Utility of Shock Index for suspected rupture of abdominal aortic aneurysms.
Authors: Dirks NPM, Mestrom M, van der Lugt M, van Osch F, Peters NALR, Elshof JM, Barten DG Abstract Background: A ruptured abdominal aortic aneurysm (rAAA) is a life-threatening condition, with high mortality rates. The Shock Index (SI) is an easy tool and a useful predictor of hemodynamic instability in trauma patients. We aimed to assess the predictive and prognostic value of the SI for patients with a suspected rAAA in the prehospital and hospital setting.Methods: This was a retrospective, observational, single-center study. Patients>18 years old who visited the emergency department with a suspected rAAA be...
Source: Prehospital Emergency Care - July 18, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

COVID-19 Preliminary Case Series: Characteristics of EMS Encounters with Linked Hospital Diagnoses.
Conclusion: In this large sample of prehospital encounters, EMS COVID-19 suspicion demonstrated sensitivity of 78% and positive predictive value of 20% compared with hospital ICD-10 codes. These data indicate that EMS suspicion alone is insufficient to determine appropriate utilization of PPE. PMID: 32677858 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 18, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Using Red Lights and Sirens for Emergency Ambulance Response: How Often are Potentially Life-Saving Interventions Performed?
ConclusionIn this large national dataset, RLS responses were very common (86%) yet potentially life-saving interventions were infrequent (6.9%). These data suggest a methodology to help EMS leaders craft targeted RLS response strategies. PMID: 32678993 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 18, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

NEMSMA Position Statement and White Paper: Process and Outcomes Data Sharing Between EMS and Receiving Hospitals.
Authors: Gunderson MR, Florin A, Price M, Reed J Abstract Emergency Medical Services provider agencies and programs for systems of care for time-sensitive conditions in many communities and regions struggle with hospitals to obtain feedback data regarding patient outcomes and hospital processes relevant to EMS quality programs. EMS provider agencies also have issues in providing information to hospitals at the time of patient transfer to support continuity of care. The paper presents a position statement and supporting rationale from the National EMS Management Association on the bi-lateral exchange of data between...
Source: Prehospital Emergency Care - July 15, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Development of a Binary End-of-Event Outcome Indicator for the NEMSIS Public Release Research Dataset.
CONCLUSION: A binary end-of-event outcome indicator can be determined for 98.6% of 9-1-1 initiated ground EMS scene responses and 89.1% of cardiac arrests included in the NEMSIS dataset. The events with a determinable outcome appear representative of the larger dataset and the end-of-event indicators are generally consistent with reported emergency department outcomes. PMID: 32658624 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 15, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Medication Dosing Safety for Pediatric Patients: Recognizing Gaps, Safety Threats, and Best Practices in the Emergency Medical Services Setting. A Position Statement and Resource Document from NAEMSP.
Authors: Cicero MX, Adelgais K, Hoyle JD, Lyng JW, Harris M, Moore B, Gausche-Hill M, pediatric committee of NAEMSP adopted by NAEMSP Board of Directors Abstract Millions of patients receive medications in the Emergency Medical Services (EMS) setting annually, and dosing safety is critically important. The need for weight-based dosing in pediatric patients and variability in medication concentrations available in the EMS setting may require EMS providers to perform complex calculations to derive the appropriate dose to deliver. These factors can significantly increase the risk for harm when dose calculations are in...
Source: Prehospital Emergency Care - July 11, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The safety and effectiveness of on-site paramedic and allied health treatment interventions targeting the reduction of emergency department visits by long-term care patients: systematic review.
ConclusionWe found five types of programs/interventions which all demonstrated a decrease in ED visits or hospitalization. However, most studies were observational and few assessed patient safety. Many identified programs focused on increased primary care for patients, and interventions addressing acute care issues, such as community paramedics, deserve more study. PMID: 32644902 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 11, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Inferior Vena Cava Diameter is an Early Marker of Central Hypovolemia during Simulated Blood Loss.
This study tested the hypothesis that ultrasound measurements of IVC diameter decreases during severe simulated blood loss. METHODS: Blood loss was simulated in 14 healthy men (22 ± 2 years) using lower body negative pressure (LBNP). Pressure within the LBNP chamber was reduced 10 mmHg of LBNP every four minutes until participants experienced pre-syncopal symptoms or until 80 mmHg of LBNP was completed. IVC diameter was imaged with POCUS using B-mode in the long and short axis views between minutes two and four of each stage. RESULTS: Maximum IVC diameter in the long axis v...
Source: Prehospital Emergency Care - July 8, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Brief Research Report: Prehospital Rapid Sequence Airway.
Conclusion: Overall and first pass RSA success rates were high and aspiration rates were low in this quality assurance registry despite predictors of airway difficulty. RSA may be a reasonable alternative to RSI for prehospital airway management that merits further research. PMID: 32628568 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - July 8, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Multicenter Evaluation of Prehospital Seizure Management in Children.
Authors: Shah MI, Ostermayer DG, Browne LR, Studnek JR, Carey JM, Stanford C, Fumo N, Lerner EB Abstract Background: Seizures are a common reason why emergency medical services (EMS) transports children by ambulance. Timely seizure cessation prevents neurologic morbidity, respiratory compromise, and mortality. Implementing recommendations from an evidence-based pediatric prehospital guideline may enhance timeliness of seizure cessation and optimize medication dosing.Objective: We compared management of pediatric prehospital seizures across several EMS systems after protocol revision consistent with an evidence-base...
Source: Prehospital Emergency Care - June 28, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Epidemiology of oxytocin administration in out-of-hospital births attended by paramedics.
Conclusion: Oxytocin is well accepted and safe treatment adjunct for the management of the third stage of labor in OOH births and should be considered for routine practice by other emergency medical services. PMID: 32584626 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 27, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The Association of Death Notification and Related Training with Burnout among Emergency Medical Services Professionals.
Conclusion: Many EMS professionals reported delivering at least one death notification within the past year. Yet, fewer than half reported training related to death notification during initial EMS education and even fewer reported receiving continuing education. More of those who delivered death notifications experienced burnout, while continuing education was associated with reduced odds of burnout. Future work is needed to develop and evaluate death notification training specifically for EMS professionals. PMID: 32584686 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 27, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Emergency Medical Services Utilization by Homeless Patients.
CONCLUSION: In the City of Los Angeles, people experiencing homelessness demonstrated disproportionately high use of EMS services and ambulance transports, were more frequently younger, male, and had lower acuity conditions when compared with housed patients. PMID: 32501745 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 7, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

myResponder Smartphone Application to Crowdsource Basic Life Support for Out-of-Hospital Cardiac Arrest: The Singapore Experience.
ConclusionThe myResponder mobile application is a feasible smart technology solution to improve community response to OHCA, and to increase bystander CPR and AED use. Future directions include increasing the number of active responders, improving response rates, app performance, and better data capture for quality improvement. PMID: 32497484 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - June 5, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Complications from Needle Thoracostomy: Penetration of the Myocardium.
We report a rare but serious complication of needle thoracostomy, penetration of the myocardium. Needle thoracostomy is typically performed in the prehospital setting or upon arrival in the emergency department for suspected tension pneumothorax. Needle decompression is generally taught and done anteriorly, in the 2nd intercostal space on the midclavicular line (MCL). An alternative approach is laterally, along the anterior axillary line (AAL) in the 4th intercostal space. Our case supports prior literature that the anterior MCL location has a low rate of efficacy to decompress the chest, as well as a high rate of complica...
Source: Prehospital Emergency Care - May 23, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital patient care protocols for suicidality in Washington State.
Conclusion: These findings demonstrated that little guidance exists for EMS providers in Washington State with regard to the screening or treatment of suicidal patients, above and beyond scene safety and transportation to hospital-based care. Development of guidelines for prehospital suicide care, as well as enhanced screening, assessment, and collaboration with on-call crisis resources has the potential to expand the scope of prehospital treatment for suicidal patients, and reduce burdens on patients, EMS providers, and Emergency Departments. PMID: 32420776 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 19, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Motor vehicle crash characteristics that are predictive of high acuity patients: an analysis of linked ambulance and crash data.
Discussion: There were two important findings from this study: (1) few MVC patients were deemed to be high acuity; and (2) several crash scene characteristics were strong predictors of high acuity patients. PMID: 32420785 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 19, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Can Emergency Medical Services Utilization Rates Be Used to Measure the Success of an Alcohol Amnesty Policy?
Conclusion: Implementation of a MAGS policy was not associated with a significant change in the number of alcohol-related EMS responses. It is unclear if these results reflect ineffective policy implementation or a general reduction in on-campus alcohol consumption. However, using EMS call volume as a marker for policy success and quality improvement offers an innovative tool through which EMS agencies can provide valuable feedback to other system stakeholders. PMID: 32420787 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 19, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Best Practices for A Novel EMS-Based Naloxone Leave Behind Program.
Authors: Scharf BM, Sabat DJ, Brothers JM, Margolis AM, Levy MJ Abstract Background: Increasing naloxone access has been identified as a primary strategy to reduce opioid overdose deaths. To supplement community naloxone training and distribution access points, EMS systems have instituted public safety-based naloxone leave behind (NLB) programs that allow emergency medical responders to distribute "leave behind" naloxone kits on the scene of an overdose. This model presents an opportunity to expand naloxone access for individuals at high risk for future overdoses. Objectives: To evaluate the preliminary o...
Source: Prehospital Emergency Care - May 19, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Emergency Medical Services traumatic brain injury protocols do not reflect Brain Trauma Foundation guidelines.
Authors: McMullan JT, Ventura A, LeBlanc DP Abstract Implementation of traumatic brain injury guideline (TBI) recommendations for prehospital care is associated with improved outcomes, but prehospital guideline uptake is frequently delayed. Our objective was to estimate how well TBI guidelines are reflected in a national sample of prehospital TBI protocols in 2012 and 2018, 5 and 11 years after guideline publication. A purposeful sample of publicly accessible prehospital protocols were obtained in 2012, and updates of those protocols were obtained in 2018. Guideline recommendations were codified into a 23-item tool...
Source: Prehospital Emergency Care - May 16, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Blood Transfusion in New South Wales, Australia: A retrospective cohort study.
Authors: Shand S, Curtis K, Dinh M, Burns B Abstract INTRODUCTION: Catastrophic hemorrhage remains the leading cause of preventable death. Not all New South Wales (NSW) hospitals stock blood products and, as such, blood products carried by NSW Ambulance retrieval teams are often the first available to critically unwell patients. OBJECTIVE: To describe the trends, characteristics and predictors of mortality prior to hospital treatment in patients receiving prehospital blood transfusion by NSW Ambulance retrieval teams attending primary missions from 2009-2018. METHODS: Retrospective review of all patients wh...
Source: Prehospital Emergency Care - May 16, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Impact of prehospital antibiotic therapy on septic shock mortality.
Conclusion: In this retrospective study, prehospital antibiotic therapy reduces 30-day mortality of septic shock patients cared for by MICU. Further studies will be needed to confirm the beneficial effect of prehospital antibiotic therapy in association or not with prehospital hemodynamic optimization to improve the survival of septic shock patients. PMID: 32352890 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - May 2, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

The Impact of Videolaryngoscopy on Endotracheal Intubation Success by a Pediatric/Neonatal Critical Care Transport Team.
Conclusion:We found use of a C-MAC videolaryngoscope by a critical care transport team was associated with improved FPS during endotracheal intubation of pediatric patients but not neonates, after controlling for other patient and provider characteristics. In addition to the impact on FPS, use of VL may offer additional educational and quality benefits. PMID: 32347776 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 30, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparing the prevalence of poor sleep and stress metrics in basic versus advanced life support emergency medical services personnel.
This study was a survey of recertifying nationally-certified EMS personnel working in civilian settings. Respondents completed an electronic questionnaire assessing their sleep quality; workday, non-workday, and average sleep duration; sleep debt; perceived stress; and chronic stress. Survey-weighted Poisson regression models were used to estimate adjusted prevalence ratios (PR) comparing BLS (emergency medical technician) to ALS (advanced emergency medical technician and paramedic) for each metric. Models were adjusted for age, sex, minority status, education level, EMS agency type, service type, EMS role, and significant...
Source: Prehospital Emergency Care - April 23, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Correction.
Authors: PMID: 32301639 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 19, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparison of Chest Compression Quality Between Transfer Sheet and Stretcher Use for Transporting Out-Of-Hospital Cardiac Arrest Patients in a High-Rise Building - A Randomized and Open-label Cross-over Design.
Authors: Chi CY, Renhao DM, Yang CW, Yang MF, Lee HJ, Lee CH, Shih FF, Ong MEH, Ko PC Abstract Objectives: Stretchers are commonly used for transporting cardiac arrest patients, but their use may be limited in confined spaces, like elevators. Use of transfer sheet as an alternative has not been explored. We aimed to compare manual chest compression quality between these two methods. Methods: In this prospective, open-label, randomized cross-over manikin study, the subjects included emergency medical technicians who were assigned to 12 three-person crews. Scenarios included transport of a cardiac arrest in a high-ri...
Source: Prehospital Emergency Care - April 19, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Emergency Care Provided by the Israeli Military Airborne Combat Evacuation Unit during Helicopter Winch Rescue Operations.
Conclusions: The reported MACEU experience provides useful information on the clinical characteristics, medical interventions, and outcomes of patients rescued using a winching operation. Study findings emphasize the importance of airway management and ventilation during winching. PMID: 32301641 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 19, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Verbal Motivation vs. Digital Real-Time Feedback During Cardiopulmonary Resuscitation: Comparing Bystander CPR Quality in a Randomized and Controlled Manikin Study of Simulated Cardiac Arrest.
Authors: Plata C, Nowack M, Loeser J, Drinhaus H, Steinhauser S, Hinkelbein J, Wetsch WA, Böttiger BW, Spelten O Abstract Purpose of the study: The use of smartphone applications increases bystander CPR quality as well as the use of telephone CPR protocols. The present prospective, randomized, controlled manikin trial analyses the effects of a smartphone application (PocketCPR©) on CPR quality in a bystander CPR scenario compared to a dispatcher-assisted telephone CPR with the additional use of a metronome and verbal motivation.Methods: 150 laypersons were included to perform 8-minute CPR on a manikin. Vo...
Source: Prehospital Emergency Care - April 19, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

A Framework for EMS Outreach for Drug Overdose Survivors: A Case Report of the Houston Emergency Opioid Engagement System.
Authors: Langabeer JR, Persse D, Yatsco A, O'Neal MM, Champagne-Langabeer T Abstract Fatalities from drug-induced overdoses in the United States have taken greater than 292,000 lives in the last five years, and nearly two-thirds of these are opioid-related. The burden on prehospital emergency medical services (EMS) to respond to these incidents is growing. The standard of care typically involves overdose reversal and rapid transport, although a few agencies have begun to use community paramedicine to more proactively follow-up, initiate treatment, and refer patients to addiction medicine providers. In this manuscri...
Source: Prehospital Emergency Care - April 16, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Systematic Review of Evidence-Based Guidelines for Prehospital Care.
Conclusions: EBGs exist addressing a variety of topics in EMS medicine. This systematic review and appraisal of EMS guidelines identified a wide range in the quality of these guidelines and variable reporting of key elements of clinical guidelines. Future guideline developers should consider established methodological and reporting recommendations to improve the quality of EMS guidelines. PMID: 32286899 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 16, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital Protocols for Post-Return of Spontaneous Circulation are Highly Variable.
CONCLUSION: Prehospital treatment and transport protocols for post-ROSC care are highly variable across the United States. PMID: 32286900 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 16, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Time to return of spontaneous circulation and survival: when to transport in out-of-hospital cardiac arrest?
Authors: de Graaf C, Donders DNV, Beesems SG, Henriques JPS, Koster RW Abstract Background: In out-of-hospital cardiac arrest (OHCA), 10-50% of patients have return of spontaneous circulation (ROSC) before hospital arrival. It is important to investigate the relation between time-to-ROSC and survival to determine the optimal timing of transport to the hospital in patients without ROSC.Methods: We analyzed data of OHCA patients with a presumed cardiac cause (excluding traumatic and other obvious non-cardiac causes) and ROSC before hospital arrival from the Amsterdam Resuscitation Study (ARREST) database. ROSC includ...
Source: Prehospital Emergency Care - April 16, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Obesity May Require a Higher Level of Trauma Care: A Propensity-Matched Nationwide Cohort Study.
Authors: Fu CY, Bajani F, Bokhari M, Butler C, Starr F, Messer T, Kaminsky M, Tatebe LC, Dennis A, Schlanser V, Poulakidas S, Cheng CT, Toor R, Mis J, Bokhari F Abstract Objective- Stable patients with less severe injuries are not necessarily triaged to high-level trauma centers according to current guidelines. Obese patients are prone to comorbidities and complications. We hypothesized that stable obese patients with low-energy trauma have lower mortality and fewer complications if treated at Level-I/II trauma centers.Methods- Blunt abdominal trauma (BAT) patients with systolic blood pressures ≥90mmHg, Glasgow ...
Source: Prehospital Emergency Care - April 16, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Comparison of Volunteer and Paid EMS Professionals in the United States.
Conclusion: Approximately 13% of the EMS workforce held a primary job in EMS as a volunteer, and these volunteer EMS professionals differed from their paid counterparts - e.g., volunteers were more likely to be women, have EMT certification, and work in rural areas. We encourage further research to understand motivations for volunteering in EMS. PMID: 32271639 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 11, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

A Four-Year-Old with History of Kawasaki Disease Presenting in Acute Shock.
We present a case in which emergency medical services (EMS) intervened on a critically ill child with known giant coronary aneurysms as sequela to her severe complicated Kawasaki disease. This patient's severe shock ultimately ended in cardiac arrest and death. We discuss the keys to recognition, and critical importance to early intervention of pediatric shock in prehospital care. We also detail the cardiac ramifications of Kawasaki disease, steps for prompt identification of high risk complaints in these patients, and opportunities for treatment. PMID: 32250719 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 8, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Development and Validation of Content Domains for Paramedic Prehospital Performance Assessment: A Focus Group and Delphi Method Approach.
CONCLUSION: The content domains identified in this study provide EMS educators a theoretical framework for designing the performance assessment of newly trained professionals in the prehospital setting. PMID: 32243208 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - April 5, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Buprenorphine Field Initiation of ReScue Treatment by Emergency Medical Services (Bupe FIRST EMS): A Case Series.
We present a case series to illustrate a new treatment paradigm utilizing front line EMS Paramedic units and high dose buprenorphine to treat withdrawal symptoms with next day bridge to long term care. The three patients described are exemplary cases, meant to represent overall characteristics of the intervention prior to complete data collection. Each patient was revived from opioid overdose with naloxone. Paramedics then treated each patient with 16 mg of buprenorphine to relieve and prevent withdrawal symptoms. Patients were provided with outpatient follow up irrespective of ED transport. To the best of our knowl...
Source: Prehospital Emergency Care - March 29, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Tension Hemopneumothorax in the Setting of Mechanical CPR during Prehospital Cardiac Arrest.
Authors: Rowland D, Vryhof N, Overton D, Mastenbrook J PMID: 32208039 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 27, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Control of severe, life-threatening external bleeding in the out-of-hospital setting: a systematic review.
Conclusion: Overall, data regarding the control of life-threatening bleeding is of very low certainty, making it difficult to draw robust conclusions for treatment by immediate responders. While more robust data is needed on first aid treatments of life-threatening bleeding, this systematic review aggregates the most comprehensive to date to help guide recommendations. PMID: 32208060 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 27, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Opportunities for emergency medical services intervention to prevent opioid overdose mortality.
We examined Emergency Medical Services (EMS) utilization among a cohort of individuals who died from opioid overdose in order to identify potential opportunities for intervention. Methods: Individuals who died of unintentional opioid overdose in a large North Carolina county between 01/01/2014 and 12/31/2016 were studied in a retrospective cohort. Death records obtained from North Carolina Vital Records were linked to EMS patient care records obtained from the county EMS System in order to describe the EMS encounters of each decedent in the year preceding their death. Patient demographics and EMS encounters were assessed t...
Source: Prehospital Emergency Care - March 17, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Position Paper on Degree Requirements for EMS Educators.
Authors: Leggio WJ, Rosenberger P, Perdziola S Abstract SummaryIt is the position of the National Association of EMS Educators (NAEMSE) Board of Directors that all EMS educators complete a degree from an accredited University or College. In this position, the academic level of the degree varies based on the role of the educator. In support of interprofessional approaches to EMS education and the broad nature of topics covered in curricula, the focus of a degree may vary. This position supports EMS educators having degrees specific to our profession, as well as in education, clinical sciences, related healthcare dis...
Source: Prehospital Emergency Care - March 7, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Demography of the National Emergency Medical Services Workforce: A Description of Those Providing Patient Care in the Prehospital Setting.
Conclusion: This is the most comprehensive study evaluating the demographics of the national EMS workforce of active patient care providers. Understanding the characteristics of EMS professionals and the settings they practice in is important for educational and training initiatives, as well as protocols and policies. PMID: 32119575 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 4, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Does Mechanism of Injury Predict Trauma Center Need for Children?
Authors: Lerner EB, Badawy M, Cushman JT, Drendel AL, Fumo N, Jones CM, Shah MN, Gourlay DM Abstract Objective: To determine if the Mechanism of Injury Criteria of the Field Triage Decision Scheme (FTDS) are accurate for identifying children who need the resources of a trauma center.Methods: EMS providers transporting any injured child ≤15 years, regardless of severity, to a pediatric trauma center in 3 midsized communities over 3 years were interviewed. Data collected through the interview included EMS observed physiologic condition, suspected anatomic injuries, and mechanism. Patients were then followed to det...
Source: Prehospital Emergency Care - March 4, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Prehospital vasopressor use is associated with worse mortality in combat wounded.
Conclusions: In this dataset, prehospital vasopressor use was associated with lower odds of survival. This finding persisted when adjusting for confounders and in a propensity matched cohort model. PMID: 32119580 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - March 4, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Emergency Medical Services (EMS) 2050: A Vision for the Future of Pediatric Prehospital Care.
Authors: Gausche-Hill M, Krug S, Wright J PMID: 32091291 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 26, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Regionalization Patterns for Children with Serious Trauma in California (2005-2015): A Retrospective Cohort Study.
Authors: Wang NE, Ewbank C, Newton CR, Spain DA, Pirrotta E, Thomas-Uribe M Abstract Objective: Trauma centers provide coordinated specialty care and have been demonstrated to save lives. Many states do not have a comprehensive statewide trauma system. Variable geography, resources, and population distributions present significant challenges to establishing an effective uniform system for pediatric trauma care. We aimed to identify patterns of primary (field) triage and transfer of serious pediatric trauma throughout California. We hypothesized that pediatric primary triage to trauma center care would be positively...
Source: Prehospital Emergency Care - February 26, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Evaluation of CPR quality via smartphone with a video livestream - a study in a metropolitan area.
Authors: Ecker H, Wingen S, Hamacher S, Lindacher F, Böttiger BW, Wetsch WA Abstract BackgroundTelephone-assisted cardiopulmonary resuscitation (CPR) is an effective and proven tool to improve patient survival and outcome after cardiac arrest, and is therefore recommended in international resuscitation guidelines. A new technology that provides the emergency medical services (EMS) dispatcher with a video livestream from a smartphone during telephone-assisted CPR was investigated to assess whether a correct judgment of CPR quality is feasible.Material and MethodsAfter Ethics Committee approval, we conducted thi...
Source: Prehospital Emergency Care - February 26, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Survival and Rearrest in Out-of-hospital Cardiac Arrest Patients with Prehospital Return of Spontaneous Circulation: A Prospective Multi-regional Observational Study.
Conclusions: A longer interval from collapse to first prehospital ROSC was associated with rearrest, and an initial shockable rhythm was associated with survival despite the occurrence of rearrest. Emergency medical service providers and physicians should be prepared to deal with rearrest when pulses are obtained late in the resuscitation. PMID: 32091295 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 26, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Degree of Bystander-Patient Relationship and Prehospital Care for Opioid Overdose.
ConclusionPresence of a proximal bystander during an overdose event is associated with dispatch codes indicative of an overdose and shorter times to naloxone administration compared with those with distal bystanders. These findings offer opportunities for public education and engagement of overdose harm reduction strategies. PMID: 32073921 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 21, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Head-neck motion in prehospital trauma patients under spinal motion restriction: a pilot study.
Conclusion Among actual patients, movement appears to be greater than previously recorded in simulation studies, and to be associated with patient behavior. Miniature IMUs are a feasible approach to field-based measurement of H-N kinematics in trauma patients. Future research should evaluate the effects of patient compliance, treatment and phase of care using larger samples. PMID: 32045315 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)
Source: Prehospital Emergency Care - February 12, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research