Editorial Prehospital Care - downloads - Hindawi Publishing
3
Hindawi Publishing Corporation Emergency Medicine International Volume 2012, Article ID 965480, 2 pages doi:10.1155/2012/965480 Editorial Prehospital Care Stephen H. Thomas, 1 Christopher Colwell, 2 Jean-Claude Deslandes, 3 Sophia Dyer, 4 and Jeffrey M. Goodloe 1 1 Department of Emergency Medicine, The University of Oklahoma, Norman, OK 13019-0390, USA 2 Department of Emergency Medicine, Denver Health and University of Colorado, Denver, CO 80217, USA 3 France’s Urgence Pratique Formation, Ganges 34190, France 4 Department of Emergency Medicine, Boston University, Boston, MA 02215, USA Correspondence should be addressed to Stephen H. Thomas, [email protected] Received 2 April 2012; Accepted 2 April 2012 Copyright © 2012 Stephen H. Thomas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The emergence of emergency medical services (EMS) as a realm within emergency medicine (EM) has recently been completed, with EMS gaining status as a boarded subspe- cialty. While there are excellent journals and a rich literature addressing EMS and out-of-hospital care, we embraced, with enthusiasm, the invitation of the editors to coordinate an EMS-related special issue on prehospital Care. The open access and online nature of the offers a unique chance for widespread attention to EMS, at a time when that attention is particular a propos given the new focus associated with subspecialty status. As guest editors, we bring to the issue’s review process over a century of experience in ground EMS, air transport, and disaster operations. Our backgrounds include experi- ence with urban and rural ground and air EMS systems all over the U.S. and abroad. Our responsibilities include involvement with ground and/or air EMS care in the USA east coast (S. Dyer, of Boston University), the USA west (C. Colwell, Denver Health and University of Colorado), and the U.S. southwest (J. Goodloe and Stephen Thomas of the University of Oklahoma). International experience comes from J. Deslandes (France’s Urgence Pratique Formation). The breadth of interests from our collective background has translated into a similarly broad range of topics covered in this special issue on prehospital care. The solicitation of manuscripts allowed for virtually any topic within prehos- pital and out-of-hospital care, and the manuscripts received were a testament to the excellence of work around the world, in our chosen fields. We believe that the papers that were ultimately approved for publication in this special issue represent important contributions to the state of the evidence in EMS as follows. A paper focuses on an EMS angle of a subject that has become one of the most important rooms in the house of medicine: quality. In his review of clinical performance indicators, M. J. El Sayed outlines EMS’s place in the dialogue about quality measurement. His overview provides background discussion, education, and practical direction for EMS services. Another article takes on a clinical conundrum facing acute care providers every day: what’s causing this patient’s dyspnea? J. E. Gough and K. L. Brewer address the differ- entiation of various causes of dyspnea-differentiation that can be tricky even in the hospital setting. The divergence of therapeutic approaches to varying dyspnea etiologies means that the earlier the true causes can be identified, the more rapidly patients can receive appropriately tailored therapy. In their pilot study, J. E. Gough and K. L. Brewer suggest that peak expiratory flow rate may provide useful clues to allow earlier differentiation of two major causes of dyspnea. Air medical transport is one of the more controversial aspects of EMS. Unfortunately, both sides of the HEMS debate frequently mischaracterize the existing evidence, with the statement “there is very little data addressing HEMS outcomes.” In an attempt to provide an overview of the
Transcript of Editorial Prehospital Care - downloads - Hindawi Publishing
Hindawi Publishing CorporationEmergency Medicine InternationalVolume 2012, Article ID 965480, 2 pagesdoi:10.1155/2012/965480
Editorial
Prehospital Care
Stephen H. Thomas,1 Christopher Colwell,2 Jean-Claude Deslandes,3
Sophia Dyer,4 and Jeffrey M. Goodloe1
1 Department of Emergency Medicine, The University of Oklahoma, Norman, OK 13019-0390, USA2 Department of Emergency Medicine, Denver Health and University of Colorado, Denver, CO 80217, USA3 France’s Urgence Pratique Formation, Ganges 34190, France4 Department of Emergency Medicine, Boston University, Boston, MA 02215, USA
Correspondence should be addressed to Stephen H. Thomas, [email protected]
Received 2 April 2012; Accepted 2 April 2012
Copyright © 2012 Stephen H. Thomas et al. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.
The emergence of emergency medical services (EMS) as arealm within emergency medicine (EM) has recently beencompleted, with EMS gaining status as a boarded subspe-cialty. While there are excellent journals and a rich literatureaddressing EMS and out-of-hospital care, we embraced, withenthusiasm, the invitation of the editors to coordinate anEMS-related special issue on prehospital Care. The openaccess and online nature of the offers a unique chance forwidespread attention to EMS, at a time when that attentionis particular a propos given the new focus associated withsubspecialty status.
As guest editors, we bring to the issue’s review processover a century of experience in ground EMS, air transport,and disaster operations. Our backgrounds include experi-ence with urban and rural ground and air EMS systemsall over the U.S. and abroad. Our responsibilities includeinvolvement with ground and/or air EMS care in the USAeast coast (S. Dyer, of Boston University), the USA west (C.Colwell, Denver Health and University of Colorado), andthe U.S. southwest (J. Goodloe and Stephen Thomas of theUniversity of Oklahoma). International experience comesfrom J. Deslandes (France’s Urgence Pratique Formation).
The breadth of interests from our collective backgroundhas translated into a similarly broad range of topics coveredin this special issue on prehospital care. The solicitation ofmanuscripts allowed for virtually any topic within prehos-pital and out-of-hospital care, and the manuscripts receivedwere a testament to the excellence of work around the
world, in our chosen fields. We believe that the papersthat were ultimately approved for publication in this specialissue represent important contributions to the state of theevidence in EMS as follows.
A paper focuses on an EMS angle of a subject that hasbecome one of the most important rooms in the houseof medicine: quality. In his review of clinical performanceindicators, M. J. El Sayed outlines EMS’s place in thedialogue about quality measurement. His overview providesbackground discussion, education, and practical directionfor EMS services.
Another article takes on a clinical conundrum facingacute care providers every day: what’s causing this patient’sdyspnea? J. E. Gough and K. L. Brewer address the differ-entiation of various causes of dyspnea-differentiation thatcan be tricky even in the hospital setting. The divergenceof therapeutic approaches to varying dyspnea etiologiesmeans that the earlier the true causes can be identified,the more rapidly patients can receive appropriately tailoredtherapy. In their pilot study, J. E. Gough and K. L. Brewersuggest that peak expiratory flow rate may provide usefulclues to allow earlier differentiation of two major causes ofdyspnea.
Air medical transport is one of the more controversialaspects of EMS. Unfortunately, both sides of the HEMSdebate frequently mischaracterize the existing evidence, withthe statement “there is very little data addressing HEMSoutcomes.” In an attempt to provide an overview of the
2 Emergency Medicine International
existing evidence, so that those with HEMS outcomesinterest can get the original research and judge quality andimpact for themselves, J. Hatfield et al. provide an annotatedbibliography of HEMS outcomes research since 2007.
Another paper addresses patient safety. C. T. Crowder etal. provide a look into a matter which has managed to eludeattention despite the recent increased emphasis on patientsafety. Rather than examine issues related to medical care,the study assesses the safety of patient transport. Specifically,F. J. Crowder et al. focus on stretcher-related problems andpatient (and EMS crew member) safety issues related tostretcher misadventures.
A different paper is a review of a potentially interestingpossibility for improving drug and fluid delivery in theprehospital and disaster settings. Hyaluronidase, used a half-century ago for “hypodermoclysis,” fell out of favor decadesago due to immune reactions to the animal-based enzyme.With the relatively new availability of human recombinanthyaluronidase, the early literature suggests there might bea potential role for subcutaneous fluid administration insome prehospital settings. A. O. Arthur et al. outline thecurrent state of the evidence and provide some directions forpotential future research.
In the paper of B. King et al., they continue the focuson disaster and mass casualty situations. In their report ona wind-caused collapse of a large tent at a city festival, theauthors outline the benefits of planning and provide someimportant lessons learned for future planning.
The review by L. J. Hamilton et al. changes focusto another area of importance in EMS: pediatric care.While most of the literature addressing pediatric prehospitalcare has understandably focused on general pediatrics andtrauma situations, Hamilton et al. narrow the discussion tochildren with complex chronic conditions. While there are(thankfully) relatively few of these patient numbers, trans-ports of children with chronic complex medical conditionscan occupy a disproportionately large percentage of an EMSservice runs. The experience and insights of L. J. Hamilton etal. should assist those EMS services and providers who carefor this special patient population.
A study by A. O. Arthur et al. changes focus to theother end of the age spectrum. With the aging of thepopulation (especially in the US), any suggestive trend ofa problem regarding older adults can be a harbinger of amajor upcoming issue. Arthur et al. identify such a potentialtrend, potentially related to economic concerns, of a risein the proportion of “transport refusal” patients who aregeriatric. It is of course unknown whether economic or otheridentifiable factors are responsible for this finding, but theauthors’ preliminary findings should prompt further analysisof the issue.
The special issue wraps up with an overview of HEMSresearch endpoints and potential benefits. The summary isintended not so much to make the case for (or against)HEMS as having outcomes benefits, as it is intended tohighlight specific areas of investigation and focus for futureefforts to define HEMS role in prehospital care.
It has been our pleasure to bring this special issue tothe readership of this journal. We hope that the literature
in the edition helps to move the EMS world forwardor at least inform debates and discussions regarding howto provide the best possible care in the out-of-hospitalsetting. Of course, we would be delighted to hear fromyou, the readers, as to comments or questions about any ofthe articles.
Stephen H. ThomasChristopher Colwell
Jean-Claude DeslandesSophia Dyer
Jeffrey M. Goodloe
Submit your manuscripts athttp://www.hindawi.com
Stem CellsInternational
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
MEDIATORSINFLAMMATION
of
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Behavioural Neurology
EndocrinologyInternational Journal of
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Disease Markers
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
BioMed Research International
OncologyJournal of
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Oxidative Medicine and Cellular Longevity
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
PPAR Research
The Scientific World JournalHindawi Publishing Corporation http://www.hindawi.com Volume 2014
Immunology ResearchHindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Journal of
ObesityJournal of
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Computational and Mathematical Methods in Medicine
OphthalmologyJournal of
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Diabetes ResearchJournal of
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Research and TreatmentAIDS
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Gastroenterology Research and Practice
Hindawi Publishing Corporationhttp://www.hindawi.com Volume 2014
Parkinson’s Disease
Evidence-Based Complementary and Alternative Medicine
Volume 2014Hindawi Publishing Corporationhttp://www.hindawi.com
![ReviewArticle - Hindawi Publishing Corporationdownloads.hindawi.com/journals/cjgh/2018/6150861.pdfCanadianJournalofGastroenterologyandHepatology .; %CI: .-., p = . ) []. Lastly, in](https://static.fdocuments.net/doc/165x107/5fd365b36bdb6805366effb8/reviewarticle-hindawi-publishing-canadianjournalofgastroenterologyandhepatology.jpg)
