjamin Sieu-Hon Leong, Han Nee Gan, Desmond Renhao Mao, Michael Yih Chong Chia, Si Oon Cheah, Lai Peng Tham, Marcus Eng Hock Ong
OBJECTIVE: We aimed to examine the association of ethnicity and socioeconomic status (SES) with Out-of-Hospital Cardiac Arrest (OHCA) incidence and 30-day survival in Singapore. METHODS: We analyzed the Singapore cohort of Pan-Asia Resuscitation Outcome Study (PAROS), a multi-center, prospective OHCA registry between 2010 and 2015. The Singapore Socioeconomic Disadvantage Index (SEDI) score, obtained according to zipcode, was used as surrogate for neighborhood SES...
December 22, 2018: Prehospital Emergency Care
Isabel Gardett, Meghan Broadbent, Greg Scott, Jeff J Clawson, Christopher Olola
OBJECTIVE: The aim of this study was to determine the frequency of automatic external defibrillator (AED) retrieval and placement by bystander callers when prompted by an Emergency Medical Dispatcher (EMD). METHODS: This retrospective descriptive study utilized a convenience sample of emergency dispatch data collected from 23 Emergency Communication Centers (ECCs) spanning 14 states across the United States (U.S.) from July 11, 2014 to August 13, 2018, including all cases in which the EMD recorded any response to the AED availability prompt...
December 20, 2018: Prehospital Emergency Care
Nichole Bosson, Benjamin Isakson, Jayson A Morgan, Amy H Kaji, Atilla Uner, Katherine Hurley Msn, Timothy D Henry, James T Niemann
OBJECTIVE: While widely used in the treatment of cardiac conditions, only limited data characterize out-of-hospital nitroglycerin (NTG) use. We sought to determine the safety of out-of-hospital sublingual NTG administered for suspected ST-segment elevation myocardial infarction (STEMI) and its effect on the patient's pain score. METHODS: We prospectively identified adult patients with suspected STEMI transported by paramedics to three PCI-capable hospitals in a large urban-suburban EMS system...
December 17, 2018: Prehospital Emergency Care
Kathleen Grisanti, Lisa Martorano, Margaret Redmond, Rebecca Scherzer, Kasey Strothman, Lauren Malthaner, James Davis, Songzhu Zhao, David Kline, Julie C Leonard
OBJECTIVE: Anaphylaxis is a medical emergency requiring prompt recognition and treatment with intramuscular epinephrine to optimize outcomes. To date, there is a paucity of data regarding the demographic characteristics of the subset of patients calling 9-1-1 for allergic reactions and the emergency medical services (EMS) dispatcher's adherence to national protocols for their response to a suspected allergic reaction. METHODS: We conducted a retrospective review of dispatch calls to a local municipality that were dispatched with an impression of an "allergic reaction" or "difficulty breathing related to a suspected allergic reaction" from January 2016 to June 2016...
December 11, 2018: Prehospital Emergency Care
Jennifer N Fishe, Kevin J Psoter, Jennifer F Anders
OBJECTIVES: Pediatric specialty care is increasingly regionalized. It is unknown how regionalization affects emergency medical services (EMS) providers' destination decisions for non-trauma pediatric patients. We sought to characterize the rates of bypass of the closest facility, and destination facilities' levels of pediatric care in three diverse EMS agencies. METHODS: This is a one-year retrospective study of non-trauma pediatric patients less than 18 years of age transported by three EMS agencies (Baltimore City, Prince George's County, and Queen Anne's County) in 2016...
December 8, 2018: Prehospital Emergency Care
(no author information available yet)
No abstract text is available yet for this article.
December 4, 2018: Prehospital Emergency Care
(no author information available yet)
No abstract text is available yet for this article.
December 4, 2018: Prehospital Emergency Care
Peter Brendt, Alexander Mathews, Randall Greenberg, Mark Arnold
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. 2. Pre-hospital ketamine/propofol sedation of an aggressive/combative patient with recovery from sedation in a private property...
December 3, 2018: Prehospital Emergency Care
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