Prehospital Telemedical Emergency Management of Severely Injured Trauma Patients

2018 ◽  
Vol 57 (05/06) ◽  
pp. 231-242 ◽  
Author(s):  
Birgit Reime ◽  
Thomas Wurmb ◽  
Uwe Kippnich ◽  
Layal Shammas ◽  
Asarnusch Rashid ◽  
...  
Keyword(s):  
Trauma Care ◽  
A Priori ◽  
Treatment Quality ◽  
Cochrane Library ◽  
Trauma Patients ◽  
Comprehensive Overview ◽  
Prehospital Trauma Care ◽  
Final Sample ◽  
Electronic Database Search ◽  
Video And Audio

Background Trauma is a global burden. Emergency medical services (EMS) provide care for individuals who have serious injuries or suffered a major trauma. Objective This paper provides a comprehensive overview of telemedicine applications in prehospital trauma care. Methods We conducted a systematic review according to PRISMA guidelines. We identified articles by electronic database search (PubMed, EMBASE, the Cochrane Library, CINAHL, SpringerLink, LIVIVO, DARE, IEEE Xplore, Google Scholar and ScienceDirect) using keywords related to prehospital settings, ambulance, telemedicine and trauma. Search terms and inclusion criteria were specified a priori by the PICOS template and revised throughout a configurative approach iteratively, to outline the complexity and variety of different telemedical concepts. Results A final sample of 15 records was systematically selected. Most interventions were piloted and/or evaluated in Germany for trauma victims in prehospital settings. Six studies were simulated scenarios. Telemedical assistance (TMA) via real-time telemetry systems (RTS), enabling video and audio conferencing between EMS by tele-emergency physicians (TEP) were associated with a higher treatment quality and a shorter time-to-treatment in invasive procedures. By initiating in-hospital preparations based on telemedical prehospital notification (TPN), loss of information during the clinical handover was reduced and in-hospital protocols were activated with high accuracy. Remotely guided ultrasound (Tele-Ultrasound) by TEP showed an overall high diagnostic accuracy in simulations. Technical solutions were reliable, seemed practical and auspicious. Conclusion The review indicates that TMA and TPN are accompanying telemedical concepts in out-of-hospital trauma care. Well-designed populated studies are needed to fully assess the effect of telemedicine in acute trauma care. Therefore, evidence regarding the effectiveness of telemedicine in prehospital setting for trauma patients is still limited.

scholarly journals Prehospital Trauma Care Registry Problems in South Brazil

2014 ◽  
Vol 3 (3) ◽  
pp. 97-100
Author(s):  
Adonis Nasr ◽  
Phillipe Abreu-Reis ◽  
Iwan Collaço ◽  
Flavio Saavedra Tomasich
Keyword(s):  
Trauma Care ◽  
Trauma Center ◽  
Prehospital Care ◽  
Gunshot Wounds ◽  
Trauma Patients ◽  
Continuous Variables ◽  
Electronic Data Collection ◽  
Prehospital Trauma Care ◽  
Care Assessment ◽  
South Brazil

ABSTRACT Background Trauma registry remains a great problem to most countries that are implementing trauma systems. Nondigital data assessment and storage may lead to information deterioration along the process. In order to verify the missing registry in prehospital trauma rescuers’ form, we ran this study. Study design A prospective observational noncontrolled study with 288 random trauma cases brought to a Level 1 Trauma Center in Curitiba, between May 28th and June 10th 2006. We analyzed data registered in the prehospital rescue team form. The including criteria were all patients delivered to the trauma center by ambulances. The excluding criteria were patients not transported by ambulances and those without the proper form filled out. Statistical analysis was performed using the Chi-square for discrete, and the student's t-test for continuous variables. Results Two hundred and eighty-eight trauma cases were observed. Twelve patients were excluded. Of the 276 patients who met the including criteria, 75% were men with a mean age of 27-year-old. In only 8.34% of times patients were brought by doctors, while in 91.66% by paramedics. 63.4% of patients were traffic injuries victims, followed by 12.31% falls, 6.52% falls from the high, 5.79% gunshot wounds, 5.34% assaults, 3.62% stab wounds, 2.89% others. Impressively, 16 patients (5.89%) had no records of respiratory rate from the prehospital care assessment, 20 (7.24%) had no data of systolic blood pressure and 13(4.71%)had no pulse registry. Furthermore, 31.25% of the RR not registered were abnormal in the hospital admission evaluation, as well as 15% of the SBPs, and 23% of HR. None of the cases had information regarding time from the scene to the hospital. Conclusion Electronic data collection shall make checklists consistently filled out. It is not well understood the importance of registering data for most of healthcare providers working in the field, especially when they do not follow the in-hospital care of trauma patients. How to cite this article Abreu-Reis P, Tomasich FS, Nasr A, Collaco I. Prehospital Trauma Care Registry Problems in South Brazil. Panam J Trauma Crit Care Emerg Surg 2014;3(3):97-100.

Effect of age on the interaction between heart rate and mortality in prehospital trauma care

2021 ◽  
Keyword(s):  
Heart Rate ◽  
Trauma Care ◽  
Primary Outcome ◽  
Interaction Analysis ◽  
Secondary Outcome ◽  
Trauma Patients ◽  
Prehospital Trauma Care ◽  
Care Protocol ◽  
Trauma Mortality ◽  
Effect Of Age

Objectives: The association between tachycardia and age in prehospital trauma mortality has not been thoroughly studied. The purpose of this study was to evaluate the interaction effects of age between prehospital tachycardia and mortality in adult trauma patients. Methods: Adult trauma patients during 2012, 2013, and 2015 who were treated and transported by emergency medical services (EMS) were analyzed. Main exposure was tachycardia (>90 beat/min) measured at the scene. The primary outcome was mortality, the secondary outcome was worsened disability. Multivariable logistic regression with interaction models between tachycardia and age was used to calculate the adjusted odds ratio (AOR) with 95% confidence intervals after adjusting for confounders. Results: A total of 35,542 patients were analyzed. Tachycardia had a significant association with mortality and worsened disability: 1.41 (1.28–1.54) for mortality and 1.25 (1.15–1.36) for worsened disability. In the interaction analysis, the AOR for mortality by tachycardia in age over 84 years was insignificant: 1.2 (1.11–1.3) for 15–64 years, 1.4 (1.29–1.52) for 65–84 years, 1.14 (0.92–1.42) for age over 85 years, respectively (p < 0.01 for interactions). Conclusion: Tachycardia had a significant association with mortality and worsened disability in prehospital trauma patients and age over 85 years old had a significantly different interaction effect. Prehospital trauma care protocol should include recognizing severe cases based on the patient’s heart rate and age. It would be helpful in the decision-making at the scene such as trauma center transfer and advanced treatment.

scholarly journals Appraisal of systematic reviews on interventions for postpartum depression: systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryan Chow ◽  
Eileen Huang ◽  
Allen Li ◽  
Sophie Li ◽  
Sarah Y. Fu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postpartum Depression ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
A Priori ◽  
Behavioural Therapy ◽  
Therapeutic Interventions ◽  
Current Evidence ◽  
Cochrane Library ◽  
Measurement Tool

Abstract Background Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions. Methods An electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD. Results Of the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, − 0.09 to 0.34), or source of funding (p = 0.19). Conclusion Overall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.

scholarly journals Effectiveness of trauma care systems at different stages of development in reducing mortality: a systematic review and meta-analysis protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047439
Author(s):  
Rayan Jafnan Alharbi ◽  
Virginia Lewis ◽  
Sumina Shrestha ◽  
Charne Miller
Keyword(s):  
Systematic Review ◽  
Trauma Care ◽  
Data Extraction ◽  
Meta Analysis ◽  
Trauma System ◽  
Secondary Data ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Trauma Systems ◽  
Stages Of Development

IntroductionThe introduction of trauma systems that began in the 1970s resulted in improved trauma care and a decreased rate of morbidity and mortality of trauma patients. Worldwide, little is known about the effectiveness of trauma care system at different stages of development, from establishing a trauma centre, to implementing a trauma system and as trauma systems mature. The objective of this study is to extract and analyse data from research that evaluates mortality rates according to different stages of trauma system development globally.Methods and analysisThe proposed review will comply with the checklist of the ‘Preferred reporting items for systematic review and meta-analysis’. In this review, only peer-reviewed articles written in English, human-related studies and published between January 2000 and December 2020 will be included. Articles will be retrieved from MEDLINE, EMBASE and CINAHL. Additional articles will be identified from other sources such as references of included articles and author lists. Two independent authors will assess the eligibility of studies as well as critically appraise and assess the methodological quality of all included studies using the Cochrane Risk of Bias for Non-randomised Studies of Interventions tool. Two independent authors will extract the data to minimise errors and bias during the process of data extraction using an extraction tool developed by the authors. For analysis calculation, effect sizes will be expressed as risk ratios or ORs for dichotomous data or weighted (or standardised) mean differences and 95% CIs for continuous data in this systematic review.Ethics and disseminationThis systematic review will use secondary data only, therefore, research ethics approval is not required. The results from this study will be submitted to a peer-review journal for publication and we will present our findings at national and international conferences.PROSPERO registration numberCRD42019142842.

Rehabilitation of Post Stroke Sensory Dysfunction—A Scoping Review

2021 ◽  
pp. 251660852098429
Author(s):  
Dorcas B. C. Gandhi ◽  
Ivy Anne Sebastian ◽  
Komal Bhanot
Keyword(s):  
Motor Behavior ◽  
Sensory Modality ◽  
Sensory System ◽  
Sensory Stimulation ◽  
Current Evidence ◽  
Cochrane Library ◽  
Post Stroke ◽  
Sensory Dysfunction ◽  
Electronic Database Search ◽  
External Stimuli

Sensory dysfunction is one of the common impairments that occurs post stroke. With sensory changes in all modalities, it also affects the quality of life and incites suicidal thoughts. The article attempts to review and describe the current evidence of various approaches of assessment and rehabilitation for post-stroke sensory dysfunction. After extensive electronic database search across Medline, Embase, EBSCO, and Cochrane library, it generated 2433 results. After screening according to inclusion and exclusion criteria, we included 11 studies. We categorized data based on type of sensory deficits and prevalence, role of sensory system on motor behavior, type of intervention, sensory modality targeted, and dosage of intervention and outcome measures used for rehabilitation. Results found the strong evidence of involvement of primary and secondary motor areas involved in processing and responding to somatosensation, respectively. We divided rehabilitation approaches into sensory stimulation approach and sensory retraining approach focused on using external stimuli and relearning, respectively. However, with varied aims and targeted sensory involvement, the study applicability is affected. Thus, this emerges the need of extensive research in future for evidence-based practice of assessments and rehabilitation on post-stroke sensory rehabilitation.

scholarly journals Accuracy and Reliability of Soft Tissue Landmarks Using Three-Dimensional Imaging in Comparison With Two-Dimensional Cephalometrics: A Systematic Review

2020 ◽  
Vol 54 (4) ◽  
pp. 289-296
Author(s):  
Adeeba Ali ◽  
Anil K. Chandna ◽  
Anshul Munjal
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
3D Imaging ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Database Search ◽  
Cochrane Library ◽  
Two Dimensional ◽  
Imaging Tool ◽  
Electronic Database Search

Background: Concerns about the accuracy and reliability of soft tissue landmarks using two-dimensional (2D) and three-dimensional (3D) imaging. Objective: The aim of the systematic review is to estimate accuracy and reliability of soft tissue landmarks with 2D imaging and 3D imaging for orthodontic diagnosis planning and treatment planning purposes. Data Sources: Electronic database search was performed in MEDLINE via PubMed, Embase via embase.com, and the Cochrane library website. Selection Criteria: The data were extracted according to two protocols based on Centre for Evidence-Based Medicine (CEBM) critical appraisal tools. Next, levels of evidence were categorized into three groups: low, medium, and high. Data Synthesis: Fifty-five publications were found through database search strategies. A total of nine publications were included in this review. Conclusion According to the available literature, 3D imaging modalities were more accurate and reliable as compared to 2D modalities. Cone beam computed tomography (CBCT) was considered the most reliable imaging tool for soft tissues.

Prehospital trauma care: what do we really know?

2007 ◽  
Vol 13 (6) ◽  
pp. 691-696 ◽  
Author(s):  
Moishe Liberman ◽  
Bahman S Roudsari
Keyword(s):  
Trauma Care ◽  
Prehospital Trauma Care

scholarly journals The Role of Traditional Acupuncture in Patients with Fecal Incontinence—Mini-Review

2021 ◽  
Vol 18 (4) ◽  
pp. 2112
Author(s):  
Agne Sipaviciute ◽  
Tomas Aukstikalnis ◽  
Narimantas E. Samalavicius ◽  
Audrius Dulskas
Keyword(s):  
Fecal Incontinence ◽  
Randomized Controlled Trials ◽  
The Elderly ◽  
Bowel Dysfunction ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Treatment Technique ◽  
Randomized Controlled ◽  
Electronic Database Search ◽  
Irritable Bowel

Objective: Fecal incontinence affects up to 15% of the general population, with higher rates of incidence among women and the elderly. Acupuncture is an old practice of Traditional Chinese Medicine that might be used to treat fecal incontinence. The aim of this mini review was to assess the effect of acupuncture for fecal incontinence. Materials and Methods: Cochrane Library, Web of Science, Embase, PubMed, and CENTRAL electronic databases were searched until August 2020. The following keywords were used: acupuncture, electroacupuncture, moxibustion, fecal incontinence, diarrhea, irritable bowel syndrome, and bowel dysfunction. In addition, references were searched. Five studies (two randomized controlled trials), out of 52,249 predefined publications after an electronic database search, were included into the review. Results: Overall, 143 patients were included. All studies report significant improvements in continence, although they all apply different acupuncture regimens. Randomized controlled trials show significant differences in experimental groups treated with acupuncture in improving continence. Significant improvement in quality of life scores was reported. In addition, improvement in fecal continence remained significantly improved after 18 months of follow-up. Conclusion: Acupuncture is a promising treatment alternative for fecal incontinence. Based on small, low-quality studies, it might be a safe, inexpensive, and efficient method. However, more high-quality studies are needed in order to apply this treatment technique routinely.

scholarly journals Advances in prehospital trauma care

2011 ◽  
Vol 1 (1) ◽  
pp. 44 ◽  
Author(s):  
Andreas Grabinsky ◽  
Kelvin Williamson ◽  
Ramaiah Ramesh
Keyword(s):  
Trauma Care ◽  
Prehospital Trauma Care
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