Showing papers in "Prehospital Emergency Care in 2019"

TL;DR: It is found that EMTs had a significantly higher Mortality Odds Ratio due to suicide compared to non-EMTs, and further research is necessary to identify the underlying causes of suicide among EMTS and to develop effective prevention strategies.

TL;DR: The MGAP scoring system demonstrated higher sensitivity and specificity for mortality but was not superior to the RTS for predicting anatomical injury severity, complementing a growing body of evidence that suggests that MGAP may be a superior and more easily calculable prehospital scoring system for the prediction of mortality in trauma patients.

TL;DR: The role of ultrasonography in measuring the optic nerve sheath diameter (ONSD) in the prehospital setting to evaluate the risk of intracranial hypertension after traumatic brain injury and the authors stated that the “ONSD measurement is easy-to-learn”.

TL;DR: CP@clinic showed a significant decrease in EMS calls, decrease in BP, and improvement in QALYs among older adults in subsidizing public housing, suggesting this simple program should be replicated in other communities with public housing.

TL;DR: The RACE scale demonstrated acceptable discrimination, yet the sensitivity and positive predictive value were lower in this cohort of EMS professionals in the United States than in the original validation study conducted in Spain.

TL;DR: Bystander training in these settings is feasible and may have an important impact on meaningful outcomes such as mortality and the need for bystander training is highlighted.

TL;DR: Adding coordination and diplopia assessments to face, arm, and speech assessment does not improve stroke detection in the prehospital setting.

TL;DR: Most non-transported patients did not have subsequent health events and deaths after non-Transport are an infrequent event that could be selected for more detailed review of individual cases, to facilitate learning and improvement.

TL;DR: DSD was associated with lower odds of prehospital ROSC, and defibrillation type was not associated with other OHCA endpoints, suggesting DSD may not be beneficial in refractory VF/VT OHCA.

TL;DR: This pilot study is one of the first attempts to operationalize an expert panel’s criterion standard definitions of triage categories in a pediatric population in order to compare accuracy between different systems.

TL;DR: As initial analgesia, opioids are no different than ketamine, APAP, and NSAIDs in reducing acute pain in the prehospital setting, although indirectness, strength of evidence is generally low, and future research in thePrehospital setting is needed.

TL;DR: Use of POCUS by EMS physicians to detect cardiac activity in OHCA is feasible and correlates with expert interpretation, and several avoidable barriers were identified and should be considered in the future implementation of prehospital POC US.

TL;DR: After multivariate controls, older age patients presenting with low-risk, non-acute chest pain, shortness of breath, and dizziness were much more likely to use ambulance transport.

TL;DR: Comparing these different triage scores concluded with a superiority of the MGAP and NTS scores compared with the T-RTS, to reduce the risk of overtriage in the Level 1 trauma centers by further directing patients at low risk of death to a lower-level trauma facility.

TL;DR: A significant reduction in pain, significantly high proportion of ketamine responders, and the lack of clinically significant AEs characterizing patients receiving low-dose ketamine IV compared to fentanyl IV, all provide further support for its use as an effective prehospital analgesic.

TL;DR: Exposure to regular incivility was associated with increased odds of dissatisfaction with EMS, a main EMS job or a main supervisor; moderate or higher stress levels; intent to leave one’s job and EMS in the next 12 months; and 10 or more workplace absences in the past 12 months.

TL;DR: An evidence-based guideline and model protocol for administration of naloxone by EMS practitioners to persons with suspected opioid overdose is developed and disseminated and the intravenous route of administration is recommended.

TL;DR: Rates of prehospital administration of IM morphine remained relatively stable while those for OTFC and ketamine both rose, suggesting that TCCC guidelines recommending the use of these agents had a material impact on prehospital analgesia patterns.

TL;DR: This study shows that it is feasible to obtain high-quality ONSD measurements in the management of patients with TBI in a prehospital setting.

TL;DR: While MS events are high risk for responders, dispatch information was lacking in almost 15% of records and documented EMS tourniquet use was uncommon, emphasizing the need to ensure all EMS providers are prepared to respond to MS incidents.

TL;DR: No evidence is found to support the hypothesis that prehospital time longer than one hour resulted in an increased risk of 30-day mortality in major trauma patients transported to hospital by ambulance paramedics, but longer on-scene time was associated with longer hospital LOS (for 30- day survivors).

TL;DR: Ketamine use was correlated with a higher frequency of intubation and a greater need for additional chemical restraint when compared with other restraint modalities, though exogenous factors such as provider preference may have impacted this result.

TL;DR: Paramedics identified multiple potential solutions to overcome several barriers to protocol adherence and system improvements to address dose standardization, protocol clarity, simplified controlled substance logistics, and equipment availability.

TL;DR: EMS advanced airway placement has a time-dependent association with ROSC, and in witnessed OHCA patients receiving advanced airways, early airways placement is associated with increased probability of ROSC.

TL;DR: The study suggests that it is possible to alter the volume provided by the BVM by altering the grip on the B VM, and the volumes of the pediatric BVM were overall more consistent with lung-protective ventilation volumes when compared to all 3 finger-grips of the adult BVM.

TL;DR: Qualitative data about the difficulties of responding to pediatric calls and resources needed to support clinicians can be used to guide EMS leaders in designing and implementing institutional initiatives to enhance training and support for prehospital clinicians providing care to children.

TL;DR: Both the dry and wet decontamination processes were rapid and were effective in removing simulant from the hair and skin of volunteers, with no observable adverse effects related to skin surface spreading of contaminant.

TL;DR: Malay and Indian communities are found to be at higher risks of OHCA compared to Chinese, and additionally, the Malay community is at higher risk of subsequent mortality than the Chinese andIndian communities.

TL;DR: It is possible that implementation and appropriate use of EMS treat-and-release protocols along with utilizing programs to educate patients on hypoglycemia risk factors and emergency preparedness could partially reduce the burden of hypoglyCEmia to the healthcare system.

TL;DR: Univariable and multivariable analysis showed alcohol related diagnoses, history of alcohol abuse and lower triage scores were less likely to require admissions and two broad subgroups of patients were identified: younger patients with social issues and older patients with multiple medical conditions.