Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Comparative Study
Risk Factors for Hypothermia in EMS-treated Burn Patients.
Hypothermia has been associated with increased mortality in burn patients. We sought to characterize the body temperature of burn patients transported directly to a burn center by emergency medical services (EMS) personnel and identify the factors independently associated with hypothermia. ⋯ A substantial proportion of burn patients demonstrate hypothermia at hospital arrival. Risk factors for hypothermia are readily identifiable by prehospital providers. Maintenance of normothermia should be stressed during prehospital care.
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Randomized Controlled Trial Comparative Study
A Randomized Controlled Trial of Aspirin and Exertional Heat Stress Activation of Platelets in Firefighters during Exertion in Thermal Protective Clothing.
Platelet aggregation is enhanced in firefighters following short bouts of work in thermal protective clothing (TPC). We sought to determine if aspirin therapy before and/or following exertion in TPC prevents platelet activation. ⋯ Daily aspirin therapy blunts platelet activation during exertional heat stress and single-dose aspirin therapy following exertional heat stress reduces platelet activation within 60 minutes.
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Comparative Study
Degradation of Benzodiazepines after 120 Days of EMS Deployment.
EMS treatment of status epilepticus improves outcomes, but the benzodiazepine best suited for EMS use is unclear, given potential high environmental temperature exposures. ⋯ Midazolam and diazepam experienced minimal degradation throughout 120 days of EMS deployment in high-heat environments. Lorazepam experienced significant degradation over 120 days and appeared especially sensitive to higher MKT exposure.
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Review Case Reports
Recognition and Treatment of Exertional Heat Illness at a Marathon Race.
Exertional heat illness is rarely encountered by individual EMS providers but can be common in certain settings and events. The notion that significantly altered mental status must accompany elevated core temperature in heat illness may delay recognition and treatment. We report on a series of marathon and half-marathon runners who suffered exertional heat illness during a marathon race in relatively mild conditions. ⋯ More than half were discharged from the medical tent without being transported to the hospital. This case series demonstrates that many runners respond to early identification and treatment of exertional heat illness. Significant preparation is required by the medical providers to handle the rapid influx of patients at the conclusion of the event.
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Comparative Study
Factors Related to the Sensitivity of Emergency Medical Service Impression of Stroke.
To examine factors related to sensitivity of emergency medical services (EMS) stroke impression. ⋯ Stroke was missed more frequently when CPSS was not documented, in patients without motor signs, and in patients with moderate-severe stroke. The sensitivity of prehospital screening for patients with moderate-severe stroke might be improved by including additional non-motor signs and by stressing indications for when screens should be performed.