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https://www.readbyqxmd.com/read/28494638/an-environmental-scan-of-emergency-response-systems-and-services-in-remote-first-nations-communities-in-northern-ontario
#1
E J Mew, S D Ritchie, D VanderBurgh, J L Beardy, J Gordon, M Fortune, S Mamakwa, A M Orkin
BACKGROUND: Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. OBJECTIVE: We aimed to understand emergency response systems, services, and training in remote NAN communities. DESIGN: We used an environmental scan approach to compile information from multiple sources including community-based participatory research...
2017: International Journal of Circumpolar Health
https://www.readbyqxmd.com/read/28466658/a-critical-analysis-of-debates-around-mental-health-calls-in-the-prehospital-setting
#2
Polly Christine Ford-Jones, Claudia Chaufan
Paramedics, health care workers who assess and manage health concerns in the prehospital setting, are increasingly providing psychosocial care in response to a rise in mental health call volume. Observers have construed this fact as "misuse" of paramedic services, and proposed as solutions better triaging of patients, better mental health training of paramedics, and a greater number of community mental health services. In this commentary, we argue that despite the ostensibly well-intentioned nature of these solutions, they shift attention and accountability away from relevant public policies, as well as from broader economic, social, and political determinants of mental health, while placing responsibility on those requiring services or, at best, on the health care system...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28399219/a-multidisciplinary-intervention-to-prevent-subsequent-falls-and-health-service-use-following-fall-related-paramedic-care-a-randomised-controlled-trial
#3
A Stefanie Mikolaizak, Stephen R Lord, Anne Tiedemann, Paul Simpson, Gideon A Caplan, Jason Bendall, Kirsten Howard, Lyndell Webster, Narelle Payne, Sarah Hamilton, Joanne Lo, Elisabeth Ramsay, Sandra O'Rourke, Linda Roylance, J C Close
Background: approximately 25% of older people who fall and receive paramedic care are not subsequently transported to an emergency department (ED). These people are at high risk of future falls, unplanned healthcare use and poor health outcomes. Objective: to evaluate the impact of a fall-risk assessment and tailored fall prevention interventions among older community-dwellers not transported to ED following a fall on subsequent falls and health service use. Design, setting, participants: Randomised controlled trial involving 221 non-transported older fallers from Sydney, Australia...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28397649/support-and-assessment-for-fall-emergency-referrals-safer-2-a-cluster-randomised-trial-and-systematic-review-of-clinical-effectiveness-and-cost-effectiveness-of-new-protocols-for-emergency-ambulance-paramedics-to-assess-older-people-following-a-fall-with-referral
#4
Helen A Snooks, Rebecca Anthony, Robin Chatters, Jeremy Dale, Rachael Fothergill, Sarah Gaze, Mary Halter, Ioan Humphreys, Marina Koniotou, Phillipa Logan, Ronan Lyons, Suzanne Mason, Jon Nicholl, Julie Peconi, Ceri Phillips, Judith Phillips, Alison Porter, A Niroshan Siriwardena, Graham Smith, Alun Toghill, Mushtaq Wani, Alan Watkins, Richard Whitfield, Lynsey Wilson, Ian T Russell
BACKGROUND: Emergency calls are frequently made to ambulance services for older people who have fallen, but ambulance crews often leave patients at the scene without any ongoing care. We evaluated a new clinical protocol which allowed paramedics to assess older people who had fallen and, if appropriate, refer them to community-based falls services. OBJECTIVES: To compare outcomes, processes and costs of care between intervention and control groups; and to understand factors which facilitate or hinder use...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28373259/home-or-hospital-for-people-with-dementia-and-one-or-more-other-multimorbidities-what-is-the-potential-to-reduce-avoidable-emergency-admissions-the-homeward-project-protocol
#5
S Voss, S Black, J Brandling, M Buswell, R Cheston, S Cullum, K Kirby, S Purdy, C Solway, H Taylor, J Benger
INTRODUCTION: Older people with multimorbidities frequently access 999 ambulance services. When multimorbidities include dementia, the risk of ambulance use, accident and emergency (A&E) attendance and hospital admission are all increased, even when a condition is treatable in the community. People with dementia tend to do poorly in the acute hospital setting and hospital admission can result in adverse outcomes. This study aims to provide an evidence-based understanding of how older people living with dementia and other multimorbidities are using emergency ambulance services...
April 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28333367/community-paramedicine-applied-in-a-rural-community
#6
Kevin J Bennett, Matt W Yuen, Melinda A Merrell
RESEARCH OBJECTIVE: Abbeville County Emergency Management Services (ACEMS) began a community paramedicine (CP) program to utilize trained paramedics to serve patients who frequently use the emergency department (ED) and have 1 or more of the following diagnoses: hypertension, diabetes, chronic heart failure, asthma, and chronic obstructive pulmonary disease. The objective of this study was to determine if the CP program reduced ED visits in Abbeville while improving patient outcomes. DESIGN: A pre/posttest with a comparison group study design was used to evaluate the CP program...
March 23, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28302422/paramedic-assessment-of-older-adults-after-falls-including-community-care-referral-pathway-cluster-randomized-trial
#7
Helen A Snooks, Rebecca Anthony, Robin Chatters, Jeremy Dale, Rachael T Fothergill, Sarah Gaze, Mary Halter, Ioan Humphreys, Marina Koniotou, Phillipa Logan, Ronan A Lyons, Suzanne Mason, Jon Nicholl, Julie Peconi, Ceri Phillips, Alison Porter, Aloysius Niroshan Siriwardena, Mushtaq Wani, Alan Watkins, Lynsey Wilson, Ian T Russell
STUDY OBJECTIVE: We aim to determine clinical and cost-effectiveness of a paramedic protocol for the care of older people who fall. METHODS: We undertook a cluster randomized trial in 3 UK ambulance services between March 2011 and June 2012. We included patients aged 65 years or older after an emergency call for a fall, attended by paramedics based at trial stations. Intervention paramedics could refer the patient to a community-based falls service instead of transporting the patient to the emergency department...
March 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28300525/disaster-preparedness-among-health-professionals-and-support-staff-what-is-effective-an-integrative-literature-review
#8
Jeremy R Gowing, Kim N Walker, Shandell L Elmer, Elizabeth A Cummings
Introduction It is important that health professionals and support staff are prepared for disasters to safeguard themselves and the community during disasters. There has been a significantly heightened focus on disasters since the terrorist attacks of September 11, 2001 in New York (USA); however, despite this, it is evident that health professionals and support staff may not be adequately prepared for disasters. Report An integrative literature review was performed based on a keyword search of the major health databases for primary research evaluating preparedness of health professionals and support staff...
March 16, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28274221/effectiveness-of-a-community-paramedic-led-health-assessment-and-education-initiative-in-a-seniors-residence-building-the-community-health-assessment-program-through-emergency-medical-services-chap-ems
#9
G Agarwal, R Angeles, M Pirrie, F Marzanek, B McLeod, J Parascandalo, L Dolovich
BACKGROUND: Seniors living in subsidized housing have lower income, poorer health, and increased risk for cardiometabolic diseases and falls. Seniors also account for more than one third of calls to Emergency Medical Services (EMS). This study examines the effectiveness of the Community Health Assessment Program through EMS (CHAP-EMS) in reducing blood pressure, diabetes risk, and EMS calls. METHODS: Paramedics on modified duty (e.g. injured) conducted weekly, one-on-one drop-in sessions in a common area of one subsidized senior's apartment building in Hamilton, Ontario...
March 9, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28186950/qualitative-study-of-paramedics-experiences-of-managing-seizures-a-national-perspective-from-england
#10
Adam J Noble, Darlene Snape, Steve Goodacre, Mike Jackson, Frances C Sherratt, Mike Pearson, Anthony Marson
OBJECTIVES: The UK ambulance service is expected to now manage more patients in the community and avoid unnecessary transportations to hospital emergency departments (ED). Most people it attends who have experienced seizures have established epilepsy, have experienced uncomplicated seizures and so do not require the full facilities of an ED. Despite this, most are transported there. To understand why, we explored paramedics' experiences of managing seizures. DESIGN AND SETTING: Semistructured interviews were conducted with a purposive sample of paramedics from the English ambulance service...
November 9, 2016: BMJ Open
https://www.readbyqxmd.com/read/28186015/community-paramedicine-initiative-transforming-paramedicine-in-british-columbia
#11
Colton Calderone, Michelle Brittain, Daniel Sirivar, Nancy Kotani
British Columbia's health care system is facing challenges related to rural access to care and an ever increasing demand for services. These variables are compounded by the anticipated needs of an aging population that can expect to live several of their golden years with a chronic illness. The introduction of community paramedicine in BC allows for a care delivery model that expands the role of qualified paramedics to include the delivery of prevention, health promotion and primary care services in the community...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28139200/-costs-of-healthcare-resource-consumption-after-a-myocardial-infarction-in-france-an-estimate-from-a-medicoadministrative-database-gsb
#12
F Philippe, P Blin, S Bouée, C Laurendeau, E Torreton, J Gourmelin, M Velkovski-Rouyer, L Levy-Bachelot, G Steg
OBJECTIVE: To estimate the costs of healthcare resource consumption in the year preceding and the year following a myocardial infarction (MI). PATIENTS AND METHODS: A historical cohort of patients experiencing an MI in France between 2007 and 2011 was extracted from the échantillon généraliste de bénéficiaires, a 1/97th sample of all beneficiaries of public health insurance in France. RESULTS: A total of 1920 patients experiencing an MI were identified...
January 27, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28135805/the-mental-health-acute-assessment-team-a-collaborative-approach-to-treating-mental-health-patients-in-the-community
#13
Steven C Faddy, Kevin J McLaughlin, Peta T Cox, Senthil S Muthuswamy
OBJECTIVE: Many models of community-based mental health crisis teams have been reported. We present our experience of an outreach team made up of a paramedic and mental health nurse. METHODS: A proof-of-concept was conducted in Western Sydney. The primary outcome was the proportion of patients where the team were able to facilitate the most appropriate care. RESULTS: Nearly 70% of patients were able to be treated outside the Emergency Department, with about two-thirds being transported directly to a mental health facility...
June 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27978969/-the-place-of-obesity-centres-in-the-treatment-of-severe-obesity
#14
Mathias Bernat, Laurent Genser, Jean-Michel Oppert
In 2011, as part of the Obesity Plan, the French health minister designated 37 specialist obesity centres. These centres, spread across France, are dedicated to managing severe obesity and form an important part of the organisation of the treatment of obese patients, from the provision of medical and paramedical care in the community to hospitalisation in cutting-edge units. The programme is based on a specific structure favouring the modelling and management of the individualised care pathway.
December 2016: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/27890027/a-longitudinal-description-of-emergency-medical-services-professionals-by-race-ethnicity
#15
Remle P Crowe, Roger Levine, Jennifer J Eggerichs, Melissa A Bentley
OBJECTIVE: The objective of this paper was to compare demographics, employment variables, satisfaction, and motivation for entering the field of Emergency Medical Services (EMS) between members of under-represented races/ethnicities and members of the majority group. METHODS: A cohort of nationally certified EMS professionals was followed for 10 years through annual surveys; however, race/ethnicity was only available for 9 years (2000-2008). Descriptive statistics and 95% confidence intervals (CIs) were calculated and significance was determined by lack of CI overlap...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27886777/characteristics-of-patients-who-are-not-resuscitated-in-out-of-hospital-cardiac-arrests-and-opportunities-to-improve-community-response-to-cardiac-arrest
#16
S Rajagopal, C R Kaye, R Lall, C D Deakin, S Gates, H Pocock, T Quinn, N Rees, M Smyth, G D Perkins
AIM: This study explores why resuscitation is withheld when emergency medical staff arrive at the scene of a cardiac arrest and identifies modifiable factors associated with this decision. METHODS: This is a secondary analysis of unselected patients who sustained an out of hospital cardiac arrest attended by ambulance vehicles participating in a randomized controlled trial of a mechanical chest compression device (PARAMEDIC trial). Patients were categorized as 'non-resuscitation' patients if there was a do-not-attempt-cardiopulmonary-resuscitation (DNACPR) order, signs unequivocally associated with death or resuscitation was deemed futile (15min had elapsed since collapse with no bystander-CPR and asystole recorded on EMS arrival)...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27844200/-education-within-the-dutch-national-care-for-the-elderly-programme
#17
Barth Oeseburg, Jos Schols, Marcel Olde Rikkert, Henriëtte van der Horst, Dini Smilde-van den Doel, Sophia de Rooij, Bianca Buurman-van Es, Marieke Schuurmans, Jacobijn Gussekloo
The Netherlands Organisation of Health Research and Development started in 2008 the Dutch National Care for the Elderly Programme (in Dutch abbreviated as NPO) with the aim to improve the quality of life for the frail older people through better quality of care (health, social, community) which is tailored to the needs and wants of older people. The delivery of good care is related with competent professional behaviour which is inextricably linked to the education of professionals. This article presents an overview of 32 educational programmes developed within the NPO...
December 2016: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/27818421/emergency-medical-service-based-care-coordination-for-three-rural-communities
#18
Cara L Pennel, Loida Tamayo, Rebecca Wells, Tenaya Sunbury
Providers in rural areas face challenges to increasing health care access, reducing costs, and improving health care quality and outcomes. One promising model is expanding paramedic roles to include non- emergency home visits to patients. Employing a comparative case study, this paper describes three Emergency Medical Services (EMS)- based care coordination programs that provide services to rural, underserved patients, who frequently use EMS/emergency departments. Across the three sites, four major themes emerged: (1) a shift in the paramedic and patient interactions from episodic, crisis- based to longer- term, ongoing relationships; (2) characteristics of rural context that both enabled and constrained paramedic care coordination programs; (3) impacts of care coordination including improvements in preventive care and disease self- management as well as peace of mind; and (4) concerns about programs' sustainability...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27676934/involvement-of-paramedical-clinicians-in-research-a-must-for-improving-clinical-practices
#19
Marc Perron, Sylvie Nadeau, François Dubé
OPINION/FEEDBACK: INTRODUCTION: The use of the results of scientific research by health professionals for the purpose of improving clinical practice is at the heart of the concerns of health system regulators and research funding agencies. It is estimated that only 50% of the measurement tools used in rehabilitation are standardized and less than half of the interventions have documented efficacy. To increase the use of evidence, the Quebec Rehabilitation Research Network (REPAR) partners with professional bodies to provide paramedical clinicians funding opportunities for clinical research projects...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27648186/trends-of-geographic-inequalities-in-the-distribution-of-human-resources-in-healthcare-system-the-case-of-iran
#20
Sara Emamgholipour Sefiddashti, Mohammad Arab, Sadegh Ghazanfari, Zhila Kazemi, Satar Rezaei, Ali Kazemi Karyani
INTRODUCTION: Considering the scarcity of skilled workers in the health sector, the appropriate distribution of human resources in this sector is very important for improving people's health. Having information about the degree of equality in the distribution of health human resources and their time trends is necessary for better planning and efficient use of these resources. The aim of this study was to determine the trend of inequality in the allocation of human resources in the health sector in Tehran between 2007 and 2013...
July 2016: Electronic Physician
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