Publications by authors named "Leslee Stein Spencer"
Article Synopsis
- Agitated patients present challenges for both emergency medical services (EMS) provider safety and patient care, and midazolam is often used to manage these situations, though data on its use outside hospitals is limited.
- A retrospective review in a large urban EMS system from 2014 to 2016 analyzed the effectiveness of administering midazolam for acute agitation, utilizing different routes of administration (IV, IM, IN) and collecting data on outcomes and side effects.
- Results indicated that midazolam effectively reduced agitation in 73.5% of cases with low adverse effects (3.4%), and no significant difference was found between the effectiveness of IM and IN administration.
Article Synopsis
- Large urban environments face specific challenges that can hinder improvements in emergency response systems, yet effective models for cardiac resuscitation care have the potential to benefit other cities.
- A retrospective analysis studied data from 6,103 cases of out-of-hospital cardiac arrest (OHCA) in Chicago from 2013 to 2016, focusing on various initiatives like CPR training and team simulations, measuring outcomes like bystander CPR rates and patient survival.
- Results showed significant improvements in key outcomes: bystander CPR rate rose from 11.6% to 19.4%, ROSC from 28.6% to 36.9%, and overall survival improved from 7.3% to 9.9%, indicating that
Objective: Accurate prehospital identification of patients with acute ischemic stroke (AIS) from large vessel occlusion (LVO) facilitates direct transport to hospitals that perform endovascular thrombectomy. We hypothesize that a cut-off score of the Cincinnati Prehospital Stroke Scale (CPSS), a simple assessment tool currently used by emergency medical services (EMS) providers, can be used to identify LVO.
Methods: Consecutively enrolled, confirmed AIS patients arriving via EMS between August 2012 and April 2014 at a high-volume stroke center in a large city with a single municipal EMS provider agency were identified in a prospective, single-center registry.
Objectives: Identifying stroke during a 9-1-1 call is critical to timely prehospital care. However, emergency medical dispatchers (EMDs) recognize stroke in less than half of 9-1-1 calls, potentially due to the words used by callers to communicate stroke signs and symptoms. We hypothesized that callers do not typically use words and phrases considered to be classical descriptors of stroke, such as focal neurologic deficits, but that a mixed-methods approach can identify words and phrases commonly used by 9-1-1 callers to describe acute stroke victims.
View Article and Find Full Text PDFObjective: Despite the value of out-of-hospital Termination of Resuscitation (TOR) and the scientific evidence in favor of this practice, TOR has not been uniformly adopted or consistently practiced in EMS systems. Previous focus group studies have identified multiple barriers to implementation of out of hospital TOR but existing literature on EMS provider perceptions is limited. We sought to identify EMS providers' perceived barriers to performing out-of-hospital TOR in a large urban EMS system.
View Article and Find Full Text PDFBackground: Snorting or smoking heroin is a known trigger of acute asthma exacerbation. Heroin abuse may be a risk factor for more severe asthma exacerbations and intubation. Heroin and other opioids provoke pulmonary bronchoconstriction.
View Article and Find Full Text PDFAs the elderly population increases and they lead more active and healthy lifestyles, their exposure to the threats of injury multiply. Undoubtedly, the geriatric population will comprise a growing percentage of trauma patients. The role of alcohol and drug use in geriatric trauma has not been clearly defined.
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