Ratrawee Pattanarattanamolee, Rujeewan Yomstreeken Sanglun, Shinji Nakahara
Recently, the Thai government introduced a novel program to train health volunteers as first responders to deal with increasing acute illness and injuries. This case study demonstrates the potential of this program to improve public access to emergency care through the integration of emergency care with a community-based health care system, specifically in a rural setting. A 39-year-old man collapsed with cardiac arrest in his village. Lay first responders from his neighborhood attended him immediately, administered chest compressions, and contacted Emergency Medical Services (EMS)...
February 18, 2021: Prehospital and Disaster Medicine
Tasuku Matsuyama, Sho Komukai, Junichi Izawa, Koichiro Gibo, Masashi Okubo, Kosuke Kiyohara, Takeyuki Kiguchi, Taku Iwami, Bon Ohta, Tetsuhisa Kitamura
BACKGROUND: Little is known about the effect of prehospital epinephrine administration in out-of-hospital cardiac arrest (OHCA) patients with refractory shockable rhythm, for whom initial defibrillation was unsuccessful. METHODS: This study using Japanese nationwide population-based registry included all adult OHCA patients aged ≥18 years with refractory shockable rhythm between January 2014 and December 2017. Patients with or without epinephrine during cardiac arrest were sequentially matched using a risk set matching based on the time-dependent propensity scores within the same minute...
February 18, 2021: European Heart Journal. Cardiovascular Pharmacotherapy
Ane Bull Iversen, Rolf Ankerlund Blauenfeldt, Søren Paaske Johnsen, Birgitte F Sandal, Bo Christensen, Grethe Andersen, Morten Bondo Christensen
Introduction: Only a minority of patients with acute ischaemic stroke receive reperfusion treatment, primarily due to prehospital delay. We aimed to investigate predictors of a primary contact to the emergency medical services, arrival at stroke centre within 3 h of symptom onset and initiation of reperfusion therapy in patients with acute stroke. Patients and methods: We conducted a cross-sectional study of consecutive patients with acute ischaemic stroke, intracerebral haemorrhage or transient ischaemic attack...
December 2020: European Stroke Journal
Shadman Aziz, Elizabeth Foster, David J Lockey, Michael D Christian
BACKGROUND: This study aimed to determine the rate of scalpel cricothyroidotomy conducted by a physician-paramedic prehospital trauma service over 20 years and to identify indications for, and factors associated with the intervention. METHODS: A retrospective observational study was conducted from 1 January 2000 to 31 December 2019 using clinical database records. This study was conducted in a physician-paramedic prehospital trauma service, serving a predominantly urban population of approximately 10 million in an area of approximately 2500 km2 ...
February 17, 2021: Emergency Medicine Journal: EMJ
Sue Anne Bell, Lesly A Dossett, Jesus Cespero, Mayuri Guntupalli, Keith Dickey, Jonathan Eliason, Dawn Coleman
Alternate care sites (ACS) are locations that can be converted to provide either in-patient and/or out-patient health care services when existing facilities are compromised by a hazard impact or the volume of patients exceeds available capacity and/or capabilities. In March through May of 2020, Michigan Medicine (MM), the affiliated health system of the University of Michigan, planned a 500 bed ACS at an off-site location. Termed the Michigan Medicine Field Hospital (MMFH), this ACS was intended to be a step-down care facility for low-acuity COVID-19 positive MM patients who could be transitioned from the hospital setting and safely cared for prior to discharge home, while also allowing increased bed capacity in the remaining MM hospitals for additional critical patient care...
February 18, 2021: Prehospital and Disaster Medicine
Urs Pietsch, Yoël Berger, David Schurter, Lorenz Theiler, Volker Wenzel, Lorenz Meuli, Andreas Grünenfelder, Roland Albrecht
BACKGROUND: Pain is one of the major symptoms complained about by patients in the prehospital setting, especially in the case of trauma. When there is mountainous topography, as in Switzerland, there may be a time delay between injury and arrival of professional rescuers, in particular on ski slopes. Administration of a safe opioid by first responders may improve overall treatment. We therefore assessed administration of nasal nalbuphine as an analgesic treatment for trauma patients in Switzerland...
February 17, 2021: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Paulina B Sergot, Andrew J Maza, Bruce J Derrick, Lane M Smith, Liam T Berti, Madeleine R Wilcox, Matthew R Kesinger, W Frank Peacock
BACKGROUND AND PURPOSE: Early detection of large vessel occlusion (LVO) stroke optimizes endovascular therapy and improves outcomes. Clinical stroke severity scales used for LVO identification have variable accuracy. We investigated a portable LVO-detection device (PLD), using electroencephalography and somatosensory-evoked potentials, to identify LVO stroke. METHODS: We obtained PLD data in suspected patients with stroke enrolled prospectively via a convenience sample in 8 emergency departments within 24 hours of symptom onset...
February 18, 2021: Stroke; a Journal of Cerebral Circulation
M Chatelet, L Lemoine, P Balouet, F Eudier, A Saleh, T Delomas, F Amiot
Umbilical cord prolapse is an acute obstetric emergency associated with high fetal morbidity and mortality. To avoid poor outcomes, rapid diagnosis with immediate intervention is required, especially in the prehospital setting where resources are limited. In this case report, we describe a 38-year-old woman with umbilical cord prolapse, with a review of appropriate prehospital maneuvers and treatment.
February 17, 2021: Prehospital Emergency Care
T Nicol, C Gil-Jardiné, P Jabre, F Adnet, P Ecollan, B Guihard, C Ferdynus, X Combes
Objectives : to evaluate first attempt intubation failure rate, its associated factors and its related complications in out-of-hospital emergency setting, when emergency physicians perform standardized airway management using rapid sequence intubation in adult patients. Material and methods : The present study was a substudy of the Succinylcholine versus Rocuronium for out-of-hospital Emergency Intubation (CURASMUR) Trial, which compared Succinylcholine and Rocuronium used for Rapid sequence intubation. First attempt Intubation failure rate and early intubation related complications were recorded...
February 17, 2021: Prehospital Emergency Care
Chien-Ching Lee, Chia-Chun Chuang, Chin-Li Lu, Bo-Cheng Lai, Edmund Cheung So, Bor-Shyh Lin
The sensitivity of pneumothorax diagnosis via handheld ultrasound is low, and there is no equipment suitable for use with life-threatening tension pneumothorax in a prehospital setting. This study proposes a novel technology involving optical fibers and near-infrared spectroscopy to assist in needle thoracostomy decompression. The proposed system via the optical fibers emitted dual wavelengths of 690 and 850 nm, allowing distinction among different layers of tissue in vivo. The fundamental principle is the modified Beer-Lambert law (MBLL) which is the basis of near-infrared tissue spectroscopy...
February 16, 2021: Scientific Reports
Danielle Bartlett, Sara Hansen, Travis Cruickshank, Timothy Rankin, Pauline Zaenker, Gavin Mazzucchelli, Matthew Gaston, Dirk Du Plooy, Zahed Minhaj, William Errey, Tyron Rumble, Taylor Hay, Alecka Miles, Brennen Mills
OBJECTIVE: Paramedics are at the forefront of emergency healthcare. Quick and careful decision making is required to effectively care for their patients; however, excessive sleepiness has the potential to impact on clinical decision making. Studies investigating the effects of night shift work on sleepiness, cognitive function and clinical performance in the prehospital setting are limited. Here, we aimed to determine the extent to which sleepiness is experienced over the course of a simulation-based 13-hour night shift and how this impacts on clinical performance and reaction time...
February 16, 2021: Emergency Medicine Journal: EMJ
Alistair Steel, Charlotte Haldane, Dan Cody
INTRODUCTION: Advanced airway management is necessary in the prehospital environment and difficult airways occur more commonly in this setting. Failed intubation is closely associated with the most devastating complications of airway management. In an attempt to improve the safety and success of tracheal intubation, we implemented videolaryngoscopy (VL) as our first-line device for tracheal intubation within a UK prehospital emergency medicine (PHEM) setting. METHODS: An East of England physician-paramedic PHEM team adopted VL as first line for undertaking all prehospital advanced airway management...
February 15, 2021: Emergency Medicine Journal: EMJ
Kyle A Weant, Stephanie L Barré, Sara Bruner, Ryan Smiley, Gregory A Hall
PURPOSE: Although guidelines recommend specific benzodiazepine doses for the treatment of generalized convulsive status epilepticus (GCSE), underdosing appears to be common. The purpose of this investigation was to assess benzodiazepine dosing strategies for the initial management of GCSE in patients presenting to the Emergency Department (ED). METHODS: This was a retrospective review of adult patients who received benzodiazepines in the ED for treatment of GCSE...
February 6, 2021: American Journal of Emergency Medicine
Lysien I Zambrano, Itzel Carolina Fuentes-Barahona, Karla Iveth Henriquez-Marquez, Walter O Vasquez-Bonilla, Manuel Sierra, Fausto Muñoz-Lara, Camila Luna, D Katterine Bonilla-Aldana, Alfonso J Rodriguez-Morales
No abstract text is available yet for this article.
February 15, 2021: Prehospital and Disaster Medicine
Thomas A G Shanahan, Gordon Ward Fuller, Trevor Sheldon, Emily Turton, Fionn Michael Appleton Quilty, Carl Marincowitz
IMPORTANCE: This paper investigates the use of a major trauma prediction model in the UK setting. We demonstrate that application of this model could reduce the number of patients with major trauma being incorrectly sent to non-specialist hospitals. However, more research is needed to reduce over-triage and unnecessary transfer to Major Trauma Centres. OBJECTIVE: To externally validate the Dutch prediction model for identifying major trauma in a large unselected prehospital population of injured patients in England...
January 28, 2021: Injury
Kristin Alm-Kruse, Gro Sørensen, Svein Are Osbakk, Kjetil Sunde, Bjørn Bendz, Geir Øystein Andersen, Arnt Fiane, Ove Andreas Hagen, Jo Kramer-Johansen
AIM: To compare the outcomes in patients with refractory out-of-hospital cardiac arrest (OHCA) fulfilling the criteria for extracorporeal cardiopulmonary resuscitation (ECPR) before and after implementation of an ECPR protocol, whether the patient received ECPR or not. METHODS: We compared cardiac arrest registry data before (2014-2015) and after (2016-2019) implementation of the ECPR protocol. The ECPR criteria were presumed cardiac origin, witnessed arrest with ventricular fibrillation, bystander CPR, age 18-65, advanced life support (ALS) within 15 min and ALS > 10 min without return of spontaneous circulation (ROSC)...
February 10, 2021: Resuscitation
Òscar Miró, Pia Harjola, Xavier Rossello, Víctor Gil, Javier Jacob, Pere Llorens, Francisco Javier Martín-Sánchez, Pablo Herrero, Gemma Martínez-Nadal, Sira Aguiló, María Luisa López-Grima, Marta Fuentes, José María Álvarez Pérez, Esther Rodríguez-Adrada, María Mir, Josep Tost, Lluís Llauger, Frank Ruschitzka, Veli-Pekka Harjola, Wilfried Mullens, Josep Masip, Ovidiu Chioncel, W Frank Peacock, Christian Müller, Alexandre Mebazaa
AIMS: The effect of early administration of intravenous (IV) furosemide in the emergency department (ED) on short-term outcomes of acute heart failure (AHF) patients remains controversial, with one recent Japanese study reporting a decrease of in-hospital mortality and one Korean study reporting a lack of clinical benefit. Both studies excluded patients receiving prehospital IV furosemide and only included patients requiring hospitalization. To assess the impact on short-term outcomes of early IV furosemide administration by emergency medical services (EMS) before patient arrival to the ED...
January 18, 2021: European Heart Journal. Acute Cardiovascular Care
Nina Fålun, Jørund Langørgen, Bengt Fridlund, Trond Pettersen, Svein Rotevatn, Tone M Norekvål
AIMS: Early treatment is crucial to successful therapy in patients with acute myocardial infarction (MI). Prehospital delay is associated with increased morbidity and mortality. There is little empirical evidence of patients' reflections on prehospital symptoms of MI and timely treatment at the time of discharge from hospital. To explore patients' reflections on prehospital symptoms of MI and their experiences of interaction with local hospitals, general practitioners, and laypersons...
January 17, 2021: European Journal of Cardiovascular Nursing
Enrico de Koning, Tom E Biersteker, Saskia Beeres, Jan Bosch, Barbra E Backus, Charles Jhj Kirchhof, Reza Alizadeh Dehnavi, Helen Am Silvius, Martin Schalij, Mark J Boogers
INTRODUCTION: Emergency department (ED) overcrowding is a major healthcare problem associated with worse patient outcomes and increased costs. Attempts to reduce ED overcrowding of patients with cardiac complaints have so far focused on in-hospital triage and rapid risk stratification of patients with chest pain at the ED. The Hollands-Midden Acute Regional Triage-Cardiology (HART-c) study aimed to assess the amount of patients left at home in usual ambulance care as compared with the new prehospital triage method...
February 12, 2021: BMJ Open
Stephanie Jarvis, Kristin Salottolo, Gina M Berg, Matthew Carrick, Rachel Caiafa, David Hamilton, Kaysie Banton, Mark Lieser, David Bar-Or
INTRODUCTION: Longer prehospital times were associated with increased odds for survival in trauma patients. The purpose of this study was to determine how the COVID-19 pandemic affected emergency medical services (EMS) prehospital times for trauma patients. METHODS: This retrospective cohort study compared trauma patients transported via EMS to six US level I trauma centers admitted 1/1/19-12/31/19 (2019) and 3/16/20-6/30/20 (COVID-19). Outcomes included: total EMS pre-hospital time (dispatch to hospital arrival), injury to dispatch time, response time (dispatch to scene arrival), on-scene time (scene arrival to scene departure), and transportation time (scene departure to hospital arrival)...
February 3, 2021: American Journal of Emergency Medicine
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"