keyword

Prehospital

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https://read.qxmd.com/read/32227791/act-fast-a-quality-improvement-project-to-increase-the-percentage-of-acute-stroke-patients-receiving-intravenous-thrombolysis-within-60-minutes-of-arrival-at-the-emergency-department
#1
Li Qi Chiu, Daniel Yong Jing Quek, Roslin Binte Salihan, Wai May Ng, Rozana Binte Othman, Chiao-Hao Lee, Daniel Chia Theng Oh
INTRODUCTION: Stroke is a leading cause of death and disability, with the administration of reverse transcriptase-plasminogen activator (rtPA) improving outcomes in a time-dependent manner. Only 52.3% of our eligible stroke patients received rtPA within 60 minutes of arrival. We aimed to better the percentage of acute stroke patients receiving rtPA within 60 minutes of arrival at the emergency department (ED). METHODS: Results from the first year of a clinical practice improvement project, where quality improvement interventions were implemented, are presented...
March 31, 2020: Singapore Medical Journal
https://read.qxmd.com/read/32224764/innovations-in-prehospital-stroke-management-utilizing-mobile-stroke-units
#2
Anne W Alexandrov, Andrei V Alexandrov
Using a representative case, this article discusses prehospital innovations for patients with acute large vessel occlusion ischemic stroke, including mobile stroke unit care supported by advanced field imaging.
April 2020: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/32223543/utstein-recommendation-for-emergency-stroke-care
#3
A G Rudd, C Bladin, P Carli, D A De Silva, T S Field, E C Jauch, P Kudenchuk, M W Kurz, T Lærdal, Meh Ong, P Panagos, A Ranta, C Rutan, M R Sayre, L Schonau, S D Shin, D Waters, F Lippert
BACKGROUND: Recent advances in treatment for stroke give new possibilities for optimizing outcomes. To deliver these prehospital care needs to become more efficient. AIM: To develop a framework to support improved delivery of prehospital care. The recommendations are aimed at clinicians involved in prehospital and emergency health systems who will often not be stroke specialists but need clear guidance as to how to develop and deliver safe and effective care for acute stroke patients...
March 29, 2020: International Journal of Stroke: Official Journal of the International Stroke Society
https://read.qxmd.com/read/32220860/the-crash3-study-prehospital-txa-for-every-injured-patient
#4
EDITORIAL
Timothy J Coats, Fiona E Lecky
No abstract text is available yet for this article.
March 27, 2020: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/32220122/poison-pixie-dust-and-prehospital-airway-management
#5
Jason T McMullan, Darren A Braude
No abstract text is available yet for this article.
March 27, 2020: Academic Emergency Medicine
https://read.qxmd.com/read/32219592/neck-cooling-induces-blood-pressure-increase-and-peripheral-vasoconstriction-in-healthy-persons
#6
Julia Koehn, Ruihao Wang, Carmen de Rojas Leal, Bernd Kallmünzer, Klemens Winder, Martin Köhrmann, Rainer Kollmar, Stefan Schwab, Max J Hilz
INTRODUCTION: Noninvasive temperature modulation by localized neck cooling might be desirable in the prehospital phase of acute hypoxic brain injuries. While combined head and neck cooling induces significant discomfort, peripheral vasoconstriction, and blood pressure increase, localized neck cooling more selectively targets blood vessels that supply the brain, spares thermal receptors of the face and skull, and might therefore cause less discomfort cardiovascular side effects compared to head- and neck cooling...
March 26, 2020: Neurological Sciences
https://read.qxmd.com/read/32218992/the-data-set-development-for-the-national-spinal-cord-injury-registry-of-iran-nscir-ir-progress-toward-improving-the-quality-of-care
#7
Zahra Azadmanjir, Seyed Behzad Jazayeri, Roya Habibi Arejan, Zahra Ghodsi, Mahdi Sharif-Alhoseini, Ghazaleh Kheiri, Kazem Zendehdel, Mahdi Safdarian, Farideh Sadeghian, Zahra Khazaeipour, Khatereh Naghdi, Jalil Arab Kheradmand, Soheil Saadat, Habibollah Pirnejad, Mohammad Reza Fazel, Esmail Fakharian, Mahdi Mohammadzadeh, Mohsen Sadeghi-Naini, Houshang Saberi, Pegah Derakhshan, Hadis Sabour, Edward C Benzel, Gerard Oreilly, Vanessa Noonan, Alexander R Vaccaro, Seyed Hassan Emami-Razavi, Vafa Rahimi-Movaghar
Study design: Descriptive study. Objectives: The aim of this manuscript is to describe the development process of the data set for the National Spinal Cord Injury Registry of Iran (NSCIR-IR). Setting: SCI community in Iran. Methods: The NSCIR-IR data set was developed in 8 months, from March 2015 to October 2015. An expert panel of 14 members was formed. After a review of data sets of similar registries in developed countries, the selection and modification of the basic framework were performed over 16 meetings, based on the objectives and feasibility of the registry...
2020: Spinal Cord Series and Cases
https://read.qxmd.com/read/32214447/intranasal-fentanyl-use-in-neonates
#8
Sonia Kaushal, Jennifer L Placencia, Salvador R Maffei, Corrie E Chumpitazi
Background: The recent addition of intranasal medication options for procedural sedation and analgesia has decreased the need for additional painful procedures such as intravenous lines for medication administration. Intranasal fentanyl (INF) has been used in the prehospital setting, as well as in the emergency department for several years, and is increasingly utilized in other locations such as the neonatal intensive care unit (NICU). A paucity of data exists in these smallest children, so we sought to explore trends in INF use in our NICU...
April 2020: Hospital Pharmacy
https://read.qxmd.com/read/32210224/the-data-set-development-for-the-national-spinal-cord-injury-registry-of-iran-nscir-ir-progress-toward-improving-the-quality-of-care
#9
Zahra Azadmanjir, Seyed Behzad Jazayeri, Roya Habibi Arejan, Zahra Ghodsi, Mahdi Sharif-Alhoseini, Ghazaleh Kheiri, Kazem Zendehdel, Mahdi Safdarian, Farideh Sadeghian, Zahra Khazaeipour, Khatereh Naghdi, Jalil Arab Kheradmand, Soheil Saadat, Habibollah Pirnejad, Mohammad Reza Fazel, Esmail Fakharian, Mahdi Mohammadzadeh, Mohsen Sadeghi-Naini, Houshang Saberi, Pegah Derakhshan, Hadis Sabour, Edward C Benzel, Gerard Oreilly, Vanessa Noonan, Alexander R Vaccaro, Seyed Hassan Emami-Razavi, Vafa Rahimi-Movaghar
STUDY DESIGN: Descriptive study. OBJECTIVES: The aim of this manuscript is to describe the development process of the data set for the National Spinal Cord Injury Registry of Iran (NSCIR-IR). SETTING: SCI community in Iran. METHODS: The NSCIR-IR data set was developed in 8 months, from March 2015 to October 2015. An expert panel of 14 members was formed. After a review of data sets of similar registries in developed countries, the selection and modification of the basic framework were performed over 16 meetings, based on the objectives and feasibility of the registry...
March 24, 2020: Spinal Cord Series and Cases
https://read.qxmd.com/read/32209272/can-prehospital-personnel-accurately-triage-patients-for-large-vessel-occlusion-strokes
#10
Blake C Guillory, Arnav A Gupta, Luigi X Cubeddu, Laurie A Boge
BACKGROUND: The Field Assessment Stroke Triage for Emergency Destination (FAST-ED) score was developed in the hospital setting to be used in the prehospital setting. It has been shown to have higher predictive value than comparable stroke scales, including the National Institutes of Health Stroke Scale, for identifying large vessel occlusion strokes. OBJECTIVE: We sought to determine whether prehospital FAST-ED scores are comparable with FAST-ED scores determined by emergency physicians...
March 21, 2020: Journal of Emergency Medicine
https://read.qxmd.com/read/32209160/just-the-facts-organ-donation-in-the-emergency-department-when-you-can-t-save-one-save-eight
#11
Jennifer Hancock, Simon Huang, Samara Zavalkoff
A 16-year-old female presents to a community emergency room following a suicide attempt by hanging. Prehospital, on arrival of paramedics, the patient was in a pulseless electrical activity rhythm. Paramedics provided advanced cardiac life support for 20 minutes before they obtained return of spontaneous circulation. In the emergency department, she had another 25-minute cardiac arrest with ultimate return of spontaneous circulation. She is now hemodynamically stable on Levophed 0.2 µg/kg/min. Her neurological exam shows pupils to be 3 mm and fixed bilaterally, absent cough and gag, and no response to central or peripheral pain...
March 2020: CJEM
https://read.qxmd.com/read/32209146/drug-and-alcohol-related-patient-presentations-to-emergency-departments-during-sporting-mass-gathering-events-an-integrative-review
#12
Catherine Delany, Julia Crilly, Jamie Ranse
BACKGROUND: Drug and alcohol consumption at sporting mass-gathering events (MGEs) has become part of the spectator culture in some countries. The direct and indirect effects of drug and alcohol intoxication at such MGEs has proven problematic to in-event health services as well as local emergency departments (EDs). With EDs already under significant strain from increasing patient presentations, resulting in access block, it is important to understand the impact of sporting and other MGEs on local health services to better inform future planning and provision of health care delivery...
March 25, 2020: Prehospital and Disaster Medicine
https://read.qxmd.com/read/32209132/hemostatic-agents-for-prehospital-hemorrhage-control-a-narrative-review
#13
REVIEW
Henry T Peng
Hemorrhage is the leading cause of preventable death in combat trauma and the secondary cause of death in civilian trauma. A significant number of deaths due to hemorrhage occur before and in the first hour after hospital arrival. A literature search was performed through PubMed, Scopus, and Institute of Scientific Information databases for English language articles using terms relating to hemostatic agents, prehospital, battlefield or combat dressings, and prehospital hemostatic resuscitation, followed by cross-reference searching...
March 25, 2020: Military Medical Research
https://read.qxmd.com/read/32208945/buprenorphine-field-initiation-of-rescue-treatment-by-emergency-medical-services-bupe-first-ems-a-case-series
#14
Gerard G Carroll, Deena D Wasserman, Aman A Shah, Matthew S Salzman, Kaitlan E Baston, Rick A Rohrbach, Iris L Jones, Rachel Haroz
The opioid epidemic is currently a leading health crisis in the United States, and evidence supports Medication for Opioid Use Disorder (MOUD) as the most effective treatment.2 In our EMS system we are observing an ever increasing number of patients who, due to refusing transport after naloxone rescue, represent an access void at the point of overdose.We present a case series to illustrate a new treatment paradigm utilizing front line EMS Paramedic units and high dose buprenorphine to treat withdrawal symptoms with next day bridge to long term care...
March 25, 2020: Prehospital Emergency Care
https://read.qxmd.com/read/32208039/tension-hemopneumothorax-in-the-setting-of-mechanical-cpr-during-prehospital-cardiac-arrest
#15
Dustin Rowland, Nicholas Vryhof, David Overton, Joshua Mastenbrook
No abstract text is available yet for this article.
March 24, 2020: Prehospital Emergency Care
https://read.qxmd.com/read/32207517/how-the-implementation-of-a-battlefield-clinical-practice-guideline-affects-documentation-practice-and-informs-future-research-initiatives-spinal-injuries-and-cervical-collars
#16
Brock Graham, Grant M Johnson, Jennifer M Gurney, Stacy A Shackelford, Jeffrey T Howard, Jud C Janak
INTRODUCTION: In 2010, the Joint Trauma System published a clinical practice guideline (CPG) for providing care to patients with suspicion of spinal cord injury. The CPG advocated for liberal use of cervical collars and adequate documentation of the practice. This performance improvement project examined C-spine CPG adherence in both the prehospital and military treatment facility (MTF) settings. Understanding challenges in CPG adherence facilitates evaluation of future CPGs and their success at implantation of the clinical guidance...
March 24, 2020: Military Medicine
https://read.qxmd.com/read/32206881/trauma-patients-eligible-for-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-a-retrospective-cohort-study
#17
Victor Mill, Eric Wellme, Carl Montán
PURPOSE: Non-compressible torso hemorrhage is a major but potentially preventable cause of trauma-related mortality. REBOA has rapidly emerged as an adjunct for hemorrhage control. However, little is known about the proportion of trauma patients in which REBOA may be indicated. The aim of our study was to determine this proportion. METHODS: A retrospective cohort study of all adult (≥ 16 years) trauma patients treated at our facility (a university hospital and trauma referral center covering 2...
March 23, 2020: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/32206315/2019-italian-society-of-cardiology-census-on-telemedicine-in-cardiovascular-disease-a-report-from-the-working-group-on-telecardiology-and-informatics
#18
Natale Daniele Brunetti, Giuseppe Molinari, Flavio Acquistapace, Tecla Zimotti, Gianfranco Parati, Ciro Indolfi, Francesco Fedele, Stefano Carugo
Background: The aim of this study was to assess by a census supported by the Italian Society of Cardiology (Società Italiana di Cardiologia, SIC) the present implementation of telemedicine in the field of cardiovascular disease in Italy. Methods: A dedicated questionnaire was sent by email to all the members of the SIC: data on telemedicine providers, service provided, reimbursement, funding and organisational solutions were collected and analysed. Results: Reported telemedicine activities were mostly stable and public hospital based, focused on acute cardiovascular disease and prehospital triage of suspected acute myocardial infarction (prehospital ECG, always interpreted by a cardiologist and not automatically reported by computerised algorithms)...
2020: Open Heart
https://read.qxmd.com/read/32205331/endotracheal-tube-fixation-time-a-comparison-of-three-fixation-methods-in-a-military-field-scenario
#19
Danny Epstein, R Strashewsky, A Furer, A M Tsur, J Chen, A Lehavi
INTRODUCTION: Endotracheal intubation is required in many emergency, trauma and prehospital scenarios. Endotracheal tube (ETT) fixation must be stable and quick to apply to enable rapid evacuation and patient transport. This study compares performance times of three common ETT securement techniques which are practical for out-of-hospital and combat scenarios. METHODS: We compared the time required by military medics to complete ETT fixation in three techniques-fixation of a wide gauze roll wrapped twice around the head and tied twice around the ETT (GR), using a Thomas Tube Holder (TH) and using a pre-tied non-adhesive tape (PT)...
March 23, 2020: BMJ military health
https://read.qxmd.com/read/32204643/influence-of-simulated-prehospital-transport-time-to-analysis-and-storage-temperature-on-s100b-values
#20
Julie Linding Kjerulff, Sophie-Charlott Seidenfaden, Niels Juul, Mette Fogh Moeller, Anna-Marie Bloch Münster, Morten Thingemann Boetker
According to in-hospital guidelines, the biomarker S100B is used to rule-out intracranial lesions in mild-moderate head trauma. It is currently investigated if S100B is applicable in a prehospital setting. The aim was to compare S100B values and hemolysis index in blood samples drawn and stored under simulated prehospital conditions to standardized blood samples. 30 patients undergoing craniotomy at Department of Neurosurgery, Aarhus University Hospital each had six blood samples drawn. Two samples, drawn in in-hospital standardized Beckton Dickinson tubes and prehospital Monovette tubes respectively, were stored as references at 21 °C for 30 minutes...
March 24, 2020: Journal of Neurotrauma
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