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Emergency paramedic

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https://www.readbyqxmd.com/read/29321074/patient-and-case-characteristics-associated-with-no-paramedic-treatment-for-low-acuity-cases-referred-for-emergency-ambulance-dispatch-following-a-secondary-telephone-triage-a-retrospective-cohort-study
#1
Kathryn Eastwood, Amee Morgans, Johannes Stoelwinder, Karen Smith
BACKGROUND: Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with 'no paramedic treatment' for cases referred for emergency ambulance dispatch following secondary telephone triage. METHODS: A retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#2
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patient patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29310869/intraosseous-vascular-access-is-associated-with-lower-survival-and-neurologic-recovery-among-patients-with-out-of-hospital-cardiac-arrest
#3
Takahisa Kawano, Brian Grunau, Frank X Scheuermeyer, Koichiro Gibo, Christopher B Fordyce, Steve Lin, Robert Stenstrom, Robert Schlamp, Sandra Jenneson, Jim Christenson
STUDY OBJECTIVE: We seek to determine the effect of intraosseous over intravenous vascular access on outcomes after out-of-hospital cardiac arrest. METHODS: This secondary analysis of the Resuscitation Outcomes Consortium Prehospital Resuscitation Using an Impedance Valve and Early Versus Delayed (PRIMED) study included adult patients with nontraumatic out-of-hospital cardiac arrests treated during 2007 to 2009, excluding those with any unsuccessful attempt or more than one access site...
January 6, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29310618/epidemiology-of-unplanned-out-of-hospital-births-attended-by-paramedics
#4
Gayle McLelland, Lisa McKenna, Amee Morgans, Karen Smith
BACKGROUND: Over the previous two decades the incidence and number of unplanned out of hospital births Victoria has increased. As the only out of hospital emergency care providers in Victoria, paramedics would provide care for women having birth emergencies in the community. However, there is a lack of research about the involvement of paramedics provide for these women and their newborns. This research reports the clinical profile of a 1-year sample caseload of births attended by a state-wide ambulance service in Australia...
January 8, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29301973/association-between-hyperacute-stage-blood-pressure-variability-and-outcome-in-patients-with-spontaneous-intracerebral-hemorrhage
#5
Pil-Wook Chung, Joon-Tae Kim, Nerses Sanossian, Sidney Starkmann, Scott Hamilton, Jeffrey Gornbein, Robin Conwit, Marc Eckstein, Frank Pratt, Sam Stratton, David S Liebeskind, Jeffrey L Saver
BACKGROUND AND PURPOSE: Increased blood pressure (BP) variability, in addition to high BP, may contribute to adverse outcome in intracerebral hemorrhage. However, degree and association with outcome of BP variability (BPV) in the hyperacute period, 15 minutes to 5 hours after onset, have not been delineated. METHODS: Among consecutive patients with intracerebral hemorrhage enrolled in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium), BPs were recorded by paramedics in the field and during the first 24 hours of hospital course...
January 4, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29298245/emergency-medical-responders-and-adolescents-with-autism-spectrum-disorder
#6
Viola Cheung, Madeline L McCarthy, Mark X Cicero, John M Leventhal, Carol Weitzman
OBJECTIVES: Because of the high prevalence of Autism Spectrum Disorder (ASD) and wandering behavior, emergency medical responders (EMRs) will likely encounter children and adolescents with ASD. The objectives were to describe interactions between EMRs and children and adolescents with ASD, to evaluate EMRs' ability to recognize ASD in a simulated trauma setting, and to determine if EMRs' demographic characteristics affected their interactions with ASD youth. METHODS: A study of 75 videos of a simulated school bus crash was performed...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29297718/evaluation-of-physiologic-alterations-during-prehospital-paramedic-performed-rapid-sequence-intubation
#7
Robert G Walker, Lynn J White, Geneva N Whitmore, Alexander Esibov, Michael K Levy, Gregory C Cover, Joel D Edminster, James M Nania
OBJECTIVE: Physiologic alterations during rapid sequence intubation (RSI) have been studied in several emergency airway management settings, but few data exist to describe physiologic alterations during prehospital RSI performed by ground-based paramedics. To address this evidence gap and provide guidance for future quality improvement initiatives in our EMS system, we collected electronic monitoring data to evaluate peri-intubation vital signs changes occurring during prehospital RSI...
January 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29258599/transition-in-care-from-paramedics-to-emergency-department-nurses-a-systematic-review-protocol
#8
Gudrun Reay, Jill M Norris, K Alix Hayden, Joanna Abraham, Katherine Yokom, Lorelli Nowell, Gerald C Lazarenko, Eddy S Lang
BACKGROUND: Effective and efficient transitions in care between emergency medical services (EMS) practitioners and emergency department (ED) nurses is vital as poor clinical transitions in care may place patients at increased risk for adverse events such as delay in treatment for time sensitive conditions (e.g., myocardial infarction) or worsening of status (e.g., sepsis). Such transitions in care are complex and prone to communication errors primarily caused by misunderstanding related to divergent professional perspectives leading to misunderstandings that are further susceptible to contextual factors and divergent professional lenses...
December 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29239074/barriers-to-the-use-of-emergency-medical-services-for-st-elevation-myocardial-infarction-determining-why-many-patients-opt-for-self-transport
#9
Mathew Mercuri, Katherine Connolly, Madhu K Natarajan, Michelle Welsford, J D Schwalm
RATIONALE, AIMS, AND OBJECTIVES: Access to timely ST-elevation myocardial infarction (STEMI) care is facilitated by paramedics and emergency medical services (EMS). However, a large proportion of STEMI patients do not access care through EMS. This study sought to identify patient-reported factors for their decision to use (or not use) EMS. METHODS: Semi-structured interviews were conducted with a sample of STEMI patients admitted to a large tertiary care centre between November 2011 and January 2012...
December 13, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29237604/stormy-weather-a-retrospective-analysis-of-demand-for-emergency-medical-services-during-epidemic-thunderstorm-asthma
#10
Emily Andrew, Ziad Nehme, Stephen Bernard, Michael J Abramson, Ed Newbigin, Ben Piper, Justin Dunlop, Paul Holman, Karen Smith
OBJECTIVES: To describe the demand for emergency medical assistance during the largest outbreak of thunderstorm asthma reported globally, which occurred on 21 November 2016. DESIGN: A time series analysis was conducted of emergency medical service caseload between 1 January 2015 and 31 December 2016. Demand during the thunderstorm asthma event was compared to historical trends for the overall population and across specific subgroups. SETTING: Victoria, Australia...
December 13, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29230475/improving-decisions-about-transport-to-the-emergency-department-for-assisted-living-residents-who-fall
#11
Jefferson G Williams, Michael W Bachman, Michael D Lyons, Benjamin B Currie, Lawrence H Brown, A Wooten Jones, Jose G Cabanas, Alan K Kronhaus, J Brent Myers
Background: Residents of assisted living facilities who fall may not be seriously ill or injured, but policies often require immediate transport to an emergency department regardless of the patient's condition. Objective: To determine whether unnecessary transport can be avoided. Design: Prospective cohort study. Setting: One large county with a single system of emergency medical services. Participants: Convenience sample of residents in 22 assisted living facilities served by 1 group of primary care physicians...
December 12, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29220618/psychological-comfort-of-paramedics-with-field-death-pronouncement-a-national-asian-study-to-prepare-paramedics-for-field-termination-of-resuscitation
#12
Desmond R H Mao, Marcus E H Ong, Chungli Bang, Mohamed D T Salim, Yih Yng Ng, Desiree A Lie
OBJECTIVES: Paramedics' decision to terminate field resuscitation without a physician present may depend on personal and external factors. This study investigates factors associated with paramedic psychological comfort with termination of resuscitation (TOR) to inform future training. METHODS: We administered an anonymous survey to all practicing paramedics in a large urban Asian Emergency Medical Services system where formal TOR training had not yet been conducted and field TOR was not routinely applied...
December 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29201958/perspectives-of-patient-handover-among-paramedics-and-emergency-department-members-a-qualitative-study
#13
Majid Najafi Kalyani, Zheila Fereidouni, Raheleh Sabet Sarvestani, Zahra Hadian Shirazi, Ali Taghinezhad
Introduction: Improving patient handover is currently considered as a patient safety goal and one of the top five WHO priorities. So, the aim of this study was to explore the perspectives of patient handover among paramedics and emergency department staff. Methods: This is a descriptive exploratory study with a qualitative content analysis approach. Twenty five paramedics and emergency department staff were selected through purposeful sampling. The data were collected through semi-structured interviews in 2015 and Qualitative Content Analysis was used to analyze the data...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/29199885/emergency-medical-services-provider-experiences-of-hospice-care
#14
Cassandra Barnette Donnelly, Karen Andrea Armstrong, Molly M Perkins, Danielle Moulia, Tammie E Quest, Arthur H Yancey
BACKGROUND: Growing numbers of emergency medical services (EMS) providers respond to patients who receive hospice care. The objective of this investigation was to assess the knowledge, attitudes, and experiences of EMS providers in the care of patients enrolled in hospice care. METHODS: We conducted a survey study of EMS providers regarding hospice care. We collected quantitative and qualitative data on EMS provider's knowledge, attitudes, and experiences in responding to the care needs of patients in hospice care...
December 4, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29183831/-she-s-sort-of-breathing-what-linguistic-factors-determine-call-taker-recognition-of-agonal-breathing-in-emergency-calls-for-cardiac-arrest
#15
Marine Riou, Stephen Ball, Teresa A Williams, Austin Whiteside, Peter Cameron, Daniel M Fatovich, Gavin D Perkins, Karen Smith, Janet Bray, Madoka Inoue, Kay L O'Halloran, Paul Bailey, Deon Brink, Judith Finn
BACKGROUND: In emergency ambulance calls, agonal breathing remains a barrier to the recognition of out-of-hospital cardiac arrest (OHCA), initiation of cardiopulmonary resuscitation, and rapid dispatch. We aimed to explore whether the language used by callers to describe breathing had an impact on call-taker recognition of agonal breathing and hence cardiac arrest. METHODS: We analysed 176 calls of paramedic-confirmed OHCA, stratified by recognition of OHCA (89 cases recognised, 87 cases not recognised)...
November 26, 2017: Resuscitation
https://www.readbyqxmd.com/read/29174289/derivation-and-validation-of-the-emergency-medical-stroke-assessment-and-comparison-of-large-vessel-occlusion-scales
#16
Toby I Gropen, Amelia Boehme, Sheryl Martin-Schild, Karen Albright, Alyana Samai, Sammy Pishanidar, Nazli Janjua, Ethan S Brandler, Steven R Levine
BACKGROUND: This study aims to develop a simple scale to identify patients with prehospital stroke with large vessel occlusion (LVO), without losing sensitivity for other stroke types. METHODS: The Emergency Medical Stroke Assessment (EMSA) was derived from the National Institutes of Health Stroke Scale (NIHSS) items and validated for prediction of LVO in a separate cohort. We compared the EMSA with the 3-item stroke scale (3I-SS), Cincinnati Prehospital Stroke Severity Scale (C-STAT), Rapid Arterial oCclusion Evaluation (RACE) scale, and Field Assessment Stroke Triage for Emergency Destination (FAST-ED) for prediction of LVO and stroke...
November 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29169918/the-use-of-body-habitus-reference-images-improves-the-ability-of-novices-to-accurately-estimate-children-s-weight-using-the-pawper-xl-tape-system
#17
Mike Wells, Lara Nicole Goldstein, Alison Bentley
BACKGROUND: The original methodology of the PAWPER (Pediatric Advanced Weight Prediction in the Emergency Room) tape relies on a gestalt visual assessment of a child's body habitus to adjust a length-based weight estimation. This assessment is dependent on the user's subjective opinion, which may result in aberrations in accuracy between users and populations. With the development of the second-generation PAWPER XL tape, a more objective method of habitus evaluation was desired. OBJECTIVE: The aim of this study was to evaluate a new, more objective figural reference image system and a new checklist system for quantifying body habitus...
November 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29169910/the-effect-of-the-number-and-level-of-emergency-medical-technicians-on-patient-outcomes-following-out-of-hospital-cardiac-arrest-in-taipei
#18
Jen-Tang Sun, Wen-Chu Chiang, Ming-Ju Hsieh, Edward Pei-Chuan Huang, Wen-Shuo Yang, Yu-Chun Chien, Yao-Cheng Wang, Bin-Chou Lee, Shyh-Shyong Sim, Kuang-Chao Tsai, Matthew Huei-Ming Ma, Lee-Wei Chen
AIM: The effect of the number and level of on-scene emergency medical technicians (EMTs) on the outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to test the association between the number and level of EMTs and the outcomes of patients with OHCA. METHODS: We analysed Utstein-based registry data on OHCA in Taipei from 2011 to 2015. The eligible patients were adults, aged ≥20 years, with non-traumatic OHCA who underwent resuscitation attempts...
January 2018: Resuscitation
https://www.readbyqxmd.com/read/29158691/project-for-the-introduction-of-prehospital-analgesia-with-fentanyl-and-morphine-administered-by-specially-trained-paramedics-in-a-rural-service-area-in-germany
#19
Maximilian Scharonow, Timo Alberding, Wolfgang Oltmanns, Christian Weilbach
Background: In patients with serious illness or trauma, reduction of severe pain is a key therapeutic goal of emergency medical service (EMS) teams. In Germany, only physicians are allowed to use opioid analgesics. In the rural EMS area studied, the mean arrival time for paramedics is 8 minutes, 23 seconds, and for the rescue physician between 10 minutes, 30 seconds and 16 minutes, 59 seconds, depending on EMS site. In cases of parallel callouts, rescue-physician arrival times may be considerably longer...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29151401/evaluation-of-a-primary-care-paramedic-stemi-bypass-guideline
#20
Jonathan L Kwong, Garry Ross, Linda Turner, Chris Olynyk, Sheldon Cheskes, Adam Thurston, P Richard Verbeek
OBJECTIVE: Limited evidence supports primary care paramedic (PCP) direct transport of ST-segment elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI). The goal of this study was to evaluate an urban-based PCP STEMI bypass guideline. METHODS: We reviewed consecutive Toronto Paramedic Services call reports between April 7, 2015, and May 31, 2016, regarding STEMI patients identified by PCPs. The primary outcome was patient assignment (stable versus unstable) according to guideline criteria...
November 20, 2017: CJEM
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