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Prehospital collection

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235 papers 100 to 500 followers
Kristin Tønsager, Marius Rehn, Kjetil G Ringdal, Hans Morten Lossius, Ilkka Virkkunen, Øyvind Østerås, Jo Røislien, Andreas J Krüger
BACKGROUND: Comparison of services and identification of factors important for favourable patient outcomes in emergency medical services (EMS) is challenging due to different organization and quality of data. The purpose of the present study was to evaluate the feasibility of physician-staffed EMS (p-EMS) to collect patient and system level data by using a consensus-based template. METHODS: The study was an international multicentre observational study. Data were collected according to a template for uniform reporting of data from p-EMS using two different data collection methods; a standard and a focused data collection method...
March 8, 2019: BMC Health Services Research
Arasch Wafaisade, Michael Caspers, Bertil Bouillon, Matthias Helm, Matthias Ruppert, Michael Gäßler
BACKGROUND: Airway management and use of intravenous anaesthetics to facilitate tracheal intubation after major trauma remains controversial. Numerous agents are available and used for pre-hospital rapid-sequence induction (RSI). The aim was to investigate usage and potential changes in administration of intravenous anaesthetics for pre-hospital RSI in trauma patients over a ten-year period. METHODS: Based on a large helicopter emergency medical service (HEMS) database in Germany between 2006 and 2015, a total of 9720 HEMS missions after major trauma leading to RSI on scene were analysed...
February 26, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Duncan Bootland, Caroline Rose, Jack W Barrett, Richard Lyon
OBJECTIVES: Patients who sustain a head injury but maintain a Glasgow Coma Scale (GCS) of 13-15 may still be suffering from a significant brain injury. We aimed to assess the appropriateness of triage and decision to perform prehospital rapid sequence induction (RSI) in patients attended by a UK Helicopter Emergency Medical Service (HEMS) following head injury. DESIGN: A retrospective cohort study of patients attended by Kent Surrey & Sussex Air Ambulance Trust (KSSAAT) HEMS...
February 19, 2019: BMJ Open
Steve Balian, David G Buckler, Audrey L Blewer, Abhishek Bhardwaj, Benjamin S Abella
AIM OF THE STUDY: Regionalization of care for out-of-hospital cardiac arrests (OHCA) may improve patient outcomes. We evaluated inter-hospital variations in post-arrest care provision and the relation between hospital case volume and survival in Pennsylvania. METHODS: This retrospective study (2013-2017) used data from adult OHCA cases in Pennsylvania from the Cardiac Arrest Registry to Enhance Survival. Analysis was performed on hospitals reporting greater than 40 cases/5 years with sustained return of spontaneous circulation upon emergency department arrival and survival to hospital admission...
February 13, 2019: Resuscitation
Renate Sørgjerd, Geir Arne Sunde, Jon-Kenneth Heltne
BACKGROUND: Intravenous access in critically ill and injured patients can be difficult or impossible in the field. Intraosseous access is a well-established alternative to achieve access to a noncollapsible vascular network. We wanted to compare the use of a sternal and tibial/humeral intraosseous device in a physician-staffed helicopter emergency medical service. METHODS: The helicopter emergency medical service in Bergen, Norway, is equipped with two different intraosseous devices, the EZ-IO and FAST-Responder...
February 13, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Christopher A Smith, Richard D Hardern, Simon LeClerc, Richard J Howes
OBJECTIVE: To compare the mortality and morbidity of traumatically injured patients who received additional prehospital care by a doctor and critical care paramedic enhanced care team (ECT), with those solely treated by a paramedic non-ECT. METHODS: A retrospective analysis of Trauma Audit and Research Network (TARN) data and case note review of all severe trauma cases (Injury Severity Score ≥9) in North East England from 1 January 2014 to 1 December 2017 who were treated by the North East Ambulance Service, the Great North Air Ambulance Service or both...
January 24, 2019: Emergency Medicine Journal: EMJ
Toni Pakkanen, Jouni Nurmi, Heini Huhtala, Tom Silfvast
BACKGROUND: Patients with isolated traumatic brain injury (TBI) are likely to benefit from effective prehospital care to prevent secondary brain injury. Only a few studies have focused on the impact of advanced interventions in TBI patients by prehospital physicians. The primary end-point of this study was to assess the possible effect of an on-scene anaesthetist on mortality of TBI patients. A secondary end-point was the neurological outcome of these patients. METHODS: Patients with severe TBI (defined as a head injury resulting in a Glasgow Coma Score of ≤8) from 2005 to 2010 and 2012-2015 in two study locations were determined...
January 28, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Patrick Schober, Tessa Biesheuvel, Marcel A de Leeuw, Stephan A Loer, Lothar A Schwarte
BACKGROUND: Creating a patent airway by cricothyrotomy is the ultimate maneuver to allow oxygenation (and ventilation) of the patient. Given the rarity of airway management catastrophes necessitating cricothyrotomy, sufficiently sized prospective randomized trials are difficult to perform. Our Helicopter Emergency Medical Service (HEMS) documents all cases electronically, allowing a retrospective analysis of a larger database for all cases of prehospital cricothyrotomy. METHODS: We analyzed all 19,382 dispatches of our HEMS 'Lifeliner 1', since set-up of a searchable digital database...
January 23, 2019: BMC Emergency Medicine
E Ter Avest, J Griggs, C Prentice, J Jeyanathan, R M Lyon
INTRODUCTION: Helicopter emergency medical services (HEMS) are often dispatched to patients in traumatic cardiac arrest (TCA) as they can provide treatments and advanced interventions in the pre-hospital environment that have the potential to contribute to an increased survival. This study, aimed to investigate the added value of HEMS in the treatment of TCA. METHODS: We performed a retrospective cohort study of all patients with a pre-hospital TCA who were attended by a non-urban HEMS (Kent, Surrey and Sussex Air Ambulance trust) between July 1st 2013 and May 1st 2018...
December 28, 2018: Resuscitation
M Weinlich, P Martus, M B Blau, H Wyen, F Walcher, S Piatek, J P Schüttrumpf
OBJECTIVES: The aim of the study was to analyze helicopter emergency medical service (HEMS) in comparison to EMS, in respect to patient's mortality and morbidity. DESIGN: From a cohort of traumatized patients (n = 1724) prospectively enrolled in the German trauma registry (DGU-R) at Frankfurt University Hospital from 2009 to 2013, 1646 could be analyzed for in-hospital mortality and short-term outcome (GOS) at discharge and compared between HEMS and EMS. MEASUREMENTS AND MAIN RESULTS: 129 patients (7...
December 16, 2018: Injury
Lars Mommers, Sean Keogh
Prehospital emergency medical services often operate in the most challenging and austere environments. Checklist use for complex tasks in these circumstances is useful but must make task completion simpler, faster and more effective. The SPEEDBOMB checklist for Prehospital Rapid Sequence Induction (PRSI) management rapidly addresses critical steps in the RSI process, is designed to improve checklist compliance and patient safety, and is adaptable for local circumstances.
April 2015: Emergency Medicine Australasia: EMA
J E Griggs, J Jeyanathan, M Joy, M Q Russell, N Durge, D Bootland, S Dunn, E D Sausmarez, G Wareham, A Weaver, R M Lyon
BACKGROUND: Major haemorrhage is a leading cause of mortality following major trauma. Increasingly, Helicopter Emergency Medical Services (HEMS) in the United Kingdom provide pre-hospital transfusion with blood products, although the evidence to support this is equivocal. This study compares mortality for patients with suspected traumatic haemorrhage transfused with pre-hospital packed red blood cells (PRBC) compared to crystalloid. METHODS: A single centre retrospective observational cohort study between 1 January 2010 and 1 February 2015...
November 20, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Yohei Hirano, Toshikazu Abe, Hiroshi Tanaka
PURPOSE: The beneficial effect of the presence of an emergency physician in prehospital major trauma care is controversial. The aim in this study is to assess whether an emergency physician on scene can improve survival outcome of critical trauma patients. METHODS: This retrospective cohort study was conducted by using nationwide trauma registry data between 2004 and 2013 in Japan. Severe trauma patients (injury severity score (ISS) ≥ 16) who were transported directly to the hospital from the injury site were included in our analysis...
November 9, 2018: American Journal of Emergency Medicine
Chase Krook, Domhnall O'Dochartaigh, Doug Martin, Zoë Piggott, Ryan Deedo, Sarah Painter, Gennifer van Werkhoven, Darcy McKay, Dennis Nesdoly, J N Armstrong
CLINICIAN'S CAPSULE What is known about the topic? Emerging evidence regarding prehospital blood transfusions for patients in hemorrhagic shock is positive. What did this study ask? Describe the implementation and stewardship of a prehospital blood transfusion program, as well as basic demographics and blood traceability. What did this study find? We provided blood transfusion to 274 mainly male trauma patients, and just 1.2% of units were wasted. Why does this study matter to clinicians? Implementation of a similar program at other prehospital organizations can be sustainably achieved...
November 8, 2018: CJEM
Jing Wang, Yun Fang, Subhashini Ramesh, Asma Zakaria, Maryann T Putman, Dan Dinescu, James Paik, Romergryko G Geocadin, Pouya Tahsili-Fahadan, Laith R Altaweel
BACKGROUND/OBJECTIVE: Prompt treatment of acute intracranial hypertension is vital to preserving neurological function and frequently includes administration of 23.4% NaCl. However, 23.4% NaCl administration requires central venous catheterization that can delay treatment. Intraosseous catheterization is an alternative route of venous access that may result in more rapid administration of 23.4% NaCl. METHODS: Single-center retrospective analysis of 76 consecutive patients, between January 2015 and January 2018, with clinical signs of intracranial hypertension received 23...
November 5, 2018: Neurocritical Care
Charlotte Cordonnier, Andrew Demchuk, Wendy Ziai, Craig S Anderson
Acute spontaneous intracerebral haemorrhage is a life-threatening illness of global importance, with a poor prognosis and few proven treatments. As a heterogeneous disease, certain clinical and imaging features help identify the cause, prognosis, and how to manage the disease. Survival and recovery from intracerebral haemorrhage are related to the site, mass effect, and intracranial pressure from the underlying haematoma, and by subsequent cerebral oedema from perihaematomal neurotoxicity or inflammation and complications from prolonged neurological dysfunction...
October 6, 2018: Lancet
Angharad Jones, Michael John Donald, Jan O Jansen
BACKGROUND: Helicopter emergency medical services (HEMS) are a useful means of reducing inequity of access to specialist emergency care. The aim of this study was to evaluate the variations in HEMS provision across Europe, in order to inform the further development of emergency care systems. METHODS: This is a survey of primary HEMS in the 32 countries of the European Economic Area and Switzerland. Information was gathered through internet searches (May to September 2016), and by emailing service providers, requesting verification and completion of data (September 2016 to July 2017)...
December 2018: Emergency Medicine Journal: EMJ
Torgrim Soeyland, Alan Garner, Sam Vidler, Cristian Humberto Gutierrez, Arnold Foster, Jane Kitcher
BACKGROUND: Prehospital medical teams are commonly required to administer a range of medications for urgent stabilisation and treatment. The safe preparation of medications during resuscitation requires attention, time and resources, and can be a source of medication error. In our two road and HEMS (Helicopter Emergency Medical Service) prehospital services, medication errors are mitigated by predrawing commonly used medications to set concentrations daily (Hunter Retrieval Service, HRS) or second-daily (CareFlight Sydney, CFS)...
December 2018: Emergency Medicine Journal: EMJ
Dag Ståle Nystøyl, Steinar Hunskaar, Hans Johan Breidablik, Øyvind Østerås, Erik Zakariassen
OBJECTIVE: To examine handling of cancelled helicopter emergency medical services (HEMS) missions with a persisting medical indication. DESIGN: Retrospective observational study. SETTING AND SUBJECTS: Cancelled HEMS missions with persisting medical indication within Sogn og Fjordane county in Norway during the period of 2010-2013. Both primary and secondary missions were included. MAIN OUTCOME MEASURES: Primary care involvement, treatment and cooperation within the prehospital system...
December 2018: Scandinavian Journal of Primary Health Care
José-Gabriel Sato Folatre, Per Arnell, Mari Henning, Kristina Josefsson, Gabriel Skallsjö, Sven-Erik Ricksten
In 2016, physician staffed helicopter emergency medical service (VGR HEMS) became the first Swedish prehospital service to routinely carry and transfuse red blood cells. In this report we describe our implementation and present our results, with preliminary analysis of our data. Out of 1 336 patients a total of 34 patients (2,5 %) were transfused without any adverse events. Our demography is predominantly male and the most common mechanism of injury is trauma. Amongst the most common interventions were endotracheal intubation, thoracostomy and CPR...
October 2, 2018: Läkartidningen
2018-10-11 19:11:00
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