Weather and temporal factors associated with use of emergency medical services.
Authors: Ramgopal S, Dunnick J, Owusu-Ansah S, Siripong N, Salcido DD, Martin-Gill C Abstract BACKGROUND: Fluctuations in EMS responses can have a substantial impact on the ability of agencies to meet resource needs within an EMS system. We aimed to identify weather characteristics as potentially predictable factors associated with EMS responses. METHODS: We reviewed hourly counts of scene responses documented by 24 EMS agencies in Western Pennsylvania from January 1st, 2014 to December 31st, 2017 and compared rates of responses to weather characteristics. Responses to counties nonadjacent to the studied weathe...
Source: Prehospital Emergency Care - March 17, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

A Geospatial Analysis of Distances to Hospitals that Admit Pediatric Asthma Patients.
CONCLUSION: In this statewide study in Florida, we found long average estimated EMS travel distances to admitting facilities for Florida's pediatric population in rural counties for pediatric asthma exacerbations. Those long distances have great implications for rural EMS operations, including pediatric destination decisions, transport times, and availability for others who call 911. Further research on bypass and secondary transport rates, and outcomes for asthma and other pediatric conditions are required to further characterize pediatric regionalization's impact on rural EMS. PMID: 30874466 [PubMed - as supplied by ...
Source: Prehospital Emergency Care - March 17, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Bolus Dose Epinephrine improves blood pressure but is associated with increased mortality in critical care transport.
Authors: Guyette FX, Martin-Gill C, Galli G, McQuaid N, Elmer J Abstract INTRODUCTION: Hypotension in the prehospital environment is common and linked to dose-dependent mortality. Bolus dose epinephrine (BDE) may reverse hypotension. We tested if BDE use to treat profound hypotension is associated with 24-hour survival. METHODS: We performed a retrospective case-cohort study of critical care transport patients with systolic blood pressure (SBP)
Source: Prehospital Emergency Care - March 17, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Layperson Ability and Willingness to Use Hemostatic Dressings: A Randomized, Controlled Trial.
This study seeks to determine if laypeople can apply hemostatic dressings, and which hemostatic dressing they can use most successfully. METHODS: 360 layperson participants in Maryland and Virginia completed 4 arms of this randomized, prospective controlled trial: plain gauze (control), z-folded gauze, s-rolled gauze, and injectable sponge (experimental) arms. Participants watched a standardized video, practiced hands-on dressing application, and were assessed applying the dressing via checklists and feedback mechanisms for pressure, timing, and packing. Participants completed pre and post questionnaires regarding will...
Source: Prehospital Emergency Care - March 17, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Push dose epinephrine use in the management of hypotension during critical care transport.
CONCLUSIONS: Push dose epinephrine may be an effective method of temporarily resolving hypotension during the CCT of critically ill patients. In the cases where PDE was administered there was close adherence to the established protocol and adverse events were found to be rare directly following PDE administration. Further research is needed to validate these findings, establish optimal dosing, and evaluate use in non-CCT prehospital settings. PMID: 30808241 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 28, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effects of Real-time EMS direction on Optimizing EMS Turnaround and Load-balancing Between Neighboring Hospital Campuses.
CONCLUSION: A proactive approach to EMS destination control using a nurse navigator with access to real-time hospital and ED capacity metrics appears to be an effective method of decreasing EMS turnaround time. PMID: 30798628 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 27, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparison of Outcomes and Characteristics of Emergency Medical Services (EMS)-Witnessed, Bystander-Witnessed, and Unwitnessed Out-of-Hospital Cardiac Arrests in Singapore.
Authors: Chia MYC, Kwa PWT, Wah W, Yap S, Doctor NE, Ng YY, Mao DR, Sieu- B, Leong H, Gan HN, Tham LP, Cheah SO, Ong MEH Abstract Objectives To compare the survival outcomes of Emergency Medical Services (EMS)-witnessed arrests to bystander-witnessed, and unwitnessed out-of-hospital cardiac arrests (OHCA) in Singapore. Secondary aims are to describe the 5-year trend in survival rates of EMS-witnessed arrests. Methods This was a retrospective analysis of the Singapore's OHCA registry data from 2011 to 2015. Excluded from the analysis were patients younger than 18 years old, arrests of traumatic etiology, resuscitati...
Source: Prehospital Emergency Care - February 25, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Evaluation of a Selective Prehospital Pediatric Spinal Protection Protocol.
CONCLUSIONS: Implementation of a selective spinal immobilization protocol was associated with reduced admission rates, but did not significantly reduce rates of plain radiographs. PMID: 30793627 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 24, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effects of spinal immobilization and spinal motion restriction on head-neck kinematics during ambulance transport.
CONCLUSION: H-N motion was somewhat coupled to ambulance acceleration and varied across a wide range, regardless of SP approach. In general, SI resulted in a modest reduction in H-N displacement and acceleration, with some exceptions. The results inform clinical decisions on SP practice during prehospital transport and demonstrates a novel approach to quantifying H-N motion in prehospital care. PMID: 30779605 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 21, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

An Executive Summary of Educational Content from EMS Agenda 2050.
This article written by members of the EMS Agenda 2050 Technical Expert Panel highlights the content in the preceding agendas for the future and content from EMS Agenda 2050 in an effort to provide a summarized guide for new and existing EMS education curriculums. PMID: 30773955 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 19, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effectiveness of Prehospital Dual Sequential Defibrillation for Refractory Ventricular Fibrillation and Ventricular Tachycardia Cardiac Arrest.
CONCLUSIONS: Compared with conventional defibrillation, DSD was associated with lower odds of prehospital ROSC. Defibrillation type was not associated with other OHCA endpoints. DSD may not be beneficial in refractory VF/VT OHCA. PMID: 30773983 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 19, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Characteristics of Neighborhoods Where Emergency Medical Services Encounter Children at Risk for Maltreatment.
The objective of this study was to determine if neighborhood rates of pediatric Emergency Medical Services (EMS) encounters correlate with rates of child maltreatment reporting and if there are neighborhood-level risk factors for EMS encountering children with maltreatment reports. METHODS: We conducted a retrospective cohort study using the electronic medical records of children ages
Source: Prehospital Emergency Care - February 2, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The effect of physician-staffed Emergency Medical Services (P-EMS) on the outcome of patients with severe traumatic brain injury. A review of the literature.
Authors: Popal Z, Bossers SM, Terra M, Schober P, de Leeuw MA, Bloemers FW, Giannakopoulos GF PMID: 30693835 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 31, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Performance of the RACE Score for the Prehospital Identification of Large Vessel Occlusion Stroke in a Suburban/Rural EMS Service.
CONCLUSION: The RACE scale demonstrated acceptable discrimination, yet the sensitivity and positive predictive value were lower in this cohort of EMS professionals in the U.S. than in the original validation study conducted in Spain. Further work is needed to determine the optimal prehospital screening tool for identification of LVO. PMID: 30668202 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 23, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Existing science on human factors and ergonomics in the design of ambulances and EMS equipment.
DISCUSSION: Of the 4125 search results, 48 relevant articles were retained, and then sorted into one of three categories: general design, patient handling, and patient transport. It was concluded that, although research has progressed over the past 15 years, more research, development, and resources are needed. Newer generations of ambulances have not been shown to be safer during collisions and there is a knowledge gap in how occupants and contents of a patient compartment behave during a collision. Crash-tests have been performed with restrained occupants and supplies, however, that scenario is unrealistic in the field. ...
Source: Prehospital Emergency Care - January 16, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Ocular ultrasound assessment to estimate the risk of increased intracranial pressure after traumatic brain injury in Prehospital setting.
Authors: PMID: 30632443 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Telehealth Impact on Primary Care Related Ambulance Transports.
We describe the patient characteristics and results from a cohort of patients in Houston, Texas who received a prehospital telehealth consultation from an emergency medicine physician. Inclusion criteria were adults and pediatric patients with complaints considered to be non-urgent, primary care related. Data were analyzed for 36 months, from January 2015 through December 2017. Our primary dependent variable was percent of patients transported by ambulance. We used descriptive statistics to describe patient demographics, chi-square to examine differences between groups, and logistic regression to explore the effects with m...
Source: Prehospital Emergency Care - January 12, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Appropriate Needle Length for Emergent Pediatric Needle Thoracostomy Utilizing Computed Tomography.
Authors: Mandt MJ, Hayes K, Severyn F, Adelgais K Abstract OBJECTIVE: Needle thoracostomy is a life-saving procedure. Advanced Trauma Life Support guidelines recommend insertion of a 5cm, 14-gauge needle for pneumothorax decompression. High-risk complications can arise if utilizing an inappropriate needle size. No study exists evaluating appropriate needle length in pediatric patients. Utilizing computed tomography (CT), we determined the needle length required to access the pleural cavity in children matched to Broselow™ Pediatric Emergency Tape color. METHODS: Three investigators reviewed chest CTs of children
Source: Prehospital Emergency Care - January 11, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Reducing 9-1-1 emergency medical service calls by implementing a community paramedicine program for vulnerable older adults in public housing in Canada: A multi-site cluster randomized controlled trial.
CONCLUSIONS: CP@clinic showed a significant decrease in EMS calls, decrease in BP, and improvement in QALYs among older adults in subsidizing public housing, suggesting this simple program should be replicated in other communities with public housing. TRIAL REGISTRATION: Clinicaltrials.gov, Registration no. NCT02152891. PMID: 30624150 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 11, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Pediatric Behavioral Health-Related EMS Encounters: A Statewide Analysis.
CONCLUSIONS: Pediatric behavioral-health related EMS encounters had a significant proportion of suspected ingestions/substance use, and we found disproportionate effects on rural agencies. Increases in EMS resource utilization (including longer EMS times) occurred in certain settings with limited behavioral health infrastructure. Those findings suggest an opportunity for community paramedicine to alleviate EMS utilization and decrease the frequency of pediatric behavioral health emergencies. PMID: 30612501 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 9, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Physician Oversight of Specialized Emergency Medical Services.
Authors: PMID: 30615541 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 9, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Emergency Medical Services Bypass of the Closest Facility for Pediatric Patients.
Authors: Fishe JN, Psoter KJ, Anders JF Abstract OBJECTIVES: Pediatric specialty care is increasingly regionalized. It is unknown how regionalization affects emergency medical services (EMS) providers' destination decisions for non-trauma pediatric patients. We sought to characterize the rates of bypass of the closest facility, and destination facilities' levels of pediatric care in three diverse EMS agencies. METHODS: This is a one-year retrospective study of non-trauma pediatric patients less than 18 years of age transported by three EMS agencies (Baltimore City, Prince George's County, and Queen Anne's Count...
Source: Prehospital Emergency Care - January 9, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Quality Assessment of Expired Naloxone Products from First-Responders' Supplies.
CONCLUSION: This quality assessment demonstrates that expired naloxone products may still meet USP standards, even after many years. Further pharmaceutical, clinical and regulatory investigation should be conducted to confirm our findings, especially for new naloxone products with different formulations and routes of administration. Extending the shelf-life of naloxone products may have important financial and public health consequences in addressing future drug shortages and meeting the needs for this critical drug. PMID: 30596290 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 2, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

An analysis of injuries and prehospital interventions sustained by females in the Iraq and Afghanistan combat zones.
CONCLUSIONS: Females accounted for a small proportion of total casualties within our dataset. After controlling for confounders, survival was comparable between males and females, but host nation females were less likely to receive ketamine and intravenous morphine. Future studies should seek to elucidate the reasons for these subtle differences between males and females in prehospital combat casualty care. PMID: 30587052 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - December 29, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Ethnic and Neighbourhood Socioeconomic Differences in Incidence and Survival from Out of Hospital Cardiac Arrest in Singapore.
CONCLUSIONS: We found Malay and Indian communities to be at higher risks of OHCA compared to Chinese, and additionally, the Malay community is at higher risk of subsequent mortality than the Chinese and Indian communities. These disparities were not explained by neighbourhood SES. PMID: 30582395 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - December 26, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Outcomes for patients who contact the emergency ambulance service and are not transported to the Emergency Department: a data linkage study.
Conclusions Most non-transported patients did not have subsequent health events. Deaths after non-transport are an infrequent event that could be selected for more detailed review of individual cases, to facilitate learning and improvement. PMID: 30582719 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - December 26, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Availability and Use of an Automated External Defibrillator at Emergency Medical Dispatch.
CONCLUSIONS: AEDs are reported as available by only a small percentage of callers to 911, and in the majority of cases in which a bystander rescuer is sent to retrieve an AED, one is never located or used. Sending someone to retrieve the AED may be more appropriate in multiple-rescuer situations than when a single bystander rescuer is alone on scene. PMID: 30572769 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - December 24, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The Safety and Effectiveness of Field Nitroglycerin in Patients with Suspected ST Elevation Myocardial Infarction.
Authors: Bosson N, Isakson B, Morgan JA, Kaji AH, Uner A, Hurley Msn K, Henry TD, Niemann JT Abstract OBJECTIVE: While widely used in the treatment of cardiac conditions, only limited data characterize out-of-hospital nitroglycerin (NTG) use. We sought to determine the safety of out-of-hospital sublingual NTG administered for suspected ST-segment elevation myocardial infarction (STEMI) and its effect on the patient's pain score. METHODS: We prospectively identified adult patients with suspected STEMI transported by paramedics to three PCI-capable hospitals in a large urban-suburban EMS system. We compared patie...
Source: Prehospital Emergency Care - December 19, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Emergency call characteristics and EMS dispatcher protocol adherence for possible anaphylaxis.
CONCLUSIONS: The majority of calls were not consistent with anaphylaxis, and EMS dispatchers rarely strictly followed the Medical Priority Dispatch System guidelines aimed at identifying anaphylaxis. Future studies would be beneficial to determine if our findings hold true in other EMS service areas. PMID: 30526221 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - December 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Autistic Man Falling Through The Cracks. Advanced patient transport and the "pop-up" recovery ward.
Autistic Man Falling Through The Cracks. Advanced patient transport and the "pop-up" recovery ward. Prehosp Emerg Care. 2018 Dec 03;:1-4 Authors: Brendt P, Mathews A, Greenberg R, Arnold M Abstract The Royal Flying Doctor Service was tasked to relocate a 19 year-old autistic patient with severe social anxiety, agoraphobia and morbid obesity from one residential location to another. The retrieval team was confronted with two main challenges: 1. Continuous risk elevation in an elective patient transportation as distinct from other urgent prehospital transfers of mental health patients. 2. Pre-h...
Source: Prehospital Emergency Care - December 7, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The Use of Epinephrine for Out-Of-Hospital Treatment of Anaphylaxis.
Authors: PMID: 30513053 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - December 6, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Emergency medical services provider perspectives on pediatric calls: A qualitative study.
CONCLUSIONS: This study provides qualitative data about the difficulties of responding to pediatric calls and resources needed to support clinicians. Findings from this study can be used to guide EMS leaders in designing and implementing institutional initiatives to enhance training and support for prehospital clinicians providing care to children. PMID: 30482077 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - November 30, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Longer prehospital time was not associated with mortality in major trauma. A retrospective cohort study.
CONCLUSION: Longer prehospital times were not associated with an increased likelihood of 30-day mortality in major trauma patients transported to hospital by ambulance paramedics. We found no evidence to support the hypothesis that prehospital time longer than one hour resulted in an increased risk of 30-day mortality. However, longer on-scene time was associated with longer hospital LOS (for 30-day survivors). Our recommendation is that prehospital care is delivered in a timely fashion and delivery of the patient to hospital is reasonably prompt. PMID: 30462550 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - November 23, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Evaluation and comparison of different prehospital triage scores of trauma patients on in-hospital mortality.
CONCLUSION: The comparison of these different triage scores concluded with a superiority of the MGAP and NTS scores compared with the T-RTS. Including the calculation of MGAP or NTS scores with the Vittel criteria would reduce the risk of overtriage in the Level 1 trauma centers by further directing patients at low risk of death to a lower-level trauma facility. PMID: 30457396 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - November 22, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Characterization of Children with Septic Shock Cared for by Emergency Medical Services.
Authors: Depinet HE, Eckerle M, Semenova O, Meinzen-Derr J, Babcock L Abstract OBJECTIVE: To inform the future development of a pediatric prehospital sepsis tool, we sought to 1) describe the characteristics, emergent care, and outcomes for children with septic shock who are transported by emergency medicine services (EMS) and compare them to those self-transported; and 2) determine the EMS capture rate of common sepsis screening parameters and the concordance between the parameters documented in the EMS record and in the emergency department (ED) record. METHODS: This is a retrospective cohort study of childre...
Source: Prehospital Emergency Care - November 17, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Characteristics and Diversity Of ACGME Accredited EMS Fellowship Programs.
Authors: March J, Adams JL, Portela R, Taylor S, McManus JG Abstract INTRODUCTION: There is little published data in regards to Emergency Medical Services (EMS) fellowship programs. The purpose of this study was to obtain program characteristics and diversity data regarding EMS fellowship programs. METHODS: A survey was sent to program directors at all EMS fellowship programs accredited by the Accreditation Council of Graduate Medical Education (ACGME). Data collected included: year program started, year program accredited, unfilled fellow positions, number of EMS faculty, gender, and race/ethnicity. Gender and...
Source: Prehospital Emergency Care - November 10, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Ready for Children: Assessing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Setting.
CONCLUSIONS: Though few EMS agencies currently have a PECC, there is interest among EMS agency administrators to integrate one into their system. Pediatric-specific psychomotor skills testing is more common in EMS agencies that respond to a higher pediatric call volume and have a PECC. For EMS agencies that infrequently treat children, the presence of a PECC may enhance the frequency of pediatric psychomotor skills evaluation. The presence of a PECC can potentially increase provider confidence and safety for all pediatric prehospital patients regardless of volume and location. PMID: 30380953 [PubMed - as supplied by pu...
Source: Prehospital Emergency Care - November 3, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

A Prospective Study of the Safety and Effectiveness of Droperidol in Children for Prehospital Acute Behavioural Disturbance.
Authors: Page CB, Parker LE, Rashford SJ, Isoardi KZ, Isbister GK Abstract STUDY OBJECTIVE: Although uncommon, children (
Source: Prehospital Emergency Care - November 3, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

NAEMSE Position Paper on the Critical Care Paramedic.
Authors: Stuhlmiller DF, Clark JR, Caffrey S, Betterton M, Nollette C, Raynovich W Abstract Critical care paramedicine is a specialty practice of the EMS profession. Development of a bachelor's degree is supported as a requirement for entry-level paramedic education and training and targeted specialty continuing education as a requirement for certifying critical care paramedics. Critical care paramedic certification is required for the establishment of national practice standards, recognition and standardization of scopes of practice at the state-level. Maintenance of critical care paramedic certification and appro...
Source: Prehospital Emergency Care - October 18, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Multi-organ system injury from inhalant abuse.
We present an illustrative case of a 24-year old male who developed cardiovascular and multi-organ system toxicity after inhaling a keyboard dust cleaner containing a halogenated hydrocarbon. In the field, the patient demonstrated neurotoxic effects in addition to electrocardiographic changes concerning for toxic myocarditis. We discuss the types of hydrocarbons, methods of abuse, and toxic effects of their inhalation including "sudden sniffing death" from myocardial sensitization. PMID: 30320538 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - October 17, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Use of Ultrasound for Joint Dislocation Reduction in an Austere Wilderness Setting: A Case Report.
We present a case of a stranded hiker with an ultrasound-confirmed glenohumeral joint dislocation who underwent ultrasound-guided intra-articular lidocaine injection and ultrasound-confirmed reduction. This procedure allowed the patient to hike out under his own power, avoiding the potential dangers of extrication to both patient and rescuers. We believe this case demonstrates the feasibility and utility of ultrasound in the out-of-hospital environment both procedurally and diagnostically. PMID: 30303761 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - October 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Real-Time Fatigue Mitigation with Air-Medical Personnel: The SleepTrackTXT2 Randomized Trial.
Authors: Patterson PD, Moore CG, Guyette FX, Doman JM, Weaver M, Sequeira DJ, Werman HA, Swanson D, Hostler D, Lynch J, Russo L, Hines L, Swecker K, Kroemer AJ, Runyon M, Buysse DJ Abstract OBJECTIVE: The aims of this study were: 1) to determine the short-term impact of the SleepTrackTXT2 intervention on air-medical clinician fatigue during work shifts; and 2) determine the longer-term impact on sleep quality over 120 days. METHODS: We used a multi-site randomized controlled trial study design with a targeted enrollment of 100 (ClinicalTrials.gov NCT02783027). The intervention was behavioral (non-pharmacologica...
Source: Prehospital Emergency Care - October 6, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

An Urban 911 System's Experience with Left Ventricular Assist Device Patients.
CONCLUSIONS: EMS interactions with LVAD patients are infrequent but have high rates of admission and incidence of life-threatening diagnoses. The most common prehospital presenting symptoms were weakness and chest pain, and most prehospital interactions did not require LVAD-specific interventions. In addition to acquiring technical knowledge regarding LVADs, EMS providers should be aware of non-device-related complications including intracranial and GI bleeding and take this into account during their assessment. PMID: 30285520 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - October 6, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Proximal External Aortic Compression for Life-Threatening Abdominal-Pelvic and Junctional Hemorrhage: An Ultrasonographic Study in Adult Volunteers.
CONCLUSION: This trial suggests that it may be reasonable to attempt temporization of major abdominal-pelvic and junctional haemorrhage using bimanual proximal external aortic compression. In the absence of immediate alternatives for this dangerous and vexing injury pattern, there appear to be few downsides to prehospital proximal external aortic compression while concomitantly expediting definite care. PMID: 30285523 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - October 6, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Statewide Method of Measuring Ambulance Patient Offload Times.
CONCLUSION: This first step to address offload delays in California consists of standardized definitions for data collection to address the significant variability inherent in obtaining data from 33 local agencies, hundreds of EMS provider agencies, and 320 acute care hospital Emergency Departments that receive 911 ambulance transports. The first year of standardized data collection of ambulance patient offload times revealed significant ambulance patient offload time delays that are not distributed uniformly, resulting in a substantial financial burden for some EMS providers in California. PMID: 30257596 [PubMed - as ...
Source: Prehospital Emergency Care - September 28, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Hypoglycemia Emergencies: Factors Associated with Prehospital Care, Transportation Status, Emergency Department Disposition, and Cost.
CONCLUSIONS: EMS activations for hypoglycemia are sizeable and yet a considerable proportion of patients are not transported to or are discharged from the ED. Seemingly, these events resolved and were not medically complex. It is possible that implementation and appropriate use of EMS treat-and-release protocols along with utilizing programs to educate patients on hypoglycemia risk factors and emergency preparedness could partially reduce the burden of hypoglycemia to the healthcare system. PMID: 30259772 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - September 28, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Combining Unmanned Aerial Vehicles, and Internet Protocol Cameras to Reconstruct 3-D Disaster Scenes During Rescue Operations.
CONCLUSION: We proposed the concept of real-time UAV imagery for reconstructing photo-realistic 3-D model which might greatly improve prehospital emergency management after disaster. PMID: 30260257 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - September 28, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The Need to Prioritize Education of the Public Regarding Stroke Symptoms and Faster Activation of the 9-1-1 System: Findings from the Florida-Puerto Rico CReSD Stroke Registry.
CONCLUSIONS: Following acute stroke onset, time elapsed for EMS response and transport is relatively short compared to the lengthy intervals elapsing between symptom onset and 9-1-1 system activation, regardless of demographics. Exploration of innovative strategies to improve public education regarding stroke symptoms and immediate 9-1-1 system activation are strongly recommended. PMID: 30239244 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - September 23, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Intraosseous Administration of Tissue Plasminogen Activator on a Mobile Stroke Unit.
We describe 3 cases in which tPA was administered via IO access on a mobile stroke unit as part of the Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit Compared to Standard Management by Emergency Medical Services (BEST-MSU) trial. No adverse events were observed in the process of obtaining IO access or administering tPA. PMID: 30235055 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - September 21, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Abstracts for the 2019 NAEMSP Scientific Assembly.
This study compared patient outcomes across EMS agencies with respect to the duration of on-scene time. We hypothesized that EMS agencies with greater average time on-scene would have more favorable outcomes. METHODS: The Cardiac Arrest Registry to Enhance Survival (CARES) was used to identify OOHCA cases, including characteristics and outcomes. EMS agencies were included if they submitted at least 80 OOHCAs from 2013 to 2017. To study outcomes based upon culture of OOHCA management, outcomes were studied by EMS agency rather than by individual patient cases. Agencies in the top and bottom quartiles of on-scene time du...
Source: Prehospital Emergency Care - September 18, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research