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https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#1
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28920706/do-night-and-around-the-clock-firefighters-shift-schedules-induce-deviation-in-tau-from-24-hours-of-systolic-and-diastolic-blood-pressure-circadian-rhythms
#2
Alain E Reinberg, Michael H Smolensky, Marc Riedel, Cedric Riedel, Eric Brousse, Yvan Touitou
Systolic (S) and diastolic (D) blood pressures (BP) [SBP and DBP] are circadian rhythmic with period (τ) in healthy persons assumed to be maintained at 24.0h. We tested this assumption in a sample of 30 healthy career (mean >12 yrs) 30-to-46 yr-old male Caucasian French firefighters (FFs) categorized into three groups according to work schedule and duties: Group A - 12 FFs working 12h day, 12h night, and occasionally 24h shifts and whose primary duties are firefighting plus paramedical and road rescue services; Group B - 9 FFs working mostly 12h day and 12h night shifts and whose duties are answering incoming emergency calls and coordinating service vehicle dispatch from fire stations with Group A personnel; Group C - 9 day shift (09:00-17:00h) FFs charged with administrative tasks...
September 18, 2017: Chronobiology International
https://www.readbyqxmd.com/read/28920524/remotely-supported-prehospital-ultrasound-a-feasibility-study-of-real-time-image-transmission-and-expert-guidance-to-aid-diagnosis-in-remote-and-rural-communities
#3
Leila Eadie, John Mulhern, Luke Regan, Alasdair Mort, Helen Shannon, Ashish Macaden, Philip Wilson
Introduction Our aim is to expedite prehospital assessment of remote and rural patients using remotely-supported ultrasound and satellite/cellular communications. In this paradigm, paramedics are remotely-supported ultrasound operators, guided by hospital-based specialists, to record images before receiving diagnostic advice. Technology can support users in areas with little access to medical imaging and suboptimal communications coverage by connecting to multiple cellular networks and/or satellites to stream live ultrasound and audio-video...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28919539/the-nexus-between-the-documentation-of-end-of-life-wishes-and-awareness-of-dying-a-model-for-research-education-and-care
#4
Deborah P Waldrop, Jacqueline M McGinley, Brian Clemency
The convergence of medical treatment that can extend life with written medical orders that make it possible to refuse such treatment brings the differential dynamics of contemporary end-of-life decision-making into sharp focus. Communication between families and clinicians can be confusing, uncertain and pressured when death is imminent. These situations create distress that ultimately influences the end-of-life experience for people who are dying and those who care for them. This paper presents the analysis of the decisional dynamics that emerge from the intersection of the patient-family-provider awareness that death is near with the presence or absence of documentation of expressed wishes for end-of-life care...
September 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28910212/feasibility-of-paramedic-performed-prehospital-lung-ultrasound-in-medical-patients-with-respiratory-distress
#5
Torben K Becker, Christian Martin-Gill, Clifton W Callaway, Francis X Guyette, Christopher Schott
OBJECTIVE: Prehospital ultrasound is not yet widely implemented. Most studies report on convenience samples and trauma patients, often by prehospital physicians or critical care clinicians. We assessed the feasibility of paramedic performed prehospital lung ultrasound in medical patients with respiratory distress. METHODS: Paramedics at 2 ambulance stations in the city of Pittsburgh, Pennsylvania, USA underwent a 2-hour training session in prehospital lung ultrasound using the SonoSite iViz, a handheld ultrasound device...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28889170/embedding-volunteer-activity-into-paramedic-education
#6
Linda Ross, Sophia Kabidi
BACKGROUND: Paramedics require a wide range of skills that are beyond clinical or technical skills in order to meet the demands of the role and provide quality and compassionate care to patients. Non-technical or "soft" skills and attributes are generally challenging to teach and develop in the classroom setting. Volunteerism provides an opportunity for students to gain exposure to different communities and develop interpersonal skills. METHODS: This cross-sectional study used one-on-one interviews with 12 third-year Bachelor of Emergency Health (Paramedic) students from Monash University, Australia, who completed a community volunteering program...
2017: Journal of Allied Health
https://www.readbyqxmd.com/read/28888248/epinephrine-autoinjectors-new-data-new%C3%A2-problems
#7
Susan Waserman, Ernie Avilla, Moshe Ben-Shoshan, Lana Rosenfield, Andrea Burke Adcock, Matthew Greenhawt
Epinephrine is the first-line treatment for anaphylaxis. Despite this, there have been identified gaps in the management of anaphylaxis including infrequent or delayed use of epinephrine for acute allergic reactions, as well as inadequate epinephrine autoinjector (EAI) training, and prescription rates of these devices for patients at risk. This paper reviews new data, and new problems in recently published literature on EAIs. A database search was conducted for publications between January 2015 and February 2017 using keywords related to EAIs including their functionality and features, carriage, prescription rates, barriers, and side effects...
September 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28841102/association-of-burnout-with-workforce-reducing-factors-among-ems-professionals
#8
Remle P Crowe, Julie K Bower, Rebecca E Cash, Ashish R Panchal, Severo A Rodriguez, Susan E Olivo-Marston
OBJECTIVES: Emergency medical services (EMS) professionals often work long hours at multiple jobs and endure frequent exposure to traumatic events. The stressors inherent to the prehospital setting may increase the likelihood of experiencing burnout and lead providers to exit the profession, representing a serious workforce and public health concern. Our objectives were to estimate the prevalence of burnout, identify characteristics associated with experiencing burnout, and quantify its relationship with factors that negatively impact EMS workforce stability, namely sickness absence and turnover intentions...
August 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28822212/comparison-of-start-and-salt-triage-methodologies-to-reference-standard-definitions-and-to-a-field-mass-casualty-simulation
#9
Salvatore Silvestri, Adam Field, Neal Mangalat, Tory Weatherford, Christopher Hunter, Zoe McGowan, Zachary Stamile, Trevor Mattox, Tanner Barfield, Aarian Afshari, George Ralls, Linda Papa
OBJECTIVES: We compared Sort, Assess, Lifesaving Intervention, Treatment/Transport (SALT) and Simple Triage and Rapid Treatment (START) triage methodologies to a published reference standard, and evaluated the accuracy of the START method applied by emergency medical services (EMS) personnel in a field simulation. DESIGN: Simulated mass casualty incident (MCI). Paramedics trained in START triage assigned each victim to green (minimal), yellow (delayed), red (immediate), or black (dead) categories...
January 2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28810931/a-comprehensive-regional-clinical-and-educational-ecpr-protocol-decreases-time-to-ecmo-in-patients-with-refractory-out-of-hospital-cardiac-arrest
#10
Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
OBJECTIVE: Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). METHODS: In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital...
August 16, 2017: CJEM
https://www.readbyqxmd.com/read/28805550/moving-toward-a-universal-digital-era-in-mass-casualty-incidents-and-disasters-emergency-personnel-s-perspective-in-romania
#11
Adrian Stănescu, Peter Eliot Gordon, Sanda Maria Copotoiu, Cristian Marius Boeriu
BACKGROUND: Despite a recognized need for improved communications and logistics in high acuity situations, the integration of telemedicine services into the mainstream health services has been difficult. This study reports on the opinions of Romanian professional responders to mass casualty incidents and disasters regarding the use and requirements of specific electronic medical documentation solutions. MATERIALS AND METHODS: Doctors, nurses, paramedics, and fire department officers participated in a customized online structured questionnaire...
August 14, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28791989/treatment-of-resistant-idiopathic-hiccups-with-pulse-radio-frequency-on-phrenic-nerve-and-gabapentin-a-case-report
#12
O Ozturk, E Yavuz, B Yazicioglu, B Uzuner
Hiccups affect life quality, career and family life when they become persistent. We present here a 54-year-old man who worked as a mason and a blacksmith with hiccups complaint for nearly one and a half years. In this period, he was admitted to emergency service ten times with fainting or almost fainting, cold sweating and hand stretching complaints. The patient expressed that he frequently threw up when he had hiccups and his social life was negatively affected. He reported that he was treated with baclofen, esomeprazole and hyoscine-n-butyl bromur without relief...
July 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28782875/comparison-of-trauma-care-systems-in-asian-countries-a-systematic-literature-review
#13
Se Jin Choi, Moon Young Oh, Na Rae Kim, Yoo Joong Jung, Young Sun Ro, Sang Do Shin
OBJECTIVE: The study aims to compare the trauma care systems in Asian countries. METHODS: Asian countries were categorised into three groups; 'lower middle-income country', 'upper middle-income country' and 'high-income country'. The Medline/PubMed database was searched for articles published from January 2005 to December 2014 using relevant key words. Articles were excluded if they examined a specific injury mechanism, referred to a specific age group, and/or did not have full text available...
August 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28771639/utilisation-of-prehospital-emergency-medical-services-for-hyperglycaemia-a-community-based-observational-study
#14
Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Arul Earnest, Karen Smith, Georgia Soldatos, Helena Teede, Sophia Zoungas
AIMS: This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport. MATERIALS AND METHODS: A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/28765132/a-systematic-review-to-identify-and-assess-the-effectiveness-of-alternatives-for-people-over-the-age-of-65-who-are-at-risk-of-potentially-avoidable-hospital-admission
#15
Alyson L Huntley, Melanie Chalder, Ali R G Shaw, William Hollingworth, Chris Metcalfe, Jonathan Richard Benger, Sarah Purdy
BACKGROUND/OBJECTIVES: There are some older patients who are 'at the decision margin' of admission. This systematic review sought to explore this issue with the following objective: what admission alternatives are there for older patients and are they safe, effective and cost-effective? A secondary objective was to identify the characteristics of those older patients for whom the decision to admit to hospital may be unclear. DESIGN: Systematic review of controlled studies (April 2005-December 2016) with searches in Medline, Embase, Cinahl and CENTRAL databases...
August 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28762896/ambulance-delivered-transdermal-glyceryl-trinitrate-versus-sham-for-ultra-acute-stroke-rationale-design-and-protocol-for-the-rapid-intervention-with-glyceryl-trinitrate-in-hypertensive-stroke-trial-2-right-2-trial-isrctn26986053
#16
Jason P Appleton, Polly Scutt, Mark Dixon, Harriet Howard, Lee Haywood, Diane Havard, Trish Hepburn, Tim England, Nikola Sprigg, Lisa J Woodhouse, Joanna M Wardlaw, Alan A Montgomery, Stuart Pocock, Philip M Bath
Rationale Vascular nitric oxide levels are low in acute stroke and donors such as glyceryl trinitrate have shown promise when administered very early after stroke. Potential mechanisms of action include augmentation of cerebral reperfusion, thrombolysis and thrombectomy, lowering blood pressure, and cytoprotection. Aim To test the safety and efficacy of four days of transdermal glyceryl trinitrate (5 mg/day) versus sham in patients with ultra-acute presumed stroke who are recruited by paramedics prior to hospital presentation...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28749410/awareness-of-the-risk-of-exposure-to-infectious-material-and-the-behaviors-of-polish-paramedics-with-respect-to-the-hazards-from-blood-borne-pathogens-a-nationwide-study
#17
Anna Garus-Pakowska, Mariusz Górajski, Franciszek Szatko
(1) Background: To determine paramedics' frequency of contact with blood and other body fluids, as well as the analysis of knowledge of paramedics about blood-borne infections, their attitudes to patients infected with blood-borne viruses, and the post-exposure procedures implemented by paramedics; (2) Methods: An anonymous questionnaire among 190 paramedics working in various health care facilities in Poland (adjusted response rate, 76.3%); (3) Results: 78% of paramedics had contact with potentially infectious material at least several times a week...
July 27, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28746084/epidemiology-and-location-of-primary-retrieval-missions-in-a-scottish-aeromedical-service
#18
Gregg Neagle, Lisa Curatolo, John Ferris, Mike Donald, Stephen Hearns, Alasdair R Corfield
INTRODUCTION: Prehospital critical care teams comprising an appropriately trained physician and paramedic or nurse have been associated with improved outcomes in selected trauma patients. These teams are a scarce and expensive resource, especially when delivered by rotary air assets. The optimal tasking of prehospital critical care teams is therefore vital and remains a subject of debate. Emergency Medical Retrieval Service (EMRS) provides a prehospital critical care response team to incidents over a large area of Scotland either by air or by road...
July 25, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28697158/how-accurate-are-pediatric-emergency-tapes-a-comparison-of-4-emergency-tapes-with-different-length-based-weight-categorization
#19
Christian P Both, Achim Schmitz, Philipp K Buehler, Markus Weiss, Alexander R Schmidt
OBJECTIVE: Pediatric emergency tapes have been developed to support paramedics and emergency physicians when dosing drugs and selecting medical equipment in pediatric emergency situations. The aim of this study was to compare the accuracy of 4 pediatric emergency tapes to correctly estimate patient's weight based on a large population of patients. METHODS: Patients undergoing general anesthesia between January 2012 and March 2015 with documented age, sex, body weight, and length were identified from the electronic anesthesia patient data management system of the Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28692167/modern-management-of-hypertensive-emergencies-and-urgencies-do-we-need-more-technology-paramedics-or-physicians
#20
Kyriakos Dimitriadis, Costas Tsioufis, Dimitris Tousoulis
No abstract text is available yet for this article.
July 2017: Journal of Clinical Hypertension
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