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Topic: Pre-hospital

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Pre-Hospital Care and Hazmat Medical Considerations Hospitals must be prepared to carry out their missions without jeopardizing the safety and health of their own personnel. To provide appropriate pre-hospital emergency medical care consistent with their certification. Hospitals should have access to a database that is compiled by the local LEPC to provide immediate information to hospital staff on the hazards associated with exposure to toxic materials that may be used in the community. www.silcom.com /~pordecon/medical_protocols.htm

Clinics and Medical Services Hospital Admissions Office recommends that the patient check with their insurance carrier to verify that visit has been authorized/pre-certified or physician referral has been obtained. A Hospital Admissions Representative will complete the Medicare Secondary Payor Questionnaire (MSP) when the patient arrives for their surgery, test or procedure. The hospital recommends that all patients check with their physician/surgeon to determine if the patient will need another individual to transport patient to their home after surgery, test or procedure. www.uams.edu /medcenter/preregistration.asp

Acute stroke: pre-hospital In the hospitals that have a stroke team but are not equipped to perform the thrombolysis, an optimal management of a stroke patient should be aimed to define the diagnosis (even using telemedicine), and to maintain stable clinical conditions. Hospitals without a stroke unit may be equipped with a mobile stroke team formed by a physician and nurses available on call 24/24 hours. A timely hospital referral of a recent transient ischaemic attack (TIA) is always advisable and the hospital admission is recommended in case of crescendo TIAs, or duration of symptoms >1 hour, or if there is a known embolic source (arterial or cardiac). www.spread.it /SpreadEng/Acute_08.htm

Elliot Hospital - Services: Pre-Admission Information Having to take care of this at the hospital may become a test of one's patience and strength, just when a minimum of stress is called for. Anticipating a visit to the hospital for a test or procedure can be nerve-wracking. All of the information that is necessary for us to gather about a patient in order to ensure optimum care and the patient's health and safety means a time-consuming procedure. www.elliothospital.org /services/patients/admission.html

Exec Summary Vol 2: Number 17. The costs and benefits of paramedic skills in pre-hospital trauma care A stratified random sample of 244 deaths occurring within 3 days of the incident was examined by a panel of five experts in pre-hospital care to assess the role of pre-hospital care in any avoidable deaths. Patients with serious trauma who died or stayed in hospital for 3 or more nights, and who were not attended by a doctor on scene, were eligible for inclusion. Characteristics of the incidents, the patients and their injuries, and the crews attending were taken from ambulance service dispatch records and patient report forms, from hospital accident and emergency (AandE), inpatient, and administrative records, and from coroners' records. www.hta.nhsweb.nhs.uk /execsumm/SUMM217.HTM

Scope: Pre-hospital initiation of fluid replacement therapy in trauma The decision of whether to initiate pre-hospital fluid therapy in trauma involves a careful consideration of the risk of death as a result of ischaemic damage to vital organs as a result of underresuscitation, and the risk of overresuscitation exacerbating uncontrolled bleeding, or causing re-bleeding after bleeding has been controlled. The aim of pre-hospital fluid replacement therapy in hypovolaemic trauma patients is to improve the haemodynamic state on arrival at hospital. The remit from the Department of Health/National Assembly for Wales was "To advise on the clinical and cost effectiveness of pre-hospital initiation of fluid replacement therapy in trauma, and if the evidence allows on the selection of patients for which this may be appropriate" www.nice.org.uk /page.aspx?o=42390

Healthy Heart - Pre-Hospital Care A pilot scheme is proposed to trial the transmission and receipt of data from an ECG monitor, as well as other patient information from an ambulance to a hospital. Implementation of ambulance to hospital patients data trial Automated external defibrillators (AEDs) have been in effective use by our Ambulance Service for 8 years and are reaching the end of their service life and are in need of replacement. www.shb.ie /content422724569_1.cfm

Pre-hospital antibiotic treatment of meningococcal disease: scope for improvement This study suggests there is scope for improvement to the pre-hospital management of suspected cases of meningococcal disease in Auckland. Interference with hospital tests and fear of rendering cultures sterile is misguided if the consequence of delayed treatment is death. These include diagnostic uncertainty, concern about interference with hospital tests, the belief that patients will be treated promptly once in hospital, fears of administering unnecessary treatment or causing an anaphylactic reaction, and unproven benefit. www.nzma.org.nz /journal/116-1182/603

Study Shows Pre-Hospital Administration Of Retavase (Reteplase) Can Accelerate Important Treatment Of Heart-Attack Patients The rapid pre-hospital administration of Retavase worked to stabilize heart attack patients, with 26% already showing a greater than 50% resolution of their elevated ST segments, an electrocardiogram indicator of heart health, by the time they arrived at the emergency room. The study found that for patients receiving pre-hospital treatment with Retavase, the median time from EMS arrival to the first Retavase bolus was 31 minutes, compared with 63 minutes for those given Retavase at the hospital. The primary endpoint is time saved with pre-hospital initiation of Retavase in fibrinolytic-eligible patients with ST elevation on a 12-lead ECG, transmitted to hospital-based medical control physicians. www.docguide.com /dg.nsf/PrintPrint/0C51EDCF05BE2EDE85256BEB005B1A18

Pre-Hospital Heart Attack Treatment Now Available This allows the physician standing by at the hospital to determine if the patient is having a heart attack. The first dose is given by the paramedics and (30 minutes later) the second dose is administered at the hospital. The ECG is then transmitted via cellular phone to a special receiving unit in the hospital emergency department. www.pslgroup.com /dg/2ecd2.htm

Health Industry Today: Market Memo: Emergency equipment market driven by pre-hospital revenues The market as defined Market segments in the hospital and pre-hospital emergency and trauma arenas range from basic and simple equipment like backboards and extrication collars, to technologically advanced devices such as defibrillators and EKG machines. The good news is that the market for pre-hospital emergency and trauma equipment is really healthy, and is expected to remain that way well into the next century. The bad news is that the hospital market for emergency equipment is in the dumps. www.findarticles.com /p/articles/mi_m3498/is_5_62/ai_54528584

Healthy Heart - Pre-hospital Care Intro The recognition that most deaths from cardiac arrest occur soon after onset of symptoms and outside of hospital can, if acted upon, lead to a reduction in mortality and morbidity from cardiovascular disease in the pre-hospital setting. GPs, Community Care services, Health Promotion, Voluntary Organisations, Community Hospitals, etc. The Cardiovascular Health Strategy Group has called for the implementation in full of the recommendations of the Review Group on the Ambulance Service. This should be inclusive of all those other health care professionals and voluntary agencies in the Community, i.e. www.shb.ie /content1872747076_1.cfm

Appraisal Consultation Document Pre-hospital initiation of fluid replacement therapy in trauma Ambulance crews are usually the first healthcare professionals to attend an accident scene, where they assess the general physiological state of the patient to determine both what pre-hospital interventions are needed and the necessary speed of transfer to hospital, depending on injury severity. The Committee considered the issue of training for those administering pre-hospital IV fluid therapy, and concluded that only paramedics or other healthcare professionals with appropriate training in ALS techniques and pre-hospital care should administer IV fluid therapy to trauma patients in the pre-hospital setting. The Committee considered cautious administration of IV fluid (with 250 ml boluses titrated against the presence of a radial pulse, with reassessment) to be appropriate for trauma patients with concomitant head injury, because this would not further compromise the perfusion of the vital organs. www.nice.org.uk /page.aspx?o=85337

Acute myocardial infarction: bring the treatment to the patient -- BOERSMA 82 (4): 404 -- Heart The ideal reperfusion strategy does not exist: prehospital thrombolysis enables very early treatment but does not always result hospitals with adequate facilities, which drastically limits the hospitals adequately equipped for and experienced in this mode www.heartjnl.com /cgi/content/full/82/4/404

BBC NEWS Northern Ireland Heart pioneer dies aged 88 Before this, defibrillators could only be operated from the mains electricity supply in hospitals. Seven out of 10 cardiac arrests happened outside hospital, but only 2 to 3% of these cases survive. Cardiac arrests usually occur because of a heart attack, when the heart is starved of oxygen. news.bbc.co.uk /go/newsFeedXML/moreover/-/1/hi/northern_ireland/4132835.stm

Impact of pre-hospital care in patients with acute myocardial infarction compared with those first managed in-hospital -- Mathew et al. 24 (2): 161 -- European Heart Journal Pre hospital thrombolysis in acute myocardial infarction: The Belgian Eminase Pre hospital Study (BEPS). Impact of pre-hospital care in patients with acute myocardial infarction compared with those first managed in-hospital -- Mathew et al. In-hospital mortality for the 750 patients was 11% (n=82) and www.eurheartj.org /cgi/content/full/24/2/161

Noninvasive- Pre-Hospital And data transmission capabilities allow serial comparisons to be performed at the hospital, providing more thorough, patient-specific assessment prior to arrival while assuring proper courses of action are ready upon arrival. GE Medical Systems has been instrumental in linking cardiology data in the field with the hospital's cardiology database, offering more informed decision-making and prompt, confident response at the earliest stages of patient interaction. If you do not agree, do not use the site or download any materials from it. www.gehealthcare.com /seen/cardiology/non_invasive/prehospital/prehospital.html

MeditSense 300E for Pre-Hospital Applications Pre-hospital services can now integrate their diagnostics recordings directly with Medical Advisory Center databases or a receiving hospitals’ electronic Patient File System (PFS) to reduce delays when arriving at the hospital and ensure continuity of patient care. MeditSense 300E is a complete solution which includes a rugged tablet PC running standard Windows 2000 operating system with the MedIT software application pre-installed and a back up CD. The MeditSense 300E is a robust yet high quality diagnostic solution built to handle usage in emergency medical situations including ambulances, ships, oil platforms or any location outside a hospital where a patient experiences a cardiovascular emergency. www.medit.no /product_solutions/product.asp?thisId=1040640098

Barnes-Jewish Hospital - Pre-Registration Please use this form only for hospital pre-registration. Barnes-Jewish Hospital is following federal guidelines that help protect patient's health information by limiting the amount of information provided to the public without patient authorization. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that is designed to ensure the portability of health insurance for individuals from one job to another and protect patient health information. www.barnesjewish.org /prereg

Welcome to Hartford Hospital! Hartford Hospital has achieved Magnet Recognition by the American Nursing Association for Nursing Excellence. We're the Top 100 Hospital with the Most Top-Ranked Doctors in Connecticut. By using the Hartford Hospital web site, you agree to these terms and conditions. www.harthosp.org

Pre-Hospital Certification As a base hospital, CGRMC provides 24-hour communication with a medical doctor to paramedics and EMT’s who may be performing basic or advanced life support to patients prior to arriving at the emergency department. “Thanks to all the staff members at the hospital and all the members of our agencies whose dedication made this flawless review possible. Casa Grande Regional Medical Center (CGRMC) recently received re-certification as an Advanced Life Support Base Hospital with no corrective actions. www.casagrandehospital.com /cgrmc.nsf/View/prehospital_cert

Welcome The Pre-hospital Trauma Course is an intensive programme aimed at providing candidates with the skills and knowledge to recognise the seriously injured patient and to provide appropriate interventions to manage the patient in the pre hospital environment, within their scope of professional practice. The course team, through a flexible and interactive approach to teaching and learning, strives to enable candidates to draw upon their previous experience and training in developing their ability to provide high quality care for the seriously injured individual during the pre hospital phase of care and within their scope of professional practice. The diversity of backgrounds of both faculty and the student body is valued in the contribution it makes to the richness of the learning experience.Teaching will draw upon the evidence based, nationally agreed guidelines and expert consensus opinion where such evidence exists. www.wmcareteam.com /teampages/phtc.htm

The Pre-hospital Volunteer Once at hospital, the sling can be left in place during x-rays (it is radiolucent and claimed to be almost invisible on x-rays) and until definitive stabilisation can be achieved. It is claimed that the sling can remain in place for several days. If necessary, it only takes seconds to release the sling and reapply the tension. www.prehospitalvolunteer.org.uk /SAM%20Pelvic.dwt

Pre-hospital Care of Road Traffic Injuries in Chiang Mai, Thailand The research objectives were (a) to describe how emergency rescue services are organized in Chiang Mai, (b) to examine ongoing public health efforts to improve emergency services, and (c) to document the training, certification, employment, and medical use of pre-hospital personnel. Thailand’s national and local pre-hospital services (i.e., services designed to transfer persons with traffic injuries into the country’s hospital infrastructure) are both insufficient and inefficient. The Thai National Government has promised funding to create a national EMS network by 2006. repositories.cdlib.org /its/tsc/UCB-TSC-RR-2004-18

Health Quest Offering the full range of hospital services, pre-hospital emergency care, homecare and nursing home care, the Health Quest system provides immediate and caring service to the one million people who reside in the New York counties of Columbia, Dutchess, Ulster, Orange, Putnam and northern Westchester. The not-for-profit system includes three hospitals with 647 beds, 29,000 patient admissions and 81,000 emergency room visits. Health Quest is the Mid-Hudson Valley's largest healthcare network providing the highest quality care across a broad spectrum of services. www.health-quest.org /index.html

Pre-hospital Paediatric Life Support - Advanced Life Support Group - Mobipocket eBooks This text was written especially for prehospital staff and provides the information needed to deal with seriously ill and severely injured children before arrival at hospital. Emphasis is placed in as speedy a transportation to hospital as possible, while providing appropriate emergency care. Download Mobipocket Reader and install it on your PDA or computer. www.ebookmall.com /ebook/93434-ebook.htm

Trauma Pre-hospital Care - OhioHealth Patient Status Follow-up provides an avenue for pre-hospital personnel to request and obtain feedback on patients brought into Riverside Methodist Hospital and Grant Medical Center. This combined effort resulted in one of the nation's largest critical care networks, serving hospitals and responding to the scene of accidents throughout Ohio when requested by EMS or law enforcement officers. Mobile Intensive Care Units provide equipment similar to what is available in hospital intensive care units, and therefore, the medical helicopter division, transporting critically ill patients form outlying hospitals to tertiary hospitals throughout Ohio. www.ohiohealth.com /medicaleducation/trauma/prehospital

Department of Emergency Medicine: Faculty He has over eleven years of experience in emergency medical services including prehospital education, flight medicine, critical care medicine, perfusion medicine, and pre-hospital administration. He received his paramedic training at Providence Hospital in Sandusky, Ohio, his Adult Critical Care training at the Medical College of Ohio and his Pediatric/Neonatal Critical Care training from the University of Maryland, Baltimore County. Most recently, he was the Administrative Director of the Centers for EMS Education and Research in Cleveland, Ohio and has continued to work as a flight paramedic for St. Vincent Mercy Medical Center and The Medical College of Ohio Life Flight program in Toledo. www.ucemergencymedicine.com /krost.asp

EMS Paramedics - New Castle County, Delaware During this phase, County Levy Court ambulances had a caseload comprised of approximately fifty- percent medical emergencies and fifty- percent non-emergency transports to and from hospitals, clinics and doctor’s offices. The second year, core paramedic curriculum will be conducted at various educational facilities, hospital clinical sites and paramedic service agencies throughout the state. The New Castle County Ambulance Service was initiated under the County Levy Court system with a single ambulance covering all of New Castle County, including the City of Wilmington in 1933. www.co.new-castle.de.us /police/NCCPolice/EMS.htm

HEART ATTACKS - Pre Hospital Emergency Care. The advent of the AED operated by people trained in its use e.g ambulance personnel, police, airport staff, airline cabin crew, voluntary service people etc., greatly improved the survival rate of heart attack victims in the pre-hospital care phase of an emergency. Equally, the AED is particularly useful in rural areas where people live quite a distance from a hospital and where ambulance response times may be proportionally lengthened. The modern AED is so sophisticated that it literally can assess its own suitability for use in any given heart attack condition. sunset.ennis.ie /article.php3?id_article=73

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