Pre-Hospital Management of Critically Ill Patients with SARS-CoV-2 Infection: A Retrospective Multicenter Study

Borgne, Pierrick Le; Oberlin, M.; Bassand, Adrien; Vuillaume, Laure Abensur; Gottwalles, Y.; Noizet, Marc; Gennai, Stéphane; Baicry, Florent; Jaeger, Déborah; Girerd, Nicolas; Lefèbvre, François; Chouihed, Tahar

doi:10.3390/jcm9113744

Cited by 10 publications

(8 citation statements)

References 33 publications

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“… Structural/ Systemic 76 Le Borgne et. al 88 Pre-Hospital Management of Critically Ill Patients with SARS-CoV-2 Infection: A Retrospective Multicenter Study Cohort Patient enrollment from regiospecific EMS calls FR ● Of patients with suspected COVID-19 no difference was found in hospital mortality between silent hypoxemia and hypoxemia with clinical acute respiratory failure. ● 53.4 of patients suspected to have COVID-19 presented with signs of respiratory distress ● All patients presenting with COVID-19 symptoms required high flow oxygen therapy.…”

Section: Resultsmentioning

confidence: 99%

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

Ventura¹,

Denton²,

David³

et al. 2022

OAEM

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This study aimed to analyze prehospital Emergency Medical Services (EMS) response to the COVID-19 pandemic in the US through a brief systematic review of available literature in context with international prehospital counterparts. An exploration of the NCBI repository was performed using a search string of relevant keywords which returned n=5128 results; articles that met the inclusion criteria (n=77) were reviewed and analyzed in accordance with PRISMA and PROSPERO recommendations. Methodical quality was assessed using critical appraisal tools, and the Egger’s test was used for risk of bias reduction upon linear regression analysis of a funnel plot. Sources of heterogeneity as defined by P < 0.10 or I^2 > 50% were interrogated. Findings were considered within ten domains: structural/systemic; clinical outcomes; clinical assessment; treatment; special populations; dispatch/activation; education; mental health; perspectives/experiences; and transport. Findings suggest, EMS clinicians have likely made significant and unmeasured contributions to care during the pandemic via nontraditional roles, ie, COVID-19 testing and vaccine deployment. EMS plays a critical role in counteracting the COVID-19 pandemic in addition to the worsening opioid epidemic, both of which disproportionately impact patients of color. As such, being uniquely influential on clinical outcomes, these providers may benefit from standardized education on care and access disparities such as racial identity. Access to distance learning continuing education opportunities may increase rates of provider recertification. Additionally, there is a high prevalence of vaccine hesitancy among surveyed nationally registered EMS providers. Continued rigorous investigation on the impact of COVID-19 on EMS systems and personnel is warranted to ensure informed preparation for future pandemic and infectious disease responses.

show abstract

Section: Resultsmentioning

confidence: 99%

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

Ventura¹,

Denton²,

David³

et al. 2022

OAEM

View full text Add to dashboard Cite

show abstract

“…Most of these patients presented with respiratory rates of approximately 30/min and oxygen saturations of 72%. Additionally, all patients required some method of high flow oxygen treatment (88)…”

Section: Discussionmentioning

confidence: 99%

EMS prehospital response to the COVID-19 pandemic in the US: A brief literature review

Ventura

Denton

David

et al. 2022

Preprint

View full text Add to dashboard Cite

This study aimed to analyze prehospital Emergency Medical Services (EMS) response to the COVID-19 pandemic in the US through a brief systematic review of available literature in context with international prehospital counterparts. An exploration of the NCBI repository was performed using a search string of relevant keywords which returned n=5128 results; articles that met the inclusion criteria (n=77) were reviewed and analyzed in accordance with PRISMA and PROSPERO recommendations. Methodical quality was assessed using critical appraisal tools, and the Eggers test was used for risk of bias reduction upon linear regression analysis of a funnel plot. Sources of heterogeneity as defined by P < 0.10 or I^2 > 50% were interrogated. Findings were considered within ten domains: structural/systemic; clinical outcomes; clinical assessment; treatment; special populations; dispatch/activation; education; mental health; perspectives/experiences; and transport. Findings suggest, EMS clinicians have likely made significant and unmeasured contributions to care during the pandemic via nontraditional roles, i.e., COVID-19 testing and vaccine deployment. EMS plays a critical role in counteracting the COVID-19 pandemic in addition to the worsening opioid epidemic, both of which disproportionately impact patients of color. As such, being uniquely influential on clinical outcomes, these providers may benefit from standardized education on care and access disparities such as racial identity. Access to distance learning continuing education opportunities may increase rates of provider recertification. Additionally, there is a high prevalence of vaccine hesitancy among surveyed nationally registered EMS providers. Continued rigorous investigation on the impact of COVID-19 on EMS systems and personnel is warranted to ensure informed preparation for future pandemic and infectious disease response.

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“…Le Borgne et al 9 conducted a retrospective multicentric study in the six main emergency departments (EDs) in the Greater East region of France including COVID-19 patients that were admitted to the intensive care units (ICUs). The authors defined two clinical phenotypes in the study population: Type 1 corresponding to “silent hypoxemia” without acute respiratory distress and Type 2 associating hypoxemia and clinical respiratory failure.…”

Section: Literature Reviewmentioning

confidence: 99%

Prevalence, Presentation and Outcomes of Silent Hypoxemia in COVID-19

Ribeiro

Mendonca

Sousa

et al. 2022

Clin Med Insights Circ Respir Pulm Med

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Dyspnea is reported in a minority of patients affected by coronavirus disease 2019 (COVID-19). Even patients with pneumonia can present hypoxemia without any respiratory distress, a phenomenon known as “silent” or “happy hypoxemia”. During the current pandemic there were only a few studies conducted on this subject and these were quite heterogeneous. Therefore, the prevalence of “silent hypoxemia” varied substantially. While studies did not show a clear tendency of “silent hypoxemia” to poorer outcomes compared to hypoxemia presenting with dyspnea, several showed that patients with “silent hypoxemia” are not protected from poor outcomes either. There is a need for a uniform definition of “silent hypoxemia”, in order to better guide clinicians and investigators. More studies are needed to shed light on the mechanisms of “silent hypoxemia”, as well as its presentation and influence in the disease's progression and outcomes, so as to better assist physicians in the care of COVID-19 patients.

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Pre-Hospital Management of Critically Ill Patients with SARS-CoV-2 Infection: A Retrospective Multicenter Study

Cited by 10 publications

References 33 publications

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

EMS prehospital response to the COVID-19 pandemic in the US: A brief literature review

Prevalence, Presentation and Outcomes of Silent Hypoxemia in COVID-19

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