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Compulsory Use of the Backboard is Associated with Increased Frequency of Thoracolumbar Imaging.
The objective of this study was to determine if this protocol change was associated with decreased backboard utilization and ED thoracolumbar spine imaging. METHODS: This was a retrospective before-and-after chart review of subjects transported by a single emergency medical services (EMS) agency to one of four EDs for emergency calls dispatched as motor vehicle collisions (MVC). EMS and ED data were included for all calls within a 6-month interval before and after the protocol change. The protocol change was implemented in the second half of 2015. Subject demographics, backboard use, and spine imaging were reviewed for...
Source: Prehospital Emergency Care - February 17, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Qualitative Evaluation of the Coach Training within a Community Paramedicine Care Transitions Intervention.
CONCLUSIONS: Paramedics as CTI coaches represent an untapped resource for supporting ED-to-home care transitions. Our results provide the necessary first step to make the community paramedic CTI coach more successful. These findings may apply to training for similar community paramedicine roles, but additional research must investigate this possibility. PMID: 29432041 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 14, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Application of Hemostatic Agents in Iraq and Afghanistan.
We describe recent use of these agents and compare patients receiving hemostatic to the baseline population. METHODS: We used a series of emergency department (ED) procedure codes to identify patients within the Department of Defense Trauma Registry (DODTR) from January 2007 to August 2016. We only included patients for whom the DODTR specified the hemostatic agent utilized (chitosan or kaolin). We defined a serious injury by body region as an Abbreviated Injury Score (AIS) of 3 or greater. RESULTS: Our predefined search codes captured 28,222 patients. Of those, 258 (0.9%) patients had documented hemostatic use: 58...
Source: Prehospital Emergency Care - February 14, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The Use of Field Triage in Disaster and Mass Casualty Incidents: A Survey of Current Practices by EMS Personnel.
Authors: Ryan K, George D, Liu J, Mitchell P, Nelson K, Kue R Abstract BACKGROUND: Mass casualty incident (MCI) triage and the use of triage tags to assign treatment priorities are not fully implemented despite emergency medical services (EMS) personnel training during drills and exercises. OBJECTIVES: To compare current field triage practices during both training and actual MCIs and identify any potential barriers to use. METHODS: During training sessions from November 2015 through March 2016, an anonymous survey was distributed to personnel in 3 distinct types of paid full-time EMS systems: Boston EMS (2-...
Source: Prehospital Emergency Care - February 11, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Alcohol as a Factor in 911 Calls in Denver.
CONCLUSIONS: Compared to 9-1-1 calls that do not involve alcohol, alcohol-related calls are more likely to involve male patients, emergent response, traumatic injuries, advanced monitoring, airway adjuncts, and medications for sedation. This represents a significant burden on the emergency system and society. Further studies are needed to evaluate whether additional interventions such as social services could be used to lessen this burden. PMID: 29419332 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 9, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

New Immobilization Guidelines Change EMS Critical Thinking in Older Adults With Spine Trauma.
Authors: Underbrink L, Dalton AT, Leonard J, Bourg PW, Blackmore A, Valverde H, Candlin T, Caputo LM, Duran C, Peckham S, Beckman J, Daruna B, Furie K, Hopgood D Abstract OBJECTIVE: The impact of immobilization techniques on older adult trauma patients with spinal injury has rarely been studied. Our advisory group implemented a change in the immobilization protocol used by emergency medical services (EMS) professionals across a region encompassing 9 trauma centers and 24 EMS agencies in a Rocky Mountain state using a decentralized process on July 1, 2014. We sought to determine whether implementing the protocol wou...
Source: Prehospital Emergency Care - February 8, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Rapid Sequence Intubation by Intensive Care Flight Paramedics.
CONCLUSION: A very high RSI procedural success rate was observed across the study period. This supports the growing recognition that appropriately trained paramedics can perform RSI safely in the prehospital environment. PMID: 29405803 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 8, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Delayed Sequence Intubation by Intensive Care Flight Paramedics in Victoria, Australia.
Authors: Waack J, Shepherd M, Andrew E, Bernard S, Smith K Abstract OBJECTIVE: Delayed sequence intubation (DSI) involves the administration of ketamine to facilitate adequate preoxygenation in the agitated patient. DSI was introduced into the Clinical Practice Guideline for Intensive Care Flight Paramedics in Victoria in late 2013. We aimed to describe the clinical characteristics of patients receiving DSI. METHODS: A retrospective analysis was undertaken of patients who received DSI between January 1, 2014, and December 31, 2016, during both primary response and retrieval missions. Patients' clinical characte...
Source: Prehospital Emergency Care - February 8, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Acute Crisis Care for Patients with Mental Health Crises: Initial Assessment of an Innovative Prehospital Alternative Destination Program in North Carolina.
CONCLUSIONS: A dedicated community mental health center is able to treat patients experiencing acute mental health crises. LOS times were significantly shorter compared to regional EDs. Successful broader programmatic implementation could improve care quality and significantly reduce the volume of patients treated in the ED for acute mental health disorders. PMID: 29412043 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 8, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Analgesia for Pediatric Trauma Patients in Iraq and Afghanistan.
CONCLUSIONS: Overall, a low proportion of pediatric trauma subjects within this population received analgesia in the prehospital environment. The most common analgesic medication administered was morphine. Those receiving analgesic agents had more severe injuries and higher rates of concomitant interventions. These results highlight the potential need for Tactical Combat Casualty Care guidelines specifically providing recommendations for analgesia administration among pediatric patients. PMID: 29412051 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 8, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Procedural Sedation and Analgesia in Trauma Patients in an Out-of-Hospital Emergency Setting: A Prospective Multicenter Observational Study.
CONCLUSION: Procedural sedation-analgesia was inadequate in almost half of the trauma patients in the out-of-hospital setting. The reasons of these failures were probably multiple. The non-administration of a sedative drug despite an indication or non-adapted doses, in the context of a lack of specific protocols, was certainly one of them. PMID: 29384419 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 2, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparative Analysis of State Trauma Triage Criteria vs. Paramedic Discretion.
CONCLUSIONS: While PD patients were less seriously injured and had lower mortality, they experienced similar lengths of stay and resource utilization after presentation. Paramedics may be able to identify patients at risk for poor outcomes who would otherwise not be captured by FATTC. Key words: trauma alert; paramedic discretion; injury outcomes. PMID: 29388855 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 2, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Neighborhood Poverty and 9-1-1 Ambulance Response Time.
CONCLUSION: Our study challenges the commonly held assumption that ambulances are later to poor neighborhoods. We scrutinize our findings before cautiously considering their relevance for ambulance response time research and for ongoing conversations on the relationship between neighborhood poverty and prehospital care. PMID: 29381111 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 1, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Flight Versus Ground Out-of-hospital Rapid Sequence Intubation Success: a Systematic Review and Meta-analysis.
CONCLUSIONS: Both overall and first-pass success of RSI did not differ between flight and road based EMS. Flight physicians have a higher overall and first-pass success compared to flight non-physicians and all ground based EMS, but no such differences are seen for ground EMS. Our results suggest that ground EMS can use RSI with similar outcomes compared to their flight counterparts. PMID: 29377753 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 30, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Expired Epinephrine Maintains Chemical Concentration and Sterility.
CONCLUSION: Recurrent epinephrine shortages impact EMS and hospital operations in the United States. Individual administrators may be hesitant to authorize use of expired pharmaceuticals due to perceived potential complications or fear of litigation. This study shows that the original parenteral epinephrine remains sterile and detectably pure more than 2.5 years after expiration. Further study of the sterility and chemical integrity of expired medications that had been subjected to the conditions of EMS vehicles may be a future research endeavor based on the aforementioned paradigm. PMID: 29373043 [PubMed - as sup...
Source: Prehospital Emergency Care - January 28, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Interactive Effect between On-Scene Hypoxia and Hypotension on Hospital Mortality and Disability in Severe Trauma.
Authors: Kim MW, Shin SD, Song KJ, Ro YS, Kim YJ, Hong KJ, Jeong J, Kim TH, Park JH, Kong SY Abstract BACKGROUND: It is unclear whether effect size of the hypoxia is different on in-hospital mortality and disability according to hypotension status in the field. METHODS: Adult severe trauma (ST) patients during 2012-13 who were treated by emergency medical services (EMS) and had abnormal revised trauma scores in the field or who had positive trauma triage criteria were analyzed. Exposure was hypoxia (
Source: Prehospital Emergency Care - January 28, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Improving Prehospital Protocol Adherence Using Bundled Educational Interventions.
CONCLUSION: The use of a bundled, multifaceted educational intervention including in-person training, decision support tools, and social media improved adherence to updated evidence-based pediatric prehospital protocols. PMID: 29364730 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 26, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

EMS Physician-Performed Clinical Interventions in the Field.
Authors: PMID: 29364735 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 26, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparison Of The I-Gel Supraglottic And King Laryngotracheal Airways In A Simulated Tactical Environment.
This study compared the I-Gel airway (IGA) to the KA in a simulated tactical environment, to determine if one device is superior in minimizing exposure and minimizing time to successful tube placement. METHODS: This prospective randomized cross over trial was performed using the same methods and tactical environment employed in a previously published study, which compared endotracheal intubation versus the KA in a tactical environment. The tactical environment was simulated with a one-foot vertical barrier. The participants were paramedic students who wore an Advanced Combat Helmet (ACH) and a ballistic vest (IIIA) dur...
Source: Prehospital Emergency Care - January 26, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Descriptive Analysis Of Mental Health-Related Presentations To Emergency Medical Services.
Authors: Roggenkamp R, Andrew E, Nehme Z, Cox S, Smith K Abstract OBJECTIVE: In many developed countries, a lack of community-based mental health services is driving increased utilization of emergency medical services (EMS). In this descriptive study, we sought to describe the demographic and clinical characteristics of mental health-related EMS presentations in Victoria, Australia. METHODS: A retrospective observational study of EMS presentations occurring between January and December 2015. Computer Aided Dispatch and electronic patient care record data were extracted from an electronic data warehouse. Charact...
Source: Prehospital Emergency Care - January 26, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Implementing Prehospital Evidence-Based Guidelines: A Systematic Literature Review.
CONCLUSIONS: While prehospital EBG implementation barriers are well described, there is a paucity of evidence for optimal implementation methods. For scientific advances to reach prehospital patients, EBG development efforts must translate into EMS practice. Future research should consider comparing implementation methodologies in different prehospital settings, with a goal of defining detailed, reproducible best practices. PMID: 29351495 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 20, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Implementation of a Prehospital Protocol Change For Asthmatic Children.
The objective of this study was to evaluate the effect of an evidence-based pediatric EMS asthma protocol update, inclusive of oral glucocorticoid administration, on time to hospital discharge. METHODS: This was a retrospective cohort study of children (2-18 years) with an acute asthma exacerbation transported by an urban EMS system to 10 emergency departments over 2 years. The investigators implemented an EMS protocol update one year into the study period requiring glucocorticoid administration for all patients, with the major change being inclusion of oral dexamethasone (0.6 mg/kg, max. dose = 10 ...
Source: Prehospital Emergency Care - January 20, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Pediatric Anaphylaxis in the Prehospital Setting: Incidence, Characteristics, and Management.
Authors: Andrew E, Nehme Z, Bernard S, Smith K Abstract OBJECTIVE: Although hospital presentations for pediatric anaphylaxis have been described in the literature, a minimal amount is known regarding the incidence, characteristics, and management of pediatric anaphylaxis presenting to emergency medical services (EMS). METHODS: We performed a retrospective observational study of pediatrics (≤16 years) presenting to EMS in Victoria, Australia. Patients with suspected anaphylaxis were included if they were treated with epinephrine before or after EMS arrival. We used descriptive statistics to compare basel...
Source: Prehospital Emergency Care - January 20, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Intubation: Further Confounders in Trial Results.
Authors: Sayeed I, Atif F, Espinosa-Garcia C, Wali B, Turan N, Yousuf S, Stein DG PMID: 29351503 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 20, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Reply to: Prehospital Intubation: Further Confounders in Trial Results.
Authors: Nuño T, Denninghoff KR, Pauls Q, Yeatts SD, Silbergleit R, Palesch YY, Merck LH, Manley G, Wright DW PMID: 29338483 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 19, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Response by Twin Italian Hub Hospitals in a Double Seismic Event: A Retrospective Observational Investigation.
CONCLUSION: The Modena medical system was redundant and ensured that disrupted emergency systems were reorganized and put back online while damaged hospital facilities were compensated for/reproduced elsewhere. PMID: 29345508 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 19, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

No Benefit in Neurologic Outcomes of Survivors of Out-of-Hospital Cardiac Arrest with Mechanical Compression Device.
CONCLUSIONS: In our study, use of the mechanical CPR device was associated with a poor neurologic outcome at hospital discharge. However, this difference was no longer evident after logistic regression adjusting for confounding variables. Resuscitation management following institution of mechanical CPR, specifically medication and airway management, may account for the poor outcome reported. Further investigation of resuscitation management when a mechanical CPR device is utilized is necessary to optimize survival benefit. PMID: 29345513 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 19, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Association between Weather-Related Factors and Cardiac Arrest of Presumed Cardiac Etiology: A Prospective Observational Study Based on Out-of-Hospital Care Data.
The objective of this study was to determine the association between weather-related factors and out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology. METHODS: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period. Weather data (temperature, humidity, air pressure, wind speed) were obtained every minute and matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the above-mentio...
Source: Prehospital Emergency Care - January 19, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effects of Telestroke on Thrombolysis Times and Outcomes: A Meta-analysis.
CONCLUSION: Telestroke significantly reduced OTD and hospital stay durations in stroke patients without increasing the risk of mortality or sICH. Therefore, telemedicine can improve stroke care in regional areas with minor experience in thrombolysis. Further randomized controlled trials are needed to assess the benefits of telestroke systems, especially in terms of cost-effectiveness and quality of life outcomes. PMID: 29345529 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 19, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Administration of Epinephrine in Pediatric Anaphylaxis - A Statewide Perspective.
This study sought to determine the frequency of administration of epinephrine by EMS providers caring for pediatric patients in the prehospital setting. METHODS: We examined data from the NC EMS database (PreMIS) from 2010-3 to determine frequency of epinephrine administration in pediatric patients with anaphylaxis. We studied patients
Source: Prehospital Emergency Care - January 18, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Detection of STEMI Using Prehospital Serial 12-Lead Electrocardiograms.
CONCLUSIONS: Through recognition of transient ST-segment changes during transport via the prehospital serial 12-lead ECG system, STEMI was identified in 8% of suspected STEMI patients who had an initial no-STEMI ECG. Key words: electrocardiography; emergency medical services; ST-elevation myocardial infarction; prehospital dynamic ECG. PMID: 29336652 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 18, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Emergency Dispatcher Stroke Recognition: Associations with Downstream Care.
Authors: Oostema JA, Chassee T, Reeves M Abstract OBJECTIVE: As the first point of contact for patients activating emergency medical services (EMS), emergency dispatchers have the earliest opportunity to recognize stroke. We sought to quantify dispatcher stroke recognition and its relationships with EMS stroke recognition and response speed. METHODS: We assembled a cohort of consecutive EMS-transported patients with a dispatcher suspected stroke or a hospital discharge diagnosis of stroke or transient ischemic attack (TIA). Dispatcher sensitivity and positive predictive value (PPV) for stroke recognition were c...
Source: Prehospital Emergency Care - January 18, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Consensus Statement- Prehospital Care of Exertional Heat Stroke.
Authors: Belval LN, Casa DJ, Adams WM, Chiampas GT, Holschen JC, Hosokawa Y, Jardine J, Kane SF, Labotz M, Lemieux RS, McClaine KB, Nye NS, O'Connor FG, Prine B, Raukar NP, Smith MS, Stearns RL Abstract Exertional heat stroke (EHS) is one of the most common causes of sudden death in athletes. It also represents a unique medical challenge to the prehospital healthcare provider due to the time sensitive nature of treatment. In cases of EHS, when cooling is delayed, there is a significant increase in organ damage, morbidity, and mortality after 30 minutes, faster than the average EMS transport and ED evaluation window...
Source: Prehospital Emergency Care - January 18, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Syringe Administration of Epinephrine by Emergency Medical Technicians for Anaphylaxis.
CONCLUSION: We observed that EMTs successfully implemented the manual "Check and Inject" program for severe allergic reactions and anaphylaxis in a manner that typically agreed with physician review and without any overt identified safety issues. PMID: 29333893 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 16, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Systematic Review Methodology for the Fatigue in Emergency Medical Services Project.
CONCLUSIONS: We describe a protocol for conducting multiple, simultaneous systematic reviews connected to fatigue with the goal of creating an EBG for fatigue risk management in the EMS setting. Our approach may be informative to others challenged with the creation of EBGs that address multiple, inter-related systematic reviews with overlapping outcomes. PMID: 29324053 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services: A Significant Step Forward and a Model for Other High-Risk Industries.
Authors: Van Dongen HPA PMID: 29324057 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services: A Step in the Right Direction Toward Better Sleep Health.
Authors: Buysse DJ PMID: 29324058 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effect of Fatigue Training on Safety, Fatigue, and Sleep in Emergency Medical Services Personnel and Other Shift Workers: A Systematic Review and Meta-Analysis.
Authors: Barger LK, Runyon MS, Renn ML, Moore CG, Weiss PM, Condle JP, Flickinger KL, Divecha AA, Coppler PJ, Sequeira DJ, Lang ES, Higgins JS, Patterson PD Abstract BACKGROUND: Fatigue training may be an effective way to mitigate fatigue-related risk. We aimed to critically review and synthesize existing literature on the impact of fatigue training on fatigue-related outcomes for Emergency Medical Services (EMS) personnel and similar shift worker groups. METHODS: We performed a systematic literature review for studies that tested the impact of fatigue training of EMS personnel or similar shift workers. Outcome...
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Proposed Performance Measures and Strategies for Implementation of the Fatigue Risk Management Guidelines for Emergency Medical Services.
CONCLUSIONS: Performance measures for fatigue risk management in the EMS setting will facilitate the implementation and evaluation of the EBG for Fatigue in EMS. PMID: 29324060 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Fatigue Risk Management in High-Risk Environments: A Call to Action.
Authors: Hersman DAP, Whitcomb EA PMID: 29324065 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Systematic Review and Meta-analysis of the Effects of Caffeine in Fatigued Shift Workers: Implications for Emergency Medical Services Personnel.
CONCLUSIONS: Although the quality of evidence was judged to be low to moderate, when taken together, these studies demonstrate that caffeine can improve psychomotor performance and vigilance. However, caffeine negatively affects sleep quality and sleep duration. More systematic, randomized studies need to be conducted in EMS workers in order to address the critical outcomes of health and safety of EMS personnel and patients. The risk/benefit ratio of chronic caffeine use in shift workers is currently unknown. PMID: 29324066 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Reliability and Validity of Survey Instruments to Measure Work-Related Fatigue in the Emergency Medical Services Setting: A Systematic Review.
CONCLUSIONS: In this systematic review, limited evidence of the reliability and validity of 14 different survey instruments to assess the fatigue and/or sleepiness status of EMS personnel and related shift worker groups was identified. PMID: 29324068 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services.
CONCLUSIONS: Based on a review of the evidence, the panel developed a guideline with 5 recommendations for fatigue risk management in EMS operations. PMID: 29324069 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Does Implementation of Biomathematical Models Mitigate Fatigue and Fatigue-related Risks in Emergency Medical Services Operations? A Systematic Review.
CONCLUSIONS: This systematic review identified no studies that investigated the impact of biomathematical models in EMS operations. Findings from one study of non-EMS shift workers were favorable toward use of biomathematical models as a fatigue mitigation scheduling aid, albeit with very low quality of evidence pertaining to EMS operations. We propose three focus areas of research priorities that, if addressed, could help better elucidate the utility and impact of biomathematical models as a fatigue-mitigation tool in the EMS environment. PMID: 29324070 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effect of Task Load Interventions on Fatigue in Emergency Medical Services Personnel and Other Shift Workers: A Systematic Review.
CONCLUSIONS: The effect of task load interventions on fatigue, fatigue-related risks, and/or sleep quality was not estimable and the overall quality of evidence was judged low or very low. There was considerable heterogeneity in how task load was defined and measured. PMID: 29324071 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

What an Evidence-based Guideline for Fatigue Risk Management Means for Us: Statements From Stakeholders.
Authors: Myers JB, Wages RK, Rowe D, Nollette C, Touchstone M, Sinclair J, Mund EL, Eberly JM, Montes JD, Sherlock RJ, Barger LK, Drummond SPA, Gurubhagavatula I PMID: 29324078 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Shorter Versus Longer Shift Durations to Mitigate Fatigue and Fatigue-Related Risks in Emergency Medical Services Personnel and Related Shift Workers: A Systematic Review.
This study comprehensively reviewed the literature on the impact of shorter versus longer shifts on critical and important outcomes for Emergency Medical Services (EMS) personnel and related shift worker groups. METHODS: Six databases (e.g., PubMed/MEDLINE) were searched, including one website. This search was guided by a research question developed by an expert panel a priori and registered with the PROSPERO database of systematic reviews (2016:CRD42016040099). The critical outcomes of interest were patient safety and personnel safety. The important outcomes of interest were personnel performance, acute fatigue, sleep...
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effects of Napping During Shift Work on Sleepiness and Performance in Emergency Medical Services Personnel and Similar Shift Workers: A Systematic Review and Meta-Analysis.
CONCLUSIONS: Reviewed literature indicated that scheduled naps at work improved performance and decreased fatigue in shift workers. Further research is required to identify the optimal timing and duration of scheduled naps to maximize the beneficial outcomes. PMID: 29324083 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Absence and Need for Fatigue Risk Management in Emergency Medical Services.
Authors: Patterson PD, Martin-Gill C PMID: 29324169 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - January 13, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Cincinnati Prehospital Stroke Scale Can Identify Large Vessel Occlusion Stroke.
Authors: Richards CT, Huebinger R, Tataris KL, Weber JM, Eggers L, Markul E, Stein-Spencer L, Pearlman KS, Holl JL, Prabhakaran S Abstract OBJECTIVE: Accurate prehospital identification of patients with acute ischemic stroke (AIS) from large vessel occlusion (LVO) facilitates direct transport to hospitals that perform endovascular thrombectomy. We hypothesize that a cut-off score of the Cincinnati Prehospital Stroke Scale (CPSS), a simple assessment tool currently used by emergency medical services (EMS) providers, can be used to identify LVO. METHODS: Consecutively enrolled, confirmed AIS patients arriving via...
Source: Prehospital Emergency Care - January 5, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research