Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Prehospital blood administration programs have demonstrated success both on the battlefield and throughout civilian emergency medical services programs. While previous research often discusses the use of prehospital blood administration for adult trauma and medical patients, few studies have reported the benefits of prehospital blood administration for pediatric patients. This case report describes treatment received by a 7-year-old female gunshot victim who was successfully treated by a prehospital blood administration program in the southern United States.
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Heat stroke is a problem that occurs primarily in the out-of-hospital environment. "Cool first, transport second" has been emphasized in consensus statements and systematic reviews regarding the treatment of exertional heat stroke by both EMS and the sports medicine/athletic training communities. However, there remains little guidance on cooling recommendations for the out-of-hospital care of non-exertional heat stroke or classic heat stroke. There is no consensus on the safety or feasibility of cooling classic heat stroke patients in the out-of-hospital environment using cold-water immersion. This case series describes the successful application of on-scene cold-water immersion for five classic heat stroke patients guided by real-time core temperature monitoring.
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COVID-19 has had significant secondary effects on health care systems, including effects on emergency medical services (EMS) responses for time-sensitive emergencies. We evaluated the correlation between COVID-19 hospitalizations and EMS responses for time-sensitive emergencies in a large EMS system. ⋯ We found significant correlation between COVID-19 hospitalizations and the frequency of EMS responses for time-sensitive emergencies in this regional EMS system. EMS systems should consider the potential effects of this and future pandemics on EMS responses and prepare to meet non-pandemic resource needs during periods of surge, particularly for time-sensitive conditions.
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The Hunter-8 prehospital stroke scale predicts large vessel occlusion in hyperacute ischemic stroke patients (LVO) at hospital admission. We wished to test its performance in the hands of paramedics as part of a prehospital triage algorithm. We aimed to determine (a) the proportion of patients identified by the Hunter-8 algorithm, receiving reperfusion therapies, (b) whether a call to stroke team improved this, and (c) performance for LVO detection using an expanded LVO definition. ⋯ The Hunter-8 workflow resulted in 28.7% of confirmed ischemic stroke patients receiving reperfusion therapies, with no secondary transfers to the comprehensive stroke center. The role of communication with stroke team needs to be further explored.
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Little is known about survival outcomes after traumatic cardiac arrest in Asia, or the association of Utstein factors with survival after traumatic cardiac arrests. This study aimed to describe the epidemiology and outcomes of traumatic cardiac arrests in Asia, and analyze Utstein factors associated with survival. ⋯ In traumatic cardiac arrest, early aggressive resuscitation may not be futile and bystander CPR may improve outcomes.