Association between post-resuscitation coronary angiography with and without intervention and neurological outcomes after out-of-hospital cardiac arrest.
CONCLUSIONS: Post-resuscitation CAG with and without PCI are associated with better neurological recovery in patients with OHCA, regardless of primary electrocardiogram and patient age. PMID: 31526205 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - September 20, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Impact of a New 9-1-1 Dispatch System on Call-Processing Times for Time-Critical Emergencies in the City of Los Angeles.
Authors: Sanko S, Lane C, Eckstein M Abstract Objective: To determine the impact of a new emergency medical services (EMS) 9-1-1 dispatch system on call-processing times for field-confirmed time-critical emergencies. Methods: An interrupted time series study compared 9-1-1 calls for field-confirmed emergencies processed by Los Angeles Fire Department (LAFD)-telecommunicators using either the Medical Priority Dispatch System® (January 1 - September 30, 2014) or the new Los Angeles Tiered Dispatch System (January 1 - September 30, 2015). Prior to the study, authors identified seven categories of time-critical eme...
Source: Prehospital Emergency Care - September 18, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Abstracts for the 2020 NAEMSP Scientific Assembly.
Authors: Carhart E PMID: 31525111 [PubMed] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - September 18, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Temporal trends in the incidence, characteristics and outcomes of hanging-related out-of-hospital cardiac arrest.
Authors: Alqahtani S, Nehme Z, Williams B, Bernard S, Smith K Abstract Aim: To describe temporal trends in the incidence, characteristics and outcomes of hanging-related out-of-hospital cardiac arrest (OHCA). Method: A retrospective study of all hanging-related OHCA in Victoria, Australia, between 2000 and 2017 was conducted. Trends in incidence, characteristics and outcomes were assessed using linear regression and a non-parametric test for trend, as appropriate. Predictors of survival to hospital discharge were identified using multivariable logistic regression. Results: Between 2000 and 2017, emergency medical s...
Source: Prehospital Emergency Care - September 14, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The Association between Presentation by EMS and EMS Prenotification with Receipt of Intravenous Tissue-type Plasminogen Activator in a State Implementing Stroke Systems of Care.
Authors: Nielsen VM, Dejoie-Stanton C, Song G, Christie A, Guo J, Zachrison KS Abstract Collaboration between emergency medical services (EMS) and hospitals receiving stroke patients is critical to ensure prompt, effective treatment, and is a key component of the stroke systems of care (SSoC). The goal of our study was to evaluate the association between presentation by EMS and EMS prenotification with odds of receiving Tissue-type Plasminogen Activator (IV-tPA) in a state implementing SSoC while rigorously accounting for missing data. We utilized data from the Massachusetts Paul Coverdell Stroke Registry for this ...
Source: Prehospital Emergency Care - September 8, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparative Effectiveness of Analgesics to Reduce Acute Pain in the Prehospital Setting.
Conclusions were made with consideration of established clinically important differences and we graded each conclusion's strength of evidence (SOE). Results: We included 52 randomized controlled trials and 13 observational studies. Due to the absence or insufficiency of prehospital evidence we based conclusions for initial analgesia on indirect evidence from the emergency department setting. As initial analgesics, there is no evidence of a clinically important difference in the change of pain scores with opioids versus ketamine administered primarily intravenously (IV) (low SOE), IV acetaminophen (APAP) (low SOE), or nonst...
Source: Prehospital Emergency Care - September 5, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Identification of Swimmers in Distress Using Unmanned Aerial Vehicles: Experience at the Mont-Tremblant IRONMAN Triathlon.
Conclusion: While our preliminary findings suggest that using UAVs to identify distressed swimmers during an IRONMAN race is feasible and safe, more research is necessary to determine how to optimize UAV surveillance at mass sporting events and integrate this technology within the existing emergency response teams. PMID: 31429611 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - August 22, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The Deployment of Alternative Response Units in a High-Volume, Urban EMS System.
Authors: Mechem CC, Yates CA, Rush MS, Alleyne A, Singleton HJ, Boyle TL Abstract Faced with increasing demand for their services, Emergency Medical Services (EMS) agencies must find more efficient ways to use their limited resources. This includes moving beyond the traditional response and transport model. Alternative Response Units (ARUs) are one way to meet the prehospital medical needs of some members of the public while reducing ambulance transports. They are non-transport vehicles tasked with very specific medical missions. These can include acute management of low-acuity complaints, ongoing home care for chr...
Source: Prehospital Emergency Care - August 22, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital ST-segment elevation myocardial infarction (STEMI) in Queensland, Australia: findings from 11 years of the statewide prehospital reperfusion strategy.
This study described real-world clinical practice in prehospital management of STEMI patients in Queensland, Australia. Methods. Retrospective analysis of data sourced from the STEMI database of the Queensland Ambulance Service, Australia. Adult STEMI patients identified by paramedics between February 2008 and December 2018 in Queensland were included. Key aspects of prehospital STEMI care were described. Clinically-important time intervals from symptom onset to reperfusion were reported. Results. A total of 8,388 patients were included. The proportion of patients receiving prehospital reperfusion treatment has improved ma...
Source: Prehospital Emergency Care - August 6, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

"Weighing CAM": A New Mobile Application for Weight Estimation in Pediatric Resuscitation.
"Weighing CAM": A New Mobile Application for Weight Estimation in Pediatric Resuscitation. Prehosp Emerg Care. 2019 Aug 01;:1-14 Authors: Park JW, Kwon H, Jung JY, Choi YJ, Lee JS, Cho WS, Lee JC, Kim HC, Lee SU, Kwak YH, Kim DK Abstract Objective: We evaluated the validity of a newly developed mobile application (i.e., the Weighing Cam) for pediatric weight estimation compared with that of the Broselow tape. Methods: We developed an application that estimates the weight of pediatric patients using a smartphone camera and displays the drug dosage, device size, and defibrillation energy on the...
Source: Prehospital Emergency Care - August 2, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Protocols Reducing Long Spinal Board Use Are Not Associated with a Change in Incidence of Spinal Cord Injury.
Conclusion: In this limited study, no change in the incidence of SCI was identified following implementation of SMR protocols. Prospective evaluation of this question is necessary to evaluate the safety of SMR protocols. PMID: 31348691 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 29, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Validity of the Pediatric Early Warning Score and the Bedside Pediatric Early Warning Score in Classifying Patients Who Require the Resources of a Higher Level Pediatric Hospital.
CONCLUSION: In the prehospital setting neither PEWS nor BPEWS exhibited sufficient sensitivity for clinical use to accurately identify children who need a hospital with higher level pediatric resources. Further research should be conducted to identify variables that are captured by prehospital care providers and are associated with children who need a hospital with higher level pediatric resources. PMID: 31339430 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 26, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effect of Implementation of Cardiopulmonary Resuscitation-Targeted Multi-Tier Response System on Outcomes After Out-of-Hospital Cardiac Arrest: A Before-and-After Population-Based Study.
This study aimed to investigate the effect of an MTR on OHCA outcomes. Methods: A natural experimental study was conducted for resuscitation-attempted adult OHCAs. The MTR system was implemented in Korea by the National Fire Agency in 2015 across the country where the single-tiered ambulance response system existed. The MTR program had the following 3 components: 1) detection of OHCA by dispatcher, 2) dispatch of ambulance or fire engine in addition to routine dispatch of ambulance, and 3) performance of team CPR. The study period of 2015-2016 was divided by 6 months (phases I [reference], II, III, and IV). The endpoints w...
Source: Prehospital Emergency Care - July 12, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Patient, Neighborhood, and Spatial Determinants of Out-of-Hospital Cardiac Arrest Outcomes throughout the Chain of Survival: A Community-Oriented Multilevel Analysis.
Authors: Gul SS, Cohen SA, Becker TK, Huesgen K, Jones JM, Tyndall JA Abstract Objective: Global and national trends of out-of-hospital cardiac arrest (OHCA) have been examined, however geographic variation and socioeconomic disparities of OHCA outcomes in the community setting are less understood. We developed and tested a replicable, community-oriented assessment strategy aimed to identify spatial variations in OHCA outcomes using socioeconomic, prehospital, and in-hospital factors. Methods: Emergency medical service records of adult, non-traumatic OHCA within Alachua County, FL (2012-2017) were retrospectively r...
Source: Prehospital Emergency Care - July 10, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparing the Accuracy of Mass Casualty Triage Systems When Used in an Adult Population.
Conclusion. We found that SALT triage most often correctly triaged adult emergency department patients when compared to a previously published criterion standard. While there are no target under- and over-triage rates that have been published for mass casualty triage, all four systems had relatively high rates of under-triage. PMID: 31287350 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 10, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Epidemiology of Prehospital Care at the San Diego (USA) - Tijuana (Mexico) International Border Crossing.
CONCLUSION: This was the first study of PHP assessment and care at the San Diego-Tijuana border crossings. We found a large diversity in patient ages. Respiratory distress and blunt trauma were the most frequent complaints and oxygen was the most frequent treatment. The busiest day of the week was Sunday, and the busiest month of the year was July. Our newly described findings may assist EMS agencies with optimizing staff, equipment, and training at international border crossings. PMID: 31276428 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 6, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

A Comprehensive Description of the Advanced Emergency Medical Technician Certification Level.
CONCLUSION: AEMTs fill an important gap in prehospital care between the EMT and paramedic level in the U.S. Many AEMT programs required a current EMT certification and completion of a portfolio and course-ending examination. Implementation of the AEMT certification level could be strengthened through further research into high-quality educational practices for AEMT training programs. PMID: 31276438 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 6, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Efficacy of Different Hair and Skin Decontamination Strategies with Identification of Associated Hazards to First Responders.
Authors: Larner J, Durrant A, Hughes P, Mahalingam D, Rivers S, Matar H, Thomas E, Barrett M, Pinhal A, Amer N, Hall C, Jackson T, Catalani V, Chilcott RP Abstract Prompt disrobing and minimization of time to casualty decontamination are key to the effective treatment of individuals exposed to toxic chemicals. Established procedures for mass casualty decontamination that involve the deployment of equipment for showering with water (such as the ladder pipe system [LPS] and technical decontamination) necessarily introduce a short, but critical delay. The purpose of this study was to investigate the effectiveness of d...
Source: Prehospital Emergency Care - June 30, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Drivers of increasing emergency ambulance demand.
Authors: Andrew E, Nehme Z, Cameron P, Smith K Abstract OBJECTIVES: Although the factors driving emergency department demand have been extensively investigated, comparatively little is known about the drivers of increasing emergency ambulance demand. Methods: We conducted a retrospective observational study of consecutive cases attended by Ambulance Victoria in Melbourne, Australia from 2008 to 2015. Incidence rates were calculated, and adjusted time series regression analyses were performed to assess drivers of ambulance demand. Results: A total of 2,443,952 consecutive cases were included. Demand grew by 29.2% ov...
Source: Prehospital Emergency Care - June 28, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Development of a Content Valid and Reliable Prehospital Environmental Falls Risk Assessment Tool for Older Adults.
CONCLUSION: We developed a construct valid and reliable assessment of environmental falls risk to be performed in the prehospital setting. Further trials should be conducted using this tool to determine appropriate cut scores and deployment in the prehospital setting to help with primary and secondary fall prevention. PMID: 31237795 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 28, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Females and Minority Racial/Ethnic Groups Remain Underrepresented in EMS: A Ten-Year Assessment, 2008-2017.
CONCLUSIONS: The underrepresentation of females and minority racial/ethnic groups observed during this ten-year investigation of EMTs and paramedics earning initial certification suggests that EMS workforce diversity is unlikely to undergo substantial change in the near future. The representation gaps were larger and more stable among paramedics compared to EMTs and suggest an area where concerted efforts are needed to encourage students of diverse backgrounds to pursue EMS. PMID: 31225772 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 23, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Assessing severity of illness in patients transported to hospital by paramedics: external validation of 3 prognostic scores.
CONCLUSIONS: Prognostic scores using physiologic measures assessed by paramedics have good predictive ability for hospital mortality. These scores, particularly the CIP score, may be considered as a tool for mortality risk stratification or as a general measure of illness severity for patients included in EMS studies. PMID: 31210571 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 20, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Transition in care from EMS providers to emergency department nurses: a systematic review.
Conclusion: While multimedia applications may potentially improve the handoff process, future intervention studies need to be rigorously designed. We recommend interdisciplinary training of EMS and ED staff in the use of flexible structured protocols, especially given review findings that interdisciplinary communication and relationships can be challenging. PMID: 31210572 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 20, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Other approaches to prehospital transesophageal echocardiography.
Authors: Braude D, White J, Wray T PMID: 31211606 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 20, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Survival Benefit of Treatment at or Transfer to a Tertiary Trauma Center among Injured Older Adults.
CONCLUSIONS: Our results suggest a survival benefit for injured older adults treated at TCs. This benefit was also observed for patients transferred from non-tertiary trauma centers. Further research should focus on identifying specific subgroups of patients who would especially benefit from this level of care to minimize trauma triage inefficiencies. PMID: 31211622 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 20, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Association between intravenous fluid bolus and biomarker trajectory during prehospital care.
Conclusions: Among non-trauma, non-cardiac arrest patients at risk for critical illness, a prehospital IV fluid bolus was associated with a relative decrease in IL-6, but not IL-10 or TNF. PMID: 31180262 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 12, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

US military medical evacuation and prehospital care of pediatric trauma casualties in Iraq and Afghanistan.
We describe injury characteristics and prehospital interventions performed on wartime pediatric trauma casualties in Afghanistan and Iraq, stratified by medical evacuation platform. Methods: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric (age
Source: Prehospital Emergency Care - June 5, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Homeless Shelter Users and Their Experiences as EMS Patients: A Qualitative Study.
CONCLUSION: Support for increased EMS awareness, research, and relationship building with homeless patients and shelters is needed. PMID: 31157584 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 5, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Guiding Cardiopulmonary Resuscitation with Focused Echocardiography: A Report of Five Cases.
CONCLUSION: Providers using focused echocardiography to evaluate cardiac arrest patients should consider initiating scans at the start of compressions to identify the optimal location for compression delivery and to detect inadequate compressions. Subsequent visualization of full left ventricular compression may be seen after a location change, and combined with end tidal carbon dioxide values, gives indication for improved forward circulatory flow. Although it is not possible in all patients, doing so hastens provision of quality compressions that affect hemodynamic parameters without causing prolongations to the pulse ch...
Source: Prehospital Emergency Care - June 3, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Challenges of being prepared for pediatric emergencies.
Authors: Kaufmann J, Laschat M PMID: 31150306 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 3, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Classification versus prediction of mortality risk using the SIRS and qSOFA scores in patients with infection transported by paramedics.
Conclusion: Assessing the predicted risk for the mSIRS and qSOFA scores instead of classification accuracy reveals that the qSOFA score provides more information to clinicians about a patient's mortality risk, supporting its use in clinical decision-making. PMID: 31140890 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 30, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Simulating Public Buses as a Mobile Platform for Deployment of Publicly Accessible Automated External Defibrillators.
Authors: Hajari H, Salerno J, Weiss LS, Menegazzi JJ, Karimi H, Salcido DD Abstract Introduction: Public access defibrillation (PAD) programs seek to optimize locations of automated external defibrillators (AEDs) to minimize the time from out-of-hospital cardiac arrest (OHCA) recognition to defibrillation. Most PAD programs have focused on static AED (S-AED) locations in high traffic areas; pervasive electronic data infrastructure incorporating real-time geospatial data opens the possibility for AED deployment on mobile infrastructure for retrieval by nearby non-passengers. Performance characteristics of such syste...
Source: Prehospital Emergency Care - May 29, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Dual defibrillation is highly variable: an analysis of pulse interval delivered in dual defibrillation.
Conclusion: DD using the various methods currently employed produces a highly variable set of pulse intervals even within a single method. It is difficult to reach a conclusion about the efficacy of DD unless the delivered pulse interval is measured or the method of activation reproducibly produces a precise pulse interval. PMID: 31116612 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 24, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Dosing Errors Made by Paramedics During Pediatric Patient Simulations After Implementation of a State-Wide Pediatric Drug Dosing Reference.
CONCLUSION: Despite implementation of a PDR, dosing errors, including ten-fold errors, still occur at a high rate. Errors occur with dilution and length-based tape use. Further error reduction strategies, beyond a PDR and that target errors of omission, are needed for pediatric prehospital drug administration. PMID: 31084508 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 17, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Critical Medication Shortages: Effective Strategies to Maintain Continuous Medication Availability for Emergency Medical Services.
CONCLUSIONS: Critical medication shortages remain a problem for many EMS systems. EMS medical directors need to implement multiple mitigation strategies to maintain supply of critical medications for prehospital patient care. PMID: 31084511 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 17, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The 2019 Core Content of Emergency Medical Services Medicine.
Authors: Delbridge TR, Dyer S, Goodloe JM, Mosesso VN, Perina DG, Sahni R, Pons PT, Rinnert KJ, Isakov AP, Kupas DF, Gausche-Hill M, Joldersma KB, Keehbauch JN Abstract On March 13, 2019 the EMS Examination Committee of the American Board of Emergency Medicine (ABEM) approved modifications to the Core Content of EMS Medicine. The Core Content is used to define the subspecialty of EMS Medicine, provides the basis for questions to be used during written examinations, and leads to development of a certification examination blueprint. The Core Content defines the universe of knowledge for the treatment of prehospital p...
Source: Prehospital Emergency Care - May 17, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Injured Older Adults Transported by Emergency Medical Services: One Year Outcomes by POLST Status.
We describe patient and event characteristics by POLST status at time of 911 contact, subsequent changes in POLST forms, and mortality to 12 months. RESULTS: Of 7,055 injured older adults, 1,412 (20.0 %) had a registered POLST form at the time of 911 contact. Among the 1,412 POLST forms, 390 (27.6%) specified full orders, 585 (41.4%) limited interventions, and 437 (30.9%) comfort measures only. By one year, 2,438 (34.6 %) patients had completed POLST forms. Among the 4 groups (no POLST, POLST-full orders, POLST-limited intervention, POLST-comfort measures), Injury Severity Scores were similar. Mortality differences wer...
Source: Prehospital Emergency Care - May 7, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

A strategy to identify paramedic transported sepsis cases in an Emergency Department administrative database.
This study linked clinical data from adult patients transported by a provincial Emergency Medical Services (EMS) system to ED and inpatient administrative databases. Sepsis cases were identified by searching ED databases for diagnosis codes consistent with infection and organ dysfunction. Organ dysfunction was further assessed using a partial Sequential Organ Failure Assessment (SOFA) score derived from EMS clinical information. Reliability was evaluated by comparing patients' ED diagnosis codes (ICD-10CA) to their inpatient diagnosis codes; criterion validity by comparing cases classified by the new strategy to an existin...
Source: Prehospital Emergency Care - May 4, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Catecholaminergic Polymorphic Ventricular Tachycardia: An unusual case of fright-induced prehospital cardiac arrest in a healthy 6 year old child.
We present a case of a 6 year old male who had a sudden unexplained prehospital cardiac arrest after being scared by a domestic animal and who presented in ventricular fibrillation. The patient was subsequently defibrillated with a return of spontaneous circulation. During the course of care, medications with beta-1 and -2 agonist properties were administered, followed by multiple further episodes of polymorphic ventricular tachycardia (PVT)/ventricular fibrillation (VF). Once these medications were discontinued and beta blockers were administered, the patient had no further episodes of PVT/VF and was subsequently discharg...
Source: Prehospital Emergency Care - May 1, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Correction.
Authors: PMID: 31006306 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 24, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Risk factors for non-optimal resource utilization for emergent interfacility transfers by air ambulance in Ontario.
This study aimed to identify risk factors associated with non-optimal resource utilization for adult patients undergoing emergent interfacility transport by air ambulance in Ontario, Canada. A secondary objective was to determine if non-optimal resource utilization was associated with deterioration in clinical status by measuring a delta rapid emergency medicine score (REMS). METHODS: This was a retrospective cohort study of all emergent, adult interfacility transfers transported by air ambulance over a 5-year period in Ontario, Canada. Determination of optimal resource use was based on distances and historic time data...
Source: Prehospital Emergency Care - April 24, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effect of Specialized Critical Care Transport Unit on Short-Term Mortality of Critically Ill Patients Undergoing Interhospital Transport.
Conclusion Transport by specialized critical care transport unit for patients undergoing interhospital transport was associated with lower 24-hour mortality, demonstrating the benefits of the SMICU. PMID: 30998115 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 20, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Improving the Continuum of Care by Bridging the Gap between Prehospital and Hospital Discharge Data through Stepwise Deterministic Linkage.
CONCLUSION: It is feasible to link prehospital and hospital data using stepwise deterministic linkage; this method returns a high linkage rate with a low false positive error rate. Data linkage is vital to identifying and bridging gaps in the continuum of care and is a useful tool in statewide and agency-specific research and quality improvement. PMID: 30973796 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 13, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Immediate Interventions for Presyncope of Vasovagal or Orthostatic Origin: A Systematic Review.
Conclusion While there is little evidence available and the findings were mixed, PCM may provide benefit for prevention of syncope during acute episodes of presyncope and may be tried in the first aid setting. No evidence was found for other non-pharmacologic interventions or for the use of PCM in children. PMID: 30957664 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 10, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Out Of Hospital Transesophageal Echocardiogram For Cardiac Arrest Resuscitation: The Initial Case.
Authors: PMID: 30957698 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 10, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Predictors of hypothermia upon trauma centre arrival in severe trauma patients transported to hospital via EMS.
Authors: Forristal C, Aarsen KV, Columbus M, Wei J, Vogt K, Mal S Abstract INTRODUCTION: Hypothermia in severe trauma patients can increase mortality by 25%. Active warming practices decrease mortality and are recommended in the Advanced Trauma Life Support (ATLS) guidelines. Despite this, many emergency medical services (EMS) vehicles do not carry equipment necessary to perform active warming. The intent of this study was to determine the rate of hypothermia in severe trauma patients upon major trauma centre (MTC) arrival, as well as to characterize factors associated with hypothermia in trauma in order to devote ...
Source: Prehospital Emergency Care - April 6, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Evidence-Based Guidelines for EMS Administration of Naloxone.
The objectives of this project were to develop and disseminate an evidence-based guideline and model protocol for administration of naloxone by EMS practitioners to persons with suspected opioid overdose. We have four recommendations relating to route of administration, all conditional, and all supported by low or very low certainty of evidence. We recommend the intravenous route of administration to facilitate titration of dose, and disfavor the intramuscular route due to difficulty with titration, slower time to clinical effect, and potential exposure to needles. We equally recommend the intranasal and intravenous routes...
Source: Prehospital Emergency Care - March 31, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Non-auto-injector epinephrine administration by basic life support providers: A literature review and consensus process.
Authors: Lyng JW, White CC, Peterson TQ, Lako-Adamson H, Goodloe JM, Dailey MW, Clemency BM, Brown LH Abstract Anaphylaxis is a life-threatening condition with a known effective prehospital intervention: parenteral epinephrine. The National Association of EMS Physicians (NAEMSP) advocates for EMS providers to be allowed to carry and administer epinephrine. Some states constrain epinephrine administration by basic life support (BLS) providers to administration using epinephrine auto-injectors (EAIs), but the cost and supply of EAIs limits the ability of some EMS agencies to provide epinephrine for anaphylaxis. This ...
Source: Prehospital Emergency Care - March 30, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Caring for Infectious Disease in the Prehospital Setting: A Qualitative Analysis of EMS Providers Experiences and Suggestions for Improvement.
CONCLUSIONS: Although first responders were excited to be a part of the response to EVD, this did not come without hesitation and emotional distress. Some of these concerns may be mitigated by first providing a clear definition of "duty to care," followed by interventions such as the development of clear and consistent ID preparedness training and interventions that address the emotional distress experienced by these providers. PMID: 30917729 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 30, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Paramedic-Identified Enablers of and Barriers to Pediatric Seizure Management: A Multicenter, Qualitative Study.
CONCLUSIONS: Paramedics identified enablers of and barriers to adherence to evidence-based pediatric seizure protocols. The identified barriers existed at both the provider and systems levels. Paramedics identified multiple potential solutions to overcome several barriers to protocol adherence. Future research should focus on using the findings of this study to revise seizure protocols and to deploy measures to improve protocol implementation. Future research should also analyze process and outcome measures before and after the implementation of revised seizure protocols informed by the findings of this study. PMID: 30...
Source: Prehospital Emergency Care - March 30, 2019 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research