After resuscitation of the cardiac arrest patient, reperfusion to the brain begins a cascade of events that may lead to permanent brain damage. Cooling suppresses the inflammatory response related to ischemia and metabolic demand, improving oxygen supply to anoxic areas. Until recently, cooling was only performed in the hospital setting. Recent studies have questioned whether initiating the cooling process immediately after resuscitation is beneficial in the pre-hospital setting. The primary purpose of this study was to examine the feasibility and safety of pre-hospital hypothermia via data extraction from randomized controlled trials and statistical meta-analysis. Studies included in this analysis did show a significant statistical difference with the ability to lower the body temperature when beginning pre-hospital cooling immediately, making it feasible to start therapeutic hypothermia in the pre-hospital setting. Further research is needed to determine neurological and discharge outcomes as the studies were not powered to determine statistical significance.
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http://dx.doi.org/10.1097/TME.0b013e3182343cb6 | DOI Listing |
Injury
January 2025
Department of Surgery, The Trauma and Orthopaedic Research Unit, The Canberra Hospital, Garran, Australian Capital Territory, Australia.
Background: Unstable posterior pelvic-ring fractures are rare and difficult to manage. There are many injury patterns, they are associated with high morbidity and mortality, and optimal surgical management remains contentions. This study aims to compare outcomes and complications for different surgical management of these injuries.
View Article and Find Full Text PDFJ Clin Med
January 2025
Institute of Infectious Diseases and Infection Control, Jena University Hospital, Friedrich-Schiller-University Jena, 07747 Jena, Germany.
: Despite recent decades' rapid advances in the management of patients with sepsis and septic shock, global sepsis mortality and post-acute sepsis morbidity rates remain high. Our aim was, therefore, to provide a first overview of sepsis care pathways as well as barriers and supportive conditions for optimal pre-clinical, clinical, and post-acute sepsis care in Germany. : Between May and September 2023, we conducted semi-structured, video-based, one-to-one pilot expert interviews with healthcare professionals representing pre-hospital, clinical, and post-acute care settings.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
UOC Emergenza Territoriale 118 Area Provinciale Aretina, Azienda USL Toscana Sud-Est, 52100 Arezzo, Italy.
: Thanks to the evolution of laboratory medicine, point-of-care testing (POCT) for troponin levels in the blood (hs-cTn) has been greatly improved in order to quickly diagnose acute myocardial infarction (AMI) with an accuracy similar to standard laboratory tests. The rationale of the HEART POCT study is to propose the application of the 0/1 h European Society of Cardiology (ESC) algorithm in the pre-hospital setting using a POCT device (Atellica VTLi). : This is a prospective study comparing patients who underwent pre-hospital point-of-care troponin testing (Atellica VTLi) with a control group that underwent standard hospital-based troponin testing (Elecsys).
View Article and Find Full Text PDFSci Rep
January 2025
Department of Military Traffic Injury Prevention and Control, Daping Hospital, Army Medical University, No. 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China.
The incidence of blast injuries has been rising globally, particularly affecting the lungs due to their vulnerability. Primary blast lung injury (PBLI) is associated with high morbidity and mortality rates, while early diagnostic methods are limited. With advancements in medical technology, and portable handheld ultrasound devices, the efficacy of ultrasound in detecting occult lung injuries early remains unclear.
View Article and Find Full Text PDFEmerg Med J
January 2025
Department of Anesthesiology & Trauma Center / HEMS Lifeliner 1, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
Thoracostomies, and subsequent placements of chest tubes (CTs), are a standard procedure in several domains of medicine. In emergency medicine, thoracostomies are indicated to release a relevant hemothorax or pneumothorax, particularly a life-threatening tension pneumothorax. In many cases, an initial finger-assisted thoracostomy is followed by placement of a CT to ensure continuous decompression of blood and air.
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