Midazolam and Ketamine for Convulsive Status Epilepticus in the Out-of-Hospital Setting.

Study Objective: To determine if ketamine, when added to midazolam for the treatment of out-of-hospital seizures, is associated with an increase in the rate of cessation of convulsions prior to hospital arrival.

Methods: We performed a retrospective cohort study of out-of-hospital patients with an active convulsive seizure being transported to a hospital by a large emergency medical services system in Florida, using data from August 1, 2015 and August 5, 2024. Per protocol, patients received midazolam first for their seizure.

The Implementation of a Prehospital Whole Blood Transfusion Program and Early Results.

Introduction: In far-forward combat situations, the military challenged dogma by using whole blood transfusions (WBTs) rather than component-based therapy. More recently, some trauma centers have initiated WBT programs with reported success. There are a few Emergency Medical Service (EMS) systems that are using WBTs, but the vast majority are not.

Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival.

Background: Survival after out-of-hospital cardiac arrest (OHCA) remains poor. A physiologically distinct cardiopulmonary resuscitation (CPR) strategy consisting of (1) active compression-decompression CPR and/or automated CPR, (2) an impedance threshold device, and (3) automated controlled elevation of the head and thorax (ACE) has been shown to improve neurological survival significantly versus conventional (C) CPR in animal models. This resuscitation device combination, termed ACE-CPR, is now used clinically.

Faster time to automated elevation of the head and thorax during cardiopulmonary resuscitation increases the probability of return of spontaneous circulation.

Objectives: Resuscitation in the Head Up position improves outcomes in animals treated with active compression decompression cardiopulmonary resuscitation and an impedance threshold device (ACD + ITD CPR).We assessed impact of time to deployment of an automated Head Up position (AHUP) based bundle of care after out-of-hospital cardiac arrest on return of spontaneous circulation (ROSC).

Methods: Observational data were analyzed from a patient registry.

Out-of-Hospital Ketamine: Indications for Use, Patient Outcomes, and Associated Mortality.

Study Objective: To describe out-of-hospital ketamine use, patient outcomes, and the potential contribution of ketamine to patient death.

Methods: We retrospectively evaluated consecutive occurrences of out-of-hospital ketamine administration from January 1, 2019 to December 31, 2019 reported to the national ESO Data Collaborative (Austin, TX), a consortium of 1,322 emergency medical service agencies distributed throughout the United States. We descriptively assessed indications for ketamine administration, dosing, route, transport disposition, hypoxia, hypercapnia, and mortality.

Rationale and Strategies for Development of an Optimal Bundle of Management for Cardiac Arrest.

Objectives: To construct a highly detailed yet practical, attainable roadmap for enhancing the likelihood of neurologically intact survival following sudden cardiac arrest.

Design Setting And Patients: Population-based outcomes following out-of-hospital cardiac arrest were collated for 10 U.S.

Confirming the Clinical Safety and Feasibility of a Bundled Methodology to Improve Cardiopulmonary Resuscitation Involving a Head-Up/Torso-Up Chest Compression Technique.

Objectives: Combined with devices that enhance venous return out of the brain and into the thorax, preclinical outcomes are improved significantly using a synergistic bundled approach involving mild elevation of the head and chest during cardiopulmonary resuscitation. The objective here was to confirm clinical safety/feasibility of this bundled approach including use of mechanical cardiopulmonary resuscitation provided at a head-up angle.

Design: Quarterly tracking of the frequency of successful resuscitation before, during, and after the clinical introduction of a bundled head-up/torso-up cardiopulmonary resuscitation strategy.

Need to Prioritize Education of the Public Regarding Stroke Symptoms and Faster Activation of the 9-1-1 System: Findings from the Florida-Puerto Rico CReSD Stroke Registry.

Demographic differences (race/ethnicity/sex) in 9-1-1 emergency medical services (EMS) access and utilization have been reported for various time-dependent critical illnesses along with associated outcome disparities. However, data are lacking with respect to measuring the various components of time taken to reach definitive care facilities following the onset of acute stroke symptoms (i.e.

First-hand approach. A novel method to rapidly calculate pediatric drug dosages.

ROSC should ideally be achieved prior to departure from the scene. Airway maintenance and post-resuscitation care become top priorities en route to the closest appropriate facility. The entire sequence should appear effortless and smooth, creating the perception of impeccable excellence.

Evaluation of a transthecal digital nerve block in the injured pediatric patient.

Background: Digital anesthesia in the pediatric population has traditionally been accomplished using a ring block that requires multiple injections. A modified transthecal digital nerve block is a single-injection technique of the midproximal phalanx that has been shown to be technically simple and highly effective in adults.

Objective: To describe the success rate of the modified transthecal digital nerve block in children.