Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Observational Study
Characterizing Strokes and Stroke Mimics Transported by Helicopter Emergency Medical Services.
Stroke is the leading cause of disability in the United States with most of these patients being transported by emergency medical services. These providers are the first medical point of contact and must be able to rapidly and accurately identify stroke and transport these patients to the appropriate facilities for treatment. There are many conditions that have similar presentations to stroke and can be mistakenly identified as potential strokes, thereby affecting the initial prehospital triage. ⋯ In our study approximately 20% of potential stroke patients transported via HEMS were mimics. Identifying the need for CSC resources can be an important factor in creating a prehospital triage tool to facilitate patient transport to an appropriate health care facility.
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To understand effective ways for EMS providers to interact with distressed family members during a field intervention involving a recent or impending out-of-hospital (OOH) pediatric death. ⋯ The study revealed effective ways for EMS providers to interact with distressed family members during an OOH pediatric death.
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Prehospital pediatric drug dosing errors affect 56,000 U.S. children annually. An accurate weight is the first step in accurate dosing. To date, the accuracy of Emergency Medical Dispatcher (EMD) obtained weights has not been evaluated. We hypothesized that EMD could obtain accurate pediatric weights. ⋯ EMD were able to obtain pediatric patient weights with relative accuracy for patients 0-7 year old. Using this EMD-obtained weight to carry out a drug dose calculation would be unlikely to result in a clinically significant dose error in the vast majority of cases. Communicating an EMD-obtained weight to EMS crews en route to a pediatric patient offers additional preparation time for drug calculations, which could improve accuracy.
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Pain is the most common symptom in patients presenting for prehospital (PH) care. Research in civilian emergency medical systems has shown wide variability in PH pain assessment and analgesic practices, yet a minimal amount is known about pain assessment and analgesic intervention practices in the military, particularly when PH care is delivered in a combat zone. ⋯ Pain assessment and treatment documentation improved each year, but remain suboptimal. Available data yielded poor prediction of the outcomes of interest, emphasizing the importance of individual assessment. Analgesic effectiveness could not be evaluated.
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Some helicopter emergency medical services (HEMS) maintain an independent supply of blood for use during transport, although practice is variable and not well described. We aimed to characterize the blood-carrying practices by HEMS programs across the United States. ⋯ There is great variability in the utilization of blood by HEMS programs in the United States. Programs that serve more rural areas and programs with a larger percentage of interfacility transports are more likely to independently carry blood.