An Urban 9-1-1 System's Experience with Left Ventricular Assist Device Patients.

Left ventricular assist devices (LVADs) are used with increasing frequency and left in place for longer periods of time. Prior publications have focused on the mechanics of troubleshooting the device itself. We aim to describe the epidemiology of LVAD patient presentations to emergency medical services (EMS), prehospital assessments and interventions, and hospital outcomes.

Prehospital Acute ST-Elevation Myocardial Infarction Identification in San Diego: A Retrospective Analysis of the Effect of a New Software Algorithm.

Background: A significant increase in false positive ST-elevation myocardial infarction (STEMI) electrocardiogram interpretations was noted after replacement of all of the City of San Diego's 110 monitor-defibrillator units with a new brand. These concerns were brought to the manufacturer and a revised interpretive algorithm was implemented.

Objectives: This study evaluated the effects of a revised interpretation algorithm to identify STEMI when used by San Diego paramedics.

Acute Stroke: Current Evidence-based Recommendations for Prehospital Care.

Introduction: In the United States, emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with a suspected stroke and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California.

Methods: We performed a literature review of the current evidence in the prehospital treatment of a patient with a suspected stroke and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations.

Preoxygenation reduces desaturation events and improves intubation success.

Objective: Oxygen desaturation occurs frequently in the course of prehospital rapid sequence intubation (RSI) and is associated with increased morbidity and mortality. Preoxygenation with positive pressure ventilation by bag valve mask may delay the onset of desaturation. The purpose of this study was to evaluate implementation of a targeted preoxygenation protocol including the use of positive pressure ventilation on desaturation events and intubation success during air medical RSI.

Assessment of the addition of prehospital continuous positive airway pressure (CPAP) to an urban emergency medical services (EMS) system in persons with severe respiratory distress.

Background: The use of continuous positive airway pressure (CPAP) assisted ventilation in the emergency department(ED) has been well described.

Objectives: The purpose of this study was to measure the efficacy of adding pre-hospital CPAP to an urban emergency medical service (EMS) respiratory distress protocol on persons with respiratory distress.

Methods: A historical cohort analysis of consecutive patients between 2005 and 2010.

Prehospital stroke diagnosis and treatment in ambulances and helicopters-a concept paper.

Stroke is the second common cause of death and the primary cause of early invalidity worldwide. Different from other diseases is the time sensitivity related to stroke. In case of an ischemic event occluding a brain artery, 2000000 neurons die every minute.

Comparison of the SALT and Smart triage systems using a virtual reality simulator with paramedic students.

Objectives: Virtual reality systems may allow for organized study of mass casualty triage systems by allowing investigators to replicate the same mass casualty incident, with the same victims, for a large number of rescuers. The study objectives were to develop such a virtual reality system, and use it to assess the ability of trained paramedic students to triage simulated victims using two triage systems.

Methods: Investigators created 25 patient scenarios for a highway bus crash in a virtual reality simulation system.

Pilot test of the SALT mass casualty triage system.

Introduction: No existing mass casualty triage system has been scientifically scrutinized or validated. A recent work group sponsored by the Centers for Disease Control and Prevention, using a combination of expert opinion and the extremely limited research data available, created the SALT (sort-assess-lifesaving interventions-treat/transport) triage system to serve as a national model. An airport crash drill was used to pilot test the SALT system.

Menopausal symptoms in Hispanic women and the role of socioeconomic factors.

The objective of this study was to assess differences in menopausal symptoms between postmenopausal (PM) Hispanic (H) and PM Caucasian (C) women. This was a prospective survey. Data from a convenience sample of 404 PM women (50% H, 50% C) were evaluated.