Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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The Singapore myResponder is a novel smartphone application developed by the Singapore Civil Defence Force (SCDF) that notifies volunteer first responders of a suspected out-of-hospital cardiac arrest (OHCA) case and locations of Automated External Defibrillators (AED) in the vicinity so that they can assist with resuscitation. We aimed to examine the performance of this application, challenges encountered, and future directions. Methods: We analyzed data from the myResponder app since its launch from April 2015 to July 2019. ⋯ In 2019, the percentages of responders who accepted notification and arrived on scene were 45.8% and 24.1%, respectively. 43% (1110/2581) of responders arrived before EMS crew. Conclusion: The myResponder mobile application is a feasible smart technology solution to improve community response to OHCA, and to increase bystander CPR and AED use. Future directions include increasing the number of active responders, improving response rates, app performance, and better data capture for quality improvement.
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The objective of this study was to evaluate the emergency care provided by the Israeli Military Airborne Combat Evacuation Unit (MACEU) during helicopter winching operations. Methods: A retrospective cohort study was performed of all patients rescued by winching by the MACEU between December 2011 and October 2018. Data were extracted from the electronic medical records of the unit registry. ⋯ All the six patients who had oxygen saturation ≥89% after entrance into the cabin, survived. Conclusions: The reported MACEU experience provides useful information on the clinical characteristics, medical interventions, and outcomes of patients rescued using a winching operation. Study findings emphasize the importance of airway management and ventilation during winching.
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Primary postpartum hemorrhage (PPH) is a life-threatening obstetric emergency that can be mitigated through the administration of a uterotonic to actively manage the third stage of labor. This study describes the prehospital administration of oxytocin by paramedics following attendance of out-of-hospital (OOH) births. ⋯ Oxytocin is well accepted and safe treatment adjunct for the management of the third stage of labor in OOH births and should be considered for routine practice by other emergency medical services.
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Catastrophic hemorrhage remains the leading cause of preventable death. Not all New South Wales (NSW) hospitals stock blood products and, as such, blood products carried by NSW Ambulance retrieval teams are often the first available to critically unwell patients. ⋯ The use of prehospital blood transfusion for suspected bleeding in NSW Australia has more than doubled since 2010. Patients who received prehospital transfusion arrived at hospital with improved hemodynamic observations.
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Motor vehicle crashes (MVCs) comprise a significant component of emergency medical service workload. Due to the potential for life-threatening injuries, ambulances are often dispatched at the highest priority to MVCs. However, previous research has shown that only a small proportion of high-priority ambulance responses to MVCs encounter high acuity patients. ⋯ A 'not ambulant patient' (one identified by paramedics as unable to walk or having an injury incompatible with being able to walk) had 15 times the odds of being high acuity than ambulant patients (OR 15.34, 95% CI, 11.48-20.49). Those who were trapped in a vehicle compared to those not trapped (OR 4.68, 95% CI, 3.95-5.54); and those who were ejected (both partial and full) from the vehicle compared to those not ejected (OR 6.49, 95% CI, 4.62-9.12) had higher odds of being high acuity patients. Discussion: There were two important findings from this study: (1) few MVC patients were deemed to be high acuity; and (2) several crash scene characteristics were strong predictors of high acuity patients.