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Prehospital life support

Avi Benov, Irena Shkolnik, Elon Glassberg, Roy Nadler, Sami Gendler, Ben Antebi, Jacob Chen, Noam Fink, Tarif Bader
BACKGROUND: The Israeli Defense Force Medical Corps (IDF-MC) is routinely collecting pre-hospital data to establish a pre-hospital registry. Since February 2013, Israel has been providing medical care to Syrian refugees. This unique humanitarian aid begins in pre-hospital settings and typically culminates in Israeli civilian hospitals. This report describes the accumulated experience of the IDF-MC to provide Syrian refugees with prehospital treatment. METHODS: Care provided by IDF-MC medical teams, including pre-hospital casualty care, is regularly documented and after-action reports are conducted...
February 13, 2019: Journal of Trauma and Acute Care Surgery
M L Avellanas Chavala, M Ayala Gallardo, Í Soteras Martínez, E Subirats Bayego
A narrative review is presented on the diagnosis, treatment and management of accidental hypothermia. Although all these processes form a continuum, for descriptive purposes in this manuscript the recommendations are organized into the prehospital and in-hospital settings. At prehospital level, it is advised to: a) perform high-quality cardiopulmonary resuscitation for cardiac arrest patients, regardless of body temperature; b) establish measures to minimize further cooling; c) initiate rewarming; d) prevent rescue collapse and continued cooling (afterdrop); and (e) select the appropriate hospital based on the clinical and hemodynamic situation of the patient...
January 22, 2019: Medicina Intensiva
Mazen J El Sayed, Hani Tamim, Aurelie Mailhac, N Clay Mann
Prehospital use of ventilators by emergency medical services (EMS) during 911 calls is increasing. This study described the impact of prehospital mechanical ventilation on prehospital time intervals and on mortality.This retrospective matched-cohort study used 4 consecutive public releases of the US National Emergency Medical Services Information System dataset (2011-2014). EMS activations with recorded ventilator use were randomly matched with activations without ventilator use (1 to 1) on age (range ± 2 years), gender, provider's primary impression, urbanicity, and level of service...
January 2019: Medicine (Baltimore)
Montse Ballbè, Cristina Martínez, Ariadna Feliu, Núria Torres, Gemma Nieva, Cristina Pinet, Antònia Raich, Sílvia Mondon, Pablo Barrio, Rosa Hernández-Ribas, Jordi Vicens, Sílvia Costa, Jordi Vilaplana, Laura Alaustre, Eva Vilalta, Roser Blanch, Susana Subirà, Eugeni Bruguera, Josep Maria Suelves, Joseph Guydish, Esteve Fernández
BACKGROUND: Up to 75% of inpatients with mental disorders smoke, and their life expectancy is decreased by up to 25 years compared to the general population. Hospitalized patients without monitoring after discharge quickly return to prehospitalization levels of tobacco use. The aim of the 061 QuitMental study is to assess the effectiveness of a multicomponent and motivational telephone-based intervention to stop smoking through a quitline addressed to smokers discharged from mental health hospital wards...
January 11, 2019: Trials
Francisco Martín-Rodríguez, Miguel Ángel Castro-Villamor, Carlos Del Pozo Vegas, José Luis Martín-Conty, Agustín Mayo-Iscar, Juan Francisco Delgado Benito, Pablo Del Brio Ibañez, Pedro Arnillas-Gómez, Carlos Escudero-Cuadrillero, Raúl López-Izquierdo
The early warning score can help to prevent, recognize and act at the first signs of clinical and physiological deterioration. The objective of this study is to evaluate different scales for use in the prehospital setting and to select the most relevant one by applicability and capacity to predict mortality in the first 48 h. A prospective longitudinal observational study was conducted in patients over 18 years of age who were treated by the advanced life support unit and transferred to the emergency department between April and July 2018...
January 9, 2019: Internal and Emergency Medicine
Cyril Sahyoun, Christina Siliciano, David Kessler
BACKGROUND: Capnography and cardiopulmonary resuscitation (CPR) feedback devices have been shown to improve resuscitation outcomes, with the American Heart Association recommending their use during advanced life support (ALS). Little is known about the availability of these devices, their protocoled use, and the attitudes toward them in the prehospital setting. OBJECTIVES: The objectives of this study were to assess the availability of capnography and CPR feedback devices among prehospital ALS agencies in New York State (NYS), to describe the protocoled use of these devices, and to evaluate the attitudes of providers toward the use of these devices...
December 27, 2018: Pediatric Emergency Care
Brian Grunau, Takahisa Kawano, Frank Scheuermeyer, John Tallon, Joshua Reynolds, Floyd Besserer, David Barbic, Steven Brooks, Jim Christenson
OBJECTIVE: Data demonstrating benefit of advanced life support (ALS) practitioners for out-of-hospital cardiac arrest (OHCA) is conflicting. In our tiered emergency medical services (EMS) system, we sought to determine if the ALS response interval was associated with patient outcomes. METHODS: We performed a secondary analysis of consecutive adult OHCAs (2006-2016) in British Columbia. Primary and secondary outcomes were survival and favorable neurological outcomes (mRS ≤3) at hospital discharge...
December 18, 2018: Resuscitation
Elena-Laura Lemaitre, Laurent Tritsch, Eric Noll, Pierre Diemunsch, Nicolas Meyer
AIM OF THE STUDY: The role of supraglottic devices in airway management in out-of-hospital cardiac arrest (OHCA) remains controversial. The aim of this study was to evaluate the feasibility and effectiveness of intubation through the Intubating Laryngeal Mask Airway (ILMA) when used by prehospital emergency nurses in the setting of OHCA. METHODS: We conducted a prospective, observational trial during 12 years by the Fire Department and prehospital emergency service of the health district of Strasbourg, France...
December 17, 2018: Resuscitation
Eleanor L DiBiasio, Mahesh V Jayaraman, Lori Oliver, Gino Paolucci, Michael Clark, Cristina Watkins, Karen DeLisi, Ann Wilks, Shadi Yaghi, Morgan Hemendinger, Grayson L Baird, J Adam Oostema, Ryan A McTaggart
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...
December 7, 2018: Journal of Neurointerventional Surgery
Michael Ely, Elizabeth A Edgerton, Russell Telford, Kent Page, Craig Hemingway, Donald Vernon, Lenora M Olson
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. METHODS: A Web-based survey was sent to EMS agencies in 2010 and 2013, and results were analyzed to determine availability of medical direction and equipment...
November 26, 2018: Pediatric Emergency Care
Francisco Martín-Rodríguez, Raúl López-Izquierdo, Miguel A Castro Villamor, Iratxe Moro Mangas, Pablo Del Brío Ibáñez, Juan F Delgado Benito, José L Martín Conty, Jesús Álvarez Manzanares, Agustín Mayo-Iscar, Carlos Del Pozo Vegas
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...
November 19, 2018: American Journal of Emergency Medicine
Peter Paal, Hermann Brugger, Giacomo Strapazzon
Accidental hypothermia causes profound changes to the body's physiology. After an initial burst of agitation (e.g., 36-37°C), vital functions will slow down with further cooling, until they vanish (e.g. <20-25°C). Thus, a deeply hypothermic person may appear dead, but may still be able to be resuscitated if treated correctly. The hospital use of minimally invasive rewarming for nonarrested, otherwise healthy patients with primary hypothermia and stable vital signs has the potential to substantially decrease morbidity and mortality for these patients...
2018: Handbook of Clinical Neurology
Bruna Dessena, Paul C Mullan
Introduction: Child abuse is a common condition in the emergency centres of South Africa. It is critical for both prehospital emergency care practitioners and emergency centre-based emergency medicine registrars to be competent in screening, diagnosing, treating, and documenting child abuse. Our goal was to assess the knowledge of child abuse management in a sample of prehospital emergency care practitioners and emergency medicine registrars in Cape Town, South Africa. Methods: A mixed-methods approach of quantitative and qualitative data was used to survey a sample of 120 participants (30 emergency medicine registrars and 90 prehospital emergency care practitioners: 30 Basic Life Support, 30 Intermediate Life Support, and 30 Advanced Life Support)...
June 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Mike Wells, Laurice Barnes, Craig Vincent-Lambert
Introduction: The choice of weight estimation method to use during prehospital paediatric emergency care is important because it needs to be both accurate and easy to use. Accuracy is important to ensure optimum drug dosing while ease-of-use is important to minimise user errors and the cognitive load experienced by healthcare providers. Little is known about which weight estimation systems are used in the prehospital environment anywhere in the world. This knowledge is important because if the use of inappropriate weight estimation practices is identified, it could be remedied through education and institutional policies...
June 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Hilary A Hewes, Michael Ely, Rachel Richards, Manish I Shah, Stephanie Busch, Diane Pilkey, Katherine Dixon Hert, Lenora M Olson
OBJECTIVE: Pediatric patients represent low frequency but potentially high-risk encounters for EMS providers. Scant information is available from EMS agencies on the frequency of pediatric skill evaluation and the presence of pediatric emergency care coordination, both which may help EMS systems optimize care for children. The objective of our study was to assess the frequency and type of methods used to assess psychomotor skills competency using pediatric-specific equipment and pediatric care coordination in EMS ground transport agencies...
October 31, 2018: Prehospital Emergency Care
Mark Froats, Andrew Reed, Richard Dionne, Justin Maloney, Susan Duncan, Rob Burns, Julie Sinclair, Michael Austin
BACKGROUND: Most patients transferred from a non-percutaneous coronary intervention (PCI) facility for primary PCI do not meet target reperfusion times. Direct transportation of patients with ST-elevation myocardial infarction (STEMI) from the scene by advanced life support (ALS) paramedics has been shown to improve reperfusion times and outcomes. OBJECTIVE: The aim of this study was to determine whether it is safe to bypass the closest hospital and transport by basic life support (BLS) provider to a PCI facility...
October 9, 2018: Journal of Emergency Medicine
J G Ten Brinke, S R Groen, M Dehnad, T P Saltzherr, M Hogervorst, J C Goslings
PURPOSE: The practice of prehospital immobilization is coming under increasing scrutiny. Unravelling the historical sequence of prehospital immobilization might shed more light on this matter and help resolve the situation. Main purpose of this review is to provide an overview of the development and reasoning behind the implementation of prehospital spine immobilization. METHODS: An extensive search throughout historical literature and recent evidence based studies was conducted...
December 2018: European Spine Journal
Michael Parenteau, Zsolt Stockinger, Stephen Hughes, Brad Hickey, James Mucciarone, Christopher Manganello, Andrew Beeghly
Highly skilled swimmers and aquatically adaptable service members such as U.S. Navy Divers, Sea, Air and Land (SEAL) Teams, and Explosive Ordnance Disposal (EOD) technicians, die every year from drowning. Drowning is the cause of over 500,000 deaths annually across the globe. This Clinical Practice Guideline (CPG) provides an overview of drowning and associated conditions based on the best available current medical evidence. Unlike basic life support and advanced cardiac life support protocols, rescue breathing should be initiated prior to chest compressions to re-expand water-filled alveoli...
September 1, 2018: Military Medicine
Deborah P Waldrop, Jacqueline M McGinley, Michael W Dailey, Brian Clemency
BACKGROUND: The primary charge of Emergency Medical Services (EMS) is to save lives. However, EMS personnel are frequently called to scenes where prolonging life may not be the primary goal. When someone is nearing death, family members may feel compelled to call 9-1-1 because they are feeling uncertain about how to manage symptoms at the end of life. OBJECTIVE: We sought to explore prehospital providers' perspectives on how the awareness of dying and documentation of end-of-life wishes influence decision-making on emergency calls near the end of life...
October 11, 2018: Prehospital Emergency Care
Seyyed Mohammad Reza Hosseini, Mohammadreza Maleki, Hasan Abolghasem Gorji, Davoud Khorasani-Zavareh, Masoud Roudbari
Introduction: Prehospital emergency medical service dispatchers should make prompt and appropriate decisions to save the life of victims. The complexity of timely and reasonable decision-making in life-threatening conditions has driven researchers to investigate varying aspects of the emergency medical dispatch (EMD) process. The purpose of this study was to explore the contributors to appropriate and prompt decision-making among dispatchers. Methods: A qualitative study through thematic analysis was designed...
2018: Journal of Multidisciplinary Healthcare
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