Queensland Ambulance Service

About: Queensland Ambulance Service is a based out in . It is known for research contribution in the topics: Emergency medical services & Emergency department. The organization has 67 authors who have published 109 publications receiving 1244 citations.

Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury: The POLAR Randomized Clinical Trial.

Abstract: Importance After severe traumatic brain injury, induction of prophylactic hypothermia has been suggested to be neuroprotective and improve long-term neurologic outcomes. Objective To determine the effectiveness of early prophylactic hypothermia compared with normothermic management of patients after severe traumatic brain injury. Design, Setting, and Participants The Prophylactic Hypothermia Trial to Lessen Traumatic Brain Injury–Randomized Clinical Trial (POLAR-RCT) was a multicenter randomized trial in 6 countries that recruited 511 patients both out-of-hospital and in emergency departments after severe traumatic brain injury. The first patient was enrolled on December 5, 2010, and the last on November 10, 2017. The final date of follow-up was May 15, 2018. Interventions There were 266 patients randomized to the prophylactic hypothermia group and 245 to normothermic management. Prophylactic hypothermia targeted the early induction of hypothermia (33°C-35°C) for at least 72 hours and up to 7 days if intracranial pressures were elevated, followed by gradual rewarming. Normothermia targeted 37°C, using surface-cooling wraps when required. Temperature was managed in both groups for 7 days. All other care was at the discretion of the treating physician. Main Outcomes and Measures The primary outcome was favorable neurologic outcomes or independent living (Glasgow Outcome Scale–Extended score, 5-8 [scale range, 1-8]) obtained by blinded assessors 6 months after injury. Results Among 511 patients who were randomized, 500 provided ongoing consent (mean age, 34.5 years [SD, 13.4]; 402 men [80.2%]) and 466 completed the primary outcome evaluation. Hypothermia was initiated rapidly after injury (median, 1.8 hours [IQR, 1.0-2.7 hours]) and rewarming occurred slowly (median, 22.5 hours [IQR, 16-27 hours]). Favorable outcomes (Glasgow Outcome Scale–Extended score, 5-8) at 6 months occurred in 117 patients (48.8%) in the hypothermia group and 111 (49.1%) in the normothermia group (risk difference, 0.4% [95% CI, –9.4% to 8.7%]; relative risk with hypothermia, 0.99 [95% CI, 0.82-1.19]; P = .94). In the hypothermia and normothermia groups, the rates of pneumonia were 55.0% vs 51.3%, respectively, and rates of increased intracranial bleeding were 18.1% vs 15.4%, respectively. Conclusions and Relevance Among patients with severe traumatic brain injury, early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic hypothermia for patients with severe traumatic brain injury. Trial Registration clinicaltrials.gov Identifier:NCT00987688; Anzctr.org.au Identifier:ACTRN12609000764235

Factors influencing Queenslanders’ willingness to perform bystander cardiopulmonary resuscitation

Abstract: Study objective: The chances of surviving an out-of-hospital cardiac arrest (OHCA) are greatly increased if a bystander provides cardiopulmonary resuscitation (CPR) while awaiting the arrival of the emergency medical services. Over 50% of adult Queenslanders have been trained in CPR at some time in the past, however, little is known about the factors that affect their willingness to perform CPR. ----------------Method: A random survey of 4480 Queensland residents was conducted to address this question. ----------------Results: The survey indicated that the most common barriers to performing CPR were a fear of disease, visible blood and perceived danger. In contrast, respondents indicated that they were more likely to administer CPR if the respondent knew the victim, the victim would die if CPR was not administered, and respondents believed that they possessed the necessary skills to perform CPR. A majority (84%) of respondents indicated that they were at least likely to administer CPR. A logistic regression analysis revealed that the respondents most likely to perform CPR were males, those who were married or in a de facto relationship, those in paid employment, smokers, those recently trained in CPR, prospective organ donors, those who cited no barriers to CPR and those who cited one or more factors that would facilitate CPR. ----------------Conclusions: This study indicates that there is considerable variation in Queenslanders’ willingness to perform bystander CPR. Public health education campaigns aimed at correcting inaccurate perceptions of risk and addressing other barriers to bystander CPR would promote its use in response to OHCA.

Do biometeorological indices improve modeling outcomes of heat-related mortality?

Abstract: Various biometeorological indices and temperature measures have been used to assess heat-related health risks. Composite indices are expected to assess human comfort more accurately than do temperature measures alone. The performances of several common biometeorological indices and temperature measures in evaluating the heat-related mortality in Brisbane, Australia—a city with a subtropical climate—were compared. Daily counts of deaths from organic causes [International Statistical Classification of Diseases and Related Health Problems, 9th Revision, (ICD9) codes 001–799 and ICD, 10th Revision, (ICD10) codes A00–R99] during the period from 1 January 1996 to 30 November 2004 were used. Several composite biometeorological indices were considered, such as apparent temperature, relative strain index, Thom discomfort index, the humidex, and wet-bulb globe temperature. Hot days were defined as those days falling into the 95th percentile of each thermal stress indicator. Case-crossover analysis was applied to estimate the relationship between exposure to heat and mortality. The performances of various biometeorological indices and temperature measures were compared using the jackknife resampling method. The results show that more deaths were likely to occur on hot days than on other (i.e., control) days regardless of the temperature measure or biometeorological index that is considered. The magnitude of the odds ratios varied with temperature indicators, between 1.08 [95% confidence interval (CI): 1.02–1.14] and 1.41 (95% CI: 1.22–1.64) after adjusting for air pollutants (particulate matter with aerodynamic diameter less than 10 μm and ozone). Average temperature performed similarly to the composite indices, but minimum and maximum temperatures performed relatively poorer. Thus, average temperature may be suitable for the development of weather–health warning systems if the findings presented herein are confirmed in different locations.