BACKGROUND Well-organised and efficient prehospital transport is associated with an improved outcome in trauma patients. In Nigeria there is a paucity of information on prehospital transport of spinal cord-injured patients and its relation to mortality. OBJECTIVE To determine whether prehospital transportation is a predictor of mortality in spinal cord-injured patients in Nigeria. DESIGN Pr...

BACKGROUND Cardiogenic shock (CS) is a serious complication of acute myocardial infarction, and the time of onset of CS has a potential role in influencing its prognosis. Limited contemporary data exist on this complication, however, especially from a population-based perspective. Our study objectives were to describe decade-long trends in the incidence, in-hospital mortality, and factors assoc...

BACKGROUND Circadian rhythms with regard to time of symptom onset for patients with acute myocardial infarction have been observed, although their relationship to outcomes has been debated. We evaluated these rhythms in patients with ST-elevation myocardial infarction as a function of the 24-hour circadian cycle. METHODS AND RESULTS The relationship between onset of symptoms during the 24-hou...

Background—Among individuals experiencing an ST segment–elevation myocardial infarction, current guidelines recommend that the interval from first medical contact to percutaneous coronary intervention be 90 minutes. The objective of this study was to determine whether prehospital time intervals were associated with ST-elevation myocardial infarction system performance, defined as first medical ...

BACKGROUND Emergency medical services (EMS) prenotification to hospitals regarding the arrival of patients who have had a stroke is recommended to facilitate the workup once the patient arrives. Most hospitals have the patient enter the emergency department (ED) before obtaining a head computed tomography (CT) scan. At Capital Health, prehospital stroke-alert patients are delivered directly to ...

BACKGROUND An improved prehospital diagnostic accuracy of cardiogenic pulmonary oedema could potentially improve initial treatment, triage, and outcome. A pilot study was conducted to assess the feasibility, time-use, and diagnostic accuracy of prehospital lung ultrasound (PLUS) for the diagnosis of cardiogenic pulmonary oedema. METHODS A prospective observational study was conducted in a pre...

Injury remains a major cause of death and disability worldwide, and places an enormous burden on countries with limited resources. The optimal way to reduce life-threatening injuries is through primary prevention efforts that decrease the incidence and severity of injuries. When prevention fails, however, it is often possible to minimize the consequences of injury through effective prehospital ...

INTRODUCTION Ketamine has been used extensively for analgesia and anesthesia in many situations, including disaster surgery where extra personnel and advanced monitoring are not available. There are many features of ketamine that seem to make it an ideal drug for prehospital use. The reported use of ketamine in the prehospital environment is limited, however. The purpose of this study is to rev...

Background—Performance of prehospital ECGs expedites identification of ST-elevation myocardial infarction and reduces door-to-balloon times for patients receiving reperfusion therapy. To fully realize this benefit, emergency medical service performance must be measured and used in feedback reporting and quality improvement. Methods and Results—This quasi-experimental design trial tested an appr...

In the prehospital setting, the emergency care provider must anticipate that some patients will manifest with difficult airways. The use of video laryngoscopy to secure an airway in the prehospital setting has not been explored widely, but has the potential to be a useful tool. This article briefly reviews some of the major video laryngoscopes on the market and their usefulness in the prehospit...