Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Brugada syndrome is an inherited genetic disorder known to cause a variety of patient complaints but may ultimately cause ventricular fibrillation and sudden cardiac death. We present a patient with witnessed seizure who was ultimately diagnosed with Brugada syndrome. Multiple ventricular arrhythmias complicated the case, which was managed in- and out-of-hospital.
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Comparative Study
A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation.
Intraosseous (IO) access is frequently utilized during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients. Due to proximity to the heart and differential flow rates, the anatomical site of IO access may impact patient outcomes. Using a large dataset, we aimed to compare the outcomes of OHCA patients who received upper or lower extremity IO access during resuscitation. ⋯ In this large prehospital dataset, upper extremity IO access was associated with a small increase in the odds of ROSC in comparison to lower extremity IO access. These data support the need for prospective investigation of the ideal IO access site during OHCA resuscitation.
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The optimal initial vascular access strategy for out-of-hospital cardiac arrest (OHCA) remains unknown. Our objective was to evaluate the association between peripheral intravenous (PIV), tibial intraosseous (TIO), or humeral intraosseous (HIO) as first vascular attempt strategies and outcomes for patients suffering OHCA. ⋯ TIO or HIO as first access strategies in OHCA were associated with lower odds of ROSC at ED arrival compared to PIV.
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Emergency medical services (EMS) clinicians demonstrate a high prevalence of chronic medical conditions that place them at risk for early mortality. Workplace health promotion programs improve health outcomes, but the availably of such programs for EMS clinicians has not been described. We investigate the availability, scope, and participation of workplace health promotion programs available to EMS clinicians in North Carolina (NC). ⋯ While most agencies offer at least one element of a worksite health promotion program, few agencies offer all elements and participation rates are low.
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Helicopter emergency services (HEMS) serve a crucial role in the triage and transport of critically ill patients. Rapid transport to definitive care has become the goal of all prehospital EMS as shorter scene intervals have been associated with decreased mortality. Over the past several years, we have seen a rise in physicians trained in emergency medicine and EMS responding in the prehospital setting in our HEMS region. Our goal is to determine if the presence of EMS physicians on scene calls with HEMS delays time to hospital for patients. ⋯ There was no significant difference between HEMS scene intervals at calls serviced by HEMS crews alone versus those where EMS physicians were present. EMS physician presence was not associated with prolonged HEMS scene intervals.