<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="6.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Wang, H. E.</style></author><author><style face="normal" font="default" size="100%">Shapiro, N. I.</style></author><author><style face="normal" font="default" size="100%">Yealy, D. M.</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Characteristics of out-of-hospital shock care</style></title><secondary-title><style face="normal" font="default" size="100%">Critical Care Medicine</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Emergency Medical Services</style></keyword><keyword><style  face="normal" font="default" size="100%">emergency-department</style></keyword><keyword><style  face="normal" font="default" size="100%">lactate</style></keyword><keyword><style  face="normal" font="default" size="100%">measurement</style></keyword><keyword><style  face="normal" font="default" size="100%">mortality</style></keyword><keyword><style  face="normal" font="default" size="100%">myocardial-infarction</style></keyword><keyword><style  face="normal" font="default" size="100%">paramedics</style></keyword><keyword><style  face="normal" font="default" size="100%">prehospital hypotension</style></keyword><keyword><style  face="normal" font="default" size="100%">sepsis</style></keyword><keyword><style  face="normal" font="default" size="100%">septic</style></keyword><keyword><style  face="normal" font="default" size="100%">severe sepsis</style></keyword><keyword><style  face="normal" font="default" size="100%">shock</style></keyword><keyword><style  face="normal" font="default" size="100%">Trauma</style></keyword><keyword><style  face="normal" font="default" size="100%">trauma team activation</style></keyword><keyword><style  face="normal" font="default" size="100%">valid indicator</style></keyword><keyword><style  face="normal" font="default" size="100%">vital signs</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2011</style></year><pub-dates><date><style  face="normal" font="default" size="100%">Nov</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%"><Go to ISI>://WOS:000296509500007</style></url></web-urls></urls><number><style face="normal" font="default" size="100%">11</style></number><volume><style face="normal" font="default" size="100%">39</style></volume><pages><style face="normal" font="default" size="100%">2431-2439</style></pages><isbn><style face="normal" font="default" size="100%">0090-3493</style></isbn><language><style face="normal" font="default" size="100%">English</style></language><abstract><style face="normal" font="default" size="100%">Objective: Regionalization of care is a potential strategy for the management of shock. There are no data describing the regional distribution of patients with out-of-hospital shock. We sought to describe the incidence, demographic, clinical, and regional characteristics of patients with traumatic and nontraumatic medical shock treated by out-of-hospital emergency medical services. Design: Descriptive study using Pennsylvania statewide emergency medical services patient care data. Setting: Commonwealth of Pennsylvania, 2006-2008. Patients: Adult (age &gt;= 18 yrs) noncardiac arrest patients with shock, defined as initial systolic blood pressure &lt;= 80 mm Hg. Interventions: None. Measurements and Main Results: We compared patient characteristics, demographics, emergency medical services treatment, and regional differences between traumatic and nontraumatic medical shock. Of 3,327,306 adult nonarrest patients, 42,941 (1.29%; 95% confidence interval, 1.28% to 1.30%) had shock in the field, including 39,424 with medical shock and 3,517 with traumatic shock. Patients with medical shock were more likely to be older, female, and treated by rural emergency medical services agencies and experienced longer transport times. Countylevel annual shock rates varied for medical (median, 99; interquartile range, 44-273; range, 5-1634) and traumatic (median, seven; interquartile range, 3-18; range, 0-300) cases. Per-capita shock rates varied for medical (median, 105 per 100,000 population; interquartile range, 83-128; range, 37-263) and traumatic (median, seven per 100,000 population; interquartile range, 5-10; range, 0-39) cases. The correlation between county-level total annual medical and traumatic shock rates was strong (rho = .80). Conclusions: While sharing similar regional distributions, key differences exist between emergency medical services patients with traumatic and nontraumatic shock. These differences identify opportunities for and barriers to regionalizing emergency medical services care of patients with shock. (Crit Care Med 2011; 39: 2431-2439)</style></abstract><work-type><style face="normal" font="default" size="100%">Article</style></work-type><accession-num><style face="normal" font="default" size="100%">WOS:000296509500007</style></accession-num><notes><style face="normal" font="default" size="100%">ISI Document Delivery No.: 841JVTimes Cited: 1Cited Reference Count: 30Cited References:      Jollis JG, 2007, JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, V298, P2371Wang, Henry E. Shapiro, Nathan I. Yealy, Donald M.Lippincott williams &amp; wilkinsPhiladelphia</style></notes><auth-address><style face="normal" font="default" size="100%">Wang, HE (reprint author), Univ Alabama, Dept Emergency Med, Birmingham, AL 35294 USA[Wang, HE] Univ Alabama, Dept Emergency Med, Birmingham, AL 35294 USA. [Shapiro, NI] Beth Israel Deaconess Med Ctr, Dept Emergency Med, Boston, MA 02215 USA. [Yealy, DM] Univ Pittsburgh, Dept Emergency Med, Pittsburgh, PA USA.hwang@uabmc.edu</style></auth-address></record></records></xml>