Prehospital Care for Patients with Head Injury and its Relevance to Post Traumatic Prognosis

1987 ◽  
Vol 3 (2) ◽  
pp. 15-20
Author(s):  
G. Singbartl
Keyword(s):  
Head Injury ◽  
Prehospital Care ◽  
Head Injuries ◽  
Cerebral Injury ◽  
Prehospital Emergency Care ◽  
Secondary Brain Damage ◽  
Thorax Trauma ◽  
Prehospital Emergency ◽  
Post Traumatic ◽  
Polytrauma Patients

Head injury has been demonstrated to be one of the most important lesions in polytrauma patients and of very decisive relevance to the posttraumatic prognosis. Moreover, other lesions and their sequelae (e.g. shock, thorax trauma) are known to worsen the primary cerebral injury by causing secondary brain damage due to hypotension and hypoxemia. This study considers the influence of prehospital emergency care to the posttraumatic prognosis in severe head injuries.

Challenges to Prehospital Care in Honduras

2018 ◽  
Vol 33 (6) ◽  
pp. 637-639
Author(s):  
Haley E. Bast ◽  
J. Lee Jenkins
Keyword(s):  
Health Care Services ◽  
Resource Constraints ◽  
Prehospital Care ◽  
Public Access ◽  
Public Health Care ◽  
Prehospital Emergency Care ◽  
Publication Type ◽  
Rural And Urban ◽  
Private And Public ◽  
Prehospital Emergency

AbstractThrough a longitudinal field experience and interviews with rural and urban clinic workers in Honduras, the following data were collated regarding the challenges to prehospital Emergency Medical Services (EMS) in this country. In Honduras, both private and public organizations provide prehospital emergency care for citizens and face both financial and resource constraints. These constraints manifest in operational concerns such as challenges of integration of EMS systems with each other, differences in medical direction oversight, and barriers to public access. Despite the availability of public health care services, authorities and locals alike do not recommend using the public systems due to lack of needed resources and time of emergency response.Private volunteer EMS organizations are scattered throughout the country and each operates as their own separate system. There is no single dispatch center available, nor is there a guarantee that calling for EMS will result in the patient’s desired response. In this report, the challenges are discussed with possible solutions presented.BastHE, JenkinsJL. Challenges to prehospital care in Honduras. Prehosp Disaster Med. 2018;33(6):637–639.

scholarly journals To study the association of CSF leak in fronotbasal skull fractures classified with the Burstein’s classification

2018 ◽  
Vol 5 (1) ◽  
pp. 126
Author(s):  
Raunaq S. Chhabra ◽  
Vinayak V. Raje ◽  
Pandurang S. Barve ◽  
Sunil R. Yadav
Keyword(s):  
Statistical Analysis ◽  
Head Injury ◽  
Data Collection ◽  
Head Injuries ◽  
Csf Leak ◽  
Type I ◽  
Skull Fractures ◽  
Type Ii ◽  
Post Traumatic ◽  
A Prospective Study

Background: To study the association of CSF leak in Fronotbasal skull Fractures classified with the Burstein’s Classification.Methods: A prospective study was conducted from November 2014 to May 2016 in patients admitted with head injuries to KIMSDU, Karad, Maharashtra. All data was retrieved using a standardized data collection form.Results: Out of the total 55 patients of frontobasal fracture, 39 (70.9%) were found to have CSF leak. Out of 39 patients with CSF leak 34 (61.8%) had Type I head injury, 3 (5.5%) had Type II head injury, and 2 (3.6%) had Type III head injury. Statistical analysis showed significant association between CSF leak and Burstein’s classes of head injury patients (p< 0.05).Conclusions: It was found that patients who had Burstein Type I injuries had a higher chance of CSF leak and most post traumatic leaks could be managed conservatively.

Cause of decline in head-injury mortality rate in San Diego County, California

1985 ◽  
Vol 62 (4) ◽  
pp. 528-531 ◽  
Author(s):  
Melville R. Klauber ◽  
Lawrence F. Marshall ◽  
Belinda M. Toole ◽  
Sharen L. Knowlton ◽  
Sharon A. Bowers
Keyword(s):  
Head Injury ◽  
San Diego ◽  
Head Injuries ◽  
Mortality Rates ◽  
San Diego County ◽  
Content Type ◽  
Severity Of Injury ◽  
Prehospital Emergency ◽  
Injured Patients ◽  
Number Of Individuals

✓ Even with an increasing population, there were 100 fewer deaths due to head injury in San Diego County, California, in 1982 compared to 1980. During the 5 years from 1976 to 1980 there was nearly a constant death rate from head injuries, followed in the next 2 years by a decline of 24%. The number of deaths at the scene of injury declined 28%, and the number of individuals listed as dead on arrival at the hospital declined 68%. Mortality rates in the emergency room increased slightly and later death rates declined slightly. Mortality rates of hospitalized patients, adjusted for severity of injury, did not vary materially by year. This decline in deaths due to head injury followed a marked improvement in the county's emergency ground and prehospital air evacuation services. The data strongly suggest that advanced prehospital emergency medical services can substantially reduce mortality rates in head-injured patients. The authors postulate that some patients who ordinarily “would die now talk” because of early airway and circulatory management by highly trained paramedical personnel and airborne trauma specialists. Despite a search for other factors that might explain these observations, no satisfactory alternatives could be identified.

A systematic review of prehospital telehealth utilization

2017 ◽  
Vol 24 (7) ◽  
pp. 473-481 ◽  
Author(s):  
Andrew S Winburn ◽  
Juliana J Brixey ◽  
James Langabeer ◽  
Tiffany Champagne-Langabeer
Keyword(s):  
Emergency Care ◽  
Prehospital Care ◽  
Feasibility Studies ◽  
The United States ◽  
Prehospital Emergency Care ◽  
Positive Trend ◽  
Prehospital Emergency ◽  
Store And Forward ◽  
Meta Analyses ◽  
Future Work

Objective There has been moderate evidence of telehealth utilization in the field of emergency medicine, but less is known about telehealth in prehospital emergency medical services (EMS). The objective of this study is to explore the extent, focus, and utilization of telehealth for prehospital emergency care through the analysis of published research. Methods The authors conducted a systematic literature review by extracting data from multiple research databases (including MEDLINE/PubMed, CINAHL Complete, and Google Scholar) published since 2000. We used consistent key search terms to identify clinical interventions and feasibility studies involving telehealth and EMS, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results We identified 68 articles focused specifically on telehealth interventions in prehospital care. The majority (54%) of the studies involved stroke and acute cardiovascular care, while only 7% of these (4) focused on telehealth for primary care. The two most common delivery methods were real-time video-conferencing capabilities (38%) and store and forward (25%); and this variation was based upon the clinical focus. There has been a significant and positive trend towards greater telehealth utilization. European telehealth programs were most common (51% of the studies), while 38% were from the United States. Discussion and Conclusions Despite positive trends, telehealth utilization in prehospital emergency care is fairly limited given the sheer number of EMS agencies worldwide. The results of this study suggest there are significant opportunities for wider diffusion in prehospital care. Future work should examine barriers and incentives for telehealth adoption in EMS.

Ethical Conflicts in Prehospital Emergency Care

2006 ◽  
Vol 13 (6) ◽  
pp. 592-607 ◽  
Author(s):  
Lars Sandman ◽  
Anders Nordmark
Keyword(s):  
Emergency Care ◽  
Prehospital Care ◽  
Self Determination ◽  
Prehospital Emergency Care ◽  
Best Interest ◽  
Focus Group Interviews ◽  
Self Identity ◽  
Ethical Conflicts ◽  
Prehospital Emergency ◽  
Group Interviews

This article analyses and presents a survey of ethical conflicts in prehospital emergency care. The results are based on six focus group interviews with 29 registered nurses and paramedics working in prehospital emergency care at three different locations: a small town, a part of a major city and a sparsely populated area. Ethical conflict was found to arise in 10 different nodes of conflict: the patient/carer relationship, the patient’s self-determination, the patient’s best interest, the carer’s professional ideals, the carer’s professional role and self-identity, significant others and bystanders, other care professionals, organizational structure and resource management, societal ideals, and other professionals. It is often argued that prehospital care is unique in comparison with other forms of care. However, in this article we do not find support for the idea that ethical conflicts occurring in prehospital care are unique, even if some may be more common in this context.

scholarly journals (A314) Challenges Faced in Establishing the Emergency Prehospital Ambulance Service in North Central Sri Lanka: Developing Something from Nothing

2011 ◽  
Vol 26 (S1) ◽  
pp. s88-s88 ◽  
Author(s):  
L. Dassanayake
Keyword(s):  
Sri Lanka ◽  
Prehospital Care ◽  
Initial Period ◽  
Ambulance Service ◽  
Prehospital Emergency Care ◽  
Trauma Patients ◽  
Infrastructure Development ◽  
North Central ◽  
Prehospital Emergency ◽  
Care System

The existence of a prehospital emergency care system signifies how secure an area is in aftermath of a health-related emergency. The systems save lives during most out-of-hospital health emergencies. Until 2010, there was no regular prehospital care system in Anuradhapura, or even in the entire north central region of Sri Lanka. Trauma patients were brought to the hospital generally with little or no prehospital care. They were transported to hospital by relatives or other people at the scene with using whatever vehicle was available at the time, which in many occasions was a trishaw. The concept of developing a prehospital emergency ambulance service to cover the municipality of Anuradhapura as a pilot project was formulated in 2009. The objectives were to: (1) provide emergency prehospital care in the municipality; (2) identify the difficulties; and (3) assess the feasibility of implementing it in the entire district. Some of the challenges faced in the process from the initial draft of the concept up to now include: 1. Studying an established emergency medical services (EMS) system; 2. Developing a pressure group in hospital; 3. Convincing the need to administration; 4. Funding in the initial period; 5. Selecting the proper team and supportive peers; 6. Providing standard training to selected staff; 7. Formulating duty norms and standard operating procedures; 8. Infrastructure development, acquiring instruments, and vehicles with limited fund capacities; 9. Cooperating with the trade unions and external/internal negative forces; 10. Rallying the collaborators with same interest; 11. Handling donors; 12. Getting the support of other key institutions (police/municipal council); 13. Utilizing local media to help promote the project; 14. Social mobilization to ensure sustainability; and 15. Ensuring worker satisfaction, encouragement, and liaison with other units of hospital.

scholarly journals Skoring outcome pasien cedera kepala menggunakan functional independence measure

2019 ◽  
Vol 11 (3) ◽  
pp. 163-170
Author(s):  
Putra Agina Widyaswara Suwaryo ◽  
Hendri Tamara Yuda
Keyword(s):  
Diabetes Mellitus ◽  
Head Injury ◽  
Head Injuries ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Daily Activities ◽  
Post Injury ◽  
Trauma Outcome ◽  
Post Traumatic ◽  
Analytic Design

Cedera kepala merupakan kasus yang paling banyak terjadi dan menjadi penyebab utama kematian dan kecacatan akibat trauma. Outcome merupakan keadaan pasien paska cedera setelah mendapatkan penanganan medis di rumah sakit. Disabilitas yang terjadi yaitu 1 tahun setelah cedera.Functional Independence Measure atau FIM adalah suatu instrumen yang bisa digunakan untuk mengukur tingkat kemandirian seseorang atau pasien. Selain itu, FIM juga digunakan untuk menilai tingkat ketergantungan pasien pasca trauma.Penelitian ini menggunakan desain analitik observasional dengan pendekatan cohort retrospektif. Analisis univariat menggunakan uji descriptive statistice. Pasien pasca cedera dan diukur tingkat kemandirian atau ketergantungan pasien cedera kepala menggunakan Functional Independence Measure atau FIM pada bulan ke-1 sampai 6. Sampel pada penelitian ini yaitu 104 pasien. Hasil penelitian didapatkan 104 pasien mengalami perbaikan selama 2 bulan dengan tingkat kemandirian tanpa dibantu orang lain untuk aktifitas sehari-hari (skor FIM 6). Ada 9 orang pasien yang mengalami ketergantungan sampai bulan ke-6 (skor FIM 2). Hal ini disebabkan karena parahnya cedera yang dialami dan disertai dengan komplikasi penyakit lain seperti hipertensi dan diabetes mellitus serta fraktur. Kesimpulan dari penelitian ini adalah FIM bisa digunakan untuk menilai tingkat kemandirian pasien pasca cedera kepala mulai dari bulan pertama sampai dengan keenam.   Kata kunci: disabilitas, functional independence measurable, outcome, cedera kepala OUTCOME SCORING OF HEAD INJURIES USING FUNCTIONAL INDEPENDENCE MEASURE   ABSTRACT Head injury is the most common case and is a major cause of death and disability due to trauma. Outcome is a post-injury condition of the patient after getting medical treatment at the hospital. Disability that occurs is 1 year after injury. Functional Independence Measure or FIM is an instrument that can be used to measure the level of independence of a person or patient. In addition, FIM is also used to assess the level of dependence of post-traumatic patients. This study uses an observational analytic design with a retrospective cohort approach. Post-injury patients and the level of independence or dependence of head injury patients was measured using Functional Independence Measure or FIM in the months 1 to 6. The sample in this study was 104 patients. The results showed 67 patients experienced improvement for 2 months with a level of independence without the help of others for daily activities (FIM score 6). There were 9 patients who experienced dependence until the 6th month (FIM score 2). This is caused by the severity of the injury suffered and is accompanied by complications of other diseases such as hypertension and diabetes mellitus and fractures. The conclusion from this study is that FIM can be used to assess the level of independence of patients after head injury from the first to the sixth month.   Keyword: disability, functional independence measura, outcome, head injury

scholarly journals Analytical report on post traumatic hydrocephalus

YMER Digital ◽  
2022 ◽  
Vol 21 (01) ◽  
pp. 144-147
Author(s):  
R Srinivas ◽  
◽  
Mohamed Naleer ◽  
Kishore Kumar ◽  
◽  
...  
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Clinical Analysis ◽  
Medical College ◽  
Fall From Height ◽  
Post Traumatic ◽  
Set Up

Post-traumatic hydrocephalus (PTH) is a field and disorder less explored in neurosurgery though we see many cases. The commonest causes in our set up includes head injury for which people have undergone decompressive craniectomies, severe head injuries with raised ICP. We did a clinical analysis on 23 cases in a period of 3 years duration from 2018 -2021. We did Evd in few cases for emergency purposes when there was decerebration and we went ahead with VP shunt in all the patients who had gross ventricular dilatation. We have projected our analytical report in these cases. METHODS A retrospective study was conducted in the Department of Neurosurgery in Sri Ramachandra medical college. The clinical outcome of patients diagnosed with PTH was studied. These cases were treated by surgery. The stastical analysis along with cause of the hydrocephalus with the outcome in pre and postoperative period were studied. RESULTS Among the 23 patients studied 82% were males. Road traffic accident was the main cause of injury. The other main cause was a fall from height. Assault was another reason for head injuries which we recorded. We found all road traffic accidents were only because of bike riders either pillion or the people driving the vehicle. . Craniotomy was done in 50 % of the patients, 90 % of the patients recovered who had a gcs of 13 to 7. People with gcs lss than 7 were intubated recovery rate was 7.5 %. . There was 100%mortality because of primary head injury in all the patients who had brain stem contusions with dilated pupil. CONCLUSIONS Trauma to head and who were operated had the highest incidence of post tramatic head injury. Smaller the decompressive craniectomies had symptomatic post traumatic head ache with post traumatic hydrocephalus.. CT scan of the brain is considered the choice of investigation toearly diagnose PTH.we even analysed the ct scan and found when there was periventricular lucency the patient outcome after VP shunting is good. KEY WORDS Hydrocephalus, Head Injury, Trauma

A prospective study of children with head injuries: I. Design and methods

1980 ◽  
Vol 10 (4) ◽  
pp. 633-645 ◽  
Author(s):  
Michael Rutter ◽  
Oliver Chadwick ◽  
David Shaffer ◽  
Gillian Brown
Keyword(s):  
Head Injury ◽  
Prospective Study ◽  
Reading Ability ◽  
School Teacher ◽  
Head Injuries ◽  
Control Group ◽  
Physical Handicap ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
A Prospective Study

SYNOPSISThe main unresolved issues with respect to the psychological sequelae of brain damage in childhood are noted, and the previous studies of children suffering head injury are critically reviewed. A new prospective study is described. Three groups of children were studied: (a) 31 children with ‘severe’ head injuries resulting in a post-traumatic amnesia of at least 7 days; (b) an individually matched control group of 28 children with hospital-treated orthopaedic injuries; and (c) 29 children with ‘mild’ head injuries resulting in a post-traumatic amnesia exceeding 1 hour but less than 1 week. The children were studied as soon as possible after the accident and then again 4 months, 1 year, and 2¼ years after the injury. The parents were interviewed, using systematic and standardized interview techniques; both parents and teachers completed behavioural questionnaires; and the children were seen for individual psychological testing using the WISC, the Neale Analysis of Reading Ability and a battery of tests of more specific cognitive functions. At the final follow-up, the severe head injury group (but not the other 2 groups) received a systematic neurological examination and the school teacher who knew the child best was personally interviewed. The findings are given on physical handicap, neurological abnormality, school placement and psychiatric referrals. All types of disabilities were both more frequent and more persistent in the children with severe head injuries.

Military Prehospital Emergency Care: defining and professionalising the levels of care provided along the Operational Patient Care Pathway

2018 ◽  
Vol 165 (3) ◽  
pp. 188-192 ◽  
Author(s):  
Danny Sharpe ◽  
J McKinlay ◽  
S Jefferys ◽  
C Wright
Keyword(s):  
Patient Care ◽  
Emergency Care ◽  
Care Pathway ◽  
Prehospital Care ◽  
The Body ◽  
Prehospital Emergency Care ◽  
Levels Of Care ◽  
Prehospital Emergency ◽  
The Right ◽  
Care Support

The Defence Medical Services aims to provide gold standard care to ill and injured personnel in the deployed environment and its prehospital emergency care (PHEC) systems have been proven to save lives. The authors have set out to demonstrate, using existing literature, consensus and doctrine that the NHS Skills for Health framework can be reflected in military prehospital care and provides an existing model for defining the levels of care our providers can offer. In addition, we have demonstrated how these levels of care support the Operational Patient Care Pathway and add to the body of evidence for the use of specialist PHEC teams to allow the right patient to be transported on the right platform, with the right medical team, to the right place. These formalised levels allow military planners to consider the scope of practice, amount of training and appropriate equipment required to support deployed operations.

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