Articles: emergency-medical-services.
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The National Governors Association (NGA) Center for Best Practices, in partnership with the National Association of State Emergency Medical Services Officials (NASEMSO), supported five states-Kentucky, Ohio, South Carolina, Vermont, and Wisconsin-in developing and implementing action plans to expand the role of EMS to help prevent overdose events and support individuals with substance use disorders. States undertook initiatives such as pilot programs for EMS-initiated buprenorphine, development of statewide naloxone leave-behind programs, and changes to EMS protocols that enable agencies and clinicians to use evidence-informed best and promising practices that utilize harm reduction strategies and provide opportunities for linkages to treatment.
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Observational Study
Out-of-hospital cardiac arrests in Victoria, 2003-2022: retrospective analysis of Victorian Ambulance Cardiac Arrest Registry data.
To examine changes in out-of-hospital cardiac arrest (OHCA) characteristics and outcomes during 2003-2022, and 12-month outcomes for people who experienced OHCA during 1 January 2010 - 30 June 2022. ⋯ Utstein survival to hospital discharge increased threefold during 2003-2022, and the proportions of cases in which bystanders provided cardio-pulmonary resuscitation or public access defibrillation increased. The COVID-19 pandemic was associated with a substantial reduction in survival, and new strategies are needed to improve outcomes.
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Out-of-hospital cardiac arrest is a leading cause of mortality in Europe. Quality cardiopulmonary resuscitation, particularly of chest compressions, is crucial. Real-time audiovisual feedback (RTAVF) devices aim to enhance chest compression quality. Recent studies on these tools have reported improved outcomes for in-hospital but not for out-of-hospital cardiac arrest. This registry-based, retrospective study investigated the use of feedback-devices by emergency medical services personnel to treat out-of-hospital cardiac arrest in Germany and assessed its effect on return of spontaneous circulation (ROSC). ⋯ We could show a minor association between the use of feedback devices and any ROSC, but not for ROSC on hospital admission, in out-of-hospital cardiac arrest patients in a generalized linear mixed model. Further research should address implementation strategies, sustainability and evaluate its effectiveness for other applications.
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Pain management in the potentially austere search and rescue (SAR) and emergency medical services (EMS) environments can be challenging. Intravenous (IV) and intramuscular (IM) routes of administration may be less practical. This study assesses the efficacy and safety of the sublingual sufentanil tablet (SST) in prehospital settings and hypothesizes that its use will reduce pain while maintaining a reasonable safety profile. ⋯ Our study demonstrated that SST administration led to a significant reduction in pain scores and exhibited a favorable safety profile regarding vital signs, including SBP, HR, respiratory rate (RR), and O2 saturation. These findings support the utilization of SST for pain management in the prehospital setting, particularly in austere environments where traditional routes of administration may be impractical.
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Scand J Trauma Resus · Dec 2024
The impact of a dedicated checklist on the quality of onsite management of critically buried avalanche victims in cardiac arrest in a Swiss helicopter emergency medical service.
The management of avalanche victims in cardiac arrest (CA) is a challenging situation for rescuers. Despite existing specific management algorithms, previous studies have reported poor compliance with international guidelines and incomplete documentation and transmission of the information required for patient management. The Avalanche Victim Resuscitation Checklist (AVRC) was developed in 2014 in response by the International Commission for Mountain Emergency Medicine. Our aim was to assess the impact of the AVRC on the quality of onsite management of critically buried avalanche victims in CA, i.e. the compliance of management with international guidelines and the completeness of documentation of avalanche specific information. ⋯ The use of the AVRC improves the quality of management of critically buried avalanche victims in CA and ensures complete documentation of avalanche specific information. Quality improvement efforts should focus on the management of avalanche victims with a long burial duration. The use of the AVRC enables identification and appropriate treatment of patients with hypothermic cardiac arrest.