Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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There are nearly 200,000 US infants/children transported annually for specialty care and there are no published best practices in transport intubation. ⋯ This represents the first multi-center neo/ped intubation dataset in PNCCT. First attempt intubation success lags behind reported anesthesia intubation rates but parallels pediatric emergency department intubation success rates. Training and operational processes are variable in PNCCT, though top performing teams require live-patient intubation success to achieve initial intubation competency.
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To evaluate the ability of out-of-hospital physiologic measures to predict serious injury for field triage purposes among older adults and potentially reduce the undertriage of seriously injured elders to non-trauma hospitals. ⋯ Existing out-of-hospital physiologic triage criteria could be revised to better identify seriously injured older adults at the expense of increasing overtriage to major trauma centers.
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Multicenter Study Clinical Trial
Comparison of Success Rates between Two Video Laryngoscope Systems Used in a Prehospital Clinical Trial.
The primary aims of this study were to compare paramedic success rates and complications of two different video laryngoscopes in a prehospital clinical study. ⋯ The CMAC had a higher likelihood of successful intubation compared to the King Vision. Complication rates were not statistically different between groups. Video laryngoscope placement success rates were not higher than our historical direct laryngoscopy success rates.
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Multicenter Study
Characteristics of the Pediatric Patients Treated by the Pediatric Emergency Care Applied Research Network's Affiliated EMS Agencies.
To describe pediatric patients transported by the Pediatric Emergency Care Applied Research Network's (PECARN's) affiliated emergency medical service (EMS) agencies and the process of submitting and aggregating data from diverse agencies. ⋯ Despite advances in data definitions and increased use of electronic databases nationally, data aggregation across EMS agencies was challenging, in part due to variable data collection methods and missing data. In our sample, only a small proportion of pediatric EMS patients required prehospital medications or interventions.
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Multicenter Study
Do Prolonged Primary Transport Times for Traumatic Brain Injury Patients Result in Deteriorating Physiology? A Cohort Study.
Recent interest has focused on reorganizing emergency medical services (EMS) for traumatic brain injury (TBI) patients, with bypass of nonspecialist hospitals and direct transportation to distant neuroscience centers. Although this could expedite neurosurgery and neurocritical care, deteriorating physiology could be deleterious. ⋯ The similarity between prehospital and ED vital signs, and lack of association between EMS interval and physiological deterioration, may support a strategy of direct transportation of TBI cases to specialist centers. Further research is necessary to identify patients at risk from deterioration during bypass and to investigate effects on mortality.