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https://www.readbyqxmd.com/read/28103121/comparison-of-helicopter-emergency-medical-services-transport-types-and-delays-on-patient-outcomes-at-two-level-i-trauma-centers
#1
Brodie Nolan, Homer Tien, Bruce Sawadsky, Sandro Rizoli, Amanda McFarlan, Andrea Phillips, Alun Ackery
BACKGROUND: Helicopter emergency medical services (HEMS) have become an engrained component of trauma systems. In Ontario, transportation for trauma patients is through one of three ways: scene call, modified scene call, or interfacility transfer. We hypothesize that differences exist between these types of transports in both patient demographics and patient outcomes. This study compares the characteristics of patients transported by each of these methods to two level 1 trauma centers and assesses for any impact on morbidity or mortality...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28102532/time-to-epinephrine-in-out-of-hospital-cardiac-arrest-a-retrospective-analysis-of-intraosseous-versus-intravenous-access
#2
Elliot M Ross, Julian Mapp, Chetan Kharod, David A Wampler, Christopher Velasquez, David A Miramontes
INTRODUCTION: The 2015 advanced cardiac life support update continues to advocate administering epinephrine during cardiac arrest. The goal of our study is to determine if prehospital intraosseous (IO) access results in shorter time to epinephrine than prehospital peripheral intravenous (PIV) access. METHODS: The out-of-hospital cardiac arrest (OHCA) database of a large, urban, fire-based emergency medical services system was searched for consecutive cases of OHCA between January 2013 and December 2015...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28101880/family-emergency-plan-and-preparedness-among-medical-practitioners-in-zaria-nigeria
#3
Jerry Godfrey Makama, Istifanus Anekoson Joshua, Elizabeth Jerry Makama
BACKGROUND: There has been an increase in the incidence of disasters in many parts of the world. Similarly, Nigeria has witnessed a recent increase of man-made disaster events such as plane crash, fire incidents, flood, and building collapse, including bomb blast orchestrated by terrorists that often create emergency situations. Therefore, the aim of the study was to evaluate family emergency plan and preparedness among medical practitioners in Zaria. METHODS: This was a cross-sectional descriptive study (May-July, 2013) of medical practitioners in Zaria, Nigeria...
November 2016: Journal of Emergency Management: JEM
https://www.readbyqxmd.com/read/28101563/world-health-organisation-global-disability-action-plan-2014-2021-challenges-and-perspectives-for-physical-medicine-and-rehabilitation-in-pakistan
#4
Fary Khan, Bhasker Amatya, Tahir M Sayed, Aamir W Butt, Khalid Jamil, Waseem Iqbal, Alaeldin Elmalik, Farooq A Rathore, Geoff Abbott
OBJECTIVE: To provide an update on disability and outline potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Pakistan. METHODS: A 6-day workshop at the Armed Forces Institute of Rehabilitation Medicine, Islamabad facilitated by rehabilitation staff from Royal Melbourne Hospital, Australia. Local healthcare professionals (n = 33) from medical rehabilitation facilities identified challenges in service provision, education and attitudes/approaches to people with disabilities, using consensus agreement for objectives listed in the GDAP...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28100764/drip-n-ship-versus-mothership-for-endovascular-treatment-modeling-the-best-transportation-options-for-optimal-outcomes
#5
Matthew S W Milne, Jessalyn K Holodinsky, Michael D Hill, Anders Nygren, Chao Qiu, Mayank Goyal, Noreen Kamal
BACKGROUND AND PURPOSE: There is uncertainty regarding the best way for patients outside of endovascular-capable or Comprehensive Stroke Centers (CSC) to access endovascular treatment for acute ischemic stroke. The role of the nonendovascular-capable Primary Stroke Centers (PSC) that can offer thrombolysis with alteplase but not endovascular treatment is unclear. A key question is whether average benefit is greater with early thrombolysis at the closest PSC before transportation to the CSC (Drip 'n Ship) or with PSC bypass and direct transport to the CSC (Mothership)...
January 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28100208/access-to-primary-health-care-for-acute-vascular-events-in-rural-low-income-settings-a-mixed-methods-study
#6
Shyfuddin Ahmed, Muhammad Ashique Haider Chowdhury, Md Alfazal Khan, Nafisa Lira Huq, Aliya Naheed
BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of global mortality. Among the CVDs, acute vascular events (AVE) mainly ischemic heart diseases and stroke are the largest contributors. To achieve 25% reduction in preventable deaths from CVDs by 2025, health systems need to be equipped with extended service coverage in order to provide person-centered care. The overall goal of this proposed study is to assess access to health care in-terms of service availability, care seeking patterns and barriers to access care after AVE in rural Bangladesh...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28100142/reduction-in-jail-emergency-department-visits-and-closure-after-implementation-of-on-site-urgent-care
#7
Erick Eiting, Carrie S Korn, Erin Wilkes, Glenn Ault, Sean O Henderson
This descriptive study evaluates the impact of implementation of full service on-site urgent care services at the Los Angeles County Jail (LACJ) by examining the number of patients seen at the referral hospital, Los Angeles County + University of Southern California Medical Center (LAC+USC), and the number of hours that the referral hospital was closed to transfers in the periods before and after the development of the LACJ Urgent Care. The appropriate utilization of public resources is a critical priority for an overburdened county medical health care system...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28100141/caring-to-learn-and-learning-to-care
#8
Kristin G Cloyes, Susan J Rosenkranz, Katherine P Supiano, Patricia H Berry, Meghan Routt, Sarah M Llanque, Kathleen Shannon-Dorcy
The increasing numbers of aging and chronically ill prisoners incarcerated in Western nations is well-documented, as is the growing need for prison-based palliative and end-of-life care. Less often discussed is specifically how end-of-life care can and should be provided, by whom, and with what resources. One strategy incorporates prisoner volunteers into end-of-life services within a peer-care program. This article reports on one such program based on focused ethnographic study including in-depth interviews with inmate hospice volunteers, nursing staff, and corrections officers working in the hospice program...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28099714/zika-virus-infection-in-brazil-and-human-rights-obligations
#9
Debora Diniz, Sinara Gumieri, Beatriz Galli Bevilacqua, Rebecca J Cook, Bernard M Dickens
The February 2016 WHO declaration that congenital Zika virus syndrome constitutes a Public Health Emergency of International Concern reacted to the outbreak of the syndrome in Brazil. Public health emergencies can justify a spectrum of human rights responses, but in Brazil, the emergency exposed prevailing inequities in the national healthcare system. The government's urging to contain the syndrome, which is associated with microcephaly among newborns, is confounded by lack of reproductive health services. Women with low incomes in particular have little access to such health services...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099701/a-systematic-review-of-implementation-strategies-to-deliver-guidelines-on-obstetric-care-practice-in-low-and-middle-income-countries
#10
REVIEW
Mari Imamura, Lovney Kanguru, Suzanne Penfold, Tim Stokes, Janette Camosso-Stefinovic, Beth Shaw, Julia Hussein
BACKGROUND: Healthcare measures to prevent maternal deaths are well known. However, effective implementation of this knowledge to change practice remains a challenge. OBJECTIVES: To assess whether strategies to promote the use of guidelines can improve obstetric practices in low- and middle-income countries (LMICs). SEARCH STRATEGY: Electronic databases were searched up to February 7, 2014, using relevant terms for implementation strategies (e...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099663/primary-health-care-care-coordinator-in-regionalized-networks
#11
Patty Fidelis de Almeida, Adriano Maia Dos Santos
OBJECTIVE: To analyze the breadth of care coordination by Primary Health Care in three health regions. METHODS: This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia...
December 22, 2016: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28098672/a-chronicle-of-pa-journals
#12
Roderick S Hooker
At its semicentennial mark, the PA profession appears to be flourishing. Over the past 50 years, a number of journals have emerged to highlight the development of the profession and offer observations on it. The Physician Associate Journal, launched in 1970, was the first foray into PA reporting. Following this small effort, a dozen journals or newspapers came into print, lasted for a while, and then were replaced or died. Of journals that survived to the present, four are in English and one in Dutch. Three of the five journals are association-based, and four produce clinical articles; publication is monthly, quarterly, or semiannually...
February 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28097413/when-surgical-resources-are-severely-constrained-who-receives-care-determinants-of-access-to-orthopaedic-trauma-surgery-in-uganda
#13
Trina Stephens, Alexander Mezei, Nathan N O'Hara, Jeffrey Potter, Rodney Mugarura, Piotr A Blachut, Peter J O'Brien, Tito Beyeza, Gerard P Slobogean
BACKGROUND: In low- and middle-income countries, the volume of traumatic injuries requiring orthopaedic intervention routinely exceeds the capacity of available surgical resources. The objective of this study was to identify predictors of surgical care for lower extremity fracture patients at a high-demand, resource-limited public hospital in Uganda. METHODS: Skeletally mature patients admitted with the intention of definitive surgical treatment of an isolated tibia or femur fractures to the national referral hospital in Uganda were recruited to participate in this study...
January 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28096681/the-relatives-voice-how-do-relatives-experience-participation-in-reablement-a-qualitative-study
#14
Kari Margrete Hjelle, Herdis Alvsvåg, Oddvar Førland
BACKGROUND: Reablement is an early and time-limited home-based model of rehabilitation intervention with an emphasis on intensive, goal-oriented, and multidisciplinary assistance for persons experiencing functional decline. When rehabilitation in general takes place in the person's own home, in contrast to an institution, relatives may have larger responsibilities in helping and supporting the family member. Although there is evidence, showing that family caregivers, such as spouses and children, experience burdens and demanding situations related to their caregiving role, there are currently few publications exploring relatives' experiences of participating in reablement...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28096254/factors-predicting-antibiotic-prescription-and-referral-to-hospital-for-children-with-respiratory-symptoms-secondary-analysis-of-a-randomised-controlled-study-at-out-of-hours-services-in-primary-care
#15
Ingrid Keilegavlen Rebnord, Hogne Sandvik, Anders Batman Mjelle, Steinar Hunskaar
OBJECTIVES: Acute respiratory infections and fever among children are highly prevalent in primary care. It is challenging to distinguish between viral and bacterial infections. Norway has a relatively low prescription rate of antibiotics, but it is still regarded as too high as the antimicrobial resistance is increasing. The aim of the study was to identify predictors for prescribing antibiotics or referral to hospital among children. DESIGN: Secondary analysis of a randomised controlled study...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28096208/improving-door-to-needle-times-for-acute-ischemic-stroke-effect-of-rapid-patient-registration-moving-directly-to-computed-tomography-and-giving-alteplase-at-the-computed-tomography-scanner
#16
Noreen Kamal, Jessalyn K Holodinsky, Caroline Stephenson, Devika Kashayp, Andrew M Demchuk, Michael D Hill, Renee L Vilneff, Erin Bugbee, Charlotte Zerna, Nancy Newcommon, Eddy Lang, Darren Knox, Eric E Smith
BACKGROUND: The effectiveness of specific systems changes to reduce DTN (door-to-needle) time has not been fully evaluated. We analyzed the impact of 4 specific DTN time reduction strategies implemented prospectively in a staggered fashion. METHODS AND RESULTS: The HASTE (Hurry Acute Stroke Treatment and Evaluation) project was implemented in 3 phases at a single academic medical center. In HASTE I (June 6, 2012 to June 5, 2013), baseline performance was analyzed...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28096207/use-of-strategies-to-improve-door-to-needle-times-with-tissue-type-plasminogen-activator-in-acute-ischemic-stroke-in-clinical-practice-findings-from-target-stroke
#17
Ying Xian, Haolin Xu, Barbara Lytle, Jason Blevins, Eric D Peterson, Adrian F Hernandez, Eric E Smith, Jeffrey L Saver, Steven R Messé, Mary Paulsen, Robert E Suter, Mathew J Reeves, Edward C Jauch, Lee H Schwamm, Gregg C Fonarow
BACKGROUND: The implementation of Target: Stroke Phase I, the first stage of the American Heart Association's national quality improvement initiative to accelerate door-to-needle (DTN) times, was associated with an average 15-minute reduction in DTN times. TARGET: Stroke phase II was launched in April 2014 with a goal of promoting further reduction in treatment times for tissue-type plasminogen activator (tPA) administration. METHODS AND RESULTS: We conducted a second survey of Get With The Guidelines-Stroke hospitals regarding strategies used to reduce delays after Target: Stroke and quantify their association with DTN times...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28096051/transitions-of-care-medication-related-barriers-identified-by-low-socioeconomic-patients-of-a-federally-qualified-health-center-following-hospital-discharge
#18
Rebecca Cope, Lauren Jonkman, Karen Quach, John Ahlborg, Sharon Connor
This article describes a qualitative research study using a semi-structured interview process to describe barriers surrounding medication access, use, and adherence for recently discharged patients of a federally qualified health center. Common themes which emerged were: 1) Team assumptions regarding patient plans to access or appropriately use discharge medications negatively impact adherence; 2) Unmet expectation for care coordination between primary care physician (PCP) and hospital; 3) Disconnect between patients and health care workers leads to disengagement; and 4) Lack of personal contact hinders access to services...
January 6, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28096039/the-impact-of-emergency-medical-services-in-acute-heart-failure
#19
Pia Harjola, James Boyd, Tuukka Tarvasmäki, Juho Mattila, Reijo Koski, Markku Kuisma, Veli-Pekka Harjola
BACKGROUND: Real-life data on the role of emergency medical services (EMS) in acute heart failure (AHF) are scarce. Our aim was to describe prehospital treatment of AHF and to compare patients using EMS with self-presented, non-EMS patients. METHODS: Data were collected retrospectively from three university hospitals in Helsinki metropolitan area between July 1, 2012 and July 31, 2013. According to the use of EMS, patients were divided into EMS and non-EMS groups...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28096018/understanding-the-distribution-of-a-e-attendances-and-hospital-admissions-for-the-case-managed-population-a-single-case-cross-sectional-study
#20
Eloise Phillips, Sarahjane Jones, Jessica Runacres, Maxine Lintern, Mark Radford
AIM: To describe the characteristics of case-managed patients presenting at accident and emergency (A & E) and to explore the distribution of their attendances and admissions. BACKGROUND: Recently, the UK Government announced extended-hours primary care provision in an effort to reduce the growing utilization of A & E. No evidence is available to understand the use of acute services by this high-risk patient group. METHOD: A cross-sectional design utilising routinely collected anonymsed A & E attendance and hospital admission data from 2010 to 2015...
February 2017: Applied Nursing Research: ANR
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