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https://www.readbyqxmd.com/read/29781406/analysis-of-emergency-health-care-workforce-and-service-readiness-for-a-mass-casualty-event-in-the-republic-of-ireland
#1
Tener Goodwin Veenema, Fiona Boland, Declan Patton, Tom O'Connor, Zena Moore, Sarah Schneider-Firestone
OBJECTIVE: Ultimately, a country's capacity for a large-scale major emergency response will be directly related to the competence of its health care provider (HCP) workforce and communication between emergency responders and hospitals. The purpose of this study was to assess HCP preparedness and service readiness for a major emergency involving mass casualties (mass casualty event or MCE) in Ireland. METHODS: A cross-sectional study using a 53-item survey was administered to a purposive sample of emergency responders and HCPs in the Republic of Ireland...
May 21, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29762299/effectiveness-of-mitigation-interventions-on-occupational-violence-against-emergency-service-workers-a-mixed-methods-systematic-review-protocol
#2
Peter Drew, Vivienne Tippett, Scott Devenish
The objective of this review is to develop an aggregated synthesis of qualitative and quantitative data on occupational violence (OV) mitigation interventions for Emergency Service Workers (ESW), to cultivate useful conclusions and recommendations for paramedic occupational safety and policy development. Emergency Service Worker is a broad term encompassing all elements of community-based emergency support and includes paramedics, firefighters, and police.The objective of the quantitative component of this review is to quantify the effectiveness of OV mitigation interventions for ESW...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29760924/extensive-subcutaneous-emphysema-following-lobectomy
#3
Fiqry Fadhlillah, Wei Jia
We present a case report of extensive subcutaneous emphysema secondary to an elective left upper lobectomy. A 65-year-old gentleman was brought into a London teaching hospital's Accident and Emergency department following report of severe swelling. He was mistakenly treated by the paramedics as an allergic reaction and given hydrocortisone and salbutamol nebulisers with no effect. Upon arrival, the patient had widespread crepitus extending from his peri-orbital muscles down to mid-torso. A computer tomography scan revealed a pleuro-cutaneous fistula at the site of a recently sited chest drain, with extensive emphysema and a pneumothorax...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29759099/procedural-sedation-by-advanced-care-paramedics-for-emergency-gastrointestinal-endoscopy
#4
Hana M Wiemer, Michael B Butler, Patrick C Froese, Allan Lapierre, Chris Carriere, Glen R Etsell, Dana Farina, Jennifer Jones, Jock Murray, Samuel G Campbell
CLINICIAN'S CAPSULE What is known about the topic? Advanced care paramedics (ACPs) in our emergency department (ED) successfully perform procedural sedation and analgesia (PSA) for several procedures, including orthopedic manipulations. What did this study ask? How does the novel practice of ACP-led ED PSA for upper gastrointestinal (UGI) endoscopy compare to that for orthopedic procedures? What did this study find? Adverse events occurred more frequently during UGI endoscopy sedations than orthopedic sedations (41...
May 15, 2018: CJEM
https://www.readbyqxmd.com/read/29748230/senior-doctor-triage-sdt-a-qualitative-study-of-clinicians-views-on-senior-doctors-involvement-in-triage-and-early-assessment-of-emergency-patients
#5
Maysam Ali Abdulwahid, Janette Turner, Suzanne M Mason
INTRODUCTION: Despite the focus during the last decade on introducing interventions such as senior doctor initial assessment or senior doctor triage (SDT) to reduce emergency department (ED) crowding, there has been little attempt to identify the views of emergency healthcare professionals on such interventions. The aim of this study was to gain an understanding of SDT from the perspective of emergency hospital staff. A secondary aim of this study was to develop a definition of SDT based on the interview findings and the available literature on this process...
May 10, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29735235/transport-of-a-prone-position-acute-respiratory-distress-syndrome-patient
#6
David Hersey, Tobias Witter, George Kovacs
We report the case of a non-physician based critical care transport team (registered nurse and paramedic) that successfully initiated prone positioning of a severe acute respiratory distress patient prior to transport to an extracorporeal membrane oxygenation capable teaching hospital. With the increasing use of advanced treatments such as extracorporeal membrane oxygenation, prone positioning, and continuous renal replacement therapy for severe acute respiratory distress syndrome (ARDS), the necessity to transport these patients to specialized hospitals will correspondingly increase...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29731285/prehospital-acute-st-elevation-myocardial-infarction-identification-in-san-diego-a-retrospective-analysis-of-the-effect-of-a-new-software-algorithm
#7
Christanne Coffey, John Serra, Mat Goebel, Sarah Espinoza, Edward Castillo, James Dunford
BACKGROUND: A significant increase in false positive ST-elevation myocardial infarction (STEMI) electrocardiogram interpretations was noted after replacement of all of the City of San Diego's 110 monitor-defibrillator units with a new brand. These concerns were brought to the manufacturer and a revised interpretive algorithm was implemented. OBJECTIVES: This study evaluated the effects of a revised interpretation algorithm to identify STEMI when used by San Diego paramedics...
May 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#8
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
May 6, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29724172/a-randomized-controlled-trial-testing-the-effectiveness-of-a-paramedic-delivered-care-transitions-intervention-to-reduce-emergency-department-revisits
#9
Ranran Mi, Matthew M Hollander, Courtney M C Jones, Eva H DuGoff, Thomas V Caprio, Jeremy T Cushman, Amy J H Kind, Michael Lohmeier, Manish N Shah
BACKGROUND: Approximately 20% of community-dwelling older adults discharged from the emergency department (ED) return to an ED within 30 days, an occurrence partially resulting from poor care transitions. Prior published interventions to improve the ED-to-home transition have either lacked feasibility or effectiveness. The Care Transitions Intervention (CTI) has been validated to decrease rehospitalization among patients transitioning from the hospital to the home but has never been tested for patients transitioning from the ED to the home...
May 3, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29709976/tuberculosis-disease-among-healthcare-workers-clinical-microbiological-characteristics-and-treatment-outcomes-at-chiang-mai-university-hospital-thailand
#10
Juthamas Inchai, Chalerm Liwsrisakun, Chaiwat Bumroongkit, Juntima Eauthrongchit, Pattraporn Tajareunmuang, Chaicharn Pothirat
Tuberculosis (TB) among healthcare workers (HCWs) highly impacts morbidity and TB transmission in hospital. A retrospective cohort study of TB among HCWs (HCW-TB) was conducted using a registered database from 2003 to 2016 at Chiang Mai University Hospital to determine clinical and microbiological characteristics and treatment outcomes of HCW-TB. Seventy-six cases of HCWs, 54 nurses (71.1%), 12 physicians (15.8%) and 10 paramedics (13.2%), were diagnosed with TB disease. Female to male ratio of 51:25, mean age of 37...
April 27, 2018: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29704520/trends-in-the-incidence-and-outcome-of-paediatric-out-of-hospital-cardiac-arrest-a-17-year-observational-study
#11
Ziad Nehme, Siva Namachivayam, Anri Forrest, Warwick Butt, Stephen Bernard, Karen Smith
BACKGROUND: System-based improvements to the chain of survival have yielded increases in survival from out-of-hospital cardiac arrest (OHCA) in adults. Comparatively little is known about the long-term trends in incidence and survival following paediatric OHCA. METHODS: Between 2000 and 2016, we included children aged ≤16 years who suffered a non-traumatic OHCA in the state of Victoria, Australia. Trends in incidence and unadjusted outcomes were assessed using linear regression and a non-parametric test for trend...
April 25, 2018: Resuscitation
https://www.readbyqxmd.com/read/29703219/primary-mass-casualty-incident-triage-evidence-for-the-benefit-of-yearly-brief-re-training-from-a-simulation-study
#12
Michael S Dittmar, Philipp Wolf, Marc Bigalke, Bernhard M Graf, Torsten Birkholz
BACKGROUND: Triage is a mainstay of early mass casualty incident (MCI) management. Standardized triage protocols aim at providing valid and reproducible results and, thus, improve triage quality. To date, there is little data supporting the extent and content of training and re-training on using such triage protocols within the Emergency Medical Services (EMS). The study objective was to assess the decline in triage skills indicating a minimum time interval for re-training. In addition, the effect of a one-hour repeating lesson on triage quality was analyzed...
April 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29688243/patterns-of-emergency-ambulance-use-2009-13-a-comparison-of-older-people-living-in-residential-aged-care-facilities-and-the-community
#13
R Dwyer, B Gabbe, T D Tran, K Smith, J A Lowthian
Objective: to examine demand for emergency ambulances by older people. Design: retrospective cohort study using secondary analysis of routinely collected clinical and administrative data from Ambulance Victoria, and population data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare. Setting: Victoria, Australia. Participants: people aged 65 years and over, living in Residential Aged Care Facilities (RACF) and the community, attended by emergency ambulance paramedics, 2009-13...
April 24, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29666129/preventing-emergency-department-ed-visits-and-hospitalisations-of-older-adults-with-cognitive-impairment-compared-with-the-general-senior-population-what-do-we-know-about-avoidable-incidents-results-from-a-scoping-review
#14
Mireille Gagnon-Roy, Benyahia Hami, Mélissa Généreux, Nathalie Veillette, Marie-Josée Sirois, Mary Egan, Véronique Provencher
OBJECTIVES: Older cognitively impaired adults present a higher risk of hospitalisation and mortality following a visit to the emergency department (ED). Better understanding of avoidable incidents is needed to prevent them and the associated ED presentations in community-dwelling adults. This study aimed to synthetise the actual knowledge concerning these incidents leading this population to ED presentation, as well as possible preventive measures to reduce them. DESIGN: A scoping review was performed according to the Arksey and O'Malley framework...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29661625/unusual-presentation-of-middle-east-respiratory-syndrome-coronavirus-leading-to-a-large-outbreak-in-riyadh-during-2017
#15
Hala Amer, Abdulrahman S Alqahtani, Hind Alzoman, Nawfal Aljerian, Ziad A Memish
BACKGROUND: The hallmark of Middle East respiratory syndrome coronavirus (MERS-CoV) disease is the ability to cause major health care-associated nosocomial outbreaks with superspreading events leading to massive numbers of cases and excessive morbidity and mortality. In this report, we describe a patient who presented with acute renal failure requiring hemodialysis and became a MERS-CoV superspreader, igniting a recent multihospital outbreak in Riyadh. MATERIAL AND RESULTS: Between May 31 and June 15, 2017, 44 cases of MERS-CoV infection were reported from 3 simultaneous clusters from 3 health care facilities in Riyadh, Saudi Arabia, including 11 fatal cases...
April 13, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29644401/-skill-retention-using-extraglottic-airways-in-out-of-hospital-emergencies-efficacy-and-long-term-results-of-simulator-based-medical-education-a-prospective-follow-up-study
#16
V Mann, F Limberg, S T W Mann, S Little, M Müller, M Sander, R Röhrig
OBJECTIVE: For emergency medicine personnel (EMP), there is little evidence concerning the adequate timing for refresher courses to maintain routine in the application of extraglottic airways. The aim of this study was to evaluate the efficacy and long-term results of a simulator-based education concept teaching the basic airway management skills with extraglottic airways for EMP and also to draw conclusions concerning the adequate time interval for refresher courses. METHODS: By use of an explorative, prospective simulator-study with nonphysician EMP, airway management skills using the Larynxmaske Supreme® (LMA‑S) after an introduction lecture were examined...
April 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#17
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29619383/-foamems-engaging-paramedics-with-free-online-open-access-education
#18
Paige Mason, Alan M Batt
BACKGROUND AND AIM: Twitter® use among paramedics and other prehospital care clinicians is on the rise and is increasingly being used as a platform for continuing education and international collaboration. In 2014, the hashtag #FOAMems was registered. It is used for the sharing of emergency medical services, paramedicine, and prehospital care-related content. It is a component of the 'free open-access meducation' (FOAM) movement. The aim of this study was to characterize and evaluate the content of #FOAMems tweets since registration...
2018: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/29596006/accuracy-of-prehospital-identification-of-stroke-in-a-large-stroke-belt-municipality
#19
Nee-Kofi Mould-Millman, Halea Meese, Ibthial Alattas, Moges Ido, Iasson Yi, Tolulope Oyewumi, Michael Colman, Michael Frankel, Arthur Yancey
OBJECTIVE: Strokes are a leading cause of morbidity and mortality in the United States, especially in the "stroke belt" of the southeast. Up to 65% of stroke patients access care by calling 9-1-1. The primary objective of this study is to measure the accuracy of emergency medical dispatchers (EMD) and paramedics, in the prehospital identification of stroke. METHODS: The study was based at Grady Emergency Medical Services, which is Atlanta, Georgia's public emergency medical services (EMS) provider...
March 29, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29580702/-methods-to-improve-suicidal-adolescents-compliance-to-care-after-emergency-discharge-a-literature-review
#20
J Lachal, S Grandclerc, M Spodenkiewicz, M R Moro
OBJECTIVES: Suicidal adolescents admitted in an Emergency Department (ED) present a high risk of suicidal reattempts. Poor observance of follow-up in this particular group imped the efficacity of the treatment. We propose to summarize the international literature on ED interventions promoting suicidal adolescents' adherence to care. METHOD: We carried out a comprehensive review of papers listed in PubMed, PsycInfo, and CINHAL databases using keywords about adolescence, suicide, and ED...
March 23, 2018: L'Encéphale
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