Articles: emergency-medical-services.
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Review Meta Analysis
Double sequential external defibrillation for refractory ventricular fibrillation out-of-hospital cardiac arrest: A systematic review and meta-analysis.
Double sequential external defibrillation (DSED) is a novel intervention which has shown potential in the management of refractory ventricular fibrillation (VF). This review aims to identify the literature surrounding the use of DSED in out-of-hospital refractory VF and assess whether this intervention improves survival outcomes. ⋯ The effectiveness of DSED remains unclear. Further well-designed prospective studies are needed to determine whether DSED has a role in the treatment of refractory VF.
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Traumatic brain injury is one of the leading causes of death and sources of heavy societal burden. Hypoxemia and hypercapnia are the 2 common complications of brain injury. Intubation seems to be an effective intervention for preventing the 2 complications in pre-hospital setting. But the results of the existing studies on the effect of pre-hospital intubation on prognosis of patients (aged less than 18) with severe traumatic brain injury are conflict. Thus, in this study, we aim to conduct a systematic review and meta-analysis to evaluate whether pre-hospital intubation is benefit for the prognosis in infants, children and adolescents with severe traumatic brain injury. ⋯ CRD42019121214.
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Review Meta Analysis
The incidence and outcomes of out-of-hospital cardiac arrest precipitated by drug overdose: A systematic review and meta-analysis.
Out-of-hospital cardiac arrests (OHCA) precipitated by drug overdose (OD) are becoming an increasing public health problem in developed countries. Empirical data on the global incidence and outcomes are needed to guide preventive and treatment strategies. ⋯ The incidence and survival outcomes of drug OD OHCA varies substantially across regions. Effective strategies designed to reduce incidence and improve survival outcomes are needed.
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Paramedics are involved in examining, treating and diagnosing patients. The accuracy of these diagnoses is evaluated using diagnostic accuracy studies. We undertook a systematic review of published literature to provide an overview of how accurately paramedics diagnose patients compared with hospital doctors. A bivariate meta-analysis was incorporated to examine the range of diagnostic sensitivity and specificity. ⋯ CRD42016039306.
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Meta Analysis
Flight Versus Ground Out-of-hospital Rapid Sequence Intubation Success: a Systematic Review and Meta-analysis.
Endotracheal intubation (ETI) is a critical procedure performed by both air medical and ground based emergency medical services (EMS). Previous work has suggested that ETI success rates are greater for air medical providers. However, air medical providers may have greater airway experience, enhanced airway education, and access to alternative ETI options such as rapid sequence intubation (RSI). We sought to analyze the impact of the type of EMS on RSI success. ⋯ Both overall and first-pass success of RSI did not differ between flight and road based EMS. Flight physicians have a higher overall and first-pass success compared to flight non-physicians and all ground based EMS, but no such differences are seen for ground EMS. Our results suggest that ground EMS can use RSI with similar outcomes compared to their flight counterparts.