Articles: emergency-medical-services.
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Pediatric emergency care · Nov 2023
Use of Intraosseous Access in Neonatal and Pediatric Retrieval-Neonatal and Pediatric Emergency Transfer Service, New South Wales.
Pediatric patients who are critically unwell require rapid access to central vasculature for administration of life-saving medications and fluids. The intraosseous (IO) route is a well-described method of accessing the central circulation. There is a paucity of data surrounding the use of IO in neonatal and pediatric retrieval. The aim of this study was to review the frequency, complications, and efficacy of IO insertion in neonatal and pediatric patients in retrieval. ⋯ Survival in retrieved neonatal and pediatric patients who required IO is higher than previously described in pediatric and adult cohorts. Early insertion of an IO facilitates early volume expansion, delivery of critical drugs, and allows time for retrieval teams to gain more definitive venous access. In this study, prostaglandin E1 delivered via a distal limb IO had no success in reopening the ductus arteriosus.
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JNMA J Nepal Med Assoc · Nov 2023
Observational StudySurgical Management among Patients with Acetabular-Pelvis Fractures in a Trauma Care Centre.
Surgical management of pelvic and acetabular fractures due to high-energy trauma is one of the most challenging in orthopaedics. Most patients are often associated with other life-threatening injuries. Several studies demonstrated that accurate fracture reduction decreases the incidence of post-traumatic arthritis and improves functional outcomes. The aim of the study was to find out the prevalence of the surgical management among patients with acetabular-pelvis fractures in a trauma care centre. ⋯ acetabulum; fracture fixation; pelvis.
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Southern medical journal · Nov 2023
Observational StudyReal-World Evaluation of a Chest Pain Digital Triage Platform at the Point of Care.
The triple aim of population health focuses on providing the right care to the right patient at the right time. Patient use of digital health tools may reduce the overuse of emergency services. We tested the safety and clinical applicability of a patient-facing, automated digital urgent care triage tool (UCTT) for patients with chest pain. ⋯ No high-risk conditions were missed by the UCTT. Our UCTT was more conservative than MD decision making, providing a sizable safety margin and adequate patient triage.
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Adults living in long-term care (LTC) are at increased risk of harm when transferred to the emergency department (ED), and programs targeting treatment on-site are increasing. We examined characteristics, clinical course, and disposition of LTC patients transported to the ED to examine the potential impact of alternative models of paramedic care for LTC patients. ⋯ This study found 7.9% of LTC patients transported to the ED did not receive diagnostics, medications, or treatment, and overall 11.1% of patients could have been treated by paramedics within current medical directives using 'treat-and-refer' pathways. This group could potentially expand utilizing community paramedics with expanded scopes of practice.