Barriers to Self-Reporting Patient Safety Incidents by Paramedics: A Mixed Methods Study.
CONCLUSIONS: A high proportion of fear-based barriers to self-reporting of PSIs exist among this study population. This suggests that a culture change is needed to facilitate the identification of future patient safety threats. PMID: 29787325 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 26, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Intravenous Low-Dose Ketamine Provides Greater Pain Control Compared to Fentanyl in a Civilian Prehospital Trauma System: A Propensity Matched Analysis.
The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016. Propensity matched analysis was performed adjusting for all baseline variables with p ≤ 0.10 and for baseline pain score to match ketamine and fentanyl patients on a one-to...
Source: Prehospital Emergency Care - May 20, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Strategy to Address Private Location Cardiac Arrest: A Public Safety Survey.
CONCLUSION: The results of this survey indicate that public safety personnel are willing to respond to suspected cardiac arrest during off-hours using geospatial smart technology to private locations with or without an AED. PMID: 29768077 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 17, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Feasibility of Bystander Administration of Public-Access Naloxone for Opioid Overdose.
CONCLUSIONS: Bystanders are willing and able to access pre-stationed naloxone and administer it to a simulated patient in a public space. Public access naloxone stations may be a useful tool to reduce time to naloxone administration, particularly in areas where opioid overdoses are clustered. PMID: 29723076 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 5, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Does Non-Targeted Community CPR Training Increase Bystander CPR Frequency?
CONCLUSIONS: We observed no impact in bystander CPR performance or outcomes from a blanket, non-targeted approach to community CPR education. The effect of targeted CPR education in locales with known low bystander CPR rates should be tested in this region. PMID: 29714510 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 3, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparison of the Force Required for Dislodgement Between Secured and Unsecured Airways.
CONCLUSION: Compared with a secured device, an unsecured airway device requires only half the force to cause airway dislodgement. The secured King had the highest dislodgement force relative to the other studied devices. PMID: 29714527 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 3, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Fatal Wounding Pattern and Causes of Potentially Preventable Death Following the Pulse Night Club Shooting Event.
CONCLUSIONS: A comprehensive strategy starting with civilian providers to provide care at the point of wounding along with a coordinated public safety approach to rapidly evacuate the wounded may increase survival in future events. PMID: 29693490 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 26, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Burden of Emergency Medical Services Usage by Dialysis Patients.
Authors: Bartolacci J, Goldstein J, Kiberd B, Swain J, Vinson A, Clark D, Tennankore KK Abstract BACKGROUND: Patients receiving chronic dialysis often require emergent and inpatient care; however, only a minimal amount is known about their out-of-hospital/inter-hospital use of Emergency Medical Services (EMS). The purpose of this study was to describe the utilization of EMS in a cohort of dialysis patients. METHODS: We analyzed a cohort of adult (≥18 years) chronic dialysis patients within the Nova Scotia Health Authority Central Zone Renal Program who initiated chronic dialysis between January 1, 2009 ...
Source: Prehospital Emergency Care - April 20, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Diabetes-Related Emergency Medical Service Activations in 23 States, United States 2015.
CONCLUSIONS: Diabetes results in a substantial burden on EMS resources. Collection of more detailed diabetes complication information in NEMSIS may help facilitate EMS resource planning and prevention strategies. PMID: 29648909 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 16, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Intrastate Variation in Treatment and Outcomes of Out-of-Hospital Cardiac Arrest.
Authors: Coute RA, Shields TA, Cranford JA, Ansari S, Abir M, Tiba MH, Dunne R, O'Neil B, Swor R, Neumar RW, SaveMiHeart Consortium and the CARES Surveillance Group Abstract OBJECTIVE: Our objective was to analyze and compare out-of-hospital cardiac arrest (OHCA) system of care performance and outcomes at the Medical Control Authority (MCA) level in the state of Michigan. We hypothesized that clinically and statistically significant variations in treatment and outcomes of OHCA exists within a single U.S. state. METHODS: We performed a retrospective, observational study of all non-traumatic EMS-treated OHCA from...
Source: Prehospital Emergency Care - April 7, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Analysis of Prehospital Scene Times and Interventions on Mortality Outcomes in a National Cohort of Penetrating and Blunt Trauma Patients.
CONCLUSIONS: Although less frequent than blunt trauma, penetrating trauma is associated with significantly higher prehospital and ED mortality. Increased scene time and number of procedures was associated with greater mortality for both blunt and penetrating trauma. Further study is required to better understand any causal relationships between prehospital times and interventions and patient outcomes. PMID: 29617208 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 6, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Defining Quality in EMS.
Authors: PMID: 29595357 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 31, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Accuracy of Prehospital Identification of Stroke in a Large Stroke Belt Municipality.
CONCLUSIONS: EMD and EMS personnel in a large city in the Southeastern United States, with high stroke prevalence, had a relatively high sensitivity in identifying acute stroke patients. Paramedic accuracy was augmented by positive CPSS screening and by EMD recognition of stroke. PMID: 29596006 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 31, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Decreased Time from 9-1-1 Call to PCI among Patients Experiencing STEMI Results in a Decreased One Year Mortality.
CONCLUSION: The model produced suggests that a linear relationship exists between time to PCI and mortality in the prehospital environment with the probability of survival decreasing significantly as time to PCI increases. PMID: 29596009 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 31, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Determinants of Pediatric EMS Utilization in Children with High-Acuity Conditions.
Authors: Quiñones C, Shah MI, Cruz AT, Graf JM, Mondragon JA, Camp EA, Reddy P, Sampayo EM Abstract BACKGROUND: Underutilization of emergency medical services (EMS) for children with high-acuity conditions is poorly understood. Our objective was to identify differences in demographic factors and describe caregivers' knowledge, beliefs, and attitudes regarding EMS utilization for children with high-acuity conditions. DESIGN/METHODS: This was a mixed-methods study of children with high acuity conditions, defined as requiring immediate medical or surgical intervention and intensive care admission, over a on...
Source: Prehospital Emergency Care - March 24, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

A Prospective Before and After Study of Droperidol for Prehospital Acute Behavioral Disturbance.
Authors: Page CB, Parker LE, Rashford SJ, Bosley E, Isoardi KZ, Williamson FE, Isbister GK Abstract STUDY OBJECTIVE: Acute behavioral disturbance is a common problem for emergency medical services. We aimed to investigate the safety and effectiveness of droperidol compared to midazolam in the prehospital setting. METHODS: This was a prospective before and after study comparing droperidol to midazolam for prehospital acute behavioral disturbance, when the state ambulance service changed medications. The primary outcome was the proportion of adverse effects (airway intervention, oxygen saturation
Source: Prehospital Emergency Care - March 23, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Effect of Dial-Out Prefix Change on 9-1-1 Calls at a Large State University.
CONCLUSION: A prefix change was not only beneficial to the UNC community but it also has potentially wide-reaching effects. A reduction of invalid 9-1-1 calls translates to telecommunicators having more time available to handle true emergencies, phone lines remaining available for true emergencies, and police officers dedicating more time and effort to matters that necessitate officer assistance. Based on the call decrease seen with the prefix change, this study may be used as evidence to advocate for a change of dial-out codes beginning with "9." PMID: 29521551 [PubMed - as supplied by publisher] (Source: Pr...
Source: Prehospital Emergency Care - March 11, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Out-of-Hospital Research in the Era of Electronic Health Records.
In this study, we describe seven key aspects of designing and implementing out-of-hospital research in the era of EHRs: (1) selection of research sites, (2) defining the patient population, (3) patient sampling and sample size calculations, (4) EMS data, (5) hospital selection, (6) handling missing data, and (7) statistical analysis. We use examples from a recent prospective out-of-hospital cohort study to illustrate these topics, including lessons learned. PMID: 29494774 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 3, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Simulation of the Effects of Co-Locating Naloxone with Automated External Defibrillators.
CONCLUSION: Using these limited methods, co-locating naloxone with AEDs is not likely to have a standalone impact on preventing overdose fatalities. PMID: 29494776 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 3, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Interventions Performed on Pediatric Trauma Patients in Iraq and Afghanistan.
We describe the prehospital care of pediatric trauma patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric subjects admitted to US and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. Subjects were grouped by age:
Source: Prehospital Emergency Care - March 3, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.
CONCLUSIONS: 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited advanced life support coverage. PMID: 29485328 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 1, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Dexamethasone-Related Perineal Burning in the Prehospital Setting: A Case Series.
We report eight cases of intravenous dexamethasone administration associated with perineal or diffuse burning sensation in female patients. PMID: 29485338 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 1, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Intubation Success in Critical Care Transport: A Multicenter Study.
Authors: Reichert RJ, Gothard M, Gothard MD, Schwartz HP, Bigham MT Abstract INTRODUCTION: Tracheal intubation (TI) is a lifesaving critical care skill. Failed TI attempts, however, can harm patients. Critical care transport (CCT) teams function as the first point of critical care contact for patients being transported to tertiary medical centers for specialized surgical, medical, and trauma care. The Ground and Air Medical qUality in Transport (GAMUT) Quality Improvement Collaborative uses a quality metric database to track CCT quality metric performance, including TI. We sought to describe TI among GAMUT particip...
Source: Prehospital Emergency Care - February 24, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

A Continuous Quality Improvement Airway Program Results in Sustained Increases in Intubation Success.
Authors: Olvera DJ, Stuhlmiller DFE, Wolfe A, Swearingen CF, Pennington T, Davis DP Abstract INTRODUCTION: Airway management is a critical skill for air medical providers, including the use of rapid sequence intubation (RSI) medications. Mediocre success rates and a high incidence of complications has challenged air medical providers to improve training and performance improvement efforts to improve clinical performance. OBJECTIVES: The aim of this research was to describe the experience with a novel, integrated advanced airway management program across a large air medical company and explore the impact of the ...
Source: Prehospital Emergency Care - February 24, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Accuracy of Intravenous Infusion Flow Regulators in the Prehospital Environment.
CONCLUSIONS: Significant deviations from expected IIFR volume were observed across all devices, flow rates, and heights in a static, laboratory environment. These findings would lend caution to the use of IIFRs as they could lead to inaccurate medication dosing (both over- or under-dosing) in the prehospital environment. PMID: 29465284 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 24, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Echocardiography During Resuscitation Impacts Treatment in a Physician-Staffed Helicopter Emergency Medical Service: an Observational Study.
CONCLUSION: Prehospital echocardiography has an impact on patient treatment and may be a useful tool to support decision-making during CPR in a Dutch HEMS. PMID: 29469616 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 24, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Cervical Spine Motion: Immobilization Versus Spine Motion Restriction.
This study aims to evaluate the efficacy of two different spinal immobilization techniques on cervical spine movement in a simulated prehospital ground transport setting. METHODS: A counterbalanced crossover design was used to evaluate two different spinal immobilization techniques in a standardized environment. Twenty healthy male volunteers (age = 20.9 ± 2.2 yr) underwent ambulance transport from a simulated scene to a simulated emergency department setting in two separate conditions: utilizing traditional spinal immobilization (TSI) and spinal motion restriction (SMR). During both transport scenarios, pa...
Source: Prehospital Emergency Care - February 18, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

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