collection
https://read.qxmd.com/read/26897074/could-ten-questions-asked-by-the-dispatch-center-predict-the-outcome-for-patients-with-chest-discomfort
#21
JOURNAL ARTICLE
Nina Rawshani, Araz Rawshani, Carita Gelang, Johan Herlitz, Angela Bång, Jan-Otto Andersson, Martin Gellerstedt
BACKGROUND AND AIMS: From 2009 to 2010, approximately 14,000 consecutive persons who called for the EMS due to chest discomfort were registered. From the seventh month, dispatchers ask 2285 patient ten pre-specified questions. We evaluate which of these questions was independently able to predict an acute coronary syndrome (ACS), life-threatening condition (LTC) and death. METHODS: The questions asked mainly dealt with previous history and type of symptoms, each with yes/no answers...
April 15, 2016: International Journal of Cardiology
https://read.qxmd.com/read/26951821/sudden-cardiac-death-in-the-young
#22
REVIEW
Michael Ackerman, Dianne L Atkins, John K Triedman
Although the occurrence of sudden cardiac death (SCD) in a young person is a rare event, it is traumatic and often widely publicized. In recent years, SCD in this population has been increasingly seen as a public health and safety issue. This review presents current knowledge relevant to the epidemiology of SCD and to strategies for prevention, resuscitation, and identification of those at greatest risk. Areas of active research and controversy include the development of best practices in screening, risk stratification approaches and postmortem evaluation, and identification of modifiable barriers to providing better outcomes after resuscitation of young SCD patients...
March 8, 2016: Circulation
https://read.qxmd.com/read/16032622/electrocardiographic-st-segment-elevation-in-the-trauma-patient-acute-myocardial-infarction-vs-myocardial-contusion
#23
JOURNAL ARTICLE
Claire U Plautz, Andrew D Perron, William J Brady
The diagnosis of myocardial contusion in the setting of blunt trauma engenders much discussion and controversy-partly because of the lack of a gold standard for its identification other than histologic findings at autopsy. Furthermore, blunt cardiac trauma represents a spectrum of disorders ranging from transient electrocardiographic change to sudden death from myocardial rupture; hence, no single terminology exists to define such a wide range of scenarios. Here, we present 2 cases of electrocardiographic ST-segment elevation after high-speed motor vehicle crashes resulting in numerous injuries, including blunt chest trauma...
July 2005: American Journal of Emergency Medicine
https://read.qxmd.com/read/26948870/paramedics-involvement-in-planned-home-birth-a-one-year-case-study
#24
JOURNAL ARTICLE
Gayle McLelland, Lisa McKenna, Amee Morgans, Karen Smith
OBJECTIVE: to report findings from a study performed prior to the introduction of publicly funded home birth programmes in Victoria, Australia, that investigated the incidence of planned home births attended by paramedics and explored the clinical support they provided as well as the implications for education and practice. METHODS: retrospective data previously collected via an in-field electronic patient care record (VACIS(®)) was provided by a state-wide ambulance service...
July 2016: Midwifery
https://read.qxmd.com/read/26886000/not-all-prehospital-time-is-equal-influence-of-scene-time-on-mortality
#25
JOURNAL ARTICLE
Joshua B Brown, Matthew R Rosengart, Raquel M Forsythe, Benjamin R Reynolds, Mark L Gestring, William M Hallinan, Andrew B Peitzman, Timothy R Billiar, Jason L Sperry
BACKGROUND: Trauma is time sensitive, and minimizing prehospital (PH) time is appealing. However, most studies have not linked increasing PH time with worse outcomes because raw PH times are highly variable. It is unclear whether specific PH time patterns affect outcomes. Our objective was to evaluate the association of PH time interval distribution with mortality. METHODS: Patients transported by emergency medical services in the Pennsylvania trauma registry from 2000 to 2013 with a total PH time (TPT) of 20 minutes or longer were included...
July 2016: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/26836060/is-it-appropriate-for-patients-to-be-discharged-at-the-scene-by-paramedics
#26
JOURNAL ARTICLE
Hideo Tohira, Daniel Fatovich, Teresa A Williams, Alexandra P Bremner, Glenn Arendts, Ian R Rogers, Antonio Celenza, David Mountain, Peter Cameron, Peter Sprivulis, Tony Ahern, Judith Finn
BACKGROUND: Outcomes of patients who are discharged at the scene by paramedics are not fully understood. OBJECTIVE: We aimed to describe the risk of re-presentation and/or death in prehospital patients discharged at the scene. METHODS: We conducted a retrospective cohort study using linked ambulance, emergency department (ED), and death data. We compared outcomes in patients who were discharged at the scene by paramedics with those who were transported to ED by paramedics and then discharged from ED between January 1 and December 31, 2013 in metropolitan Perth, Western Australia...
2016: Prehospital Emergency Care
https://read.qxmd.com/read/25593060/remote-ischemic-conditioning
#27
REVIEW
Gerd Heusch, Hans Erik Bøtker, Karin Przyklenk, Andrew Redington, Derek Yellon
In remote ischemic conditioning (RIC), brief, reversible episodes of ischemia with reperfusion in one vascular bed, tissue, or organ confer a global protective phenotype and render remote tissues and organs resistant to ischemia/reperfusion injury. The peripheral stimulus can be chemical, mechanical, or electrical and involves activation of peripheral sensory nerves. The signal transfer to the heart or other organs is through neuronal and humoral communications. Protection can be transferred, even across species, with plasma-derived dialysate and involves nitric oxide, stromal derived factor-1α, microribonucleic acid-144, but also other, not yet identified factors...
January 20, 2015: Journal of the American College of Cardiology
https://read.qxmd.com/read/26427535/a-16-year-old-with-st-elevation-myocardial-infarction-case-report-and-review-of-the-literature
#28
REVIEW
Dustin Hill, Adam Waldman, Deepak Vivek
Chest pain in young adults presents a unique diagnostic challenge, placing young patients at an increased risk to be misdiagnosed, as this patient population typically does not demonstrate the traditional risk factors associated with cardiovascular disease. This study details the case of a 16-year-old male who presented with new-onset chest pain and ST elevation on electrocardiogram. His history was unremarkable for known cardiac risk factors, but laboratory evaluation demonstrated markedly elevated troponins and electrocardiographic findings confirmed ST-segment elevation myocardial infarction...
February 2016: Cardiology in the Young
https://read.qxmd.com/read/25153541/advanced-clinical-interventions-performed-by-emergency-medical-responder-firefighters-prior-to-ambulance-arrival
#29
JOURNAL ARTICLE
Lori L Boland, Paul A Satterlee, Karl M Fernstrom, Kai G Hanson, Prasanna Desikan, Brian K LaCroix
Abstract Introduction. Data on the clinical interventions performed by emergency medical responder firefighters (EMRFs) are limited outside the context of cardiac arrest. We sought to understand the broader medical role of firefighters by examining fire-ambulance arrival order and documenting specific interventions provided by firefighters with advanced EMR training. Methods. A secondary analysis was conducted using electronic patient care records from a single ambulance service and two municipal fire departments that partner to provide emergency response in two suburbs of Minneapolis, Minnesota...
January 2015: Prehospital Emergency Care
https://read.qxmd.com/read/26012478/transfer-of-care-and-offload-delay-continued-resistance-or-integrative-thinking
#30
REVIEW
Brian Schwartz
The disciplines of paramedicine and emergency medicine have evolved synchronously over the past four decades, linked by emergency physicians with expertise in prehospital care. Ambulance offload delay (OD) is an inevitable consequence of emergency department overcrowding (EDOC) and compromises the care of the patient on the ambulance stretcher in the emergency department (ED), as well as paramedic emergency medical service response in the community. Efforts to define transfer of care from paramedics to ED staff with a view to reducing offload time have met with resistance from both sides with different agendas...
November 2015: CJEM
https://read.qxmd.com/read/26068514/rationale-and-methods-of-a-multicentre-randomised-controlled-trial-of-the-effectiveness-of-a-community-health-assessment-programme-with-emergency-medical-services-chap-ems-implemented-on-residents-aged-55-years-and-older-in-subsidised-seniors-housing-buildings
#31
RANDOMIZED CONTROLLED TRIAL
Gina Agarwal, Beatrice McDonough, Ricardo Angeles, Melissa Pirrie, Francine Marzanek, Brent McLeod, Lisa Dolovich
INTRODUCTION: Chronic diseases and falls substantially contribute to morbidity/mortality among seniors, causing this population to frequently seek emergency medical care. Research suggests the paramedic role can be successfully expanded to include community-based health promotion and prevention. This study implements a community paramedicine programme targeting seniors in subsidised housing, a high-risk population and frequent users of emergency medical services (EMS). The aims are to reduce EMS calls, improve health outcomes and healthcare utilisation...
June 11, 2015: BMJ Open
https://read.qxmd.com/read/26165229/the-impact-of-prehospital-resuscitation-research-on-in-hospital-care
#32
REVIEW
Justin Mausz, Sheldon Cheskes
Since their introduction over 40 years ago, paramedics have been trained to deliver select advanced life support interventions in the community with the goal of reducing morbidity and mortality from cardiovascular disease and trauma. The ensuing decades witnessed a great deal of interest in paramedic care, with an exponential growth in prehospital resuscitation research. As part of the CJEM series on emergency medical services (EMS), we review recent prehospital research in out-of-hospital cardiac arrest and discuss how, in a novel departure from the origins of EMS, prehospital research is beginning to influence in-hospital care...
September 2015: CJEM
https://read.qxmd.com/read/26280821/systemic-complications-of-traumatic-brain-injury
#33
REVIEW
Dhuleep S Wijayatilake, Peter B Sherren, Suyogi V Jigajinni
PURPOSE OF REVIEW: Increased understanding of the pathophysiology in traumatic brain injury (TBI) has resulted in the development of core physiological targets and therapies to preserve cerebral oxygenation, and in doing so prevent secondary insult. This review addresses the many systemic complications of TBI that make achieving these targets challenging and can influence outcome. RECENT FINDINGS: There are a wide range of systemic complications following TBI. Complications involve the cardiovascular, respiratory, immunological, haematological and endocrinological systems amongst others, and can influence early management and long-term outcomes...
October 2015: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/26517201/a-novel-approach-to-improve-time-to-first-shock-in-prehospital-stemi-complicated-by-ventricular-fibrillation
#34
JOURNAL ARTICLE
Maxwell Osei-Ampofo, Sheldon Cheskes, Adam Byers, Ian R Drennan, Jason E Buick, P Richard Verbeek
Lethal cardiac arrhythmias such as ventricular fibrillation and pulseless ventricular tachycardia (VF/pVT) complicate up to 6% of all out-of-hospital STEMIs. Typically, paramedics respond to this by applying defibrillation pads and delivering a shock as soon as possible. A recently introduced "pads-on" protocol directed paramedics to apply defibrillation pads to all STEMI patients (regardless of clinical stability) with the aim of decreasing time to first shock. In this article we present two cases of prehospital STEMI complicated by VF to illustrate times to first shock for the two different protocols...
2016: Prehospital Emergency Care
https://read.qxmd.com/read/26316210/early-goal-directed-resuscitation-of-patients-with-septic-shock-current-evidence-and-future-directions
#35
REVIEW
Ravi G Gupta, Sarah M Hartigan, Markos G Kashiouris, Curtis N Sessler, Gonzalo M L Bearman
Severe sepsis and septic shock are among the leading causes of mortality in the intensive care unit. Over a decade ago, early goal-directed therapy (EGDT) emerged as a novel approach for reducing sepsis mortality and was incorporated into guidelines published by the international Surviving Sepsis Campaign. In addition to requiring early detection of sepsis and prompt initiation of antibiotics, the EGDT protocol requires invasive patient monitoring to guide resuscitation with intravenous fluids, vasopressors, red cell transfusions, and inotropes...
August 28, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/21615299/mortality-after-fluid-bolus-in-african-children-with-severe-infection
#36
RANDOMIZED CONTROLLED TRIAL
Kathryn Maitland, Sarah Kiguli, Robert O Opoka, Charles Engoru, Peter Olupot-Olupot, Samuel O Akech, Richard Nyeko, George Mtove, Hugh Reyburn, Trudie Lang, Bernadette Brent, Jennifer A Evans, James K Tibenderana, Jane Crawley, Elizabeth C Russell, Michael Levin, Abdel G Babiker, Diana M Gibb
BACKGROUND: The role of fluid resuscitation in the treatment of children with shock and life-threatening infections who live in resource-limited settings is not established. METHODS: We randomly assigned children with severe febrile illness and impaired perfusion to receive boluses of 20 to 40 ml of 5% albumin solution (albumin-bolus group) or 0.9% saline solution (saline-bolus group) per kilogram of body weight or no bolus (control group) at the time of admission to a hospital in Uganda, Kenya, or Tanzania (stratum A); children with severe hypotension were randomly assigned to one of the bolus groups only (stratum B)...
June 30, 2011: New England Journal of Medicine
https://read.qxmd.com/read/26170352/assessment-of-competency-during-orotracheal-intubation-in-medical-simulation
#37
JOURNAL ARTICLE
J Garcia, A Coste, W Tavares, N Nuño, K Lachapelle
BACKGROUND: Clinicians performing orotracheal intubation need to be competent to perform this technical skill safely. It is recognized that aggressive force applied during direct laryngoscopy may damage the oropharyngeal soft tissue; however, force is seldom considered in assessment of competency. The objective of this study was to explore the force applied during orotracheal intubation as a method of further discriminating between levels of competence. We sought evidence of construct validity in the form of discriminant, criterion, and concurrent validity...
August 2015: British Journal of Anaesthesia
https://read.qxmd.com/read/22850221/do-technical-skills-correlate-with-non-technical-skills-in-crisis-resource-management-a-simulation-study
#38
JOURNAL ARTICLE
N Riem, S Boet, M D Bould, W Tavares, V N Naik
BACKGROUND: Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario. METHODS: This study was a retrospective analysis of performances from a previously published work...
November 2012: British Journal of Anaesthesia
https://read.qxmd.com/read/26362582/confirmation-of-suboptimal-protocols-in-spinal-immobilisation
#39
JOURNAL ARTICLE
Mark Dixon, Joseph O'Halloran, Ailish Hannigan, Scott Keenan, Niamh M Cummins
BACKGROUND: Spinal immobilisation during extrication of patients in road traffic collisions is routinely used despite the lack of evidence for this practice. In a previous proof of concept study (n=1), we recorded up to four times more cervical spine movement during extrication using conventional techniques than self-controlled extrication. OBJECTIVE: The objective of this study was to establish, using biomechanical analysis which technique provides the minimal deviation of the cervical spine from the neutral in-line position during extrication from a vehicle in a larger sample of variable age, height and mass...
December 2015: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/26346296/rationale-development-and-implementation-of-the-electrocardiographic-methods-for-the-prehospital-identification-of-non-st-elevation-myocardial-infarction-events-empire
#40
JOURNAL ARTICLE
Salah S Al-Zaiti, Christian Martin-Gill, Ervin Sejdić, Mohammad Alrawashdeh, Clifton Callaway
BACKGROUND: The serum rise of cardiac troponin remains the gold standard for diagnosing non-ST elevation (NSTE) myocardial infarction (MI) despite its delayed response. Novel methods for real-time detection of NSTEMI would result in more immediate initiation of definitive medical therapy and faster transport to facilities that can provide specialized cardiac care. METHODS: EMPIRE is an ongoing prospective, observational cohort study designed to quantify the magnitude of ischemia-induced repolarization dispersion for the early detection of NSTEMI...
November 2015: Journal of Electrocardiology
label_collection
label_collection
1346
2
3
2015-09-14 17:55:24
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"

We want to hear from doctors like you!

Take a second to answer a survey question.