Dear Editor,Most battlefield casualties occur prior to the arrival of medical facilities.Uncontrollable hemorrhage accounts for more than 90%of those potentially survivable battlefield casualties[1].In both military a...Dear Editor,Most battlefield casualties occur prior to the arrival of medical facilities.Uncontrollable hemorrhage accounts for more than 90%of those potentially survivable battlefield casualties[1].In both military and civilian conditions,non-compressible torso hemorrhage always caused rapid exsanguination and high mortality rates before definitive treatment[2].More than half of the deaths due to non-compressible torso hemorrhage occur before hospital care can be provided[2].Therefore,early and rapid pre-hospital hemorrhage control is essential to reduce mortality.展开更多
BACKGROUND Acute myocardial infarction(AMI)is a severe cardiovascular disease caused by the blockage of coronary arteries that leads to ischemic necrosis of the myocardium.Timely medical contact is critical for succes...BACKGROUND Acute myocardial infarction(AMI)is a severe cardiovascular disease caused by the blockage of coronary arteries that leads to ischemic necrosis of the myocardium.Timely medical contact is critical for successful AMI treatment,and delays increase the risk of death for patients.Pre-hospital delay time(PDT)is a significant challenge for reducing treatment times,as identifying high-risk patients with AMI remains difficult.This study aims to construct a risk prediction model to identify high-risk patients and develop targeted strategies for effective and prompt care,ultimately reducing PDT and improving treatment outcomes.AIM To construct a nomogram model for forecasting pre-hospital delay(PHD)likelihood in patients with AMI and to assess the precision of the nomogram model in predicting PHD risk.METHODS A retrospective cohort design was employed to investigate predictive factors for PHD in patients with AMI diagnosed between January 2022 and September 2022.The study included 252 patients,with 180 randomly assigned to the development group and the remaining 72 to the validation group in a 7:3 ratio.Independent risk factors influencing PHD were identified in the development group,leading to the establishment of a nomogram model for predicting PHD in patients with AMI.The model's predictive performance was evaluated using the receiver operating characteristic curve in both the development and validation groups.RESULTS Independent risk factors for PHD in patients with AMI included living alone,hyperlipidemia,age,diabetes mellitus,and digestive system diseases(P<0.05).A characteristic curve analysis indicated area under the receiver operating characteristic curve values of 0.787(95%confidence interval:0.716–0.858)and 0.770(95%confidence interval:0.660-0.879)in the development and validation groups,respectively,demonstrating the model's good discriminatory ability.The Hosmer–Lemeshow goodness-of-fit test revealed no statistically significant disparity between the anticipated and observed incidence of PHD in both development and validation cohorts(P>0.05),indicating satisfactory model calibration.CONCLUSION The nomogram model,developed with independent risk factors,accurately forecasts PHD likelihood in AMI individuals,enabling efficient identification of PHD risk in these patients.展开更多
BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered...BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.展开更多
Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency n...Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.展开更多
Objective:To explore the effectiveness of humanistic care in pre-hospital emergency care.Methods:From April 2020 to January 2021,80 pre-hospital emergency patients were studied.The patients were randomly divided into ...Objective:To explore the effectiveness of humanistic care in pre-hospital emergency care.Methods:From April 2020 to January 2021,80 pre-hospital emergency patients were studied.The patients were randomly divided into two groups:a control group(n=40),which received conventional care,and an experimental group(n=40),which received humanistic care.The effects of nursing care and psychological state were compared between the two groups.Results:The experimental group showed better nursing outcomes and a more positive psychological state compared to the control group(P<0.05).Conclusion:Humanistic care in pre-hospital emergency settings is more effective in reducing patients’anxiety and depression,enhancing the operational abilities and service attitudes of nursing staff,and increasing the emergency success rate.展开更多
BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of...BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, prehospital service can signifi cantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China.DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure(CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identifi ed articles.RESULTS: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions.CONCLUSION: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.展开更多
Objective: To analyze the data of pre-hospital emergency treatment in zhengzhou from 2007 to 2016, and evaluate the current situation of pre-hospital trauma emergency treatment, in order to provide a scientific basis ...Objective: To analyze the data of pre-hospital emergency treatment in zhengzhou from 2007 to 2016, and evaluate the current situation of pre-hospital trauma emergency treatment, in order to provide a scientific basis for effective use of first aid resources and enhance success rate of trauma emergency treatment. Methods: Retrospective analysis was conducted based on pre-hospital emergency resources of Zhengzhou Emergency Medical Rescue Center from 2007 to 2016. Results: The total number of pre-hospital emergency treatment cases was 9305687 from 2007 to 2016 in Zhengzhou, of which 418882 were trauma cases. The top five causes of injury were traffic accident injury, cutting injury, beating injury, crushing injury and falling injury. The top five emergency treatments used were oxygen, hemostasis, dressing and fixation, fluid supplementation, analgesics and sputum aspiration. According to different directions of diagnosis, the pre-hospital emergency patients were divided into four groups:emergency treatment group, emergency observation group, admission to general ward group and admission to ICU group. There was no statistical difference in the ages among the four groups (P>0.05). There were significantly statistical differences in gender composition among the four groups, with more males than females (P<0.01). Significant statistical differences also showed in CRAMS scores among the four groups (P<0.01). Before and after the training of primary trauma care, there was no significant difference in the constituent ratio of the trauma (P>0.05), but the mortality of the trauma, the average arrival time, and the mean treatment time were significantly different (P<0.01). Conclusions: The number of pre-hospital emergency trauma patients increased year by year, but the constituent ratio changed little. CRAMS score is important for the patients triage. Through the training of primary trauma care, the constituent ratio of death was reduced, and the average treatment time was shortened.展开更多
Objective:A computer-based STS(simulative training system) in providing pre-hospital trauma care at a disaster site was applied to teaching nursing students in the Second Military Medical University,China.This article...Objective:A computer-based STS(simulative training system) in providing pre-hospital trauma care at a disaster site was applied to teaching nursing students in the Second Military Medical University,China.This article reports on the teaching effectiveness of this system.Methods:Among 92 participants,46 were in the study group and 46 were in the 'control' group. Each student completed a multiple-choice quiz after completing 18 hours(six three-hour sessions) of the study module,and a score was recorded.The simulative training module was completed only by the study group;the 'control' group was assigned in-class discussions for the same amount of time covering the same content as the study group.The final course scores,which included both comprehensive and group task-based tests were compared between these two groups.The study used a descriptive and comparative approach for quantitative data analysis.Tests of independency between the multiple choice scores and the simulation scores were also performed.Finally,anonymous surveys were conducted.Results:The study group performed better than the 'control' group with a significantly higher average score for the group scenario task-based test score,and consequently the study group's final course score was significantly higher than the 'control' group.As per chi-square tests,no significant associations were found between the multiple choice scores and the simulated training scores.The final surveys showed students overwhelmingly agreed that STS training improved their knowledge and skills,their ability to recognize a potential critical event, and their initial response for trauma care at pre-hospital settings.The survey responses of the study group were noteworthy as they indicated that students recognized the importance of simulative training,appreciated the realism of the simulation,and were able to fight/adjust to the stressful feelings in order to focus on the task.Conclusion:Computer-based STS may be an effective teaching model to help students improve their capability in providing pre-hospital trauma care,and in their effectiveness in disaster response.展开更多
Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complic...Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.展开更多
AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positi...AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positive predictive value(PPV) of pre-hospital trauma triage.METHODS: This was a monocentric prospective cohort study of injured adults transported by emergency medi-cal service to a trauma center. Patients who met any of the field trauma triage criteria were considered "triage positive". Hospital data was statistically linked to prehospital records. The primary outcome of defining a "major trauma patient" was Injury Severity Score(ISS) > 16. RESULTS: There were a total of 200 injured patients evaluated over a 2 years period who met at least 1 triage criterion. The number of false positives was 64 patients(ISS < 16). The PPV was 68%. The sensitivity and the negative predictive value could not be evaluated in this study since it only included patients with positive Vittel criteria. The criterion of "PH resuscitation" was present for 64 patients(32%),but 10 of them had an ISS < 16. This was statistically significant in correlation with the severity of the trauma in univariate analysis(OR = 7.2; P = 0.005; 95%CI: 1.6-31.6). However,despite this correlation the overall PPV was not significantly increased by the use of the criterion "PH resuscitation"(68% vs 67.8%).CONCLUSION: The criterion of "pre-hospital resuscitation" was statistically significant with the severity of the trauma,but did not increase the PPV. The use of "prehospital resuscitation" criterion could be re-considered if these results are confirmed by larger studies.展开更多
Objective: to explore the effect of seamless pre-hospital emergency and emergency rescue on patients with acute myocardial infarction. Methods: our hospital within the last two years the rescue of 50 cases of patients...Objective: to explore the effect of seamless pre-hospital emergency and emergency rescue on patients with acute myocardial infarction. Methods: our hospital within the last two years the rescue of 50 cases of patients with acute myocardial infarction (mi), with the method of randomly selected from 25 patients were divided into group A (normal group), the other 25 patients in group B (optimization) in two groups of patients from the onset of symptoms to emergency personnel arrived at the treatment time, the percent of pass in and out of the emergency time, and after treatment were compared. Results: the first-aid effect rate of group B was higher than that of group A, and the satisfaction of first-aid measures of group B was higher than that of group A, the difference was significant, P<0.05. Conclusion: this emergency treatment measure is beneficial to improve the treatment rate of patients with acute myocardial infarction, this rescue measure can save the time of rescue and treatment, in addition, it is a new breakthrough in emergency medical treatment, worthy of promotion.展开更多
Objective: to investigate and analyze the causes of acupuncture injuries among nurses in emergency department during pre-hospital emergency treatment, to put forward improvement measures to reduce the incidence of acu...Objective: to investigate and analyze the causes of acupuncture injuries among nurses in emergency department during pre-hospital emergency treatment, to put forward improvement measures to reduce the incidence of acupuncture injuries. Methods: 189 nurses in the emergency department of hospitals in Guangxi were investigated by questionnaire, and the related factors of acupuncture injury in pre-hospital emergency treatment were analyzed. Results: 21 subjects (11.11%) experienced acupuncture injuries. With the highest incidence (57.14%) occurring while the ambulance was driving. The percentage of sharp injuries contaminated by blood and body fluids of patients was 52.38%. 88.89% of the nurses considered the bumpy and unstable journey were the main reason for the occurrence of acupuncture injury. Conclusion: acupuncture injury is a common phenomenon among nurses in emergency department during pre-hospital emergency treatment. The self-prevention consciousness needs to be strengthened, and the protective measures and system need to be further improved.展开更多
With the improvement of people's living standard and the continuation of healthy life, people's demand for emergency care is increasing. Pre-hospital emergency care plays an important role in rescuing patients...With the improvement of people's living standard and the continuation of healthy life, people's demand for emergency care is increasing. Pre-hospital emergency care plays an important role in rescuing patients and is a decisive factor in saving patients' lives. Nowadays, pre-hospital first aid mainly includes on-site first aid, monitoring of relevant vital signs sent to the hospital, and targeted treatment measures for different patients. Generally speaking, in pre-hospital first aid, due to the lack of first aid time and equipment, the possibility of dangerous situations in the first aid process increases, thus increasing the risk of first aid.展开更多
Objective: to study and analyze the application value of fiberoptic bronchoscopy-guided nasotracheal intubation in pre-hospital first aid. Methods: 60 pre-hospital emergency critical cases admitted in our hospital fro...Objective: to study and analyze the application value of fiberoptic bronchoscopy-guided nasotracheal intubation in pre-hospital first aid. Methods: 60 pre-hospital emergency critical cases admitted in our hospital from February 2020 to December 2021 were randomly divided into the research group and the control group with 30 cases in each group. All of them were treated with conventional pre-hospital emergency treatment. The research group was treated with nasotracheal intubation under the guidance of fiberoptic bronchoscope, while the control group was treated with open-vision endotracheal intubation. The effects of tracheal intubation and blood gas indexes before and after emergency treatment were evaluated and compared between the two groups.展开更多
Objective: To explore the therapeutic value of modified Valsalva manipulation in pre-hospital emergency treatment of paroxysmal ventricular tachycardia (PSVT). From January 2018 to December 2020, the patients with par...Objective: To explore the therapeutic value of modified Valsalva manipulation in pre-hospital emergency treatment of paroxysmal ventricular tachycardia (PSVT). From January 2018 to December 2020, the patients with paroxysmal ventricular tachycardia in our county from January 2018 to December 2020 were collected and randomly divided into standard group and variant group, with 30 cases in each group. Success rate of cardioversion and incidence of side effects. The success rate of sinus rhythm ECG conversion in standard group was significantly lower than that in improved group. The hospitalization rate of the improved group was significantly lower than that of the standard group. The incidence of chest tightness, dizziness, headache, hypotension and other adverse events in the deformation group is higher than that in the standard group, but the emergency treatment of tachycardia in the two groups before hospital can increase the success rate of heart conversion, reduce hospitalization, and will not significantly increase the incidence of side effects, which can be popularized and applied in pre-hospital emergency treatment.展开更多
Purpose To construct a decision-making app for pre-hospital damage control resuscitation(PHDCR)for severely injured patients,and to make a preliminary trial test on the effectiveness and usability aspects of the const...Purpose To construct a decision-making app for pre-hospital damage control resuscitation(PHDCR)for severely injured patients,and to make a preliminary trial test on the effectiveness and usability aspects of the constructed app.Methods Decision-making algorithms were first established by a thorough literature review,and were then used to be learned by computer with 3 kinds of text segmentation algorithms,i.e.,dictionary-based segmentation,machine learning algorithms based on labeling,and deep learning algorithms based on understanding.B/S architecture mode and Spring Boot were used as a framework to construct the app.A total of 16 Grade-5 medical students were recruited to test the effectiveness and usability aspects of the app by using an animal model-based test on simulated PHDCR.Twelve adult Bama miniature pigs were subjected to penetrating abdominal injuries and were randomly assigned to the 16 students,who were randomly divided into 2 groups(n=8 each):group A(decided on PHDCR by themselves)and group B(decided on PHDCR with the aid of the app).The students were asked to complete the PHDCR within 1 h,and then blood samples were taken and thromboelastography,routine coagulation test,blood cell count,and blood gas analysis were examined.The lab examination results along with the value of mean arterial pressure were used to compare the resuscitation effects between the 2 groups.Furthermore,a 4-statement-based post-test survey on a 5-point Likert scale was performed in group B students to test the usability aspects of the constructed app.Results With the above 3 kinds of text segmentation algorithm,B/S architecture mode,and Spring Boot as the development framework,the decision-making app for PHDCR was successfully constructed.The time to decide PHDCR was(28.8±3.41)sec in group B,much shorter than that in group A(87.5±8.53)sec(p<0.001).The outcomes of animals treated by group B students were much better than that by group A students as indicated by higher mean arterial pressure,oxygen saturation and fibrinogen concentration and maximum amplitude,and lower R values in group B than those in group A.The post-test survey revealed that group B students gave a mean score of no less than 4 for all 4 statements.Conclusion A decision-making app for PHDCR was constructed in the present study and the preliminary trial test revealed that it could help to improve the resuscitation effect in animal models of penetrating abdominal injury.展开更多
Background Cumulative evidence demonstrates that primary percutaneous coronary intervention（PCI）is a mperfusion strategy for ST-elevation myocardial Infarction（STEMI）.This study was undertaken to evaluate the pre-...Background Cumulative evidence demonstrates that primary percutaneous coronary intervention（PCI）is a mperfusion strategy for ST-elevation myocardial Infarction（STEMI）.This study was undertaken to evaluate the pre-hospital care-seeking pathway and subsequent care quality in patients with STEMI in the Beijing health care system,which offers patients a choice between seeking care in a small community hospital（SH group）or a large hospital（LH group）.Methods Between January 1 and December 31,2006, a cross-sectional and multicenter survey was conducted in 11 hospitals qualified as tertiary centers in Beijing and included consecutive patients with STEMI admitted within 24 hours after onset of symptoms.Results Among the 566 patients interviewed,28.3%first arnved at a small community hospitaI and were transferred to large hospitals with the ability to perform primary PCI.The median total pre-hospital delay in the SH group（n=160）was significantly longer than in the LH group（n=406）（225 vs.120 minutes,P〈0.001）.Multivariate analysis showed that interpreting symptoms to non-cardiac origin（OR,1.996;95%CI： 1.264-3.155）,absence of history of myocardial infarction（OR,1.595;95%CI：1.086-3.347）,non-health insuranca coverage（OR,1.931;95%Cl：1.079-3.012）and absence of sense of impending doom （OR,4.367;95%CI：1.279-1 4.925） were independent predictors for choosing small hospitals.After adjusting for demographics and medical history,patients in the SH group were 1.698 times（95% CI： 1.1 82-3.661） less likely to receive primary PCI compared with those in the LH group. Conclusions Above one fourth of the STEMI patients in Beijing experienced inter-hospital transfer.Factors including symptoms interpretation,symptoms,history of myocardial infarcUon,and insurance coverage were associated with the patients＇pre-hospital care-seeking pathway.The patients who were transferred had longer pre-hospital delays and were less Iikely to receive primary PCI.展开更多
Background Acute myocardial infarction （AMI） is the leading cause of morbidity and disability among Iranian population. Pre-hospital delay is an important cause of increasing early and also late mortality in AMI. Th...Background Acute myocardial infarction （AMI） is the leading cause of morbidity and disability among Iranian population. Pre-hospital delay is an important cause of increasing early and also late mortality in AMI. Thus the aim of the present study was to identify the factors influencing pre-hospital delay among patients with AMI in Iran. Methods Between August 2010 and May 2011, a cross-sectional and single-center survey was conducted on 162 consecutive patients with ST-elevation myocardial infarction （STEMI） admitted to Cardiac Care Unit （CCU） of Dr. Heshmat Hospital, Rasht. All patients were interviewed by the third author within 7 days after admission by using a four-part questionnaire including socio-demographic, clinical, situational and cognitive factors. Data were analyzed by descriptive and Logistic regression model at P 〈 0.05 using SPSS 16. Results Mean age was （60.11±12.29） years in all patients. Majority of patients （65.4%） were male. The median of pre-hospital delay was 2 hours, with a mean delay of 7.4 hours （±16.25 hours）. Regression analysis showed that admission in weekend （P 〈0.04, 0R=1.033, 95% Cl=1.187-2.006） and misinterpretation of symptoms as cardiac origin （P 〈0.002, OR=1.986, 95% Cl=1.254-3.155） and perceiving symptoms to not be so serious （P 〈0.003, OR=3.264, 95% Cl=1.492-7.142） were factors influencing pre-hospital delay 〉 2 hours. Conclusions Our findings highlight the importance of cognitive factors on decision-making process and pre-hospital delays. Health care providers can educate the public on AMI to enable them recognize the signs and symptoms of AMI correctly and realize the benefits of early treatment.展开更多
Purpose:The majority of acute anterior shoulder dislocations are sustained during sports and wilderness activities.The management of acute dislocations in the pre-hospital setting is currently without guidelines based...Purpose:The majority of acute anterior shoulder dislocations are sustained during sports and wilderness activities.The management of acute dislocations in the pre-hospital setting is currently without guidelines based on the evidence.The study aims to assess the risk of acute complications in pre-hospital shoulder reduction and identify which pre-hospital reduction technique has the highest success rate in the published literature.Methods:The involved databases were Allied and Complementary Medicine,CENTRAL,CINAHL,Cochrane Database of Systematic Reviews,Embase,Europe PMC,Ovid MEDLINE®,Pedro,Proquest,Trip,and World Health Organization International Clinical Trials Registry platform.Only original research of high methodological quality was included,which was defined by the recently developed assessment tooleassessing the methodological quality of published papers(AMQPP)and investigated the management of acute anterior shoulder dislocations in the pre-hospital setting.Results:Two hundred and ninety-eight articles were identified and screened.A full text review was performed on 40 articles.Four articles published between 2015 and 2018 met the inclusion criteria.A total of 181 patients were included with the study duration ranging from 6 to 60 months.All studies reported zero immediate complication following pre-hospital reduction and there were no documented subsequent adverse events regardless of the technique used.Prompt resolution of neurological symptoms was observed following the early and successful pre-hospital reduction.First attempt success rate,when performed by skilled practitioners,ranged from 72.3%to 94.9%.Conclusion:Pre-hospital shoulder reduction appears to be a safe and feasible option when carried out with the appropriate expertise.A novel reduction technique adapted from the mountain medicine diploma course at the University of Paris North was found to have the highest first attempt reduction success rate of 94.9%.Other techniques described in the literature included Hippocratic,Stimson's,Counter-traction and external rotation with the success rates ranging from 54%to 71.7%.展开更多
Objective:To evaluate the status of the pre-hospital trauma care in a road traffic accidents in a rural area of Kancheepuram district.Methods:A cross-sectional study of two months duration(June and July 2014)was condu...Objective:To evaluate the status of the pre-hospital trauma care in a road traffic accidents in a rural area of Kancheepuram district.Methods:A cross-sectional study of two months duration(June and July 2014)was conducted in the tertiary care hospital of a medical college,and its affiliated urban/rural health centers.Universal sampling was used and all road accident victims were enrolled as study participants.The required information was obtained with the help of a semi-structured questionnaire.Ethical clearance was obtained before the start of the study.SPSS version 18 was used for data entry and statistical analysis.Descriptive statistics were calculated for all the variables.Results:A total of 80(77.7%)study subjects were from the productive age group(15-45 years).Most of the accidents were reported at night time[43(41.7%)],on weekends[59(56.5%)],and involved two-wheelers[81(78.6%)].In addition,69 cases(67%)of the victims were not aware of the existence of emergency ambulance services,while only 6(5.8%)of the victims were brought to the hospital in an emergency ambulance.Conclusions:The study findings clearly suggest that the quality of the pre-hospital trauma care for road traffic accident victims in a rural area of Kancheepuram district lacks on multiple dimensions and there is an immense need to improve and strengthen the range of services to save the lives of the victims.展开更多
文摘Dear Editor,Most battlefield casualties occur prior to the arrival of medical facilities.Uncontrollable hemorrhage accounts for more than 90%of those potentially survivable battlefield casualties[1].In both military and civilian conditions,non-compressible torso hemorrhage always caused rapid exsanguination and high mortality rates before definitive treatment[2].More than half of the deaths due to non-compressible torso hemorrhage occur before hospital care can be provided[2].Therefore,early and rapid pre-hospital hemorrhage control is essential to reduce mortality.
文摘BACKGROUND Acute myocardial infarction(AMI)is a severe cardiovascular disease caused by the blockage of coronary arteries that leads to ischemic necrosis of the myocardium.Timely medical contact is critical for successful AMI treatment,and delays increase the risk of death for patients.Pre-hospital delay time(PDT)is a significant challenge for reducing treatment times,as identifying high-risk patients with AMI remains difficult.This study aims to construct a risk prediction model to identify high-risk patients and develop targeted strategies for effective and prompt care,ultimately reducing PDT and improving treatment outcomes.AIM To construct a nomogram model for forecasting pre-hospital delay(PHD)likelihood in patients with AMI and to assess the precision of the nomogram model in predicting PHD risk.METHODS A retrospective cohort design was employed to investigate predictive factors for PHD in patients with AMI diagnosed between January 2022 and September 2022.The study included 252 patients,with 180 randomly assigned to the development group and the remaining 72 to the validation group in a 7:3 ratio.Independent risk factors influencing PHD were identified in the development group,leading to the establishment of a nomogram model for predicting PHD in patients with AMI.The model's predictive performance was evaluated using the receiver operating characteristic curve in both the development and validation groups.RESULTS Independent risk factors for PHD in patients with AMI included living alone,hyperlipidemia,age,diabetes mellitus,and digestive system diseases(P<0.05).A characteristic curve analysis indicated area under the receiver operating characteristic curve values of 0.787(95%confidence interval:0.716–0.858)and 0.770(95%confidence interval:0.660-0.879)in the development and validation groups,respectively,demonstrating the model's good discriminatory ability.The Hosmer–Lemeshow goodness-of-fit test revealed no statistically significant disparity between the anticipated and observed incidence of PHD in both development and validation cohorts(P>0.05),indicating satisfactory model calibration.CONCLUSION The nomogram model,developed with independent risk factors,accurately forecasts PHD likelihood in AMI individuals,enabling efficient identification of PHD risk in these patients.
文摘BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.
文摘Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.
文摘Objective:To explore the effectiveness of humanistic care in pre-hospital emergency care.Methods:From April 2020 to January 2021,80 pre-hospital emergency patients were studied.The patients were randomly divided into two groups:a control group(n=40),which received conventional care,and an experimental group(n=40),which received humanistic care.The effects of nursing care and psychological state were compared between the two groups.Results:The experimental group showed better nursing outcomes and a more positive psychological state compared to the control group(P<0.05).Conclusion:Humanistic care in pre-hospital emergency settings is more effective in reducing patients’anxiety and depression,enhancing the operational abilities and service attitudes of nursing staff,and increasing the emergency success rate.
文摘BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, prehospital service can signifi cantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China.DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure(CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identifi ed articles.RESULTS: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions.CONCLUSION: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.
文摘Objective: To analyze the data of pre-hospital emergency treatment in zhengzhou from 2007 to 2016, and evaluate the current situation of pre-hospital trauma emergency treatment, in order to provide a scientific basis for effective use of first aid resources and enhance success rate of trauma emergency treatment. Methods: Retrospective analysis was conducted based on pre-hospital emergency resources of Zhengzhou Emergency Medical Rescue Center from 2007 to 2016. Results: The total number of pre-hospital emergency treatment cases was 9305687 from 2007 to 2016 in Zhengzhou, of which 418882 were trauma cases. The top five causes of injury were traffic accident injury, cutting injury, beating injury, crushing injury and falling injury. The top five emergency treatments used were oxygen, hemostasis, dressing and fixation, fluid supplementation, analgesics and sputum aspiration. According to different directions of diagnosis, the pre-hospital emergency patients were divided into four groups:emergency treatment group, emergency observation group, admission to general ward group and admission to ICU group. There was no statistical difference in the ages among the four groups (P>0.05). There were significantly statistical differences in gender composition among the four groups, with more males than females (P<0.01). Significant statistical differences also showed in CRAMS scores among the four groups (P<0.01). Before and after the training of primary trauma care, there was no significant difference in the constituent ratio of the trauma (P>0.05), but the mortality of the trauma, the average arrival time, and the mean treatment time were significantly different (P<0.01). Conclusions: The number of pre-hospital emergency trauma patients increased year by year, but the constituent ratio changed little. CRAMS score is important for the patients triage. Through the training of primary trauma care, the constituent ratio of death was reduced, and the average treatment time was shortened.
文摘Objective:A computer-based STS(simulative training system) in providing pre-hospital trauma care at a disaster site was applied to teaching nursing students in the Second Military Medical University,China.This article reports on the teaching effectiveness of this system.Methods:Among 92 participants,46 were in the study group and 46 were in the 'control' group. Each student completed a multiple-choice quiz after completing 18 hours(six three-hour sessions) of the study module,and a score was recorded.The simulative training module was completed only by the study group;the 'control' group was assigned in-class discussions for the same amount of time covering the same content as the study group.The final course scores,which included both comprehensive and group task-based tests were compared between these two groups.The study used a descriptive and comparative approach for quantitative data analysis.Tests of independency between the multiple choice scores and the simulation scores were also performed.Finally,anonymous surveys were conducted.Results:The study group performed better than the 'control' group with a significantly higher average score for the group scenario task-based test score,and consequently the study group's final course score was significantly higher than the 'control' group.As per chi-square tests,no significant associations were found between the multiple choice scores and the simulated training scores.The final surveys showed students overwhelmingly agreed that STS training improved their knowledge and skills,their ability to recognize a potential critical event, and their initial response for trauma care at pre-hospital settings.The survey responses of the study group were noteworthy as they indicated that students recognized the importance of simulative training,appreciated the realism of the simulation,and were able to fight/adjust to the stressful feelings in order to focus on the task.Conclusion:Computer-based STS may be an effective teaching model to help students improve their capability in providing pre-hospital trauma care,and in their effectiveness in disaster response.
文摘Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.
文摘AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positive predictive value(PPV) of pre-hospital trauma triage.METHODS: This was a monocentric prospective cohort study of injured adults transported by emergency medi-cal service to a trauma center. Patients who met any of the field trauma triage criteria were considered "triage positive". Hospital data was statistically linked to prehospital records. The primary outcome of defining a "major trauma patient" was Injury Severity Score(ISS) > 16. RESULTS: There were a total of 200 injured patients evaluated over a 2 years period who met at least 1 triage criterion. The number of false positives was 64 patients(ISS < 16). The PPV was 68%. The sensitivity and the negative predictive value could not be evaluated in this study since it only included patients with positive Vittel criteria. The criterion of "PH resuscitation" was present for 64 patients(32%),but 10 of them had an ISS < 16. This was statistically significant in correlation with the severity of the trauma in univariate analysis(OR = 7.2; P = 0.005; 95%CI: 1.6-31.6). However,despite this correlation the overall PPV was not significantly increased by the use of the criterion "PH resuscitation"(68% vs 67.8%).CONCLUSION: The criterion of "pre-hospital resuscitation" was statistically significant with the severity of the trauma,but did not increase the PPV. The use of "prehospital resuscitation" criterion could be re-considered if these results are confirmed by larger studies.
文摘Objective: to explore the effect of seamless pre-hospital emergency and emergency rescue on patients with acute myocardial infarction. Methods: our hospital within the last two years the rescue of 50 cases of patients with acute myocardial infarction (mi), with the method of randomly selected from 25 patients were divided into group A (normal group), the other 25 patients in group B (optimization) in two groups of patients from the onset of symptoms to emergency personnel arrived at the treatment time, the percent of pass in and out of the emergency time, and after treatment were compared. Results: the first-aid effect rate of group B was higher than that of group A, and the satisfaction of first-aid measures of group B was higher than that of group A, the difference was significant, P<0.05. Conclusion: this emergency treatment measure is beneficial to improve the treatment rate of patients with acute myocardial infarction, this rescue measure can save the time of rescue and treatment, in addition, it is a new breakthrough in emergency medical treatment, worthy of promotion.
文摘Objective: to investigate and analyze the causes of acupuncture injuries among nurses in emergency department during pre-hospital emergency treatment, to put forward improvement measures to reduce the incidence of acupuncture injuries. Methods: 189 nurses in the emergency department of hospitals in Guangxi were investigated by questionnaire, and the related factors of acupuncture injury in pre-hospital emergency treatment were analyzed. Results: 21 subjects (11.11%) experienced acupuncture injuries. With the highest incidence (57.14%) occurring while the ambulance was driving. The percentage of sharp injuries contaminated by blood and body fluids of patients was 52.38%. 88.89% of the nurses considered the bumpy and unstable journey were the main reason for the occurrence of acupuncture injury. Conclusion: acupuncture injury is a common phenomenon among nurses in emergency department during pre-hospital emergency treatment. The self-prevention consciousness needs to be strengthened, and the protective measures and system need to be further improved.
文摘With the improvement of people's living standard and the continuation of healthy life, people's demand for emergency care is increasing. Pre-hospital emergency care plays an important role in rescuing patients and is a decisive factor in saving patients' lives. Nowadays, pre-hospital first aid mainly includes on-site first aid, monitoring of relevant vital signs sent to the hospital, and targeted treatment measures for different patients. Generally speaking, in pre-hospital first aid, due to the lack of first aid time and equipment, the possibility of dangerous situations in the first aid process increases, thus increasing the risk of first aid.
文摘Objective: to study and analyze the application value of fiberoptic bronchoscopy-guided nasotracheal intubation in pre-hospital first aid. Methods: 60 pre-hospital emergency critical cases admitted in our hospital from February 2020 to December 2021 were randomly divided into the research group and the control group with 30 cases in each group. All of them were treated with conventional pre-hospital emergency treatment. The research group was treated with nasotracheal intubation under the guidance of fiberoptic bronchoscope, while the control group was treated with open-vision endotracheal intubation. The effects of tracheal intubation and blood gas indexes before and after emergency treatment were evaluated and compared between the two groups.
文摘Objective: To explore the therapeutic value of modified Valsalva manipulation in pre-hospital emergency treatment of paroxysmal ventricular tachycardia (PSVT). From January 2018 to December 2020, the patients with paroxysmal ventricular tachycardia in our county from January 2018 to December 2020 were collected and randomly divided into standard group and variant group, with 30 cases in each group. Success rate of cardioversion and incidence of side effects. The success rate of sinus rhythm ECG conversion in standard group was significantly lower than that in improved group. The hospitalization rate of the improved group was significantly lower than that of the standard group. The incidence of chest tightness, dizziness, headache, hypotension and other adverse events in the deformation group is higher than that in the standard group, but the emergency treatment of tachycardia in the two groups before hospital can increase the success rate of heart conversion, reduce hospitalization, and will not significantly increase the incidence of side effects, which can be popularized and applied in pre-hospital emergency treatment.
基金supported by Key Project of State Key Laboratory of Trauma,Burn and Combined Injury(SKLTS202213).
文摘Purpose To construct a decision-making app for pre-hospital damage control resuscitation(PHDCR)for severely injured patients,and to make a preliminary trial test on the effectiveness and usability aspects of the constructed app.Methods Decision-making algorithms were first established by a thorough literature review,and were then used to be learned by computer with 3 kinds of text segmentation algorithms,i.e.,dictionary-based segmentation,machine learning algorithms based on labeling,and deep learning algorithms based on understanding.B/S architecture mode and Spring Boot were used as a framework to construct the app.A total of 16 Grade-5 medical students were recruited to test the effectiveness and usability aspects of the app by using an animal model-based test on simulated PHDCR.Twelve adult Bama miniature pigs were subjected to penetrating abdominal injuries and were randomly assigned to the 16 students,who were randomly divided into 2 groups(n=8 each):group A(decided on PHDCR by themselves)and group B(decided on PHDCR with the aid of the app).The students were asked to complete the PHDCR within 1 h,and then blood samples were taken and thromboelastography,routine coagulation test,blood cell count,and blood gas analysis were examined.The lab examination results along with the value of mean arterial pressure were used to compare the resuscitation effects between the 2 groups.Furthermore,a 4-statement-based post-test survey on a 5-point Likert scale was performed in group B students to test the usability aspects of the constructed app.Results With the above 3 kinds of text segmentation algorithm,B/S architecture mode,and Spring Boot as the development framework,the decision-making app for PHDCR was successfully constructed.The time to decide PHDCR was(28.8±3.41)sec in group B,much shorter than that in group A(87.5±8.53)sec(p<0.001).The outcomes of animals treated by group B students were much better than that by group A students as indicated by higher mean arterial pressure,oxygen saturation and fibrinogen concentration and maximum amplitude,and lower R values in group B than those in group A.The post-test survey revealed that group B students gave a mean score of no less than 4 for all 4 statements.Conclusion A decision-making app for PHDCR was constructed in the present study and the preliminary trial test revealed that it could help to improve the resuscitation effect in animal models of penetrating abdominal injury.
文摘Background Cumulative evidence demonstrates that primary percutaneous coronary intervention（PCI）is a mperfusion strategy for ST-elevation myocardial Infarction（STEMI）.This study was undertaken to evaluate the pre-hospital care-seeking pathway and subsequent care quality in patients with STEMI in the Beijing health care system,which offers patients a choice between seeking care in a small community hospital（SH group）or a large hospital（LH group）.Methods Between January 1 and December 31,2006, a cross-sectional and multicenter survey was conducted in 11 hospitals qualified as tertiary centers in Beijing and included consecutive patients with STEMI admitted within 24 hours after onset of symptoms.Results Among the 566 patients interviewed,28.3%first arnved at a small community hospitaI and were transferred to large hospitals with the ability to perform primary PCI.The median total pre-hospital delay in the SH group（n=160）was significantly longer than in the LH group（n=406）（225 vs.120 minutes,P〈0.001）.Multivariate analysis showed that interpreting symptoms to non-cardiac origin（OR,1.996;95%CI： 1.264-3.155）,absence of history of myocardial infarction（OR,1.595;95%CI：1.086-3.347）,non-health insuranca coverage（OR,1.931;95%Cl：1.079-3.012）and absence of sense of impending doom （OR,4.367;95%CI：1.279-1 4.925） were independent predictors for choosing small hospitals.After adjusting for demographics and medical history,patients in the SH group were 1.698 times（95% CI： 1.1 82-3.661） less likely to receive primary PCI compared with those in the LH group. Conclusions Above one fourth of the STEMI patients in Beijing experienced inter-hospital transfer.Factors including symptoms interpretation,symptoms,history of myocardial infarcUon,and insurance coverage were associated with the patients＇pre-hospital care-seeking pathway.The patients who were transferred had longer pre-hospital delays and were less Iikely to receive primary PCI.
文摘Background Acute myocardial infarction （AMI） is the leading cause of morbidity and disability among Iranian population. Pre-hospital delay is an important cause of increasing early and also late mortality in AMI. Thus the aim of the present study was to identify the factors influencing pre-hospital delay among patients with AMI in Iran. Methods Between August 2010 and May 2011, a cross-sectional and single-center survey was conducted on 162 consecutive patients with ST-elevation myocardial infarction （STEMI） admitted to Cardiac Care Unit （CCU） of Dr. Heshmat Hospital, Rasht. All patients were interviewed by the third author within 7 days after admission by using a four-part questionnaire including socio-demographic, clinical, situational and cognitive factors. Data were analyzed by descriptive and Logistic regression model at P 〈 0.05 using SPSS 16. Results Mean age was （60.11±12.29） years in all patients. Majority of patients （65.4%） were male. The median of pre-hospital delay was 2 hours, with a mean delay of 7.4 hours （±16.25 hours）. Regression analysis showed that admission in weekend （P 〈0.04, 0R=1.033, 95% Cl=1.187-2.006） and misinterpretation of symptoms as cardiac origin （P 〈0.002, OR=1.986, 95% Cl=1.254-3.155） and perceiving symptoms to not be so serious （P 〈0.003, OR=3.264, 95% Cl=1.492-7.142） were factors influencing pre-hospital delay 〉 2 hours. Conclusions Our findings highlight the importance of cognitive factors on decision-making process and pre-hospital delays. Health care providers can educate the public on AMI to enable them recognize the signs and symptoms of AMI correctly and realize the benefits of early treatment.
文摘Purpose:The majority of acute anterior shoulder dislocations are sustained during sports and wilderness activities.The management of acute dislocations in the pre-hospital setting is currently without guidelines based on the evidence.The study aims to assess the risk of acute complications in pre-hospital shoulder reduction and identify which pre-hospital reduction technique has the highest success rate in the published literature.Methods:The involved databases were Allied and Complementary Medicine,CENTRAL,CINAHL,Cochrane Database of Systematic Reviews,Embase,Europe PMC,Ovid MEDLINE®,Pedro,Proquest,Trip,and World Health Organization International Clinical Trials Registry platform.Only original research of high methodological quality was included,which was defined by the recently developed assessment tooleassessing the methodological quality of published papers(AMQPP)and investigated the management of acute anterior shoulder dislocations in the pre-hospital setting.Results:Two hundred and ninety-eight articles were identified and screened.A full text review was performed on 40 articles.Four articles published between 2015 and 2018 met the inclusion criteria.A total of 181 patients were included with the study duration ranging from 6 to 60 months.All studies reported zero immediate complication following pre-hospital reduction and there were no documented subsequent adverse events regardless of the technique used.Prompt resolution of neurological symptoms was observed following the early and successful pre-hospital reduction.First attempt success rate,when performed by skilled practitioners,ranged from 72.3%to 94.9%.Conclusion:Pre-hospital shoulder reduction appears to be a safe and feasible option when carried out with the appropriate expertise.A novel reduction technique adapted from the mountain medicine diploma course at the University of Paris North was found to have the highest first attempt reduction success rate of 94.9%.Other techniques described in the literature included Hippocratic,Stimson's,Counter-traction and external rotation with the success rates ranging from 54%to 71.7%.
文摘Objective:To evaluate the status of the pre-hospital trauma care in a road traffic accidents in a rural area of Kancheepuram district.Methods:A cross-sectional study of two months duration(June and July 2014)was conducted in the tertiary care hospital of a medical college,and its affiliated urban/rural health centers.Universal sampling was used and all road accident victims were enrolled as study participants.The required information was obtained with the help of a semi-structured questionnaire.Ethical clearance was obtained before the start of the study.SPSS version 18 was used for data entry and statistical analysis.Descriptive statistics were calculated for all the variables.Results:A total of 80(77.7%)study subjects were from the productive age group(15-45 years).Most of the accidents were reported at night time[43(41.7%)],on weekends[59(56.5%)],and involved two-wheelers[81(78.6%)].In addition,69 cases(67%)of the victims were not aware of the existence of emergency ambulance services,while only 6(5.8%)of the victims were brought to the hospital in an emergency ambulance.Conclusions:The study findings clearly suggest that the quality of the pre-hospital trauma care for road traffic accident victims in a rural area of Kancheepuram district lacks on multiple dimensions and there is an immense need to improve and strengthen the range of services to save the lives of the victims.
