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  1. Article ; Online: Implementing a Patient Tracking System in a Large EMS System.

    Farcas, Andra M / Zaidi, Hashim Q / Wleklinski, Nicholas P / Tataris, Katie L

    Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors

    2021  Volume 26, Issue 2, Page(s) 305–310

    Abstract: Objective: ...

    Abstract Objective:
    MeSH term(s) Chicago ; Emergency Medical Services ; Hospitals ; Humans ; Patient Identification Systems ; Triage
    Language English
    Publishing date 2021-03-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 1461751-1
    ISSN 1545-0066 ; 1090-3127
    ISSN (online) 1545-0066
    ISSN 1090-3127
    DOI 10.1080/10903127.2021.1883166
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4762: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Prehospital Intranasal Glucagon for Hypoglycemia.

    Haamid, Ameera / Christian, Errick / Tataris, Katie / Markul, Eddie / Zaidi, Hashim Q / Mycyk, Mark B / Weber, Joseph M

    Prehospital emergency care

    2022  Volume 27, Issue 3, Page(s) 356–359

    Abstract: Background: Prehospital hypoglycemia is usually treated with oral or intravenous (IV) dextrose in a variety of concentrations. In the absence of vascular access, intramuscular (IM) glucagon is commonly administered. Occupational needle-stick injury ... ...

    Abstract Background: Prehospital hypoglycemia is usually treated with oral or intravenous (IV) dextrose in a variety of concentrations. In the absence of vascular access, intramuscular (IM) glucagon is commonly administered. Occupational needle-stick injury remains a significant risk while attempting to obtain vascular access or administer medications intramuscularly in the prehospital setting. We sought to determine if intranasal (IN) glucagon is effective in the prehospital treatment of hypoglycemia.
    Methods: We performed a retrospective analysis of all consecutive cases where recombinant glucagon was administered IN by paramedics from January 1, 2015 through December 31, 2020. Excluded were cases without pre or post administration blood glucose documentation, and cases where another form of treatment for hypoglycemia was administered at any time during the EMS encounter. The primary outcome was clinical response to IN glucagon documented by paramedics; secondary outcomes included pre and post administration blood glucose values.
    Results: Out of 44 cases that met study inclusion criteria, 14 patients (32%) had substantial improvement, 13 patients (30%) had slight improvement, and 17 patients (38%) had no improvement in mental status after administration of IN glucagon. In cases with substantial improvement (n = 14), the mean pre administration blood glucose was 33.8 mg/dl and the mean post administration blood glucose was 87.1 mg/dl (mean increase 53.3 mg/dl, 95% CI: 21.5 to 85.1). In cases with slight improvement (n = 13), the mean pre administration blood glucose was 23.9 mg/dl and the mean post administration blood glucose was 53.8 mg/dl (mean increase 29.9 mg/dl, 95% CI = 2.9 to 56.9). In case with no improvement (n = 17) the mean pre administration blood glucose was 30.1 mg/dl and the mean post administration glucose was 33.1 mg/dl (mean difference 3.1 mg/dl, 95% CI: -10.1 to 3.9).
    Conclusion: Intranasal administration of recombinant glucagon for hypoglycemia resulted in a clinically significant improvement in mental status and a corresponding increase in blood glucose levels in select cases in the prehospital setting.
    MeSH term(s) Humans ; Glucagon/therapeutic use ; Blood Glucose/analysis ; Administration, Intranasal ; Retrospective Studies ; Emergency Medical Services/methods ; Hypoglycemia/drug therapy ; Hypoglycemia/complications
    Chemical Substances Glucagon (9007-92-5) ; Blood Glucose
    Language English
    Publishing date 2022-03-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1461751-1
    ISSN 1545-0066 ; 1090-3127
    ISSN (online) 1545-0066
    ISSN 1090-3127
    DOI 10.1080/10903127.2022.2045406
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4762: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Disparities in Prehospital Non-Traumatic Pain Management.

    Aceves, Angie / Crowe, Remle P / Zaidi, Hashim Q / Gill, Joseph / Johnson, Renee / Vithalani, Veer / Fairbrother, Hilary / Huebinger, Ryan

    Prehospital emergency care

    2022  Volume 27, Issue 6, Page(s) 794–799

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) Adult ; Humans ; United States ; Pain Management ; Analgesics, Opioid/therapeutic use ; Emergency Medical Services ; Ethnicity ; Pain/drug therapy ; Healthcare Disparities
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2022-09-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 1461751-1
    ISSN 1545-0066 ; 1090-3127
    ISSN (online) 1545-0066
    ISSN 1090-3127
    DOI 10.1080/10903127.2022.2107122
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4762: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article ; Online: The utility of computed tomography to evaluate thoracic complications after cardiopulmonary resuscitation.

    Zaidi, Hashim Q / Li, Shu / Beiser, David G / Tataris, Katie L / Sharp, Willard W

    Resuscitation plus

    2020  Volume 3, Page(s) 100017

    Abstract: Background: Cardiopulmonary resuscitation (CPR) in adults following non-traumatic out of hospital cardiac arrest (OHCA) can cause thoracic complications including rib fractures, sternal fractures, and pneumothorax. Post-CPR complication rates are poorly ...

    Abstract Background: Cardiopulmonary resuscitation (CPR) in adults following non-traumatic out of hospital cardiac arrest (OHCA) can cause thoracic complications including rib fractures, sternal fractures, and pneumothorax. Post-CPR complication rates are poorly studied and the optimum imaging modality to detect these complications post-resuscitation has not been established.
    Methods: We performed a retrospective review of adult patients transported to a single, urban, academic hospital following atraumatic OHCA between September 2015 and January 2020. Patients who achieved sustained return of spontaneous circulation (ROSC) and who underwent computed tomography (CT) imaging of the chest following radiographic chest x-ray were included in the analyses. Patient demographics and prehospital data were collected. Descriptive statistics and multivariate logistic regression analysis were performed. Sensitivity and specificity of chest x-ray for the detection of thoracic injury in this population were estimated.
    Results: 786 non-traumatic OHCA patients were transported to the ED, 417 of whom obtained sustained ROSC and were admitted to the hospital (53%). 137 (32.9%) admitted patients underwent CT imaging of the chest in the ED. Of these imaged patients median age was 62 years old (IQR 53-70) with 54.0% female and 38.0% of patients having received bystander CPR. 40/137 (29.2%) patients had skeletal fractures noted on CT imaging and 12/137 (8.8%) had pneumothorax present on CT imaging. X-ray yielded a sensitivity of 7.5% for rib fracture and 50% for pneumothorax with a specificity of 100% for both. Logistic regression analysis revealed no significant association between age, sex, bystander CPR, or resuscitation length with thoracic fractures or pneumothorax.
    Conclusions: Complications from OHCA CPR were high with 29.2% of CT imaged patients having rib fractures and 8.8% having pneumothoraces. X-ray had poor sensitivity for these post-resuscitation complications. Post-CPR CT imaging of the chest should be considered for detecting post-CPR complications.
    Language English
    Publishing date 2020-08-07
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-5204
    ISSN (online) 2666-5204
    DOI 10.1016/j.resplu.2020.100017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Retrospective Study of Midazolam Protocol for Prehospital Behavioral Emergencies.

    Huebinger, Ryan M / Zaidi, Hashim Q / Tataris, Katie L / Weber, Joseph M / Pearlman, Kenneth S / Markul, Eddie / Stein-Spencer, Leslee / Richards, Christopher T

    The western journal of emergency medicine

    2020  Volume 21, Issue 3, Page(s) 677–683

    Abstract: Introduction: Agitated patients in the prehospital setting pose challenges for both patient care and emergency medical services (EMS) provider safety. Midazolam is frequently used to control agitation in the emergency department setting; however, ... ...

    Abstract Introduction: Agitated patients in the prehospital setting pose challenges for both patient care and emergency medical services (EMS) provider safety. Midazolam is frequently used to control agitation in the emergency department setting; however, limited data exist in the prehospital setting. We describe our experience treating patients with midazolam for behavioral emergencies in a large urban EMS system. We hypothesized that using midazolam for acute agitation leads to improved clinical conditions without causing significant clinical deterioration.
    Methods: We performed a retrospective review of EMS patient care reports following implementation of a behavioral emergencies protocol in a large urban EMS system from February 2014-June 2016. For acute agitation, paramedics administered midazolam 1 milligram (mg) intravenous (IV), 5 mg intramuscular (IM), or 5 mg intranasal (IN). Results were analyzed using descriptive statistics, Levene's test for assessing variance among study groups, and t-test to evaluate effectiveness based on route.
    Results: In total, midazolam was administered 294 times to 257 patients. Median age was 30 (interquartile range 24-42) years, and 66.5% were male. Doses administered were 1 mg (7.1%) and 5 mg (92.9%). Routes were IM (52.0%), IN (40.8%), and IV (7.1%). A second dose was administered to 37 patients. In the majority of administrations, midazolam improved the patient's condition (73.5%) with infrequent adverse events (3.4%). There was no significant difference between the effectiveness of IM and IN midazolam (71.0% vs 75.4%; p = 0.24).
    Conclusion: A midazolam protocol for prehospital agitation was associated with reduced agitation and a low rate of adverse events.
    MeSH term(s) Administration, Intranasal ; Administration, Intravenous ; Adult ; Allied Health Personnel ; Clinical Protocols ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Emergencies ; Emergency Medical Services/methods ; Female ; Humans ; Hypnotics and Sedatives/administration & dosage ; Hypnotics and Sedatives/therapeutic use ; Injections, Intramuscular ; Male ; Mental Disorders/drug therapy ; Midazolam/administration & dosage ; Midazolam/therapeutic use ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult
    Chemical Substances Hypnotics and Sedatives ; Midazolam (R60L0SM5BC)
    Language English
    Publishing date 2020-04-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2375700-0
    ISSN 1936-9018 ; 1936-900X
    ISSN (online) 1936-9018
    ISSN 1936-900X
    DOI 10.5811/westjem.2020.3.45552
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Creation and Implementation of a Mastery Learning Curriculum for Emergency Department Thoracotomy.

    Miller, Danielle T / Zaidi, Hashim Q / Sista, Priyanka / Dhake, Sarah S / Pirotte, Matthew J / Fant, Abra L / Salzman, David H

    The western journal of emergency medicine

    2020  Volume 21, Issue 5, Page(s) 1258–1265

    Abstract: Introduction: Emergency department thoracotomy (EDT) is a lifesaving procedure within the scope of practice of emergency physicians. Because EDT is infrequently performed, emergency medicine (EM) residents lack opportunities to develop procedural ... ...

    Abstract Introduction: Emergency department thoracotomy (EDT) is a lifesaving procedure within the scope of practice of emergency physicians. Because EDT is infrequently performed, emergency medicine (EM) residents lack opportunities to develop procedural competency. There is no current mastery learning curriculum for residents to learn EDT. The purpose of this study was to develop and implement a simulation-based mastery learning curriculum to teach and assess EM residents' performance of the EDT.
    Methods: We developed an EDT curriculum using a mastery learning framework. The minimum passing standard (MPS) for a previously developed 22-item checklist was determined using the Mastery Angoff approach. EM residents at a four-year academic EM residency program underwent baseline testing in performing an EDT on a simulation trainer. Performance was scored by two raters using the checklist. Learners then participated in a novel mastery learning EDT curriculum that included an educational video, hands-on instruction, and deliberate practice. After a three-month period, residents then completed initial post testing. Residents who did not meet the minimum passing standard after post testing participated in additional deliberate practice until mastery was obtained. Baseline and post-test scores, and time to completion of the procedure were compared with paired t-tests.
    Results: Of 56 eligible EM residents, 54 completed baseline testing. Fifty-two residents completed post-testing until mastery was reached. The minimum passing standard was 91.1%, (21/22 items correct on the checklist). No participants met the MPS at the baseline assessment. After completion of the curriculum, all residents subsequently reached the MPS, with deliberate practice sessions not exceeding 40 minutes. Scores from baseline testing to post-testing significantly improved across all postgraduate years from a mean score of 10.2/22 to 21.4/22 (p <0.001). Mean time to complete the procedure improved from baseline testing (6 minutes [min] and 21 seconds [sec], interquartile range [IQR] = 4 min 54 sec - 7 min 51 sec) to post-testing (5 min 19 seconds, interquartile range 4 min 17sec - 6 min 15 sec; p = 0.001).
    Conclusion: This simulation-based mastery learning curriculum resulted in all residents performing an EDT at a level that met or exceeded the MPS with an overall decrease in time needed to perform the procedure.
    MeSH term(s) Adult ; Clinical Competence/standards ; Curriculum ; Educational Measurement/methods ; Emergency Medicine/education ; Female ; Humans ; Internship and Residency/methods ; Male ; Simulation Training/methods ; Thoracotomy/education
    Language English
    Publishing date 2020-08-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2375700-0
    ISSN 1936-9018 ; 1936-9018
    ISSN (online) 1936-9018
    ISSN 1936-9018
    DOI 10.5811/westjem.2020.5.46207
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Emergency Department Thoracotomy: Development of a Reliable, Validated Checklist for Procedural Training.

    Zaidi, Hashim Q / Dhake, Sarah S / Miller, Danielle T / Sista, Priyanka / Pirotte, Matthew J / Fant, Abra L / Salzman, David H

    AEM education and training

    2019  Volume 4, Issue 2, Page(s) 139–146

    Abstract: Objectives: Emergency department thoracotomy (EDT) is a rare and challenging procedure. Emergency medicine (EM) residents have limited opportunities to perform the procedure in clinical or educational settings. Standardized, reliable, validated ... ...

    Abstract Objectives: Emergency department thoracotomy (EDT) is a rare and challenging procedure. Emergency medicine (EM) residents have limited opportunities to perform the procedure in clinical or educational settings. Standardized, reliable, validated checklists do not exist to evaluate procedural competency. The objectives of this project were twofold: 1) to develop a checklist containing the critical actions for performing an EDT that can be used for future procedural skills training and 2) to evaluate the reliability and validity of the checklist for performing EDT.
    Methods: After a literature review, a preliminary 22-item checklist was developed and disseminated to experts in EM and trauma surgery. A modified Delphi method was used to revise the checklist. To assess usability of the checklist, EM and trauma surgery faculty and residents were evaluated performing an EDT while inter-rater reliability was calculated with Cohen's kappa. A Student's t-test was used to compare the performance of participants who had or had not performed a thoracotomy in clinical practice. Item-total correlation was calculated for each checklist item to determine discriminatory ability.
    Results: A final 22-item checklist was developed for EDT. The overall inter-rater reliability was strong (κ = 0.84) with individual item agreement ranging from moderate to strong (κ = 0.61 to 1.00). Experts (attending physicians and senior residents) performed well on the checklist, achieving an average score of 80% on the checklist. Participants who had performed EDT in clinical practice performed significantly better than those that had not, achieving an average of 80.7% items completed versus 52.3% (p < 0.05). Seventeen of 22 items had an item-total correlation greater than 0.2.
    Conclusions: A final 22-item consensus-based checklist was developed for the EDT. Overall inter-rater reliability was strong. This checklist can be used in future studies to serve as a foundation for curriculum development around this important procedure.
    Language English
    Publishing date 2019-09-12
    Publishing country United States
    Document type Journal Article
    ISSN 2472-5390
    ISSN (online) 2472-5390
    DOI 10.1002/aet2.10387
    Database MEDical Literature Analysis and Retrieval System OnLINE

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