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JOURNAL ARTICLE
Marta Amengual-Gual, Iván Sánchez Fernández, Alejandra Vasquez, Nicholas S Abend, Anne Anderson, Ravindra Arya, Cristina Barcia Aguilar, J Nicholas Brenton, Jessica L Carpenter, Kevin E Chapman, Justice Clark, Raquel Farias-Moeller, William D Gaillard, Tracy A Glauser, Joshua L Goldstein, Howard P Goodkin, Yi-Chen Lai, Mohamad A Mikati, Lindsey A Morgan, Edward J Novotny, Adam P Ostendorf, Eric T Payne, Katrina Peariso, Juan Piantino, Latania Reece, James J Riviello, Kumar Sannagowdara, Theodore Sheehan, Robert C Tasker, Dmitry Tchapyjnikov, Alexis A Topjian, Mark S Wainwright, Angus Wilfong, Korwyn Williams, Tobias Loddenkemper
PURPOSE: Delayed treatment in status epilepticus (SE) is independently associated with increased treatment resistance, morbidity, and mortality. We describe the prehospital management pathway and Emergency Medical Services (EMS) timeliness in children who developed refractory convulsive status epilepticus (RCSE). METHODS: Retrospective multicenter study in the United States using prospectively collected observational data from June 2011 to March 2020. We selected pediatric patients (one month-21 years) with RCSE initiated outside the hospital and transported to the hospital by EMS...
October 2023: Seizure: the Journal of the British Epilepsy Association
#42
JOURNAL ARTICLE
Gregory A Peters, Scott A Goldberg, Jane M Hayes, Rebecca E Cash
OBJECTIVE: We aimed to evaluate the differences in characteristics and illness/injury severity among patients who present to the emergency department (ED) via emergency medical services (EMS) compared to patients who present via other means. METHODS: We analyzed a nationwide sample of ED visits from the 2015-2019 National Hospital Ambulatory Medical Care Survey. We excluded patients <18 or >92 years old, who eloped or left against medical advice, or who arrived via interfacility transport...
August 2023: Journal of the American College of Emergency Physicians open
#43
REVIEW
James E Manning, Jonathan J Morrison, Paul E Pepe
Prehospital resuscitation is a dynamic field now being energized by new technologies and a shift in thinking regarding intravascular resuscitation. Growing evidence discourages use of intravenous (IV) crystalloid and colloid solutions in trauma, whereas blood products, particularly whole blood, are becoming preferred. Although randomized clinical trials validating definitive resuscitative protocols are still lacking, most preclinical and clinical indicators support this approach. In addition, emerging technologies such as external and endovascular hemorrhage control devices and extracorporeal perfusion are now being used routinely, even in the prehospital setting in many countries, generating new lines of emerging investigations for trauma specialists...
September 2023: Advances in Surgery
#44
JOURNAL ARTICLE
Thomas John Howe, H Claireaux, H Fox, G Morgan, L McMenemy, S D Masouros, A Ramasamy
INTRODUCTION: Pelvic fractures often result from high-energy trauma and are associated with a 10% mortality rate and significant morbidity. Pelvic binders are applied in suspected pelvic injury to stabilise fractured bone, decrease bleeding and potentiate tamponade. A binder must hold the pelvis with sufficient force for this effect to be achieved. This study aims to quantify the ability of proprietary and improvised pelvic binders to hold a target tensile force over time. METHODS: The ability of three proprietary and three improvised binders to hold a binding force for 2 hours was tested...
August 4, 2023: BMJ military health
#45
JOURNAL ARTICLE
Ryan Huebinger, Hei Kit Chan, Justin Reed, N Clay Mann, Benjamin Fisher, Lesley Osborn
OBJECTIVE: Prior studies identified increased penetrating trauma rates during the earlier phase of the COVID-19 pandemic, but there is limited study of penetrating trauma rates in 2021 or at a national level. We evaluated trends in prehospital encounters for penetrating trauma in 2020 and 2021 using a national database. METHODS: We conducted a retrospective analysis of the National Emergency Medicinal Services (EMS) Information System (NEMSIS) combined 2018-2021 databases of prehospital encounters...
October 2023: American Journal of Emergency Medicine
#46
JOURNAL ARTICLE
Pei-Ze Tan, Shang-Lun Li, Qing Zhang, Xiang Liu, Feng Tang, Chang-Le Liu
BACKGROUND: Myocardial infarction (MI) is a series of clinical syndromes caused by ischemic necrosis of myocardial cells that results from severe and persistent acute ischemia of the myocardium due to a dramatic reduction or interruption of coronary blood supply. OBJECTIVE: In this study, we analyzed the role of pre-hospital emergency services in the rescue of patients suffering from ST-elevation myocardial infarction (STEMI). METHODS: We enrolled 229 patients with STEMI who were transported to the Second Hospital of Tianjin Medical University by Tianjin Emergency Center from January 2017 to June 2021...
2023: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
#47
JOURNAL ARTICLE
Andrew J Latimer, Catherine R Counts, Molly Van Dyke, Natalie Bulger, Charles Maynard, Thomas D Rea, Peter J Kudenchuk, Richard B Utarnachitt, Jennifer Blackwood, Amy J Poel, Saman Arbabi, Michael R Sayre
Background: The compensatory reserve index (CRI) is a noninvasive, continuous measure designed to detect intravascular volume loss. CRI is derived from the pulse oximetry waveform and reflects the proportion of physiologic reserve remaining before clinical hemodynamic decompensation. Methods: In this prospective, observational, prehospital cohort study, we measured CRI in injured patients transported by emergency medical services (EMS) to a single Level I trauma center. We determined whether the rolling average of CRI values over 60 s (CRI trend [CRI-T]) predicts in-hospital diagnosis of hemorrhagic shock, defined as blood product administration in the prehospital setting or within 4 h of hospital arrival...
October 1, 2023: Shock
#48
JOURNAL ARTICLE
Abigail Polzin, Kaihlen Smith, Thomas Rumpza
BACKGROUND: Whole blood transfusion has been used for resuscitation in trauma patients; however, case reports of whole blood transfusion for obstetric-related hemorrhage are limited. Whole blood transfusion typically is accomplished with low titer O-positive whole blood, and, despite success in trauma, use in persons with childbearing potential is of concern due to risk of alloimmunization. CASE: We present a case series of patients who received low titer O-positive whole blood for obstetric hemorrhage...
August 10, 2023: Obstetrics and Gynecology
#49
JOURNAL ARTICLE
Mozdalefa Azarkane, Tim W H Rijnhout, Isa A L van Merwijk, Tjarda N Tromp, Edward C T H Tan
BACKGROUND: Trauma patients with hypothermia have substantial increases in mortality and morbidity. In severely injured patients, hypothermia is common with a rate up to 50% in various geographic areas. This study aims to elucidate the incidence, predictors, and impact of hypothermia on outcomes in severely injured patients. METHODS: This was a retrospective cohort study which included trauma patients with an Injury Severity Score (ISS) ≥ 16 admitted to a level 1 trauma center in the Netherlands between January 1, 2015 and December 31, 2021...
January 2024: Injury
#50
MULTICENTER STUDY
Courtney Wham, Theresa Morin, Angela Sauaia, Robert McIntyre, Shane Urban, Kevin McVaney, Mitchell Cohen, Alexis Cralley, Ernest E Moore, Eric M Campion
BACKGROUND: Prehospital identification of shock in trauma patients lacks accurate markers. Low end tidal carbon dioxide (ETCO2 ) correlates with mortality in intubated patients. The predictive value of ETCO2 obtained by nasal capnography cannula (NCC) is unknown. We hypothesized that prehospital ETCO2 values obtained by NCC and in-line ventilator circuit (ILVC) would be predictive of mortality. METHODS: This was a prospective, observational, multicenter study. ETCO2 values were collected by a NCC or through ILVC...
December 2023: American Journal of Surgery
#51
JOURNAL ARTICLE
Lisa J Woodhouse, Jason P Appleton, Sandeep Ankolekar, Timothy J England, Grant Mair, Keith Muir, Christopher I Price, Stuart Pocock, Marc Randall, Thompson G Robinson, Christine Roffe, Else C Sandset, Jeffrey L Saver, Aloysius Niroshan Siriwardena, Nikola Sprigg, Joanna M Wardlaw, Philip M Bath
BACKGROUND: The Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2) reported no overall treatment difference between glyceryl trinitrate (GTN) and sham at day 90. Here we assess participants' outcomes 1 year after randomisation. METHODS: RIGHT-2 was an ambulance-based prospective randomised controlled trial where patients with presumed stroke and systolic blood pressure (BP) of >120 mm Hg received either GTN (5 mg/day) or sham patch...
2023: BMJ neurology open
#52
JOURNAL ARTICLE
James M Bradford, Pedro G Teixeira, Joseph DuBose, Marc D Trust, Tatiana Cp Cardenas, Simin Golestani, Jessica Efird, James Kempema, Jessica Zimmerman, Clea Czysz, Michelle Robert, Sadia Ali, Lawrence H Brown, Carlos Vr Brown
INTRODUCTION: Aggressive prehospital interventions (PHI) in trauma may not improve outcomes compared to prioritizing rapid transport. The aim of this study was to quantify temporal changes in the frequency of PHI performed by EMS. METHODS: Retrospective chart review of adult patients transported by EMS to our trauma center from January 1, 2014 to 12/31/2021. PHI were recorded and annual changes in their frequency were assessed via year-by-year trend analysis and multivariate regression...
August 6, 2023: American Journal of Surgery
#53
JOURNAL ARTICLE
Shao-An Wang, Chih-Jung Chang, Shan Do Shin, Sheng-En Chu, Chun-Yen Huang, Li-Min Hsu, Hao-Yang Lin, Ki Jeong Hong, Sabariah Faizah Jamaluddin, Do Ngoc Son, T V Ramakrishnan, Wen-Chu Chiang, Jen-Tang Sun, Matthew Huei-Ming Ma
BACKGROUND/PURPOSE: To develop a prediction model for emergency medical technicians (EMTs) to identify trauma patients at high risk of deterioration to emergency medical service (EMS)-witnessed traumatic cardiac arrest (TCA) on the scene or en route. METHODS: We developed a prediction model using the classical cross-validation method from the Pan-Asia Trauma Outcomes Study (PATOS) database from 1 January 2015 to 31 December 2020. Eligible patients aged ≥18 years were transported to the hospital by the EMS...
August 10, 2023: Journal of the Formosan Medical Association
#54
JOURNAL ARTICLE
Yao Cheng, Fujun Yao, Yanling Chen
OBJECTIVE: This study aimed to compare the effectiveness of prehospital emergency treatments using midazolam (MDL) intramuscularly, diazepam (DZP) enema, and chloral hydrate (CH) enema in managing pediatric convulsions. METHODS: A comparative observational study was conducted, and a total of 140 children with acute convulsions treated with prehospital anti-convulsions at Qinhuangdao First Hospital's emergency department between June 2015 and May 2019 were included in this study...
August 11, 2023: Alternative Therapies in Health and Medicine
#55
JOURNAL ARTICLE
Brian L Risavi, Jestin Carlson, Erin M Reese, Aaron Raleigh, Jordan Wallis
BACKGROUND: The objective of this study is to describe the education, training, and use of prehospital surgical airways in a rural Emergency Medical Service (EMS) system. MATERIALS AND METHODS: We conducted an internet-based survey instrument of all advanced life support (ALS) EMS agencies in a seven-county rural EMS system in Pennsylvania. ALS agencies were queried regarding basic demographic information as well as the number of surgical airways performed in the previous 10 years as well as the education and training of EMS providers in surgical airways...
July 2023: Curēus
#56
COMMENT
Johanna M Ospel, Mayank Goyal
No abstract text is available yet for this article.
September 2023: Lancet Neurology
#57
EDITORIAL
Mohsen Saidinejad, Susan Duffy, Dina Wallin, Jennifer A Hoffmann, Madeline Joseph, Jennifer Schieferle Uhlenbrock, Kathleen Brown, Muhammad Waseem, Sally K Snow, Madeline Andrew, Alice A Kuo, Carmen Sulton, Thomas Chun, Lois K Lee, Gregory P Conners, James Callahan, Toni Gross, Madeline Joseph, Lois Lee, Elizabeth Mack, Jennifer Marin, Suzan Mazor, Ronald Paul, Nathan Timm, Ann M Dietrich, Kiyetta H Alade, Christopher S Amato, Zaza Atanelov, Marc Auerbach, Isabel A Barata, Lee S Benjamin, Kathleen T Berg, Kathleen Brown, Cindy Chang, Jessica Chow, Corrie E Chumpitazi, Ilene A Claudius, Joshua Easter, Ashley Foster, Sean M Fox, Marianne Gausche-Hill, Michael J Gerardi, Jeffrey M Goodloe, Melanie Heniff, James Jim L Homme, Paul T Ishimine, Susan D John, Madeline M Joseph, Samuel Hiu-Fung Lam, Simone L Lawson, Moon O Lee, Joyce Li, Sophia D Lin, Dyllon Ivy Martini, Larry Bruce Mellick, Donna Mendez, Emory M Petrack, Lauren Rice, Emily A Rose, Timothy Ruttan, Mohsen Saidinejad, Genevieve Santillanes, Joelle N Simpson, Shyam M Sivasankar, Daniel Slubowski, Annalise Sorrentino, Michael J Stoner, Carmen D Sulton, Jonathan H Valente, Samreen Vora, Jessica J Wall, Dina Wallin, Theresa A Walls, Muhammad Waseem, Dale P Woolridge, Cam Brandt, Krisi M Kult, Justin J Milici, Nicholas A Nelson, Michele A Redlo, Maureen R Curtis Cooper, Michele Redlo, Krisi Kult, Katherine Logee, Dixie Elizabeth Bryant, Maureen Curtis Cooper, Kristen Cline
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior...
September 2023: Annals of Emergency Medicine
#58
JOURNAL ARTICLE
Jonathan Gushing, Scott G Blair, Roxie M Albrecht, Zoona Sawar, Kenneth Stewart, Curtis Knoles, Cooper Little, Celia Y Quang
BACKGROUND: Extremity tourniquets (ET) use has increased in trauma systems to manage traumatic hemorrhage. This study aims to evaluate prehospital ET placement. METHODS: This is a retrospective review of a prospectively collected cohort of 211 adult patients who underwent prehospital ET placement over 3 ½ years. Data regarding ET placement was analyzed regarding ET applier, reported indications, extremity appearance at arrival and outcomes. RESULTS: A total of 211 patients had completed data sheets...
December 2023: American Journal of Surgery
#59
JOURNAL ARTICLE
Ashley A Foster, Kenshata Watkins, Tarak K Trivedi, Marisol Cruz-Romero, Sara A Leibovich, Rajesh K Daftary, Aaron E Kornblith, Jacqueline Grupp-Phelan, Karl A Sporer, Colleen Kellison, Nicolaus W Glomb
OBJECTIVE: Emergency medical services (EMS) transport for mental and behavioral health (MBH) emergencies occurs frequently in children, yet little is understood regarding prehospital physical restraint use despite the potential for serious adverse events. We aim to describe restraint use prevalence and primary impressions among children with MBH emergencies. METHODS: This is a retrospective cross-sectional study of children with MBH emergencies evaluated by Alameda County (ALCO), California EMS from January 1, 2012 to December 31, 2018...
August 2023: Journal of the American College of Emergency Physicians open
#60
JOURNAL ARTICLE
Viivi Tikkanen, Marija Arsic, Maria Henricson
AIM: The aim of this study was to describe the general attributes and competence that nurses in the ambulance's single responder units are considered to need. BACKGROUND: The development of ambulance care has led to an increased need for new units and working methods. Single responder unit is a single crewed unit that often uses for the patient assessments, to refer patients to the right level of care and to release regular ambulances. There is a lack of description of the needed competence for the nurses within single responder unit...
August 21, 2023: BMC Emergency Medicine
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