Prehospital and disaster medicine
-
Prehosp Disaster Med · Feb 2018
Observational StudyDisease and Non-Battle Traumatic Injuries Evaluated by Emergency Physicians in a US Tertiary Combat Hospital.
Introduction Analysis of injuries during military operations has focused on those related to combat. Non-combat complaints have received less attention, despite the need for many troops to be evacuated for non-battle illnesses in Iraq. This study aims to further characterize the disease and non-battle injuries (DNBIs) seen at a tertiary combat hospital and to describe the types of procedures and medications used in the management of these cases.
-
Prehosp Disaster Med · Feb 2018
ReviewQuality Indicators for Evaluating Prehospital Emergency Care: A Scoping Review.
Introduction Historically, the quality and performance of prehospital emergency care (PEC) has been assessed largely based on surrogate, non-clinical endpoints such as response time intervals or other crude measures of care (eg, stakeholder satisfaction). However, advances in Emergency Medical Services (EMS) systems and services world-wide have seen their scope and reach continue to expand. This has dictated that novel measures of performance be implemented to compliment this growth. ⋯ Problem Quality indicators represent an increasingly popular component of health care quality and performance measurement. However, little is known about the development of QIs in the PEC environment. The purpose of this study was to assess the development and characteristics of PEC-specific QIs in the literature.
-
Prehosp Disaster Med · Feb 2018
ReviewHealth Outcomes for Children in Haiti Since the 2010 Earthquake: A Systematic Review.
Haiti remains the poorest country in the Americas and one of the poorest in the world. Children in Haiti face many health concerns, some of which were exacerbated by the 2010 earthquake. This systematic review summarizes published research conducted since the 2010 earthquake, focusing on health outcomes for children in Haiti, including physical, psychological, and socioeconomic well-being. ⋯ Future health programs in Haiti should focus on provision of clean water, sanitation, and other measures to prevent infectious diseases. Mental health programming and services for children also appear to be greatly needed, and food insecurity/malnutrition must be addressed if children are to lead healthy, productive lives. Given the burden of injury after the 2010 earthquake, further research on long-term disabilities among children in Haiti is needed. Dube A , Moffatt M , Davison C , Bartels S . Health outcomes for children in Haiti since the 2010 earthquake: a systematic review. Prehosp Disaster Med. 2018;33(1):77-88.
-
Prehosp Disaster Med · Feb 2018
Comparative StudyA 12-Month Clinical Audit Comparing Point-of-Care Lactate Measurements Tested by Paramedics with In-Hospital Serum Lactate Measurements.
Prehospital point-of-care lactate (pLA) measurement may be a useful tool to assist paramedics with diagnosing a range of conditions, but only if it can be shown to be a reliable surrogate for serum lactate (sLA) measurement. The aim of this study was to determine whether pLA is a reliable predictor of sLA. ⋯ Overall, the level of agreement between pLA and sLA was poor. Accuracy of pLA diminished markedly as the time between the two measurements increased. It may be possible to use pLA as a screening tool; when considered this way, pLA performed much better, though larger prospective trials would be needed to confirm this. Swan KL , Keene T , Avard BJ . A 12-month clinical audit comparing point-of-care lactate measurements tested by paramedics with in-hospital serum lactate measurements. Prehosp Disaster Med. 2018;33(1):36-42.
-
Prehosp Disaster Med · Feb 2018
Ketamine in the Prehospital Environment: A National Survey of Paramedics in the United States.
Use of ketamine in the prehospital setting may be advantageous due to its potent analgesic and sedative properties and favorable risk profile. Use in the military setting has demonstrated both efficacy and safety for pain relief. The purpose of this study was to assess ketamine training, use, and perceptions in the civilian setting among nationally certified paramedics (NRPs) in the United States. ⋯ This was the first large, national survey to assess ketamine training, use, and perceptions among paramedics in the civilian prehospital setting. While training related to ketamine use was commonly reported among paramedics, few were authorized to administer the drug by their agency's protocols. Of those authorized to use ketamine, most paramedics had limited experience administering the drug. Future research is needed to determine why the prevalence of ketamine use is low and to assess the safety and efficacy of ketamine use in the prehospital setting. Buckland DM , Crowe RP , Cash RE , Gondek S , Maluso P , Sirajuddin S , Smith ER , Dangerfield P , Shapiro G , Wanka C , Panchal AR , Sarani B . Ketamine in the prehospital environment: a national survey of paramedics in the United States. Prehosp Disaster Med. 2018;33(1):23-28.