Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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This study reports measurements of hydration status among firefighters prior to training, documents changes in hydration status after prolonged firefighting training, and reports the utility of salivary measurements to assess changes in hydration in field environments. ⋯ Firefighters arriving in a dehydrated state are at risk for heat injuries and may be in a physically and/or psychologically compromised state at the outset of firefighter training. Even during cool autumn days with ample fluids available, firefighters experience dehydration during typical firefighting activities, so the ability to measure hydration status throughout such activities may be important. Our data suggest that quantification of changes in hydration status through salivary osmolality measurements may provide a viable field measurement tool for such activities.
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Determining appropriate disposition for referred pediatric patients is difficult, since it relies primarily on a telephone description of the patient. In this study, we evaluate the Transport Risk Assessment in Pediatrics (TRAP) score's ability to assist in appropriate placement of these patients. This novel tool is derived from physiologic variables. ⋯ The TRAP score is a novel objective pediatric transport assessment tool where an elevated score is associated with PICU admission for more than 24 hours. This score may assist with the triage decisions for transported pediatric patients.
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Traumatic brain injury (TBI) represents a serious subset of injuries among persons in the United States, and prehospital care of these injuries can mitigate both the morbidity and the mortality in patients who suffer from these injuries. Guidelines for triage of injured patients have been set forth by the American College of Surgeons Committee on Trauma (ACS-COT) in cooperation with the Centers for Disease Control and Prevention (CDC). These guidelines include physiologic criteria, such as the Glasgow Coma Scale (GCS) score, systolic blood pressure, and respiratory rate, which should be used in determining triage of an injured patient. ⋯ These findings support the validity of the ACS-COT/CDC physiologic criteria in this population and stress the importance of prehospital triage of patients with TBI in the hopes of reducing both the morbidity and the mortality resulting from this injury.
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Drowning following a fall from a bridge can lead to cardiac arrest caused by hypoxia, hypothermia, or severe traumatic injury. Every year patients are brought to our hospital who have nearly drowned in the local river after a jump from a bridge (approximate height 16-22 meters). We report traumatic injuries in patients admitted to our hospital for out-of-hospital cardiac arrest due to drowning. ⋯ Patients found nearly drowned in a river spanned by a medium-height bridge should undergo spinal immobilization and complete radiologic examination as soon as possible.
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We aimed to assess the diagnostic accuracy of focused assessment with sonography for trauma (FAST) examinations when used by emergency medical technicians (EMTs) to detect the presence of free abdominal fluid. ⋯ EMTs in Korea showed a high diagnostic performance that was comparable to that of surgeons and physicians when detecting peritoneal cavity free fluid in a Korean emergency department setting. The validity of FAST examinations in prehospital care situations should be investigated further.