Browsing by Subject "Ambulance"

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    Evaluation of Tranexamic Acid and Calcium Chloride in Major Traumas in a Prehospital Setting: A Narrative Review
    (Wolters Kluwer, 2023) Bell, Kameron T.; Salmon, Chase M.; Purdy, Benjamin A.; Canfield, Scott G.; Anatomy, Cell Biology and Physiology, School of Medicine
    Excessive blood loss in the prehospital setting poses a significant challenge and is one of the leading causes of death in the United States. In response, emergency medical services (EMS) have increasingly adopted the use of tranexamic acid (TXA) and calcium chloride (CaCl2) as therapeutic interventions for hemorrhagic traumas. Tranexamic acid functions by inhibiting plasmin formation and restoring hemostatic balance, while calcium plays a pivotal role in the coagulation cascade, facilitating the conversion of factor X to factor Xa and prothrombin to thrombin. Despite the growing utilization of TXA and CaCl2 in both prehospital and hospital environments, a lack of literature exists regarding the comparative effectiveness of these agents in reducing hemorrhage and improving patient outcomes. Notably, Morgan County Indiana EMS recently integrated the administration of TXA with CaCl2 into their treatment protocols, offering a valuable opportunity to gather insight and formulate updated guidelines based on patient-centered outcomes. This narrative review aims to comprehensively evaluate the existing evidence concerning the administration of TXA and CaCl2 in the prehospital management of hemorrhages, while also incorporating and analyzing data derived from the co-administration of these medications within the practices of Morgan County EMS. This represents the inaugural description of the concurrent use of both TXA and CaCl2 to manage hemorrhages in the scientific literature.
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    Indianapolis Emergency Medical Service and the Indiana Network for Patient Care: Evaluating the Patient Match Process
    (2014-01-03) Park, Seong Cheol; Finnell, John T.; Jones, Josette F.; Kharrazi, Hadi
    In 2009, Indianapolis Emergency Medical Service (I-EMS, formerly Wishard Ambulance Service) launched an electronic medical record system within their ambulances and started to exchange patient data with the Indiana Network for Patient Care (INPC). This unique system allows EMS personnel in an ambulance to get important medical information prior to the patient’s arrival to the accepting hospital from incident scene. In this retrospective cohort study, we found EMS personnel made 3,021 patient data requests (14%) of 21,215 EMS transports during a one-year period, with a “success” match rate of 46%, and a match “failure” rate of 17%. The three major factors for causing match “failure” were (1) ZIP code 55%, (2) Patient Name 22%, and (3) Birth Date 12%. This study shows that the ZIP code is not a robust identifier in the patient identification process and Non-ZIP code identifiers may be a better choice due to inaccuracies and changes of the ZIP code in a patient’s record.