Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Buprenorphine is becoming a key component of prehospital management of opioid use disorder. It is unclear how many prehospital patients might be eligible for buprenorphine induction, as traditional induction requires that patients first have some degree of opioid withdrawal. The primary aim of this study was to quantify how many patients developed precipitated withdrawal after receiving prehospital naloxone for suspected overdose, as they could be candidates for prehospital buprenorphine. The secondary objective was to identify associated factors contributing to precipitated withdrawal, including dose of naloxone administered, and identify rate of subsequent transport. ⋯ Almost half of patients who received a dose of prehospital naloxone for suspected overdose met our proxy criteria for precipitated withdrawal. Patients who met our precipitated withdrawal definition were more likely to have received greater doses of naloxone and were more likely to accept transport to an emergency department.
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This systematic review aims to determine the effectiveness of ambulance transportation versus helicopter transportation on mortality for trauma patients. ⋯ This systematic review found that adjusted analyses consistently favored air transport over ground transport. Unadjusted analyses showed no significant difference between the two modes of transport, except in specific subgroups. Further subgroup analyses revealed notable disparities between the two modalities, suggesting that these differences may be influenced by multiple factors. These findings highlight the need for further research to clarify the true impact of transport modality on trauma outcomes.
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To compare the effects of powered and manual stretchers on participants' perceived comfort and measured acceleration during lifting and loading operations. ⋯ In a controlled, laboratory-based setting, simulated use of manual and powered stretchers showed that powered stretchers significantly minimize patient discomfort and vibrations. This study underscores the potential for enhancing patient safety and quality of care. In conclusion, the powered stretcher is a promising tool for improving the quality and safety of patient transportation in prehospital settings.
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Antiarrhythmic administration is an important treatment for out-of-hospital cardiac arrest (OHCA) with a shockable rhythm, but a minimal amount is known about disparities in such antiarrhythmic practices. We sought to investigate the association between community race/ethnicity and prehospital antiarrhythmic administration for OHCA. ⋯ While antiarrhythmic administration rate was lower for minority communities and time to antiarrhythmic was higher for Black OHCAs, time to antiarrhythmic administration was lower for Hispanic/Latino OHCAs.
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Emergency Medical Services (EMS) agencies are beginning to provide low-barrier access to treatment for opioid use disorder (OUD) through the development of EMS buprenorphine (EMS-Bupe) programs. However, evidence-based practices for these programs are lacking. Our aim was to review the current literature on EMS and emergency department (ED) based buprenorphine treatment programs to provide consensus recommendations on the EMS-Bupe program development. ⋯ The EMS-Bupe program data are limited but show important variability. In general, we recommend that programs respond to community needs by establishing relationships with local resources. We also favor protocols that increase patient eligibility and treatment retention. Lastly, programs should consider low-barrier, patient-centered strategies aimed at preventing gaps in treatment.