EMS Student » Studies

Glass intact assures safe cervical spine protocol

Jason — Tue, 30 Apr 2013 22:58:15 +0000

Selective cervical spine immobilization performed by Emergency Medical Services (EMS) is being utilized with increasing frequency. These protocols, although very sensitive, still include subjective data such as “mild cervical discomfort.” The aim of this study is to create an objective clinical decision rule that would enhance the selective approach for cervical spine immobilization in patients aged 16-60 years.

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Should we use lights and sirens?

Jason — Thu, 04 Apr 2013 01:18:09 +0000

Monoc released this PSA:

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Alberta Health to trial CPR Cards

Jason — Tue, 27 Nov 2012 23:35:01 +0000

21 Nov 12

CALGARY – An international research project to determine whether new technology can help save children’s lives during cardiac emergencies is being led through a partnership between Alberta Health Services and the University of Calgary.

Video: CPR Card

Source: Alberta Health Services

May 1 2012: New Study Launches in Toronto

Jason — Tue, 19 Jun 2012 05:17:37 +0000

Continuous Chest Compressions is the latest buzz word in the First Aid community. The major players such as St John Ambulance and Heart and Stroke have begun to change their protocols to reflect recent recommendations.

Even though the transition stage has begun, Sunnybrook and Toronto Fire Services have teamed up in a study for continuous compressions.

The following video demonstrates the new study standard. Please note that this is a study explicitly done through Toronto Fire and Sunnybrook. As of this post, this is not the recommended method and does not supersede formal training:

Toronto Fire Service ROC Sunnybrook CCC Study

Researchers design Alzheimer’s antibodies

Jason — Sun, 11 Dec 2011 07:28:08 +0000

A surprisingly simple method to target harmful proteins

Troy, N.Y. – Researchers at Rensselaer Polytechnic Institute have developed a new method to design antibodies aimed at combating disease. The surprisingly simple process was used to make antibodies that neutralize the harmful protein particles that lead to Alzheimer’s disease.

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Neurotransmitter might improve cancer treatment: study

Jason — Fri, 09 Dec 2011 11:33:50 +0000

Doses of a neurotransmitter might offer a way to boost the effectiveness of anticancer drugs and radiation therapy, according to a new study led by researchers at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

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Ecstasy drug produces lasting toxicity in the brain

Jason — Thu, 08 Dec 2011 03:10:21 +0000

Recreational use of Ecstasy – the illegal “rave” drug that produces feelings of euphoria and emotional warmth – is associated with chronic changes in the human brain, Vanderbilt University investigators have discovered.

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New study fundamentally alters our understanding of lung growth

Jason — Wed, 07 Dec 2011 03:40:18 +0000

A ground-breaking international study into the ways lungs grow and develop has challenged existing medical understanding that our lungs are completely formed by the age of three.

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Blood clot risk halved for patients checking their own Warfarin dose

Jason — Fri, 02 Dec 2011 00:48:00 +0000

University of Oxford – Patients who monitor their own treatment with warfarin or other blood-thinning drugs reduce their risk of developing blood clots by half, an Oxford University study has found.

Taking charge of their own treatment can empower patients, improve the quality of treatment and be more convenient. The researchers say their findings confirm that self-monitoring of warfarin is safe for suitable patients of all ages.

The results are published in the medical journal The Lancet.

‘Warfarin is used for a number of conditions to prevent the blood clotting,’ explains Dr Carl Heneghan, who led the work at the Department of Primary Health Care at Oxford University. ‘These conditions include atrial fibrillation, treatment of deep-vein thrombosis and patients with artificial heart valves.’

In the UK, it is thought that around 1 million people are eligible for blood-thinning drugs, or anticoagulants, with demand set to rise further due to the ageing population.

But the use of anticoagulants needs regular monitoring to make sure the dose remains within the right range.

‘If the dose is too high then individuals can be at substantial risk of a major bleed, whereas if it is too low they run the risk of having a blood clot,’ says Dr Heneghan.

The right dose is affected by a number of factors that make safe and effective management of anticoagulation challenging. For example, increasing age, medications, vitamins, alcohol, diet, and changes in lifestyle can all affect the dose that should be used.

‘Management of oral anticoagulation treatment is often done badly,’ says Dr Heneghan. Up to 40% of cases can be outside the correct dosing level. ‘But it is possible to empower patients not only to self-measure but also to self-adjust their therapy.

Patients use a simple test, much like a blood glucose meter for diabetics, to ‘self-monitor’ their treatment. Some patients also then ‘self-adjust’ their dose as appropriate, while others may see their doctor at this point.

The Oxford team looked at the evidence for any benefits of self-monitoring by pooling individual patient data from 11 previous randomised trials involving over 6,400 patients.
It is possible to empower patients not only to self-measure but also to self-adjust their therapy

Dr Carl Heneghan

The researchers found that self-monitoring reduced by 49% the risk of blood clots – events including deep vein thrombosis, stroke, or a heart attack – compared with usual care. There was no difference in the number of major bleeds or deaths.

‘A wide range of ages was included in the analysis. The youngest was 17 and the oldest was 94 years of age. Across all these ages self-monitoring proved to be a safe intervention,’ says Dr Heneghan.

The group’s results show that patients with artificial heart valves and younger patients benefitted the most. ‘For these two groups we would now expect widespread use of self-monitoring,’ says Dr Heneghan.

For people with artificial heart valves who monitored their own treatment, the risk of blood clots was halved. For every 1000 patients monitoring their warfarin therapy for 5 years, 42 such ‘thromboembolic events’ would be prevented with no extra risk of bleeding.

The risk was reduced by two-thirds for patients under 55 years old, with 48 thromboembolic events prevented per 1000 patients.

Dr Heneghan does say that: ‘Patients vary considerably in their ability to self-monitor. Some are very capable of both self-testing and self-management, whereas others are either unable or unwilling to do either. The challenge then is to identify which individuals are suitable for self-monitoring of oral anticoagulation therapy, and to provide sufficient training to ensure that they can do so safely and effectively.’

‘The concept of self-care and self-monitoring is a growing part of health care,’ adds Dr Heneghan. ‘It is recognized in many chronic conditions as an important part of the overall management strategy. For instance, it use widely in diabetes, asthma and hypertension management.’

He notes that managing chronic disease is an important and costly element of health care which accounts for about 80% of GP consultations.

From University of Oxford

Epidural vs Subdural Hematomas

Melissa — Thu, 01 Dec 2011 05:01:44 +0000

Epidural and Subdural Hematomas: Dangerous Blood Clots on the Brain
Gary E Cordingley, MD, PhD

In many cases of head injury, dangerous blood clots (hematomas) form
on the brain’s surface. They must be identified and removed in order to
minimize brain damage.

To understand epidural and subdural hematomas — two serious consequences of head injuries — we need to know the basic anatomy of the brain and its coverings. Imagine an evil carpenter with an electric drill intent on drilling into a person’s brain. What layers would the drill encounter in its passage from the outside of the head to its destination?

The drill would pass through the skin and then the skull (braincase) before penetrating a series of three membranes comprising the meninges. In sequence, the three membranes are the dura mater (Latin for “tough mother”), the arachnoid mater (cobwebby mother) and the pia mater (tender mother) and then finally the brain itself.

Epidural and subdural hematomas are alike in that they are masses of clotted blood (hematomas) caused by head trauma and deposited outside the brain but inside the skull. However, they differ in their locations relative to the dura mater. An epidural hematoma lies outside (on top of) the dura mater, while a subdural hematoma lies inside (beneath) the dura mater and outside the arachnoid mater. Thus, the locations of the two kinds of hematoma are encoded in their names — “epi” is Greek for “upon” and “sub” is Latin for “below.” A third kind of hematoma caused by head injuries is traumatic intracerebral hemorrhage. These occur within the brain tissue itself and are no less serious than those outside the brain, but are not the subject of the current essay.

Epidural and subdural hematomas are produced by ruptures of different blood vessels. Epidural hematomas are usually caused by bleeding from an artery that nourishes the meninges known as the middle meningeal artery, while subdural hematomas are usually due to bleeding from veins that drain blood away from the surface of the brain.

To read the rest of this article click on the link below:
http://www.cordingleyneurology.com/epiduralsubdural.html