Showing papers in "Prehospital Emergency Care in 2018"

TL;DR: The purpose of this document is to present a paradigm for prehospital healthcare systems to minimize the risk of morbidity and mortality for EHS patients.

TL;DR: In this article, the authors analyze prehospital management of pain using NEMSIS data, and assess if variables such as patient age and/or race/ethnicity are associated with disparity in pain treatment.

TL;DR: The high estimated prevalence of burnout among EMS professionals represents a significant concern for the physical and mental well-being of this critical healthcare workforce and the strong association between burnout and variables that negatively impact the number of available EMS professionals signals an important workforce concern.

TL;DR: In this paper, a review and synthesis of existing literature on the impact of scheduled napping during work shifts on fatigue-related risk is presented. But, the authors did not consider the effect of sleep duration on sleep quality.

TL;DR: Telemedicine can improve stroke care in regional areas with minor experience in thrombolysis and further randomized controlled trials are needed to assess the benefits of telestroke systems, especially in terms of cost-effectiveness and quality of life outcomes.

TL;DR: The Fatigue in EMS Project was to create an evidence-based guideline for fatigue risk management tailored to EMS operations, and a guideline with 5 recommendations was developed.

TL;DR: Reviewed literature indicated that fatigue training improved safety and health outcomes in shift workers, and identified the optimal components of fatigue training programs to maximize the beneficial outcomes.

TL;DR: Pediatric subjects comprised over 1 in 13 casualties treated in the joint theaters with the majority injured by explosives, and vascular access and hypothermia prevention interventions were the most frequently performed procedures.

TL;DR: This updated consensus statement on spinal motion restriction in the trauma patient represents the collective positions of the ACS-COT, ACEP and NAEMSP and has further been formally endorsed by a number of national stakeholder organizations.

TL;DR: 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.

TL;DR: Although less frequent than blunt trauma, penetrating trauma is associated with significantly higher prehospital and ED mortality, and increased scene time and number of procedures was associated with greater mortality for both blunt and penetrating trauma.

TL;DR: A large proportion of mental health presentations receive little intervention by EMS, and could benefit from community-based services provided by mental health clinicians.

TL;DR: A CPSS score of 3 reliably identifies LVO in AIS patients, and EMS providers may be able to use the CPSS, a simple, widely adopted prehospital stroke assessment tool, with a cut-off score to screen for patients with suspected LVO.

TL;DR: The quality of existing evidence on the impact of shift duration on fatigue and fatigue-related risks is low or very low, and this systematic review suggests that for outcomes considered critical or important to EMS personnel, shifts <24 hours in duration are more favorable than shifts ≥24 hours.

TL;DR: Emergency Departments are overburdened with patients experiencing acute mental health crises and pre-hospital transport by Emergency Medical Services to community mental health and substance abuse treatment facilities could reduce ED utilization and costs.

TL;DR: One of every three U.S. EMS emergency responses involves older adults, and EMS personnel must be prepared to care for the older patient.

TL;DR: The use of the Pediatric emergency ruler resulted in a 90% reduction of medication errors and prevented all potentially life-threatening errors associated with epinephrine administration and there is an urgent need to increase the safety of emergency drug dosing in children during emergencies.

TL;DR: The current study reports no difference between the SIRS and the qSOFA scores for prehospital triage of septic patients to predict ICU admission, and an improved score for pre-hospital triaging is needed to predictICU admission of sepsis patients.

TL;DR: At this time, further evaluations must be done in the prehospital setting to determine the ease of use and true sensitivity and specificity of these scales in identifying LVOs.

TL;DR: An inverse association between prehospital EtCO2 and mortality in trauma patients is found and has implications for improving triage and assisting EMS in directing patients to an appropriate trauma center.

TL;DR: Four of 8 studies in shift workers showed that caffeine improved psychomotor vigilance, which is important for performance, and two studies demonstrate that caffeine can improvePsychomotor performance and vigilance, however, caffeine negatively affects sleep quality and sleep duration.

TL;DR: The Pan-Asia Trauma Outcomes Study (PATOS) network is expected to provide comparison of the trauma EMS systems and to benchmark best practice with participating communities to analyze the association between potential risks and outcomes of trauma.

TL;DR: No single time difference between IRH and ERH transportation optimizes triage for all patients, so Allowable IRH bypass time should be increased and acute ischemic stroke guidelines should incorporate the onset to EMS triage interval, IRH transportation time, and ERh transportation time.

TL;DR: During high-risk out-of-hospital care of pediatric patients, safety events are common, potentially severe, and largely preventable.

TL;DR: Paramedic performed prehospital lung ultrasound for patients with respiratory distress and remote interpretation by EMS physicians did not meet the predetermined thresholds to be considered “feasible” in a real-world environment with currently available technologies.

TL;DR: In this population, OHCA was frequently recognized and DA-CPR performed but was not associated with a significant improvement in survival, and temporal measures of dispatch performance were substantially below proposed national standards.

TL;DR: There is no direct evidence for best prehospital EBG implementation practices, and future research should consider comparing implementation methodologies in different prehospital settings, with a goal of defining detailed, reproducible best practices.

TL;DR: A very high RSI procedural success rate was observed across the study period, which supports the growing recognition that appropriately trained paramedics can perform RSI safely in the prehospital environment.

TL;DR: Limited evidence of the reliability and validity of 14 different survey instruments to assess the fatigue and/or sleepiness status of EMS personnel and related shift worker groups was identified.

TL;DR: Spinal motion restriction controlled cervical motion at least as well as traditional spinal immobilization in a simulated prehospital ground transport setting, and SMR is supported as an alternative to TSI.