Environmental temperature variations cause degradations in epinephrine concentration and biological activity Terry A. Grant, Robert G. Carroll, William H. Church, Anthony Henry, N.Heramba Prasad, Abdel A. Abdel-Rahman, E.Jackson Allison Jr
DOI: http://dx.doi.org/10.1016/0735-6757(94)90148-1
The American Journal of Emergency Medicine , Vol. 12 , Issue 3 ,
Published in issue: May 1994
x This study determined the biological consequence of temperature induced epinephrine degradation. Two different epinephrine preparations (1:1,000 and 1:10,000) were exposed to either cold (5°C) or hot (70°C) temperatures. The exposure occurred for 8-hour periods each day in 4-, 8-, and 12-week intervals. Samples and identical controls were then chemically evaluated using high-pressure liquid chromatography (HPLC), and biological activity of samples showing chemical degradation was assessed in conscious rats.
Decrease in medical command errors with use of a “standing orders” protocol system C.James Holliman, Richard C. Wuerz, Steven A. Meador
DOI: http://dx.doi.org/10.1016/0735-6757(94)90138-4
The American Journal of Emergency Medicine , Vol. 12 , Issue 3 ,
Published in issue: May 1994
x The purpose of this study was to determine the physician medical command error rates and paramedic error rates after implementation of a “standing orders” protocol system for medical command. These patientcare error rates were compared with the previously reported rates for a “required call-in” medical command system (Ann Emerg Med 1992; 21(4):347–350). A secondary aim of the study was to determine if the on-scene time interval was increased by the standing orders system. Prospectively conducted audit of prehospital advanced life support (ALS) trip sheets was made at an urban ALS paramedic service with on-line physician medical command from three local hospitals.
Chest injuries transferred to trauma centers after the 1999 Taiwan earthquake Wen Yi-Szu, Hsu Chung-Ping, Lin Tzu-Chieh, Yang Dar-Yu, Wu Tain-Cheng
DOI: http://dx.doi.org/10.1053/ajem.2000.18132
The American Journal of Emergency Medicine , Vol. 18 , Issue 7 ,
Published in issue: November 2000
x To better understand the effects of delayed medical care and long transportation times when emergency medical services (EMS) failed after the 1999 Chi-Chi, Taiwan earthquake, we analyzed the patterns and outcomes of patients with chest injuries who were transferred to an unaffected back-up hospital. The medical records of 164 trauma patients who were transferred to Taichung Veterans General Hospital from September 21 to September 24, 1999 were reviewed. Of the 164 patients, 26 (15.9%) had chest injuries.
The use of calcium in cardiac resuscitation Fric E. Harrison, Brent D. Amey
DOI: http://dx.doi.org/10.1016/0735-6757(83)90103-1
The American Journal of Emergency Medicine , Vol. 1 , Issue 3 ,
Published in issue: November 1983
x All records of cardiac arrest patients presenting to the Tampa EMS system for the 24-month period of January, 1980, through December, 1982, were reviewed. Paramedics were given direct orders or standing orders to administer calcium intravenously or intracardiac in patients in ventricular fibrillation, asystole, or electromechanical dissociation. Of the 480 patients receiving calcium for the above conditions, only patients with electromechanical dissociation responded to calcium. Twenty-seven EMD patients responded positively with the immediate return of blood pressure and pulse.
Etomidate versus succinylcholine for intubation in an air medical setting Christine Kociszewski, Stephen H. Thomas, Tim Harrison, Suzanne K. Wedel
DOI: http://dx.doi.org/10.1053/ajem.2000.18033
The American Journal of Emergency Medicine , Vol. 18 , Issue 7 ,
Published in issue: November 2000
x The objective was to compare rates of successful endotracheal intubation (ETI) and requirement for multiple ETI attempts in patients receiving etomidate (ETOM) versus succinylcholine (SUX). This retrospective study analyzed adults in whom oral ETI was attempted by a helicopter EMS (HEMS) service between July 1997 to July 1999. Data were from records of the HEMS service, which uses a RN/EMTP crew; analysis was with chi-square and logistic regression (P = .05). ETI was successful in 269 (97.8%) of 275 patients, with multiple attempts occurring in 54 (20.1%) of 269.
Acute myocardial infarction complicated by hemodynamically unstable bradyarrhythmia: Prehospital and ED treatment with atropine Gary Swart, William J Brady Jr, Daniel J DeBehnke, O John, Tom P Aufderheide
DOI: http://dx.doi.org/10.1016/S0735-6757(99)90151-1
The American Journal of Emergency Medicine , Vol. 17 , Issue 7 ,
Published in issue: November 1999
x The purpose of this study was to investigate the therapeutic response to atropine of patients experiencing hemodynamically compromising bradyarrhythmia related to acute myocardial infarction (AMI) in the prehospital (PH) setting and the therapeutic impact of the PH response to atropine on further Emergency Department (ED) care. In addition, the prevalence of AMI in patients presenting with atrioventricular block (AVB) is noted. Retrospective review of PH, emergency department (ED), and hospital records.
Evaluation of American college of surgeons trauma triage criteria in a suburban and rural setting Mark C Henry, Jeanne M Alicandro, Judd E Hollander, Janice G Moldashel, Guy Cassara, Henry C Thode Jr
DOI: http://dx.doi.org/10.1016/S0735-6757(96)90117-5
The American Journal of Emergency Medicine , Vol. 14 , Issue 2 ,
Published in issue: March 1996
x In suburban and rural counties, patient transport to specialized facilities such as trauma centers may result in prolonged transport times with the resultant loss of ambulance coverage in the primary service area. We evaluated the American College of Surgeons trauma triage criteria as modified by New York State to determine the ability of these criteria to predict the need for trauma center care in victims of blunt traumatic injury. Blunt trauma patients were retrospectively identified through review of patient care reports for the presence either of mechanism or of physiological criteria for transport to a trauma center.
Gender differences in state-wide EMS transports Steven J. Weiss, Amy A. Ernst, Joe Phillips, Blaine Hill†
DOI: http://dx.doi.org/10.1053/ajem.2000.16299
The American Journal of Emergency Medicine , Vol. 18 , Issue 6 ,
Published in issue: October 2000
x There are gender differences in emergency medical services (EMS) transports and management based on diagnosis. Data were extracted from the EMS State Ambulance Transport database. This database exists because of a legal requirement that all EMS transports generated by 911 calls and all interhospital transports be reported to the State EMS Bureau. All ambulance transports reported to the State EMS Division during 1995 were evaluated. Cases were excluded if they were aborted, admission or discharge transports, outpatient transports, or cases listed as “other” without a diagnosis.
Inadequate hemodynamic management in patients undergoing interfacility transfer for suspected aortic dissection Greg Winsor, Stephen H. Thomas, Paul D. Biddinger, Suzanne K. Wedel
DOI: http://dx.doi.org/10.1016/j.ajem.2004.01.008
The American Journal of Emergency Medicine , Vol. 23 , Issue 1 ,
Published in issue: January 2005
x The study goal was the analysis of effectiveness of hemodynamic management of patients undergoing interfacility transport for suspected acute aortic dissection (SAAD). Our retrospective, consecutive-case review examined 62 nonhypotensive patients transported by an air emergency medical services (EMS) service during 1998 to 2002, with referral hospital diagnosis of SAAD. Of patients with systolic blood pressure (SBP) less than 120 upon air EMS arrival, antihypertensives had been given in only 23/42 (54.8%).
Prevalence of methicillin-resistant Staphylococcus aureus colonization in emergency medical service providers Barry J. Knapp, Sara N. Tsuchitani
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.024
The American Journal of Emergency Medicine , Vol. 29 , Issue 8 ,
Published in issue: October 2011
x Understanding the epidemiological spread of methicillin-resistant Staphylococcus aureus (MRSA) is an important aspect in limiting the pathogen's prevalence in a community. Because emergency medical service (EMS) personnel are potential portals of infection both into and out of the hospital, knowledge of their MRSA colonization status may have implications on limiting the further spread of this organism. The prevalence of nasal MRSA colonization in EMS providers has not been documented in the current literature.
Syphilis screening in out-of-hospital care Eduardo Marvez-Valls, Steven J Weiss, Amy A Ernst, William D Johnson
DOI: http://dx.doi.org/10.1016/0735-6757(95)90125-6
The American Journal of Emergency Medicine , Vol. 13 , Issue 4 ,
Published in issue: July 1995
x To estimate the rates of syphilis infection in inner-city patients managed by prehospital providers, a convenience sampling of prehospital patients who had intravenous lines initiated was screened for syphilis over a nine-month study period from February 1992 through October 1992. In a university-affiliated inner-city emergency department served by a city ambulance company, patients 18 years of age or older transported via ambulance who had had intravenous lines initiated at the scene or en route had a Venereal Disease Research Laboratory (VDRL) and microhe-magglutination-Treponema pallidum (MHA-TP) drawn and performed by the state laboratory as a routine serological test.
The impact of a mass gathering events with an on-site medical management team on municipal 911 emergency medical services Michael J. Heiby, William Barnhardt, Thomas Berry, Melanie Welcher, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2012.08.036
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: October 22 2012
x Mass gathering medical care is defined by the National Association of Emergency Medical Physicians as “organized emergency health care services provided for spectators and participants in which at least 1000 persons are gathered at a specific location for a defined period of time” [1]. Health care providers at these events care for patients presenting with a variety of complaints, from mild heat illness and ankle sprain to cardiac arrest and multiple trauma. These events include many different settings and patient populations including football games, concerts, and festivals with relatively young, mixed age, and elderly groupings of persons.
Systems approach to emergency medical care: By Boyd DR, Edlich RF, Micik S. Norwalk, Connecticut, Appleton-Century-Crofts, 1983, 528 pages, $48.00 Jon R. Krohmer
DOI: http://dx.doi.org/10.1016/0735-6757(85)90224-4
The American Journal of Emergency Medicine , Vol. 3 , Issue 5 ,
Published in issue: September 1985
Erratum
DOI: http://dx.doi.org/10.1016/0735-6757(85)90225-6
The American Journal of Emergency Medicine , Vol. 3 , Issue 5 ,
Published in issue: September 1985
Emergency Medical Services and 9-1-1 pandemic influenza preparedness: a national assessment Anthony L. Oliver, Gerald S. Poplin, Christopher A. Kahn
DOI: http://dx.doi.org/10.1016/j.ajem.2011.11.014
The American Journal of Emergency Medicine , Vol. 30 , Issue 3 ,
Published online: February 10 2012
x The likelihood of an influenza pandemic places public agencies under pressure to ensure readiness for local outbreaks. Emergency Medical Services (EMS) is a critical infrastructure that needs to be part of preparedness and response planning for a severe pandemic. Legal and regulatory frameworks should recognize prehospital capabilities as lawmakers attempt to facilitate capacity-building collaboration, which is critical to disaster response. The prehospital system's lack of surge capacity has been detailed [1-5], and agencies seek direction regarding preparedness planning from state agencies [6,7].
Information transfer from prehospital to ED health care providers John P. Benner, Josh Hilton, Gordon Carr, Kimberly Robbins, Robert C. Schutt, Matthew P. Borloz, Kostas Alibertis, Benjamin Sojka, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2007.04.003
The American Journal of Emergency Medicine , Vol. 26 , Issue 2 ,
Published in issue: February 2008
x The integration of emergency medical services (EMS) with other health care providers, particularly emergency department (ED)–based personnel, has been identified as an area deserving of attention and improvement [1]. The enhancement of communication, particularly at patient transfer, between EMS and the ED health care team is certainly a first step to such integration. We write to you with the results of an ED-based study that we performed involving both qualitative and quantitative analysis of patient-specific data relayed to the ED staff by EMS at the time of patient transfer of care in the ED.
Effect of levalbuterol on prehospital patient parameters Howard Rodenberg
DOI: http://dx.doi.org/10.1053/ajem.2002.32648
The American Journal of Emergency Medicine , Vol. 20 , Issue 5 ,
Published in issue: September 2002
x This study was performed to determine if levalbuterol improves dyspnea as assessed by prehospital clinical parameters. All EMS patients ≥16 years old given nebulized levalbuterol over 6 months were included in this prospective, open-label work. Data collected included demographics, initial pulse rate (P), respiratory rate (R), patient report of respiratory distress (S), and peak expiratory flow (PF). Outcome variables were P, R, S, and PF after levalbuterol use. Statistical analysis used t tests, with P ≤ .05.
Knowledge, attitudes, and practices regarding infection prevention among emergency medical services providers Stephen Y. Liang, Paige Vantassell, Remle P. Crowe, Brian R. Froelke, Jonas Marschall, Melissa A. Bentley
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.026
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: February 20 2015
x Infection prevention is a significant challenge in prehospital emergency care. Hand hygiene [1-3], adherence to standard and transmission-based precautions [4], and environmental disinfection [1] by emergency medical services (EMS) providers is variable and often suboptimal. Ambulances can become contaminated during patient care with multidrug-resistant organisms (MDRO) [5-7], increasing the potential for transmission. Little is known about the knowledge, attitudes, and practices of EMS providers in relation to infection prevention and MDRO transmission.
Announcements
DOI: http://dx.doi.org/10.1016/0735-6757(95)90154-X
The American Journal of Emergency Medicine , Vol. 13 , Issue 4 ,
Published in issue: July 1995
A program to improve health among prehospital providers Scott Oglesbee, David Riss, Amy A. Ernst, Steven J. Weiss, William H. Brady, Nicholas W. Brady, Stephine L. Otero
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.023
The American Journal of Emergency Medicine , Vol. 33 , Issue 4 ,
Published online: January 21 2015
x According to the National Highway Traffic Safety Administration (2011), there were an estimated 956
