Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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We sought to identify a scale or components of a scale that optimize detection of older adult traumatic brain injury (TBI) patients who require transport to a trauma center, regardless of mechanism. ⋯ Existing scales to identify TBI are inadequate to detect older adult TBI patients who require transport to a trauma center. A new algorithm, derived from elements of previously established scales, has the potential to guide prehospital providers in improving the triage of older adult TBI patients, but needs further evaluation prior to use.
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The National Emergency Medical Services Information System (NEMSIS) is a federally funded project designed to standardize emergency medical services (EMS) patient care reporting and facilitate state and national data repositories for the assessment of EMS systems of care. The purpose of this assessment is to characterize the annual NEMSIS 2012 Public-Release Research Dataset, detailing the strengths and limitations associated with use of these data for EMS quality assurance and/or research purposes. ⋯ The annual NEMSIS Public-Release Research Dataset is a valuable resource for evaluating the U.S. EMS activation population and can be used to conduct in-depth descriptions of the care of specific populations. However, the utility of the data are limited until the number of null values can be diminished and reporting becomes universal.
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This study was conducted to associate tourniquet use and survival in casualty care over a decade of war in order to provide evidence to emergency medical personnel for the implementation and efficacy of tourniquet use in a large trauma system. ⋯ Average injury severity increased during the decade of war for casualties with extremity injury. Both tourniquet use rates and casualty survival rates rose when injuries were amenable to tourniquets.
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Inadvertent hyperventilation is associated with poor outcomes from traumatic brain injury (TBI). Hypocapnic cerebral vasoconstriction is well described and causes an immediate and profound decrease in cerebral perfusion. The hemodynamic effects of positive-pressure ventilation (PPV) remain incompletely understood but may be equally important, particularly in the hypovolemic patient with TBI. ⋯ Predicted MITP values increased with ventilation rates. Future studies to externally validate this model are warranted.