Prehospital delays for patients with chest pain. Medical search. Frequent questions

RESULTS: The mean prehospital delay times (ie, symptom onset to hospital arrival) was 25.4 hours (+/- 46.5), and the median was 5 hours. (aacnjournals.org)
Delay groups were divided into those arriving less than 3 hours (n = 31 or 40%) and those arriving more than 3 hours (n = 46 or 60%) after symptom onset. (aacnjournals.org)
Univariate statistical analyses revealed that advanced age, symptom onset with a family member present, and self-determination of symptoms as not being serious in nature all contributed to a delay of longer than 3 hours. (aacnjournals.org)
Guidelines recommend thrombolysis within 1 hour of symptom onset and 30 minutes of hospital arrival for patients with ST-elevation myocardial infarction (STEMI) in order to prevent morbidity and mortality. (bvsalud.org)
There is a paucity of data pertaining to the time between onset of chest pain and thrombolysis in STEMI patients in SA. (bvsalud.org)
The median (IQR) time from symptom onset to calling for help was 60 (30 - 240) minutes, the median time from arrival of help to hospital arrival was 114 (48 - 468) minutes, and the median in-hospital delay to thrombolysis after arrival was 105 (45 - 240) minutes. (bvsalud.org)
Thirty per 1 000 participants could have been saved had they received thrombolytic therapy within 1 hour from the onset of chest pain. (bvsalud.org)
Contrary to the overall findings, in the patients who were treated within 2 hours of symptom onset, tPA performed better than PCI. (emcrit.org)
The study found that patients with gradual symptom onset took eight hours to get medical help compared to 2.6 hours for those with abrupt symptoms. (escardio.org)
Gradual symptoms begin with mild discomfort that slowly gets worse, while abrupt onset refers to sudden and severe pain from the start. (escardio.org)
Symptom characteristics and time from symptom onset to arrival in the emergency department were assessed using the ACS Patient Information Questionnaire. (escardio.org)
Nearly half of patients had a slow onset, so this is not uncommon," said Dr Mirzaei. (escardio.org)
The association between symptom onset characteristics and prehospital delay in women and men with acute coronary syndrome. (escardio.org)
Zègre-Hemsey JK , Hogg M, Crandell J, Pelter MM, Gettes L, Chung EH, Pearson D, Tochiki P, Studnek JR, Rosamond W. Prehospital ECG with ST-depression and T-wave Inversion are Associated with New Onset Heart Failure in Individuals Transported by Ambulance for Suspected Acute Coronary Syndrome. (unc.edu)
Factors associated with longer time from symptom onset to hospital presentation for patients with ST-elevation myocardial infarction. (jamanetwork.com)
Patients who suffer stroke due to a blockage of the arteries supplying the brain (LVO-stroke), benefit from surgical restoration of the blood supply (known as endovascular clot retrieval, ECR), but this is only effective if performed within 24 hours of stroke onset. (emergencyfoundation.org.au)

BACKGROUND: Patients experiencing chest pain (or other cardiac symptoms) in the community delay hours, even days, in seeking medical care. (aacnjournals.org)
CONCLUSIONS: Critical care nurses and physicians should focus on patients at high risk for prolonged delay and educate the public about action to take if a family member experiences cardiac symptoms. (aacnjournals.org)
ABSTRACT This cross-sectional study aimed to assess interpretation of symptoms as a cause of delays in patients with acute myocardial infarction (AMI). (who.int)
Most patients attributed AMI-related symptoms to a reason other than heart disease. (who.int)
Misinterpretation of symptoms and misconceptions about emergency treatment during AMI cause delays in admission and may affect treatment. (who.int)
Bugiardini said the most important factor for worse outcomes for women in his study was the pre-hospital delay, and he called for broad efforts to improve recognition of heart attack symptoms, especially among women. (acc.org)
The total pre-hospital delay period includes: the time spent to recognize the symptoms were serious enough to call for help and the time between when emergency care arrived and hospital admission. (acc.org)
Symptoms may be apparent immediately or delayed for a few hours. (cdc.gov)
of symptoms, and common compli- the symptom interpretation and care- Fourteen patients were excluded be- cations include recurrent ischaemia, seeking behaviour. (who.int)
hospitalized with AMI was 2.1 hours in 1997, and 32% of Awareness of heart attack signs and symptoms and the patients with AMI had delay times of more than four need to call 911 increased significantly among employees hours (3). (cdc.gov)
However, Act in Time posters were placed on bulletin persons who believe that their symptoms boards, in hallways, and in all bathrooms at are serious are less likely to delay and more each work site during the six-week test peri- likely to use emergency medical services. (cdc.gov)
Women were more likely to have additional and more diverse concurrent symptoms besides chest pain (≥2 other symptoms in 37.1% of women vs. 32.4% of men). (acponline.org)
Itchhaporia also remarked that women and primary care clinicians must be educated on the symptoms of heart disease so that they can be on the alert and provide patients with comprehensive treatments when necessary. (medscape.com)
There was an average difference in reperfusion time of 60 minutes between the two treatment arms.In patients whose symptoms began less than 2 hours earlier, those who received PHF fared better than those who received PCI. (emcrit.org)
Inversely, in patients whose symptoms began greater than 2 hours earlier, those who received PCI did better. (emcrit.org)
The symptoms of acute coronary syndrome are non-specific, and interpretation is often challenging for patients. (escardio.org)
Normal Prehospital Electrocardiography is Linked to Long-term Survival in Patients Presenting to the Emergency Department with Symptoms of Acute Coronary Syndrome. (unc.edu)
Often within 1 year, patients have generalized symptoms such as weakness or fatigue and one third of patients develop respiratory weakness, requiring mechanical ventilation. (medscape.com)
Thyroid disorders may be seen in as many as 10% of patients with myasthenia gravis, and symptoms of hyperthyroidism or hypothyroidism may be present. (medscape.com)
The EMS1 Academy features 'Opioid Crisis: Protecting Our First Responders,' a one-hour accredited course covering proper identification of the various opioids, signs and symptoms of exposure, and immediate life-saving measures to be employed in the event of exposure, critical to patient and provider safety. (ems1.com)
Rapid detection of patients with LVO-stroke is key, however many unrelated conditions can mimic stroke symptoms. (emergencyfoundation.org.au)

Awareness of chest pain, pain or discomfort in the arms or department. (cdc.gov)
Chest pain, chest discomfort, and chest pressure are warning signs that an artery may be blocked, and patients should call the emergency medical services immediately. (escardio.org)
Men with ischaemic heart disease or with multiple risk factors such as hypertension, diabetes, high cholesterol, or family history of heart disease should be aware that chest pain or discomfort after physical effort could be a heart attack," said Dr Mirzaei. (escardio.org)
Dr Mirzaei said: "Chest pain or discomfort, whether severe and sudden or mild and slow, should not be ignored. (escardio.org)
Eligible patients were persons aged ≥30 years presenting with chest pain or discomfort to emergency departments (EDs) who were admitted and discharged with a cardiac-related diagnoses (ICD 410-414, 427-429, 440, 786.9). (umn.edu)
A 54-year old man presents by private vehicle to the Emergency Department with chest discomfort he described as " heartburn . (litfl.com)

While direct presentation to the hospital with acute chest pain is preferable, in urban Indian patients presenting first to a GP, an ECG performed by the GP is a cost-effective strategy to reduce disability and mortality. (biomedcentral.com)
CONCLUSION: Prehospital and hospital-related factors played a significant role in delays to thrombolysis that led to increased morbidity and mortality of patients with STEMI. (bvsalud.org)
and (5) ability to communi- transportation of patients with AMI cate verbally, and read, understand and Mortality associated with acute (6,20) predicted early access to medical speak Turkish. (who.int)
Women had higher mortality for STEMI, but better outcomes for other etiologies of chest pain compared with men," they wrote. (acponline.org)
Time to intervention can be a risk: delays to reperfusion correlate with higher rates of mortality and morbidity. (gehealthcare.com.au)
Further, angiography or PCI should be deferred in favor of medical management for patients with a high risk of procedure-related morbidity or mortality. (msdmanuals.com)
Chest trauma accounts for approximately 25% of mortality in trauma patients.1,2 This rate is much higher in patients with polytraumatic injuries. (saem.org)
Not only do the patients do poorly early on, but there is even an impact on their long-term mortality. (ptca.org)
Association of the 2011 ACGME resident duty hour reforms with mortality and readmissions among hospitalized Medicare patients. (ahrq.gov)
In the Amsterdam region, time delays and mortality were not significantly different between men and women presenting with STEMI. (bsl.nl)
Therefore, the main goal of this study was to examine if sex-based differences exist in STEMI patients in Amsterdam and the surrounding region, focusing on patient delay, system delay and overall ischaemic time as well as all-cause mortality at 30 days and 1 year following primary percutaneous coronary intervention (pPCI). (bsl.nl)
1,2 Falls cause significant morbidity and mortality among elderly patients compared to younger patients. (reliasmedia.com)
11 Geriatric patients experience additional complications that lead to age-related higher mortality during post-trauma hospitalization, such as delirium, pneumonia, and respiratory failure. (reliasmedia.com)
Baseline characteristics, ICU and hospital stay, hospital mortality, and in-patient costs were compared between patients successfully extubated and those with reintubation outside the operating room, using regression techniques. (rcjournal.com)
2 , 7 - 12 The ability to accurately identify patients at higher risk of extubation failure and what the likely causes of failure may be has the potential to positively impact morbidity and mortality by reducing extubation failures and improving patient safety at the time of reintubation. (rcjournal.com)
Delaying community transmission allowed USAPIs to establish testing capacity, immunize large proportions of their populations, and use novel COVID-19 therapeutics to reduce severe disease and mortality. (cdc.gov)

In her current research, Dr. Zègre-Hemsey investigates (1) cardiac monitoring (electrocardiography) and other non-invasive physiological measures, and (2) implementation of evidence-based innovations into prehospital and acute care settings, to advance patient triage, diagnosis, and access to care. (unc.edu)
9- 11 To date, there has been little research concerning the abilities of crews to triage patients to alternative receiving units, although two studies have pointed to the complexity of this change in practice 12 13 and a recent review concluded that evidence concerning the safety and effectiveness of alternative models is lacking. (bmj.com)
They should also understand that there has to be some very careful triage of patients. (ptca.org)
In 2004, a pre-hospital triage system was introduced in Amsterdam and the surrounding region with the aim of quickly identifying patients with ST-elevation myocardial infarction (STEMI) who are candidates for coronary reperfusion therapy. (bsl.nl)
This study investigates data from the pre-hospital triage system focusing on STEMI patients receiving pPCI in Amsterdam and the surrounding area. (bsl.nl)
Move as quickly as possible �Begin transports of red patients as soon as feasible, BUT don't neglect processes (triage, allocation of patients to hospitals, command, etc. (slidetodoc.com)
Prehospital EMS encompasses a range of related activities, including 9-1-1 dispatch, response to the scene by ambulance, treatment and triage by EMS personnel, and transport to a care facility via ground and/or air ambulance. (nationalacademies.org)

Rapid diagnosis and treatment with appropriate reperfusion therapies has been proven to increase survival for patients with STEMI. (biomedcentral.com)
This finding was attributed to improved diagnosis of ACS and more prompt referral of patients to a hospital (unpublished data - with permission from Dr. Rajagopalan 5/25/08). (biomedcentral.com)
and 5 patients felt too ing early diagnosis and treatment avoid patients could increase the rate of early tired to participate. (who.int)
Prompt diagnosis, timely ECGs [electrocardiograms], and early treatment should be a top priority for all patients with undifferentiated chest pain, including women," the editorialist wrote. (acponline.org)
An ECG is a quick and conclusive diagnostic test for a STEMI diagnosis and timely ECGs in all patients with chest pain might be an easy and inexpensive remedy for the implicit bias that appears to impede the diagnosis and care in women with STEMIs. (acponline.org)
Prehospital 12-lead ST-segment Monitoring Improves the Early Diagnosis of Acute Coronary Syndrome. (unc.edu)
Discuss the eventual disposition of chest trauma patients based on their diagnosis. (saem.org)
Rethinking diagnostic delay in cancer: how difficult is the diagnosis? (ahrq.gov)
This can result in delays in diagnosis and in the timely treatment of women. (bsl.nl)
Initiation of treatment was achieved within 90 min after STEMI diagnosis in 85% of patients (87% in women, 85% in men). (bsl.nl)
In Amsterdam and the surrounding region, 85% of the patients presenting with STEMI receive pPCI within 90 min after diagnosis. (bsl.nl)
Most patients who present to the emergency department (ED) have an established diagnosis of myasthenia gravis and are already taking appropriate medications. (medscape.com)
Get the tools and knowledge you need for effective diagnosis, evaluation, and management of patients with acute myocardial infarction. (physioshop.co.uk)
Patients suspected of suffering a stroke therefore require intensive examination and brain scans to confirm diagnosis before treatment can begin. (emergencyfoundation.org.au)

CDC has recommended supportive care including pain control. (cdc.gov)

To assess the causes of delay for presentation with ST elevation myocardial infarction (STEMI). (edu.om)
Patients who presented with STEMI to the Emergency Department at the Sultan Qaboos University Hospital, Muscat, Oman between January 2017 and December 2019 and were admitted for primary angioplasty were included in this study. (edu.om)
A high proportion of patients presenting to our institution with a STEMI arrived within recommended times. (edu.om)
OBJECTIVES: To elucidate the time to thrombolytic therapy, establish the reasons for treatment delays, and calculate the loss of benefit of thrombolysis associated with delays in treatment of patients presenting with STEMI at Chris Hani Baragwanath Academic Hospital (CHBAH), Johannesburg, SA. (bvsalud.org)
METHOD: A prospective observational study of 100 consecutive patients with STEMI was conducted at CHBAH (2021 - 2022). (bvsalud.org)
An accompanying editorial said that the study shows "cascading delays" in prehospital and hospital care for women with acute chest pain and noted that such delays are particularly problematic in the case of STEMI. (acponline.org)
The delays in care and disparities in STEMI outcomes observed in this study are a call for the medical profession to act. (acponline.org)
The assumption was that this study would prove that all the resources invested had proved their worth, including training an army of cardiologists to be on 24 hour call and mobilizing a pre-hospital system to quickly and effectively deliver our chest pain patients to certified STEMI centers which were equipped with state of the art cath labs designed to be ready for action at a moments notice. (emcrit.org)
The opinion piece published in conjunction with this article by Dr. Eric Bates and Dr. Alice Jacobs (2), postulates that we have reached the nadir of door-to-balloon time and to further improve STEMI outcomes we must now focus on prehospital time. (emcrit.org)
Early in the disease process (within the first 2 hours) the difference between the interventions is far less, because in this stage of a STEMI time actually does matter and the small delay to get to the cath lab has an effect. (emcrit.org)
This quality registry study included all patients with STEMI who received primary percutaneous coronary intervention in 2015 or 2016 in Amsterdam and the surrounding region. (bsl.nl)
Patient delay, system delay and total ischaemic times are similar in female and male patients presenting with ST-elevated myocardial infarction (STEMI) who have received primary percutaneous coronary intervention (pPCI). (bsl.nl)
This patient needs to be managed as a STEMI with analgesia, nitrates, oxygen, aspirin, heparin and (most importantly) emergent PCI or thrombolysis! (litfl.com)

OBJECTIVES: A descriptive study was conducted to determine the amount of time patients delayed in seeking medical care when experiencing chest pain and the characteristics of patients delaying longer than 3 hours. (aacnjournals.org)
In a multivariate logistic regression analysis, the type of AMI was classified based on electrocardiography findings (odds ratio 5.18, 95% confidence interval: 1.69-15.91, P=0.004) and was independently associated with a long prehospital delay time, indicating that patients with ST segment elevation MI would seek early medical care. (who.int)
Women suffering a heart attack wait much longer than men to call emergency medical services and face significantly longer delays getting to a hospital equipped to care for them, putting women at greater risk for adverse outcomes, according to research to be presented at the American College of Cardiology's 64th Annual Scientific Session in San Diego. (acc.org)
A cohort study in Australia found that women with acute chest pain were less likely than men to receive guideline-directed care across most measures, including transport to the hospital, prehospital administration of aspirin or analgesia, and 12-lead electrocardiogram. (acponline.org)
W omen with acute chest pain are managed differently than men across the care spectrum, an Australian study found. (acponline.org)
Researchers performed a population-based cohort study in Victoria, Australia, to assess sex differences in epidemiology and care pathways for acute chest pain from emergency medical services (EMS) contact through clinical outcomes after discharge . (acponline.org)
Multivariable models found that women were less likely to receive guideline-directed care across most measures, including transport to the hospital, prehospital administration of aspirin or analgesia, 12-lead electrocardiogram, IV cannula insertion, and transfer from EMS or review by ED clinicians within target times. (acponline.org)
In this state-wide population-based study of acute chest pain presentations, women were less likely to receive guideline-directed care compared with men across most care quality measures in the prehospital, hospital, and ACS care settings. (acponline.org)
These findings highlight a need to reduce substantial care discrepancies for women presenting with acute chest pain. (acponline.org)
As a heart patient, he was assigned a team of physicians and nurses who provide specialized care for patients with heart and chest problems. (missouribaptist.org)
Consider intensive care unit admission for patients with seizures, coma, severe methemoglobinemia, or hemolysis. (medscape.com)
This course is designed for all healthcare professionals involved in the care of pediatric patients, especially those in trauma care centers. (netce.com)
In support of improving patient care, NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. (netce.com)
Barriers to the use of emergency medical services (EMS) and patient delay in seeking care can limit the receipt or effectiveness of reperfusion therapies and the availability of prehospital emergency cardiac care. (umn.edu)
Prehospital Emergency Care , 6 (2), 175-185. (umn.edu)
Optimizing Patient Outcomes in Emergency Cardiac Care Through Advances in Technology: Nurse Scientists in Action. (unc.edu)
Drew BJ, Harris P , Zègre-Hemsey JK , Mammone T, Schindler D, Salas-Boni R, Bai Y, Tinoco A, Ding Q, Hu X. Insights into the Problem of Alarm Fatigue with Physiologic Monitor Devices: A Comprehensive Observational Study of Consecutive Intensive Care Unit Patients. (unc.edu)
MIU patients were 7.2 times as likely to rate their care as excellent (95% CI 1.99 to 25.8). (bmj.com)
Improving handoff communications in critical care: utilizing simulation-based training toward process improvement in managing patient risk. (ahrq.gov)
Objective: The study objective was to explore how often and why HF nurses in outpatient clinics discuss prognosis and end-of-life care in the context of patient education. (edu.au)
Conclusions: Currently, patient-nurse communication about prognosis and end-of-life care does not seem to be routine in patient education in HF clinics, and these discussions could be included more often. (edu.au)
To improve future care, communication with patients needs to be further developed. (edu.au)
This study investigated the nature and source of disruptions in an ambulance during the telemedicine-based caregiving process for stroke patients to enhance the ambulance design for supporting telemedicine-based care. (ahrq.gov)
A future article will be based on Abe's unfolding case scenario and will describe various treatment modalities necessary to manage the extended care of patients with burn injuries in the ICU, including what nurses need to know about skin grafting and in-hospital rehabilitation. (bellasanpietro.it)
It is important that anesthesiologists working in receiving hospitals perceive the capacity, distinctive challenges, and limitations of providing care in the prehospital surroundings so they can be ready to proceed with ongoing care. (edu.au)
Understanding what can (and cannot) be accomplished within the prehospital setting minimizes duplication and stagnation of care in-hospital, and is important to avoiding the therapeutic vacuum. (edu.au)
For first responders and others who deliver trauma care in the prehospital environment, there are numerous hazards that need to be thought-about and addressed to ensure as secure an surroundings as possible-for themselves and their patient. (edu.au)
Through these encounters, prehospital EMS care is delivered directly to patients, in the locations where help is needed. (nationalacademies.org)
Moreover, with greater emphasis now being placed on bystander care and prearrival instructions provided by dispatchers, care to patients can be initiated even more rapidly. (nationalacademies.org)
EMS personnel form the backbone of the prehospital care system despite working under conditions that are stressful and at times dangerous. (nationalacademies.org)
Whilst research has established a safe approach to the sedation of people with ABD, other aspects of their retrieval remain lacking in evidence, and may contribute to suboptimal care and delayed access to specialist mental health services. (emergencyfoundation.org.au)
This delays care provision, particularly for patients in regional areas who must travel to access specialist equipment. (emergencyfoundation.org.au)
Dr. Staudenmayer's clinical focus is on trauma, emergency general surgery, and surgical critical care, and her research interests encompass trauma systems of care and vulnerable patient populations such as the elderly. (stanford.edu)
Dr. Staudenmayer was promoted to Associate Professor of Surgery in 2016, and continues her research, policy and advocacy work to improve the care and outcomes for patients with traumatic injuries and critical surgical illnesses. (stanford.edu)
In the prehospital care-delivery system of 9-1-1 emergency medical services (EMS) calls, emergency medical technicians (EMTs) routinely collect medical information, including blood pressure values, that may indicate the presence of chronic disease. (cdc.gov)

A multidisciplinary model for reviewing severe maternal morbidity cases and teaching residents patient safety principles. (ahrq.gov)
The extent to which the difficult airway at reintubation contributes to patient morbidity is unknown. (rcjournal.com)

By contrast, patients with persistent chest pain despite maximal medical therapy or complications (eg, markedly elevated cardiac biomarkers, presence of cardiogenic shock, acute mitral regurgitation, ventricular septal defect, unstable arrhythmias) should proceed directly to the cardiac catheterization laboratory to identify coronary lesions requiring PCI or CABG. (msdmanuals.com)

Numerous reasons that led to delay in treatment were identified, but the most frequent was prehospital delays related to patient factors. (bvsalud.org)
Treatment to aid pain relief for this condition includes intra-thoracic nerve blocks/opiates and epidurals, although results vary from person to person and are dependent on numerous factors. (wikipedia.org)
For patients not sent immediately to the interventional lab for revascularization, guidelines suggest use of biomarkers, clinical history, ECG and non-invasive imaging measurement results, and other factors, to determine TIMI risk score which in turn can guide revascularization decisions. (gehealthcare.com.au)
5 There are available estimates for sensitivity and specificity for the various non-invasive tests to diagnose the presence of CAD, but other factors are frequently considered such as equipment availability and patient tolerance. (gehealthcare.com.au)
Decade-long trends and factors associated with time to hospital presentation in patients with acute myocardial infarction: the Worcester Heart Attack study. (jamanetwork.com)
Unexpected complications can occur with flight schedules, vehicle breakdowns, weather delays, and other factors. (cdc.gov)
Understanding these factors may help to optimize patient selection and the timing of CEM examinations. (arrs.org)

In patients who are awake and lucid, the chest trauma may present with chest pain, dyspnea, back or abdominal pain, and occasionally syncope. (saem.org)
Treatment is conservative for spontaneous pneumothorax in which no signs of increased pleural pressure appear (indicating tension Pneumothorax), lung collapse is less than 30%, and the patient shows no signs of Dyspnea or other indications of physiologic compromise. (lifenurses.com)

Complications such as pneumothorax, tension pneumothorax, or subcutaneous emphysema can occur if these chest tubes become clogged. (wikipedia.org)
Furthermore, complications such as pleural effusion or hemothorax can occur if the chest tubes fail to drain the fluid around the lung in the pleural space after a thoracotomy. (wikipedia.org)
Clinicians should be on the look out for chest tube clogging as these tubes have a tendency to become occluded with fibrinous material or clot in the post operative period, and when this happens, complications ensue. (wikipedia.org)
As with many orthopedic injuries, neurovascular complications and pain management are the most significant issues in patients who come to the ED with a femoral shaft fracture. (medscape.com)
[ 18 , 19 ] In the presence of contraindications to surgery, this repair may be delayed for days without significant complications if leg length is maintained with traction. (medscape.com)
Acquiring information concerning complications in patients receiving pPCI is difficult but of upmost importance for quality purposes. (bsl.nl)

Prehospital delay time ranged from 15 minutes to 10 days, with a median of 2 hours (interquartile range: 9.50). (who.int)
The median (interquartile range) pain-to-door time was 60 min (30-120 min). (edu.om)

For example, instead of crushing chest pain, they may have shortness of breath, nausea or vomiting, or pain in the back, neck or jaw. (acc.org)
A 21-year-old male presents to the ED by ambulance with complaints of chest pain and shortness of breath that began after he was involved in an altercation outside of a gas station. (saem.org)

Cui ER, Fernandez AR, Zègre-Hemsey JK , Grover JM, Honvoh G, Brice JH, Rossi JS, Patel MD. Disparities in Emergency Medical Services Time Intervals for Patients with Suspected Acute Coronary Syndrome: Findings from the North Carolina Prehospital Medical Information System. (unc.edu)
However, in comparison to penetrating trauma, blunt chest trauma patients may have a more subtle presentation with less obvious physical exam findings. (saem.org)
Lack of familiarity with these ECG findings may lead to reluctance to activate the cath lab and unacceptable delays in reperfusion. (litfl.com)
Eymen Ucisik, MD discusses a recently published AJR article aiming to explore the potential of the insular ribbon involvement on the initial MRI as a marker of tissue fate by analyzing serial follow up MRI findings and the affected patients' clinical outcomes. (arrs.org)

Consecutive adults treated by EMS for acute undifferentiated chest pain from Jan. 1, 2015, to June 30, 2019, were included in the study, and EMS clinical data were individually linked to ED and hospital data. (acponline.org)
Patients with gyromitrin ingestion who are asymptomatic 8 hours after ingestion and are without clinical or laboratory signs of toxicity may be considered for discharge. (medscape.com)
The Rapid Early Action for Coronary Treatment (REACT) trial was designed to determine the impact of a community intervention on use of EMS among demographic and clinical subgroups of patients with suspected acute cardiac ischemia. (umn.edu)
A randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome. (jamanetwork.com)
However, there is no knowledge on which demographic, clinical, and quality of life (QoL) aspects are related to difficulties in sexual activity nor on the course of sexual difficulties in patients with HF. (edu.au)
12 Clinical Practice/Controversy Emergency Department Evaluation of the Lower-Risk Patient: Whom Can You Send Home? (physioshop.co.uk)
The purpose of the present European Respiratory Society (ERS) statement is to provide physicians with a comprehensive clinical review of chest imaging techniques for the assessment of patients with acute respiratory failure, based on the scientific evidence as identified by systematic searches. (ersjournals.com)
This statement highlights characteristics, clinical indications and limitations of each technique as a guide for patient management. (ersjournals.com)
This study aims to provide some epidemiological and clinical aspects of patients admitted to the emergency centre at Beni General Referral Hospital. (bvsalud.org)
System-wide Surveillance for Clinical Encounters by Patients Previously Identified with MRSA and VRE. (cdc.gov)

Variables describing the accuracy of a GP's referral decision in chest pain and ACS, ACS treatment patterns, the effectiveness of thrombolytic reperfusion, and costs were derived from Indian data where available and other developed world studies. (biomedcentral.com)
The study found that delays in getting hospital treatment-either because women waited longer to call for help or were not taken to the right hospital as quickly as men-were associated with a higher risk of dying. (acc.org)
Interestingly, once patients were admitted, there were no significant differences between men and women in time to treatment with a medication to breakdown blood clots, which took 26 minutes on average for men and 28 minutes for women, or with balloon angioplasty to open clogged arteries, which took 45 minutes on average for both men and women. (acc.org)
Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on Cardiovascular Nursing and Stroke. (jamanetwork.com)
Patients with acute respiratory failure require one or several imaging studies of the chest to diagnose underlying diseases, assess progression and evaluate treatment efficacy. (ersjournals.com)
Wenhui Zhou, MD, PhD reviews a recent AJR article which compares the efficacy and safety of delayed versus upfront thermal ablation in the treatment of colorectal cancer liver oligometastases. (arrs.org)

Left anterolateral thoracotomy is the incision of choice for open chest massage, a critical maneuver in the management of traumatic cardiac arrest. (wikipedia.org)
Unlike other disease entities, trauma patients often present with a known traumatic mechanism such as a car collision, fall, gunshot or stab wound. (saem.org)
Unstable chest trauma patients can also deteriorate to the point of traumatic arrest and depending on the mechanism of chest trauma, may be candidates for an emergent ED thoracotomy. (saem.org)
There is considerable overlap amongst the various traumatic disorders experienced in both penetrating and blunt chest trauma. (saem.org)
Traumatic Pneumothorax may result from insertion of a central venous line, thoracic surgery, or a penetrating chest injury, such as a gunshot or knife wound, or it may follow a transbronchial biopsy. (lifenurses.com)
When traumatic Pneumothorax follows a penetrating chest injury, hemothorax (blood in the pleural space) may also occur. (lifenurses.com)
2009 Oct;26 (10):738-40, "Chest decompression in traumatic cardiac arrest identifies and treats a high proportion of potentially life-ending injuries and should be considered as part of the resuscitation effort of patients in traumatic cardiac arrest. (bellasanpietro.it)
3-5 When treating a patient who has fallen, the emergency medicine physician should identify traumatic injuries, evaluate for medical pathology contributing to the fall, as well as manage the patient. (reliasmedia.com)
All patients should receive a comprehensive physical examination to avoid delayed medical or traumatic diagnoses. (reliasmedia.com)

METHODS: Adult patients (N = 77) admitted to an emergency department with chest pain participated. (aacnjournals.org)
Patients and methods. (bvsalud.org)

Introduction: Little information is available regarding the characteristics of patients attending the emergency centre (EC) in the Democratic Republic of Congo. (bvsalud.org)

Delays in Presentation by Patients with ST Elevation Myocardial Infarction: A single centre experience from Oman. (edu.om)
The analysis included 474 patients presenting to the emergency department with acute coronary syndrome (myocardial infarction and unstable angina). (escardio.org)
2 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. (escardio.org)
Rapid transport, ECG monitoring and patient stabilization are critical for patients having an ST-segment elevation myocardial infarction. (gehealthcare.com.au)
The REACT trial demonstrated a significant impact on the use of EMS among patients admitted to the hospital for suspected acute myocardial infarction, with greater increases among patients with chronic or other cardiac ICD-9 discharge diagnoses, those presenting with lower SBP, and retired persons. (umn.edu)
Immediate reperfusion is not as urgent in patients with uncomplicated non-ST-segment elevation myocardial infarction (NSTEMI), in whom a completely occluded infarct-related artery at presentation is uncommon, or in patients with unstable angina who respond to medical therapy. (msdmanuals.com)
Delay in presentation and reperfusion therapy in ST-elevation myocardial infarction. (jamanetwork.com)

Project Title: Electrocardiographic Detection of Non-ST Elevation Myocardial Events for Accelerated Classification of Chest Pain Encounters (ECG-SMART-2). (unc.edu)

Patients with acute coronary syndrome (ACS) in India have increased pre-hospital delay and low rates of thrombolytic reperfusion. (biomedcentral.com)
Use of ECG could reduce pre-hospital delay among patients who first present to a general practitioner (GP). (biomedcentral.com)
However, one retrospective Indian study of hospitalized ACS patients observed that although overall pre-hospital presentation to a GP doubled the risk of significant pre-hospital delay [ 8 ], a subgroup in which the GP performed an electrocardiogram (ECG) had reduced delay compared to patients who did not have an ECG and even to those who presented to the hospital directly. (biomedcentral.com)
Pre-hospital delays remain unacceptably long in women, and time matters," said Raffaele Bugiardini, M.D., professor of cardiology, University of Bologna, Italy, and lead author of the study, which examined records of 7,457 European patients enrolled from 2010 to 2014 in an international registry to study heart disease and treatments. (acc.org)
Overall delays-the time to call for help and then be taken to the right hospital-ranged from five minutes to three days. (acc.org)
10 of the patients who received a thrombolytic (19.6%) did so within 30 minutes of arrival at the hospital. (bvsalud.org)
Arrival by ambulance was associated with a shorter interval between the start of pain and hospital arrival. (escardio.org)
Just 45% of patients called an ambulance, while more than half (52%) used their own transport and 3% were transferred from another hospital. (escardio.org)
Patients were followed up through ambulance service, hospital and/or MIU records, and by postal questionnaire. (bmj.com)
Acting in response to an incident of preventable hypoglycemia, this Israeli hospital conducted a simulation training exercise focusing on teamwork training for nurses, with the goal of improving patient handoffs . (ahrq.gov)
Does hypothermia versus normothermia after out-of-hospital cardiac arrest improve patient-oriented outcomes? (mcmaster.ca)
As many as 10-30% of mechanically ventilated patients will fail extubation and require reintubation during their hospital stay. (rcjournal.com)
The aim of the study was to describe the course of patients with sepsis and/or septic shock in the polyvalent ICU of the University Teaching Hospital of Brazzaville. (bvsalud.org)

Three hours was chosen based on a mean time, taken from the literature, of 84 minutes spent in the emergency department so that patients in the first group would be able to receive thrombolysis within 4 hours. (aacnjournals.org)
Many delays occurred because women simply waited longer than men to call emergency medical services, with women waiting an average of one hour compared to 45 minutes for men. (acc.org)
No sooner does the patient with midsternal chest pressure and ST elevations set foot in the emergency department, when they are packaged up and swept away to the cath lab by a gang of cardiology fellows and attendings. (emcrit.org)
Trauma patients are commonly encountered in all emergency departments, not just in specified trauma centers. (saem.org)
For this reason, emergency medicine providers should be prepared to appropriately evaluate, resuscitate and stabilize any patient with chest trauma. (saem.org)
Chest trauma patients can present to the ED via Emergency Medical Services (EMS), often placed on a backboard and in a cervical collar. (saem.org)
Utilization of pharmacy technicians to increase the accuracy of patient medication histories obtained in the emergency department. (ahrq.gov)
This paper describes the outcomes of a pilot study that used novel emergency medical services (EMS) protocol to expedite transfer of patients with large vessel occlusions (LVOs) to a comprehensive stroke center (CSC). (ahrq.gov)
It involves a middle-aged male patient arriving at the emergency department via Emergency Medical Services (EMS). (bellasanpietro.it)
Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. (litfl.com)
A thorough history should include emergency medical services (EMS), family, or facility history of the patient at baseline and the situation surrounding the incident. (reliasmedia.com)
Older patients with minor head injury routinely get a head scan in emergency departments due to the risk of a brain bleed. (emergencyfoundation.org.au)
The study will inform emergency doctors about the feasibility of larger Australian studies to develop a reliable and accurate method to identify older patients who do not have a brain bleed and do not need a head scan. (emergencyfoundation.org.au)
Such a method could benefit patients by reducing transfer from rural and remote communities to bigger hospitals for a head scan, reducing waiting times in emergency departments and reducing exposure to radiation. (emergencyfoundation.org.au)
Such a method could also have significant cost savings to the Australian healthcare system by reducing costs associated with patient transfers, head scans and prolonged emergency department wait times. (emergencyfoundation.org.au)
Just the facts: how to diagnose and manage patients with multiple myeloma in the emergency department? (mcmaster.ca)

Our clinician researchers are making a difference in patient outcomes and saving lives through innovative research to identify new treatments, interventions, cures, and improving quality of life outcomes for patients. (cabrini.com.au)

Time was so valuable in the first few hours that the delay to intervention involved in performing PCI is important enough to make tPA (overall an inferior choice for reperfusion) superior or equivalent to PCI. (emcrit.org)
41 intervention cluster patients attended MIU, 303 attended A&E, 65 were not conveyed. (bmj.com)
Appreciate the necessity for emergent surgical intervention in certain chest trauma conditions. (saem.org)
Surgical intervention by pleurodesis or thoracotomy with resection of apical blebs is advised for patients with recurrent spontaneous pneumothorax. (lifenurses.com)

Increased challenges can be added such as increasing the environmental chaos, adding patients, or increasing the acuity of patient injuries. (ahrq.gov)
Injuries that Indicate a Priority Patient: Poor general impression Unresponsive or altered mental status Airway compromise Inadequate or difficult breathing Inadequate perfusion or shock, including cardiac arrest Severe bleeding that can't be controlled. (bellasanpietro.it)
Trauma naked = cutting off the clothes to expose the patient fully so that no injuries are missed during the assessment. (bellasanpietro.it)

[ 2 ] The guidelines include the use of the CRUSADE risk score (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines). (medscape.com)
Unstable chest trauma patients may show signs of severe respiratory distress or profound shock requiring emergent resuscitation. (saem.org)

Researchers also had access to patients' subsequent use of medications and cardiac revascularization procedures, which are usually less frequent in women. (acc.org)

3 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. (escardio.org)
For patients sent for revascularization in the catheterization lab, attempts are made to rapidly access the culprit artery and complete further assessment of coronary tree. (gehealthcare.com.au)
Unusual Fatigue and Failure to Utilize EMS Are Associated With Prolonged Prehospital Delay for Suspected Acute Coronary Syndrome. (unc.edu)

This study demonstrates improved rates of complete pathologic necrosis for patients with HCC who underwent thermal ablation and TARE therapies, when compared to those who received TACE. (arrs.org)

Now with the addition of prehospital EKGs we barely have time to get a set of vitals and toss and aspirin and prasugrel (if your cardiologists are anything like ours) in their mouth as they pass by. (emcrit.org)
3 The ability to send observations and test results wirelessly can be invaluable to attending physicians and interventional lab preparations - potentially enabling fast action upon arrival to aid quality patient outcomes such as door to balloon time. (gehealthcare.com.au)
Conclusions: Perceived difficulties in sexual activity are common in patients with HF, particularly in younger and male patients and continue over time. (edu.au)

List commonly utilized imaging modalities in chest trauma. (saem.org)
The available modalities range from plain chest X-ray to computed tomography, lung ultrasound, electrical impedance tomography and positron emission tomography. (ersjournals.com)

We assessed whether performing ECG on patients with acute chest pain would improve long-term outcomes and be cost-effective. (biomedcentral.com)

These chest imaging techniques allow a better assessment and understanding of the pathogenesis and pathophysiology of patients with acute respiratory failure, but have different indications and can provide additional information to each other. (ersjournals.com)

Chest imaging in patients with acute respiratory failure plays an important role in diagnosing, monitoring and assessing the underlying disease. (ersjournals.com)
A variety of chest imaging techniques are now available for assessing patients with acute respiratory failure. (ersjournals.com)
376 patients (19%) required reintubation, and 230 (11%) were reintubated within 48 hours, primarily due to respiratory failure. (rcjournal.com)

Ambulance crews in two services were asked to transport appropriate patients to MIU during randomly selected weeks of one year. (bmj.com)
Of seven patients transferred by ambulance from MIU to A&E, medical reviewers judged that three had not met the protocol for conveyance to MIU. (bmj.com)
When they were used, patients and the ambulance service benefited. (bmj.com)
The left ambulance seat zone and head of the patient bed had more environmental hazard-related disruptions, while the right zone was more prone to interruptions and communication-related disruptions. (ahrq.gov)
In addition, air ambulance operations allow more advanced medical capacity to be delivered to patients directly and can often reduce transport times to medical facilities. (nationalacademies.org)
Of the 113.9 million ED visits that occurred in 2003, an estimated 14 percent were made by patients who arrived by ambulance. (nationalacademies.org)

A thoracotomy is a surgical procedure to gain access into the pleural space of the chest. (wikipedia.org)

Admit all symptomatic patients in whom gyromitrin poisoning is suspected for further management and monitoring. (medscape.com)
The ACP recommendations do not apply to symptomatic patients or to screening athletes before participation in various events. (medscape.com)

A recent Cochrane review concluded that there is moderate-quality evidence that regional anaesthesia may reduce the risk of developing persistent postoperative pain three to 18 months after thoracotomy. (wikipedia.org)

Identify common pathophysiologic conditions occurring in chest trauma patients. (saem.org)
However, doctors do not currently have an accurate method to identify those patients who do not need a scan. (emergencyfoundation.org.au)
This research aims to identify a subgroup of older patients with minor head injury who do not have a brain bleed and can be safely managed without a head scan. (emergencyfoundation.org.au)
It is relevant for the general radiologists and neurologists since it may help identify patients who could benefit from late-window reperfusion treatments or neuromodulation treatments. (arrs.org)

Results: In total, 48% (n = 380) of the patients perceive difficulties in sexual activity at 1 month after discharge, and 70% continued to perceive this at 18 months. (edu.au)
Data regarding patients' characteristics, admission modality, stay duration, reason for admission, and discharge modality was anonymously collected from patients' registers. (bvsalud.org)

In total, 93 AMI fatalities and maintain quality of life by admission and administration of inter- patients participated in the study. (who.int)
Patients requiring reintubation were older, more likely to be male, and had higher admission severity score. (rcjournal.com)
At admission, the median number of organ failures per patient was three (maximum 5). (bvsalud.org)

Diagnose, resuscitate, stabilize and manage chest trauma patients. (saem.org)

However more public education is required to improve awareness about the importance of early evaluation of chest pain. (edu.om)
To improve thrombolysis rates in the region, addressing prehospital delays, increasing public awareness, and implementing stroke protocols and national guidelines are key strategies. (bvsalud.org)

A patient presenting with cardiogenic shock will probably require a right-heart catheterization, will often require an intra-aortic balloon pump or the Impella device. (ptca.org)

Researchers propose developing a blood test to rapidly screen patients for stroke. (emergencyfoundation.org.au)
Previous research identified 11 new markers in the blood of stroke patients, suggesting diagnostic potential. (emergencyfoundation.org.au)
In this study, researchers we will screen blood samples collected from patients with LVO-stroke to discover markers specifically associated with ECR requirement. (emergencyfoundation.org.au)

Enhancing patient safety during pediatric sedation: the impact of simulation-based training of nonanesthesiologists. (ahrq.gov)

The researchers noted that their study looked only at patients who used EMS, among other limitations. (acponline.org)
Because of low study design compliance, outcomes of patients taken to MIU were compared with those taken to A&E, adjusted for case mix. (bmj.com)
This comparison study shows upfront thermal ablation results in better progression-free-survival compared to delayed ablation, for patients with low tumor burden. (arrs.org)
Cohort study of 2,007 critically ill adult patients admitted to the ICU with an ETT. (rcjournal.com)
This was a cross-sectional, monocentric and descriptive study, lasting 12 months, including patients aged at least 18 years admitted to ICU for sepsis or septic shock. (bvsalud.org)
Outcomes of Early Versus Late Tracheostomy in Patients With COVID-19: A Multinational Cohort Study. (lvhn.org)

RESULTS: 67 observational studies with 778,046 patients with AIS were included in the meta-analysis. (bvsalud.org)
Potential harms of cardiac screening include false-positive results causing patients to undergo potentially unnecessary tests and procedures. (medscape.com)
Timely follow-up of abnormal outpatient test results: perceived barriers and impact on patient safety. (ahrq.gov)
Results: Two hundred seventy-nine nurses registered 1809 patient conversations using a checklist. (edu.au)
Stimulation of these receptors generally results in euphoria, decreased perception of pain and drowsiness. (ems1.com)

One or more chest tubes-with one end inside the opened pleural cavity and the other submerged under saline solution inside a sealed container, forming an airtight drainage system-are necessary to remove air and fluid from the pleural cavity, preventing the development of pneumothorax or hemothorax. (wikipedia.org)

Given suitable protocols, minor injury units (MIUs) may be an appropriate destination for some 999 patients. (bmj.com)
Accordingly, the prehospital management of trauma sufferers has the potential to begin the method of restoration from the purpose of injury. (edu.au)
Elderly patients have greater injury severity scores than younger patients with comparable mechanisms of injury. (reliasmedia.com)

In the prehospital environment, first responders could also be required to assess, deal with, and safely transport folks with a variety of underlying disorders. (edu.au)
Patients could also be drug affected, head injured, delirious, or affected by a variety of medical or neurosurgical disorders. (edu.au)

There is no evidence that cardiac screening improves patient outcomes in asymptomatic, low-risk adults. (medscape.com)

This is a 1-view, abdominal, upright radiograph in a male patient who intentionally ingested 8 ounces of elemental mercury. (medscape.com)

Cervical spine fracture is more common in elderly patients. (reliasmedia.com)
As the number of elderly patients increases, nurses and other healthcare providers must become knowledgeable about the special healthcare needs of the geriatric population. (netce.com)

Describe the components of a primary survey in a chest trauma patient. (saem.org)

Anatomy8

Diseases77

Chemicals and Drugs19

Analytical, Diagnostic and Therapeutic Techniques and Equipment88

Psychiatry and Psychology7

Phenomena and Processes8

Disciplines and Occupations7

Anthropology, Education, Sociology and Social Phenomena4

Technology, Industry, Agriculture2

Information Science10

Named Groups3

Health Care87

Geographicals10

Onset16

Symptoms21

Discomfort6

Mortality16

Triage7

Diagnosis14

Supportive care1

STEMI13

Care35

Morbidity2

CABG1

Factors7

Dyspnea2

Complications6

Interquartile range2

Shortness of bre2

Findings4

Clinical10

Treatment6

Traumatic9

METHODS2

Characteristics of patients1

Myocardial Infarction7

Encounters1

Hospital13

Emergency16

Outcomes for patients1

Intervention4

Injuries3

Unstable2

Frequent1

Coronary3

Therapies1

Time3

Modalities2

Long-term outcomes1

Assessment1

Respiratory failure3

Ambulance6

Pleural space1

Symptomatic patients2

Persistent1

Identify4

Discharge2

Admission3

Diagnose1

Awareness2

Cardiogenic shock1

Stroke3

Pediatric1

Study6

RESULTS5

Hemothorax1

Injury3

Disorders2

Improves1

Abdominal1

Elderly patients2

Trauma Patient1