Prehospital Emergency Care最新文献

{"title":"Pharmacokinetics of tranexamic acid (TXA) delivered by expeditious routes in a swine model of polytrauma and hemorrhagic shock","authors":"Mallori Wilson, Sean Stuart, Brittany Lassiter, Timothy Parker Jr., Clyde Martin III, Robert Healy, Christopher Treager, Eric Sulava, Lorie Gower, Pravina Fernandez, Emily Friedrich","doi":"10.1080/10903127.2024.2342025","DOIUrl":"https://doi.org/10.1080/10903127.2024.2342025","url":null,"abstract":"Hemorrhage is the leading cause of preventable death in civilian trauma centers and on the battlefield. One of the emerging treatment options for hemorrhage in austere environments is tranexamic ac...","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":"98 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140612546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response to Dr. Golcuk RE: Delta Shock Index: Enhancing Prehospital Assessment of GI Bleeding","authors":"Joshua Lowe","doi":"10.1080/10903127.2024.2343396","DOIUrl":"https://doi.org/10.1080/10903127.2024.2343396","url":null,"abstract":"Published in Prehospital Emergency Care (Just accepted, 2024)","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":"50 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dispatch Categories as Indicators of Out-of-Hospital Time Critical Interventions and Associated Emergency Department Outcomes","authors":"Matthew J. Levy, Remle P. Crowe, Heidi Abraham, Anna Bailey, Matt Blue, Reinhard Ekl, Eric Garfinkel, Joshua B. Holloman, Jeff Hutchens, Ryan Jacobsen, Colin Johnson, Asa Margolis, Ruben Troncoso, Jefferson G. Williams, J. Brent Myers","doi":"10.1080/10903127.2024.2342015","DOIUrl":"https://doi.org/10.1080/10903127.2024.2342015","url":null,"abstract":"Emergency medical services (EMS) systems increasingly grapple with rising call volumes and workforce shortages, forcing systems to decide which responses may be delayed. Limited research has linked...","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":"92 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and adverse events during primary care paramedic interfacility transfer of stable STEMI patients","authors":"Michael Feldman, Fahad Bahaidarah, Mahbod Rahimi, Sara Howaidi, Linda Turner, P. Richard Verbeek, Warren Cantor, Sheldon Cheskes, Ian Drennan, Kristen Gilmartin","doi":"10.1080/10903127.2024.2342569","DOIUrl":"https://doi.org/10.1080/10903127.2024.2342569","url":null,"abstract":"Current guidelines recommend that patients presenting with ST-elevation myocardial infarction (STEMI) to hospitals not capable of performing primary percutaneous coronary intervention (PCI) be tran...","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":"33 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measures of Patient Acuity Among Children Encountered by Emergency Medical Services by the Child Opportunity Index.","authors":"Sriram Ramgopal, Remle P Crowe, Lindsay Jaeger, Jennifer Fishe, Michelle L Macy, Christian Martin-Gill","doi":"10.1080/10903127.2024.2333493","DOIUrl":"10.1080/10903127.2024.2333493","url":null,"abstract":"<p><p><b>Background:</b> Children have differing utilization of emergency medical services (EMS) by socioeconomic status. We evaluated differences in prehospital care among children by the Child Opportunity Index (COI), the agreement between a child's COI at the scene and at home, and in-hospital outcomes for children by COI. <b>Methods:</b> We performed a retrospective study of pediatric (<18 years) scene encounters from approximately 2,000 United States EMS agencies from the 2021-2022 ESO Data Collaborative. We evaluated socioeconomic status using the multi-dimensional COI v2.0 at the scene. We described EMS interventions and in-hospital outcomes by COI categories using ordinal regression. We evaluated the agreement between the home and scene COI. <b>Results:</b> Data were available for 99.8% of pediatric scene runs, with 936,940 included EMS responses. Children from lower COI areas more frequently had a response occurring at home (62.9% in Very Low COI areas; 47.1% in Very High COI areas). Children from higher COI areas were more frequently not transported to the hospital (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.86-0.87). Children in lower COI areas had lower use of physical (OR 1.23, 95% CI 1.13-1.33) and chemical (OR 1.41, 95% CI 1.29-1.55) restraints for behavioral health problems. Among injured children with elevated pain scores (≥7), analgesia was provided more frequently to children in higher COI areas (OR 1.73, 95% CI 1.65-1.81). The proportion of children in cardiac arrest was lowest from higher COI areas. Among 107,114 encounters with in-hospital data, the odds of hospitalization was higher among children from higher COI areas (OR 1.14, 95% CI 1.11-1.18) and was lower for in-hospital mortality (OR 0.75, 95% CI 0.65-0.85). Home and scene COI had a strong agreement (Kendall's <i>W</i> = 0.81). <b>Conclusion:</b> Patterns of EMS utilization among children with prehospital emergencies differ by COI. Some measures, such as for in-hospital mortality, occurred more frequently among children transported from Very Low COI areas, whereas others, such as admission, occurred more frequently among children from Very High COI areas. These findings have implications in EMS planning and in alternative out-of-hospital care models, including in regional placement of ambulance stations.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-9"},"PeriodicalIF":2.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Medical Service attendances for adults with repeat falls in Western Australia: A state-wide retrospective cohort study","authors":"Paige M Watkins, Peter Buzzacott, Hideo Tohira, David Majewski, Anne-Marie Hill, Deon Brink, Rudi Brits, Judith Finn","doi":"10.1080/10903127.2024.2338915","DOIUrl":"https://doi.org/10.1080/10903127.2024.2338915","url":null,"abstract":"Objectives: The risk of falls increases with age and often requires an emergency medical service (EMS) response. We compared the characteristics of patients attended by EMS in response to repeat fa...","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":"38 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delta Shock Index: Enhancing Prehospital Assessment of GI Bleeding","authors":"Yalcin Golcuk","doi":"10.1080/10903127.2024.2341413","DOIUrl":"https://doi.org/10.1080/10903127.2024.2341413","url":null,"abstract":"Published in Prehospital Emergency Care (Just accepted, 2024)","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":"2014 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Patient Weight on Prehospital Advanced Airway Procedure Success Rates","authors":"Michael W. Hubble, Melisa Martin, Sara Houston, Stephen Taylor, Ginny R. Kaplan","doi":"10.1080/10903127.2024.2338459","DOIUrl":"https://doi.org/10.1080/10903127.2024.2338459","url":null,"abstract":"Objective: Previous investigations of the relationship between obesity and difficult airway management have provided mixed results. Almost universally, these studies were conducted in the hospital ...","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":"358 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Out-of-Hospital Cardiac Arrest Outcomes Among Five Racial/Ethnic Groups","authors":"Kenton L. Anderson, Monica R. Saxena, Loretta W. Matheson, Marc Gautreau, John F. Brown, Leo Ishoda, Michael A. Kohn","doi":"10.1080/10903127.2024.2335639","DOIUrl":"https://doi.org/10.1080/10903127.2024.2335639","url":null,"abstract":"Introduction: Out-of-hospital cardiac arrest (OHCA) is a major health problem and one of the leading causes of death in adults over the age of forty. Multiple prior studies have demonstrated surviv...","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":"50 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the Medical Priority Dispatch System® in Identifying Patients Requiring Chest Compressions at Overdose Prevention Services: A Retrospective Cohort Study.","authors":"Richard Armour, Brian Grunau, Sammy Iammarino, Jane Buxton, Brooke Kinniburgh, Heather Burgess, Kali-Olt Sedgemore, Paul Choisil, Suzanne Nielsen, Linda Ross","doi":"10.1080/10903127.2024.2319150","DOIUrl":"10.1080/10903127.2024.2319150","url":null,"abstract":"<p><strong>Background and aims: </strong>The Medical Priority Dispatch System (MPDS)® is used to triage 9-1-1 calls according to acuity, with certain coding receiving telecommunicator cardiopulmonary resuscitation (T-CPR) for suspected out-of-hospital cardiac arrest (OHCA). However, this may be challenging for those with drug poisoning emergencies, who may resemble OHCA. We sought to examine the performance of the system to correctly identify cases requiring T-CPR, specifically at overdose prevention services (OPS).</p><p><strong>Methods: </strong>This retrospective cohort study included patients attended by the provincial emergency medical system (EMS) (May 1, 2019-January 31, 2023). We calculated the diagnostic performance of MPDS® assessment of whether the case required T-CPR instructions against the gold standard of whether the patient was found pulseless on EMS clinician arrival. We compared performance among subgroups, specifically OPS vs other locations and drug poisoning-classified cases vs other case classifications.</p><p><strong>Results: </strong>Comparing OPS to other locations, the sensitivity of MPDS^® was similar (66.7% vs 62.4%, <i>p</i> = 0.4), with lower specificity (87.3% vs 98.1%, <i>p</i> < 0.01) and positive predictive value (0.3% vs 35.7%, <i>p</i> < 0.01) and higher negative predictive value (99.9% vs 99.4%, <i>p</i> < 0.01). The negative likelihood ratio of MPDS^® was 0.381 at OPS locations, compared with 0.383 at other locations, while the positive likelihood ratio was 5.24, compared with 32.36. In patients with drug poisoning emergencies, compared with other 9-1-1 events, MPDS^® had higher sensitivity (83.6% vs 60.6%, <i>p</i> < 0.01) but lower specificity (77.6% vs 98.9%, <i>p</i> < 0.01) and positive predictive value (10.5% vs 48.5%, <i>p</i> < 0.01), and similar negative predictive value (99.33% vs 99.35%, <i>p</i> = 0.03). The negative likelihood ratio of MPDS® was 0.212 in drug poisoning emergencies compared with 0.398 for all other presentations, and the positive likelihood ratio was 3.73 compared with 57.88.</p><p><strong>Discussion and conclusions: </strong>The ability of MPDS^® to correctly identify patients needing telecommunicator cardiopulmonary resuscitation instructions differed between OPS settings and other locations, frequently recommending T-CPR for patients not suffering OHCA at an OPS. Different strategies developed in collaboration with people who use substances are required to better tailor dispatch instructions prior to EMS arrival to avoid delays in life-saving interventions.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-8"},"PeriodicalIF":2.4,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}