Transporting Patients to Appropriate Receiving Destinations

Conclusion EMS is in a position to be the initiator of specialty center destination. In large cities with multiple hospitals, EMS should transport patients to the closest, most appropriate facility based on patient condition, even if this requires passing a closer facility. Where there are hospitals with multiple specialty services, EMS may be asked to activate a specific team, such as the stroke or cardiac team. In rural communities, EMS can communicate with the local hospital and by letting the hospital know of patient condition, help start the interfacility transport process from the field. EMS is, and should be, considered part of the healthcare team.  EMS providers should strive to recognize conditions requiring specialty centers and work as patient advocates to get patients to an appropriate facility as timely as possible. 
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Exclusive Articles Columns Operations Source Type: news

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In this study, it was aimed to demonstrate that posterior perichondrioadipodermal flap is a safe and simple method for revision otoplasty. The technique is highly advantageous if the primary otoplasty technique is a cartilage-sparing method. However, if the primary otoplasty technique is a cartilage-sculpting method, the efficiency of this technique remains unknown because no patient in this study had cartilage-sculpting otoplasty as primary otoplasty, which is possibly the main drawback of this study.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Aesthetic Surgery Source Type: research
Conclusions Our findings reveal that the majority of survey respondents do not immobilize the extremities after autograft without joint involvement. When grafts cross major joints, most surgeons immobilize for 3 or 5 days. Despite some practice variability, surveyed burn surgeons' current lower extremity ambulation practices generally align with the 2012 guidelines of Nedelec et al.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Burn Surgery and Research Source Type: research
Conclusions It is fundamental that appropriate diagnostic and management guidelines are developed. Furthermore, this case highlights the importance of educating patient's carers and health professionals of key symptoms to be wary of postburn.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Burn Surgery and Research Source Type: research
Conclusions Overall, a majority of patients recovered well postoperatively with minimal complications and low rate of reoperation. Our research provides a foundation to develop a risk-stratified approach to determine the need for an ICU admission or early transfer to floor care.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Microsurgery Source Type: research
This study aimed to compare toxicity and efficacy for conventional fraction versus hypofraction schedules. From January 2009 through December 2014, 183 patients with HCC bone metastases were randomly assigned to conventional fraction EBRT (Group A) or hypofraction radiotherapy (Group B). Study outcomes were pain relief, response rate and duration, overall survival, and toxicity incidence. Median follow-up time was 9.3 months. Response times were 6.7 ± 3.3 fractions in Group A and 4.1 ± 1.2 fractions in Group B (p
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
Objective: To investigate the safety and effectiveness of ultrasound-guided radiofrequency ablation (RFA) combined with preoperative three-dimensional (3D) reconstruction versus surgical resection for solitary hepatocellular carcinoma of 3-5 cm.Methods: The cohort of this retrospective study included 66 consecutive patients who underwent open hepatectomy (Surgery group) between January 2009 and December 2014, as well as 54 consecutive patients who underwent ultrasound-guided RFA combined with preoperative 3D reconstruction (RFA group) during the same period. Preoperative 3D reconstruction was performed using Myrian-XP-Live...
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
In this study, a support-vector-machine (SVM) model for diagnosis of lung cancer was established based on plasma miRNAs biomarkers, clinical symptoms and epidemiology material.Methods: The expressions of plasma miRNA were examined with SYBR Green-based quantitative real-time PCR.Results: We identified that the expressions of 10 plasma miRNAs (miR-21, miR-20a, miR-210, miR-145, miR-126, miR-223, miR-197, miR-30a, miR-30d, miR-25), smoking status, fever, cough, chest pain or tightness, bloody phlegm, haemoptysis, were significantly different between lung cancer and control groups (P
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
In this study, we investigated the effects of these granules on myocardial fibrosis in a rat model of myocardial infarction in vivo. Methods: Male Wistar rats were randomly divided into four groups: the sham operation group, the acute myocardial infarction (AMI) group, the Luhong granule group, and the vancomycin group, with a sample size (n) of 10 rats in each group. The AMI model was established in all rats by ligation of the left anterior descending (LAD) coronary artery (the sham operation group did not undergo ligation). Luhong granules (0.5 ml·kg-1·d-1), vancomycin (0.075 g·ml-1...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Authors: Li J, Lv L, Zhang J, Xu L, Zeng E, Zhang Z, Wang F, Tang X Abstract A combination of peppermint oil and caraway oil (POCO) with its unique properties has been shown clinical benefits for FD. However, the potent statistical data to confirm its effects are lacking. This meta-analysis thus aimed at evaluating the efficacy and safety of POCO compared with placebo in treating patients with FD. We searched CENTRAL, PubMed, EMBASE (Ovid), Web of Science, Google Scholar, China National Knowledge Infrastructure database, Wanfang, and VIP databases for randomized clinical trials (RCTs) up to June 2019. Dichotomous d...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Efficacy of "Pinggan Formula" in Controlling Acute Type B Aortic Dissection Perioperative Blood Pressure: A Randomized Controlled Clinical Trial. Evid Based Complement Alternat Med. 2019;2019:6432953 Authors: Zhang H, Zhang D, Sun Y, Lu Y, Feng J, Zhang L, Song C, Jing Z, Yu C, Lu Q Abstract Objective: To explore a new treatment that can proceed from the whole, control blood pressure smoothly and coordinate the treatment of multiple factors causing blood pressure fluctuations. Method: We conducted a single-center, double-blinded, and randomized controlled clinical trial. 48 patients with ...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
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