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Current applications and limitations of European guidelines on blood pressure measurement: implications for clinical practice
AbstractHypertension is the most common cardiovascular (CV) risk factor, strongly and independently associated with an increased risk of major CV outcomes, including myocardial infarction, stroke, congestive heart failure, renal disease and death due to CV causes. Effective control of hypertension is of key importance for reducing the risk of hypertension-related CV complications, as well as for reducing the global burden of CV mortality. However, several studies reported relatively poor rates of control of high blood pressure (BP) in a setting of real-life practice. To improve hypertension management and control, national...
Source: Internal and Emergency Medicine - March 31, 2022 Category: Emergency Medicine Source Type: research

Healthcare in transition in the Republic of Armenia: the evolution of emergency medical systems and directions forward
AbstractArmenia, an ex-Soviet Republic in transition since independence in 1991, has made remarkable strides in development. The crisis of prioritization that has plagued many post-Soviet republics in transition has meant differential growth in varied sectors in Armenia. Emergency systems is one of the sectors which is neglected in the current drive to modernize. The legacy of the Soviet Semashko system has left a void in specialized care including emergency care. This manuscript is a descriptive overview of the current state of emergency care in Armenia using in-depth key informant interviews and review of published and u...
Source: International Journal of Emergency Medicine - January 12, 2021 Category: Emergency Medicine Source Type: research

Approaches in Prehospital Sepsis Screening
Discussion In the United States, sepsis is one of the leading causes of death, which requires timely identification and proper treatment (CDC, 2019; Guerra et al., 2020; Polito et al., 2015). Based upon a review of literature conducted from 2014 to 2018, the primary investigators could locate five prehospital EMS screening tools to assist EMS providers in identifying at-risk sepsis patients. The researchers explored how the modified SIRS and qSOFA scoring systems were used in hospital settings in addition to these five prehospital EMS screening tools. The Bas 90-30-90, Guerra, PRESEP, PRESS, and Robson tools have ove...
Source: JEMS Operations - January 5, 2021 Category: Emergency Medicine Authors: JEMS Staff Tags: Exclusives Patient Care EMS EMT Paramedic Prehospital Sepsis Source Type: news

Clinical Performance Measures that Matter —Are You Ready?
Conclusion The future will belong to those who can prove value. The use of a clinical performance dashboard and comparisons to national data will help to ensure that when the payers come knocking on our doors looking for "proof" that what we do enhances patient care and improves patient outcome, we’ll have an answer! This is the first in a yearlong series of articles developed by the Academy of International Mobile Healthcare Integration (AIMHI).The AIMHI article series is developed in partnership with JEMS to help educate EMS agencies on the hallmarks and attributes of high-performance/high-value EMS system de...
Source: JEMS Special Topics - December 11, 2018 Category: Emergency Medicine Authors: Wayne C. Harbour, NRP Tags: Exclusive Articles Operations Administration and Leadership Source Type: news

ECG Educational Standards for Prehospital Providers
Conclusion As the role of evidence-based medicine becomes more prominent in the field of emergency medicine, a clear view of the current state of ECG education and platform from which to implement uniform standards becomes increasingly essential; especially as research expands into the prehospital setting. Further research into EMS education may identify both strengths and weaknesses in basic ECG interpretation appropriate for first responders. Implementing minimum ECG interpretation standards for EMS personnel nationwide is one potential option to ensure prehospital educational institutions stay responsive to current scie...
Source: JEMS Special Topics - November 27, 2018 Category: Emergency Medicine Authors: Jonathan Barney, BA, EMT, MS3 Tags: Training Exclusive Articles Cardiac & Resuscitation Source Type: news

Stroke Triage: EMS needs a diagnostic tool that goes beyond a simple history & physical exam
As a young EMT and paramedic, I had relatively little education about acute myocardial infarctions. In the age of the 3-lead ECG, education was largely focused on arrhythmia detection and how to differentiate heart blocks, tachycardia and bradycardia. Detection of heart attack was largely based upon history and physical exam findings. Three decades later, the thought of relying on a physical exam to diagnose a ST- elevation myocardial infarction (STEMI) is hard to imagine. Although we’ve made remarkable progress in the prehospital detection of STEMI, we’ve made significantly less progress in the diagnosis of acute stro...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Mark E.A. Escott, MD, MPH, FACEP, NRP Tags: Patient Care Columns Source Type: news