Prehospital and Disaster Medicine最新文献

{"title":"Bleeding Control Protections Within US Good Samaritan Laws - CORRIGENDUM.","authors":"Matthew J Levy, Christopher M Wend, William P Flemming, Antoin Lazieh, Andrew J Rosenblum, Candace M Pineda, Douglas M Wolfberg, Jennifer Lee Jenkins, Craig A Goolsby, Asa M Margolis","doi":"10.1017/S1049023X24000499","DOIUrl":"10.1017/S1049023X24000499","url":null,"abstract":"","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"39 3","pages":"280"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Vital Sign Thresholds Associated with 24-Hour Mortality among Trauma Patients: A Trauma Quality Improvement Program (TQIP) Study - CORRIGENDUM.","authors":"Michael D April, Andrew D Fisher, Julie A Rizzo, Franklin L Wright, Julie M Winkle, Steven G Schauer","doi":"10.1017/S1049023X24000384","DOIUrl":"10.1017/S1049023X24000384","url":null,"abstract":"","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"279"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulance Transports from NCAA Division 1 Football Games.","authors":"Aditya C Shekhar, Abel Alexander, Michael Simms, Mehek Jahan, Anna Haugen, Michelle Lu, Robert Ball, Jeffrey Clement","doi":"10.1017/S1049023X24000402","DOIUrl":"10.1017/S1049023X24000402","url":null,"abstract":"<p><strong>Introduction: </strong>There is significant public health interest towards providing medical care at mass-gathering events. Furthermore, mass gatherings have the potential to have a detrimental impact on the availability of already-limited municipal Emergency Medical Services (EMS) resources. This study presents a cross-sectional descriptive analysis to report broad trends regarding patients who were transported from National Collegiate Athletic Association (NCAA) Division 1 collegiate football games at a major public university in order to better inform emergency preparedness and resource planning for mass gatherings.</p><p><strong>Methods: </strong>Patient care reports (PCRs) from ambulance transports originating from varsity collegiate football games at the University of Minnesota across six years were examined. Pertinent information was abstracted from each PCR.</p><p><strong>Results: </strong>Across the six years of data, there were a total of 73 patient transports originating from NCAA collegiate football games: 45.2% (n = 33) were male, and the median age was 22 years. Alcohol-related chief complaints were involved in 50.7% (n = 37) of transports. In total, 31.5% of patients had an initial Glasgow Coma Scale (GCS) of less than 15. The majority (65.8%; n = 48; 0.11 per 10,000 attendees) were transported by Basic Life Support (BLS) ambulances. The remaining patients (34.2%; n = 25; 0.06 per 10,000 attendees) were transported by Advanced Life Support (ALS) ambulances and were more likely to be older, have abnormal vital signs, and have a lower GCS.</p><p><strong>Conclusions: </strong>This analysis of ambulance transports from NCAA Division 1 collegiate football games emphasizes the prevalence of alcohol-related chief complaints, but also underscores the likelihood of more life-threatening conditions at mass gatherings. These results and additional research will help inform emergency preparedness at mass-gathering events.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"266-269"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Disaster and Dignitary Medicine Principles into a Medical Framework for Organizational Travel Health and Security Planning.","authors":"Derrick Tin, Fredrik Granholm, Michael Guirguis, Mobarak Almulhim, Gregory Ciottone","doi":"10.1017/S1049023X2400044X","DOIUrl":"10.1017/S1049023X2400044X","url":null,"abstract":"<p><p>This Editorial explores organizational travel risk management and advocates for a comprehensive approach to fortify health security for travelers, emphasizing proactive risk management, robust assessments, and strategic planning. Leveraging insights from very important persons (VIP) protocols, organizations can enhance duty of care and ensure personnel safety amidst global travel complexities.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"233-235"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Collegiate Football Games on Emergency Response Intervals: A Case Study of College Station, Texas (USA).","authors":"Christine Crudo Blackburn, Mayra Rico","doi":"10.1017/S1049023X24000487","DOIUrl":"10.1017/S1049023X24000487","url":null,"abstract":"<p><strong>Objectives: </strong>Little is known about how mass gatherings affect emergency response intervals. Previous research suggests that college football games increase ambulance transport intervals, but their impact on emergency response intervals is unexplored. This study examines how collegiate home football games in College Station, Texas (USA) affect emergency vehicle response intervals.</p><p><strong>Methods: </strong>The study determined the impact of collegiate football games on emergency response intervals using incident data provided by the College Station Fire Department (CSFD). Home games during the 2021-2023 Texas A&M University (TAMU) football seasons were the period of interest. Responses for a 72-hour period (Friday-Sunday) on home game weekends (HGWs) and non-home game weekends (NHGWs) were included (n = 5,095).</p><p><strong>Results: </strong>Response intervals on football HGWs were an average of 30 seconds faster than on NHGWs. Emergency vehicles were 16.5% less likely to respond from fire station locations on HGWs compared to NHGWs. There was also a 12.1% increase in the number of calls to campus locations and a 9.7% increase in calls to the local entertainment district on HGWs compared to NHGWs.</p><p><strong>Conclusions: </strong>Home collegiate football games do not delay response intervals for emergency response vehicles. Further research is needed to determine if these findings can be reproduced in other communities.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"39 3","pages":"270-274"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Randomized Controlled Trial of Augmented Reality Just-in-Time Guidance for the Performance of Rugged Field Procedures.","authors":"Laurel O'Connor, Sepahrad Zamani, Xinyi Ding, Nicolette McGeorge, Susan Latiff, Cindy Liu, Jorge Acevedo Herman, Matthew LoConte, Andrew Milsten, Michael Weiner, Timothy Boardman, Martin Reznek, Michael Hall, John P Broach","doi":"10.1017/S1049023X24000372","DOIUrl":"10.1017/S1049023X24000372","url":null,"abstract":"<p><strong>Introduction: </strong>Medical resuscitations in rugged prehospital settings require emergency personnel to perform high-risk procedures in low-resource conditions. Just-in-Time Guidance (JITG) utilizing augmented reality (AR) guidance may be a solution. There is little literature on the utility of AR-mediated JITG tools for facilitating the performance of emergent field care.</p><p><strong>Study objective: </strong>The objective of this study was to investigate the feasibility and efficacy of a novel AR-mediated JITG tool for emergency field procedures.</p><p><strong>Methods: </strong>Emergency medical technician-basic (EMT-B) and paramedic cohorts were randomized to either video training (control) or JITG-AR guidance (intervention) groups for performing bag-valve-mask (BVM) ventilation, intraosseous (IO) line placement, and needle-decompression (Needle-d) in a medium-fidelity simulation environment. For the interventional condition, subjects used an AR technology platform to perform the tasks. The primary outcome was participant task performance; the secondary outcomes were participant-reported acceptability. Participant task score, task time, and acceptability ratings were reported descriptively and compared between the control and intervention groups using chi-square analysis for binary variables and unpaired t-testing for continuous variables.</p><p><strong>Results: </strong>Sixty participants were enrolled (mean age 34.8 years; 72% male). In the EMT-B cohort, there was no difference in average task performance score between the control and JITG groups for the BVM and IO tasks; however, the control group had higher performance scores for the Needle-d task (mean score difference 22%; P = .01). In the paramedic cohort, there was no difference in performance scores between the control and JITG group for the BVM and Needle-d tasks, but the control group had higher task scores for the IO task (mean score difference 23%; P = .01). For all task and participant types, the control group performed tasks more quickly than in the JITG group. There was no difference in participant usability or usefulness ratings between the JITG or control conditions for any of the tasks, although paramedics reported they were less likely to use the JITG equipment again (mean difference 1.96 rating points; P = .02).</p><p><strong>Conclusions: </strong>This study demonstrated preliminary evidence that AR-mediated guidance for emergency medical procedures is feasible and acceptable. These observations, coupled with AR's promise for real-time interaction and on-going technological advancements, suggest the potential for this modality in training and practice that justifies future investigation.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"257-265"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Ultrasonography for Shock and Hypotension Protocol Performed using Handheld Ultrasound Devices by Paramedics in a Moving Ambulance: Evaluation of Image Accuracy and Time in Motion.","authors":"Burcu Azapoglu Kaymak, Merve Eksioglu","doi":"10.1017/S1049023X24000426","DOIUrl":"https://doi.org/10.1017/S1049023X24000426","url":null,"abstract":"<p><strong>Introduction: </strong>Handheld ultrasound (US) devices have become increasingly popular since the early 2000s due to their portability and affordability compared to conventional devices. The Rapid Ultrasonography for Shock and Hypotension (RUSH) protocol, introduced in 2009, has shown promising accuracy rates when performed with handheld devices. However, there are limited data on the accuracy of such examinations performed in a moving ambulance. This study aimed to assess the feasibility and accuracy of the RUSH protocol performed by paramedics using handheld US devices in a moving ambulance.</p><p><strong>Objectives: </strong>The study aimed to examine the performability of the RUSH protocol with handheld US devices in a moving ambulance and to evaluate the accuracy of diagnostic views obtained within an appropriate time frame.</p><p><strong>Methods: </strong>A prospective study was conducted with paramedics who underwent theoretical and practical training in the RUSH protocol. The participants performed the protocol using a handheld US device in both stationary and moving ambulances. Various cardiac and abdominal views were obtained and evaluated for accuracy. The duration of the protocol performance was recorded for each participant.</p><p><strong>Results: </strong>Nine paramedics completed the study, with 18 performances each in both stationary and moving ambulance groups. The accuracy of diagnostic views obtained during the RUSH protocol did not significantly differ between the stationary and moving groups. However, the duration of protocol performance was significantly shorter in the moving group compared to the stationary group.</p><p><strong>Conclusion: </strong>Paramedics demonstrated the ability to perform the RUSH protocol effectively using handheld US devices in both stationary and moving ambulances following standard theoretical and practical training. The findings suggest that ambulance movement does not significantly affect the accuracy of diagnostic views obtained during the protocol. Further studies with larger sample sizes are warranted to validate these findings and explore the potential benefits of prehospital US in dynamic environments.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ethical Principles in Ethical Guidance Documents during the COVID-19 Pandemic in the United Kingdom and the Republic of Ireland: A Qualitative Systematic Review","authors":"Kesidha Raajakesary, Lucy Galvin, Kate Prendiville, Sarah Newport, Calum MacAnulty, Ghaiath Hussein","doi":"10.1017/s1049023x24000396","DOIUrl":"https://doi.org/10.1017/s1049023x24000396","url":null,"abstract":"Background: The sudden onset of the coronavirus disease 2019 (COVID-19) pandemic was accompanied by a myriad of ethical issues that prompted the issuing of various ethical guidance documents for health care professionals in clinical, research, and public health settings throughout the United Kingdom (UK) of Great Britain and Northern Ireland and the Republic of Ireland. The aim of this review was to identify the main principles in ethical guidance documents published in the UK and Ireland during the COVID-19 pandemic. Methods: This review used a qualitative systematic review methodology with thematic synthesis to analyze the included ethics-related guidance documents, as defined in this review, published in the UK and Ireland from March 2020 through March 2022. The search included a general search in Google Scholar and a targeted search on the websites of the relevant professional bodies and public health authorities in the two countries. The ethical principles in these documents were analyzed using the constant comparative method (CCM). Results: Forty-four guidance documents met the inclusion and exclusion criteria. Ten main ethical principles were identified, namely: fairness, honesty, minimizing harm, proportionality, responsibility, autonomy, respect, informed decision making, duty of care, and reciprocity. Conclusion: The guidelines did not present the ethical principles in equal detail. Some principles lacked definitions, leaving them vulnerable to misinterpretation by the documents’ end users. Priority was frequently given to collectivist ethics over individualistic approaches. Further clarity is required in future ethical guidance documents to better guide health care professionals in similar situations.","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"89 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Alcohol-Related Presentations to Emergency Departments on Days with a Public Holiday or Sporting Event: A Retrospective Cohort Study","authors":"Stephanie Rae Hagan, Julia Crilly, Jamie Ranse","doi":"10.1017/s1049023x24000232","DOIUrl":"https://doi.org/10.1017/s1049023x24000232","url":null,"abstract":"Introduction: The consumption of alcohol within the Australian community continues to rise, impacting care delivery in already over-burdened emergency departments (EDs). Study Objective: This study aimed to examine the impact of alcohol-related presentations (ARPs) to EDs on days with a public holiday or sporting event. Methods: A retrospective cohort study was undertaken using routinely collected health data pertaining to patient presentations diagnosed with an alcohol-related disorder (ICD-10-AM code F10) to two EDs in Queensland, Australia from January 1, 2016 – December 31, 2020. Descriptive and inferential statistics were used to describe and compare ARPs on event days versus non-event days and uncomplicated versus other ARPs on event days only. Results: Of all 5,792 ARPs, nine percent (n = 529) occurred on public holidays or sporting event days. When compared by day type, type of presentation, mode of arrival, and day of week differed between event and non-event days. On event days, uncomplicated ARPs differed to other ARPs, with uncomplicated ARPs being younger, having shorter median length-of-stay (LOS), and less likely to be admitted to hospital. Conclusions: In this multi-site study, public holidays and sporting events had a noteworthy impact on ARPs to EDs. Focused refinement on the clinical management of uncomplicated ARPs is warranted to inform future resource allocation, including on event days.","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"28 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Injury Associated Shock: An Under-Recognized and Challenging Prehospital Phenomenon","authors":"Christopher Partyka, Alexander Alexiou, John Williams, Jimmy Bliss, Matthew Miller, Ian Ferguson","doi":"10.1017/s1049023x24000359","DOIUrl":"https://doi.org/10.1017/s1049023x24000359","url":null,"abstract":"<span>Objective:</span><p>Hemodynamic collapse in multi-trauma patients with severe traumatic brain injury (TBI) poses both a diagnostic and therapeutic challenge for prehospital clinicians. Brain injury associated shock (BIAS), likely resulting from catecholamine storm, can cause both ventricular dysfunction and vasoplegia but may present clinically in a manner similar to hemorrhagic shock. Despite different treatment strategies, few studies exist describing this phenomenon in the early post-injury phase. This retrospective observational study aimed to describe the frequency of shock in isolated TBI in prehospital trauma patients and to compare their clinical characteristics to those patients with hemorrhagic shock and TBI without shock.</p><span>Methods:</span><p>All prehospital trauma patients intubated by prehospital medical teams from New South Wales Ambulance Aeromedical Operations (NSWA-AO) with an initial Glasgow Coma Scale (GCS) of 12 or less were investigated. Shock was defined as a pre-intubation systolic blood pressure under 90mmHg and the administration of blood products or vasopressors. Injuries were classified from in-hospital computed tomography (CT) reports. From this, three study groups were derived: BIAS, hemorrhagic shock, and isolated TBI without shock. Descriptive statistics were then produced for clinical and treatment variables.</p><span>Results:</span><p>Of 1,292 intubated patients, 423 had an initial GCS of 12 or less, 24 patients (5.7% of the original cohort) had shock with an isolated TBI, and 39 patients had hemorrhagic shock. The hemodynamic parameters were similar amongst these groups, including values of tachycardia, hypotension, and elevated shock index. Prehospital clinical interventions including blood transfusion and total fluids administered were also similar, suggesting they were indistinguishable to prehospital clinicians.</p><span>Conclusions:</span><p>Hemodynamic compromise in the setting of isolated severe TBI is a rare clinical entity. Current prehospital physiological data available to clinicians do not allow for easy delineation between these patients from those with hemorrhagic shock.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"2016 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140809255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}