Paramedic assessment and treatment of upper airway obstruction in pediatric patients: an exploratory analysis by the Children's Safety Initiative-Emergency Medical Services Matthew Hansen, Garth Meckler, William Lambert, Caitlin Dickinson, Kathryn Dickinson, Jeanne-Marie Guise
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.082
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 30 2015
x Croup, asthma, and anaphylaxis are potentially life-threatening pediatric emergencies. These medical conditions have distinct yet effective treatments. Croup causes upper airway obstruction, although virally mediated edema of the upper airway. Nebulized epinephrine, via its α -1 effect of vasoconstriction, is a highly effective treatment for upper airway obstruction caused by croup [1–5]. Asthma causes lower airway obstruction and is treated with albuterol whose β -2 mechanism causes relaxation of the lower airways [6].
Safety and Feasibility of the Laryngeal Tube When Used by EMTs During Out-of-Hospital Cardiac Arrest Dominik Roth, Christina Hafner, Werner Aufmesser, Kurt Hudabiunigg, Christian Wutti, Harald Herkner, Wolfgang Schreiber
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.048
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: April 29 2015
x Ventilation is still one key element of advanced life support. Emergency medical technicians (EMTs) without training in advanced airway management usually use bag valve mask ventilation (BVM). Bag valve mask ventilation requires proper training and yet may be difficult and ineffective. Supraglottic airway devices, such as the laryngeal tube (LT), have been proposed as alternatives. Safety and feasibility are unclear if used by EMTs with limited training only. We compared efficacy of the LT to BVM for out-of-hospital cardiac arrest in a primarily volunteer-based emergency medical services.
Tracheal intubation with a VivaSight-SL endotracheal tube by paramedics in a cervical-immobilized manikin Łukasz Szarpak, Zenon Truszewski, Andrzej Kurowski, Łukasz Czyzewski, Togay Evrin, Łukasz Bogdanski
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.013
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 15 2015
x The incidence of cervical spine injury is reported to be from 1% to 4% in all major trauma victims and may be as high as 34% in patients with severe injuries [1]. Endotracheal intubation is still considered a gold standard to secure the airway of severely ill or injured patients [2–4]. However, pre-hospital intubation using direct laryngoscopy is more difficult than in-hospital, with a relatively high rate of failed intubations [5]. A helpful option may be novel techniques of intubation, including video laryngoscopes, for example, the VivaSight-SL (ETView; ETView Ltd, Misgav, Israel).
Clinically meaningful reduction in pain severity in children treated by paramedics: a retrospective cohort study Paul A. Jennings, Bill Lord, Karen Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.026
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: June 17 2015
x Pediatric pain is a common presenting symptom in the prehospital setting; however, there is a lack of data identifying factors associated with effective pain management in this population. We sought to identify the factors associated with clinically meaningful pain reduction in children.
Comparison of infant intubation through the TruView EVO2, TruView PCD, and Miller laryngoscope by paramedics during simulated infant cardiopulmonary resuscitation: A randomized crossover manikin study Łukasz Szarpak, Andrzej Kurowski, Łukasz Czyżewski, Marcin Madziała, Zenon Truszewski
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.018
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: February 19 2015
x The aim of the study was to compare the efficacy of the TruView EVO2, TruView PCD, and Miller laryngoscopes for tracheal intubation during cardiopulmonary resuscitation with and without chest compressions (CCs) by paramedics in an infant manikin model.
Comparison of intubation through the McGrath MAC, GlideScope, AirTraq, and Miller Laryngoscope by paramedics during child CPR: a randomized crossover manikin trial Lukasz Szarpak, Katarzyna Karczewska, Togay Evrin, Andrzej Kurowski, Lukasz Czyzewski
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.017
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: April 21 2015
x Advanced airway management and endotracheal intubation (ETI) during cardiopulmonary resuscitation (CPR) is more difficult than, for example, during anesthesia. However, new devices such as video laryngoscopes should help in such circumstances. The aim of this study was to compare the performance of 4 intubation devices in pediatric manikin-simulated CPR.
Randomized crossover trial of laryngeal tube exchange by paramedics during simulated resuscitation Lukasz Szarpak, Andrzej Kurowski, Lukasz Czyzewski, Lukasz Bogdanski, Piotr Zasko
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.049
The American Journal of Emergency Medicine , Vol. 33 , Issue 7 ,
Published online: April 29 2015
x The recent article by Budde et al [1], which compares 2 techniques of laryngeal tube (LT) exchange by 30 anesthesia providers, was of great interest to us. Two fiberoptic bronchoscope–facilitated techniques for exchanging an LT for an endotracheal tube (ETT) were compared: an intraluminal technique using an Auntree intubating catheter and an extraluminal technique using a nasal route alongside the laryngeal tube disposable (LT-D) (size 4; VBM Medizintechnik GmbH, Noblesville, IN). The article suggests that the intraluminal technique may be a suitable alternative for fiberoptic-guided rapid exchange of the LT for an ETT.
Comparison of 4 Supraglotttic Devices Used by Paramedics During Simulated CPR : A Randomized Controlled Crossover Trial Łukasz Szarpak, Andrzej Kurowski, Zenon Truszewski, Oliver Robak, Michael Frass
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.050
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: April 29 2015
x Ensuring an open airway during cardiopulmonary resuscitation is fundamental. The aim of this study was to determine the success rate of blind intubation during simulated cardiopulmonary resuscitation by untrained personnel.
Child endotracheal intubation with a Clarus Levitan fiberoptic stylet vs Macintosh laryngoscope during resuscitation performed by paramedics: a randomized crossover manikin trial Lukasz Szarpak, Zenon Truszewski, Lukasz Czyzewski, Andrzej Kurowski, Lukasz Bogdanski, Piotr Zasko
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.003
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: June 6 2015
x The main cause of cardiac arrest in pediatric patients is respiratory failure.
A pilot study of emergency medical technicians' field assessment of intoxicated patients' need for ED care Alexandra H. Cornwall, Nickolas Zaller, Otis Warren, Kenneth Williams, Nina Karlsen-Ayala, Brian Zink
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.004
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: November 7 2011
x Alcohol–intoxicated individuals account for a significant proportion of emergency department care and may be eligible for care at alternative sobering facilities. This pilot study sought to examine intermediate-level emergency medical technician (EMT) ability to identify intoxicated individuals who may be eligible for diversion to an alternative sobering facility.
Paramedics successfully perform humeral EZ-IO intraosseous access in adult out-of-hospital cardiac arrest patients David Wampler, Daniel Schwartz, Joi Shumaker, Scotty Bolleter, Robert Beckett, Craig Manifold
DOI: http://dx.doi.org/10.1016/j.ajem.2011.07.010
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: October 26 2011
x Studies on humeral placement of the EZ-IO (Vidacare, Shavano Park, TX, USA) have shown mixed results. We performed a study to determine the first-attempt success rate at humeral placement of the EZ-IO by paramedics among prehospital adult cardiac arrest patients.
Video rigid flexing laryngoscope (RIFL) vs Miller laryngoscope for tracheal intubation during pediatric resuscitation by paramedics: a simulation study Lukasz Szarpak, Andrzej Kurowski, Lukasz Czyzewski, Antonio Rodríguez-Núñez
DOI: http://dx.doi.org/10.1016/j.ajem.2015.04.054
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: April 29 2015
x Endotracheal intubation (ETI) is an essential resuscitation procedure in children. Video laryngoscopes have been developed to avoid intubation failures in a variety of scenarios, including cardiopulmonary resuscitation. We hypothesized that the video laryngoscope RIFL (AI Medical Devices, Inc, Williamston, MI) offers advantages in the ETI of a pediatric manikin while performing chest compressions (CCs).
Tele-ultrasound and paramedics: real-time remote physician guidance of the Focused Assessment With Sonography for Trauma examination Keith S. Boniface, Hamid Shokoohi, E. Reed Smith, Kari Scantlebury
DOI: http://dx.doi.org/10.1016/j.ajem.2009.12.001
The American Journal of Emergency Medicine , Vol. 29 , Issue 5 ,
Published online: April 14 2010
x The aim of this study was to examine the capability of ultrasound-naïve paramedics to obtain interpretable Focused Assessment With Sonography for Trauma (FAST) images under the remote direction of emergency physicians (EPs).
Transmission of 12-lead electrocardiographic tracings by Emergency Medical Technician–Basics and Emergency Medical Technician–Intermediates: a feasibility study Howard A. Werman, Robert Newland, Brad Cotton
DOI: http://dx.doi.org/10.1016/j.ajem.2010.01.015
The American Journal of Emergency Medicine , Vol. 29 , Issue 4 ,
Published online: May 5 2010
x Prehospital transmission of the electrocardiogram (ECG) in ST-elevation myocardial infarction patients has been shown to reduce door to treatment time and improve outcome. Acquisition of the ECG tracing is a paramedic skill, thus limiting the benefit of early ECG transmission to primarily urban areas. The purpose of this investigation was to determine whether prehospital ECGs could be transmitted by nonparamedic personnel.
Disposable stainless steel vs plastic laryngoscope blades among paramedics Frank D. Dos Santos, Roberto Schnakofsky, Anthony Cascio, Junfeng Liu, Mark A. Merlin
DOI: http://dx.doi.org/10.1016/j.ajem.2009.12.022
The American Journal of Emergency Medicine , Vol. 29 , Issue 6 ,
Published online: April 5 2010
x Several studies have been published in the literature about intubation methods, but little is available on intubation equipment used in this setting. This is the first prehospital comparison of disposable plastic vs disposable stainless steel laryngoscope blades used by paramedics.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(15)00997-3
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published in issue: December 2015
Is 15 minutes an appropriate resuscitation duration before termination of a traumatic cardiac arrest? A case-control study Cheng-Yu Chien, Yi-Chia Su, Chi-Chun Lin, Chan-Wei Kuo, Shen-Che Lin, Yi-Ming Weng
DOI: http://dx.doi.org/10.1016/j.ajem.2015.12.004
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: December 11 2015
x Previous guidelines suggest up to 15 minutes of cardiopulmonary resuscitation (CPR) accompanied by other resuscitative interventions before terminating resuscitation of a traumatic cardiac arrest. The current study evaluated the duration of CPR according to outcome using the model of a county-based emergency medical services (EMS) system in Taiwan.
2010: the emergency medical services literature in review Benjamin J. Lawner, Jose Victor Nable, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.031
The American Journal of Emergency Medicine , Vol. 30 , Issue 6 ,
Published online: December 14 2011
Prehospital endotracheal intubation and survival after out-of-hospital cardiac arrest: results from the Korean nationwide registry Kyung Kang, Taeyun Kim, Young Sun Ro, Yu Jin Kim, Kyung Jun Song, Sang Do Shin
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.036
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 2 2015
x Optimal out-of-hospital cardiac arrest (OHCA) airway management strategies are still controversial. Recent studies reported survival was higher among patients who received bag-valve-mask (BVM) than those receiving endotracheal intubation (ETI) or supraglottic airway (SGA). The aim of this study was to compare neurologically favorable survival outcomes among adult nontraumatic OHCA patients by prehospital airway.
Air pollution and activation of mobile medical team for out-of-hospital cardiac arrest Catherine Pradeau, Virginie Rondeau, Emilie Lévèque, Pierre-Yves Guernion, Eric Tentillier, Michel Thicoipé, Patrick Brochard
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.007
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: December 15 2014
x The association between air pollution exposure and cardiovascular events is well established, and the effect of short-term exposure on out-of-hospital cardiac arrest (OHCA) has received some attention. The effect of air pollution exposure and the activation of mobile intensive care units (MICUs) for cardiac arrest have never been studied.
