Daniel P Davis

..Secondary aims are to compare functional status and depression at discharge and at 3 and 6 months post-discharge in survivors...

..The safety of bypassing non-designated facilities with such a regional system is not known...

..The identical pattern of improved outcomes in post-menopausal but not pre-menopausal females versus age-matched males was observed. These data suggest that endogenous female sex hormone production is not neuroprotective...

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..Here we explore factors affecting outcome in the entire cohort of patients undergoing paramedic RSI to confirm previous findings. This also represents a synthesis of findings from previous analyses..

..This may mandate a paradigm shift away from advanced cardiac life support and basic life support, which emphasize standardization of content and format rather than institution- or agency-specific protocols and training...

..This analysis explores ventilation patterns in a cohort of trial patients undergoing end-tidal CO2 (ETCO2) monitoring...

..Here we explore the impact of aeromedical response in patients with moderate to severe traumatic brain injury...

..Aeromedical crews routinely use needle thoracostomy (NT) and tube thoracostomy (TT) to treat major trauma victims (MTVs) with potential tension pneumothorax; however, the efficacy of prehospital NT and TT is unclear...

..The article reviews the evidence for and against early intubation for brain-injured patients...

..This study explores the predictive value of field GCS (fGCS) and arrival GCS (aGCS) as well as TRISS calculations using field (fTRISS) and arrival (aTRISS) data in patients with moderate-to-severe traumatic brain injury (TBI)...

..This study uses a large, comprehensive database to explore risk factors for head-injured patients who deteriorate after their initial presentation...

..Recent studies document a high incidence of hyperventilation by prehospital providers, with a potentially detrimental effect on outcome in traumatic brain injury (TBI)...

..The objective of this analysis was to evaluate the effectiveness of a simulator-based difficult airway curriculum in a large, aeromedical company...

..The success and complication rates for the procedure in the hands of flight air medical personnel must be considered in the decision to institute a central venous access procedure...

..Finally, the limited data regarding the impact of hypoventilation and hypercapnia on outcome from TBI are discussed...

..Whether the ECG should undergo physician review prior to activation of a percutaneous intervention (PCI) team is unclear...

..Objective. To define the rate of SpO2 decline at various pulse oximetry values and identify a threshold below which active BVM should be performed during prehospital RSI...

..Endotracheal intubation (ETI) is commonly used by paramedics for definitive airway management. The predictors of success and therapeutic value with regard to oxygenation are not well studied...

..Aortic dissection (AD) may present similarly to acute coronary syndrome or pulmonary embolus; however, anticoagulation may be detrimental to patients with AD...

..Traditional strategies to determine hospital bed surge capacity have relied on cross-sectional hospital census data, which underestimate the true surge capacity in the event of a mass-casualty incident...

..This study aimed to determine whether field end-tidal carbon dioxide CO2 (ETCO2) monitoring decreases inadvertent severe hyperventilation after paramedic rapid sequence intubation...

..Although early intubation to prevent the mortality that accompanies hypoxia is considered the standard of care for severe traumatic brain injury (TBI), the efficacy of this approach remains unproven...

..However, loss of signal may be a frequent occurrence in patients with poor peripheral perfusion. In addition, a delay or latency period in the timeliness of pulse oximetry data may exist with probes placed on the fingers...

..Here we describe our experience with the Combitube (esophageal-tracheal twin-lumen airway device) as a salvage airway device for paramedic rapid sequence intubation...

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..However, multiple studies document an association between out-of-hospital intubation and increased mortality for severe traumatic brain injury...

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..Only through these efforts can we elucidate the true benefits - or harm - of advanced airway management during critical resuscitation...

..The optimal ventilation strategy in these "low-flow" states remains unclear...

..However, recent evidence suggests that the procedure may be associated with increased mortality, possibly reflecting inadequate training, suboptimal patient selection, or inappropriate ventilation...

..Learning algorithms, such as artificial neural networks (ANN), support vector machines (SVM), and decision trees, can identify relationships between data set variables but are not empirically useful for hypothesis testing...

..We conclude that both hypoxemia and extreme hyperoxemia are associated with increased mortality and a decrease in good outcomes among TBI patients...

..An increase in mortality has been documented in association with paramedic rapid sequence intubation (RSI) of severely head-injured patients. This analysis explores the impact of hypoxia and hyperventilation on outcome...

..These data are consistent with the three-phase model of cardiac arrest...

..The optimal intervals for shock delivery following cessation of compressions (pre-shock interval) and resumption of compressions following a shock (post-shock interval) remain unclear...

..The vast majority of aspiration events seem to occur before the arrival of prehospital personnel. Alteration in consciousness from TBI may carry a higher risk of aspiration than with other causes, such as alcohol intoxication...

..We examined EMS witnessed OHCA from the Resuscitation Outcomes Consortium (ROC) to determine the effect of EMS witnessed vs. bystander witnessed and unwitnessed OHCA...

..We determine the incidence of desaturation and pulse rate reactivity during paramedic rapid sequence intubation of patients with severe head injuries (Glasgow Coma Scale score <or=8)...

..Other factors should be considered to screen TBI patients for prehospital RSI...

..Continuing quality improvement (CQI) reviews reflect that medication administration errors occur in the prehospital setting. These include errors involving dose, medication, route, concentration, and treatment...

..CONCLUSION: Paramedic RSI protocols to facilitate intubation of head-injured patients were associated with an increase in mortality and decrease in good outcomes versus matched historical controls...

..This study examined whether survival to hospital discharge was related to receiving hospital characteristics, including bed number, capability of performing cardiac catheterization and hospital volume of OOHCA cases...

..This pilot study suggests that dynamic transcricothyroid US is a potentially accurate method of confirming ET placement during the intubation process. Further investigation in live humans is warranted to validate these data...

..We evaluate the association between emergency medical services (EMS) intervals and mortality among trauma patients with field-based physiologic abnormality...

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..Although the treatment of foreign body airway obstruction in adults has been well studied, few data exist on the characterization of prehospital experiences...

..nonintubated patients. CONCLUSIONS: Arrival hypercapnia and hypocapnia are common and associated with worse outcomes in intubated but not spontaneously breathing patients with traumatic brain injury...

..These data suggest that the use of etomidate as part of a prehospital RSI protocol is associated with hemodynamic stability and a low incidence of hypotension...

..The ESR may be a useful screening test before magnetic resonance imaging in selected patients...

..We assessed whether more restrictive physiologic criteria would improve the specificity of this triage step without missing high-risk patients...

..001). It is concluded that a significant association exists between operator confidence and the accuracy of ED ultrasound. High confidence values are associated with clinically useful test performance characteristics...

..Previous studies have suggested that the use of an ITD during CPR may improve survival rates after cardiac arrest...

..We sought to assess the survival of OOHCA patients by transport distance and hospital proximity...

..5 mg/dL). However, combining Udip results with risk factor screening may allow a rapid method for predicting which patients may safely undergo contrast CT scanning in the ED, but this needs prospective evaluation...

..This data registry samples patients from 264 EMS agencies transporting to 287 acute care hospitals in both the United States and Canada...

..Ultimately the ability of capnometry to guide ventilation and even chest compressions may be its most important contribution to the care of critically ill and injured patients...

..Continuing quality improvement (CQI) reviews reflect that medication administration errors occur in the prehospital setting. These include errors involving dose, medication, route, concentration, and treatment...

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..Administration of opioids for migraine headache may result in longer ED stays when compared with non-opioid migraine treatments. Judicious use of opioids as a treatment for migraine headaches is recommended...

..Our data suggest that the tolerant brain responds to subsequent ischemic stress by partially downregulating inflammatory and upregulating protein synthesis and energy metabolism pathways...

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..NCCT in the evaluation of acute ischemic stroke. Data from studies meeting our screening criteria are combined to produce overall values for each...

..The Resuscitation Outcomes Consortium (ROC) is a United States-Canada research network that organized EMS agencies from 11 different systems to perform controlled trials in cardiac arrest and life-threatening trauma resuscitation...

..The emergency approach should be focused on excluding more significant illnesses, such as meningitis or an intracranial mass lesion. Here we present a case of a young girl with ACA and review the relevant literature...

..CONCLUSION: Air medical transport of severely head-injured patients undergoing paramedic RSI was associated with improved outcomes. Improved ventilation by capnometry may account for part of these improvements...

..To describe the development, design and consequent scientific implications of the Resuscitation Outcomes Consortium (ROC) population-based registry; ROC Epistry-Cardiac Arrest...

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..001). In the thawed fresh frozen cadaveric model, the Toomey syringe was unreliable in detecting an esophageal intubation after gastric distention insufflation...

..Although stingray barbs can be radio-opaque, radiography in our series failed to detect barbs or other foreign bodies in stung extremities, although no barbs or other stinger material were found on inspection of wounds...

..A substantial number of patients enrolled in the study were diagnosed as having cardiac disease...

..Helicopters offer expedited transport to trauma centers and can deliver advanced practice personnel to the scene of injury, but many systems do not dispatch air medical crews until after assessment by ground providers...