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community paramedic

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
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
Hideo Tohira, Daniel Fatovich, Teresa A Williams, Alexandra Bremner, Glenn Arendts, Ian R Rogers, Antonio Celenza, David Mountain, Peter Cameron, Peter Sprivulis, Tony Ahern, Judith Finn
OBJECTIVE: To examine the ability of paramedics to identify patients who could be managed in the community and to identify predictors that could be used to accurately identify patients who should be transported to EDs. METHODS: Lower acuity patients who were assessed by paramedics in the Perth metropolitan area in 2013 were studied. Paramedics prospectively indicated on the patient care record if they considered that the patient could be treated in the community...
September 4, 2016: Emergency Medicine Australasia: EMA
Karen A Abrashkin, Jonathan Washko, Jenny Zhang, Asantewaa Poku, Hyun Kim, Kristofer L Smith
Models addressing urgent clinical needs for older adults with multiple advanced chronic conditions are lacking. This observational study describes a Community Paramedicine (CP) model for treatment of acute medical conditions within an Advanced Illness Management (AIM) program, and compares its effect on emergency department (ED) use and subsequent hospitalization with that of traditional emergency medical services (EMS). Community paramedics were trained to evaluate and, with telemedicine-enhanced physician guidance, treat acute illnesses in individuals' homes...
August 30, 2016: Journal of the American Geriatrics Society
Madison Brydges, Margaret Denton, Gina Agarwal
BACKGROUND: Expanded roles for paramedics, commonly termed community paramedicine, are becoming increasingly common. Paramedics working in community paramedicine roles represent a distinct departure away from the traditional emergency paradigm of paramedic services. Despite this, little research has addressed how community paramedics are perceived by their clients. METHODS: This study took an interpretivist qualitative approach to examine participants' perceptions of paramedics providing a community paramedicine program, named the Community Health Assessment Program through Emergency Medical Services (CHAP-EMS)...
2016: BMC Health Services Research
Jason J Bischof, Ashish R Panchal, Geoffrey I Finnegan, Thomas E Terndrup
UNLABELLED: Introduction Endotracheal intubation (ETI) is a complex clinical skill complicated by the inherent challenge of providing care in the prehospital setting. Literature reports a low success rate of prehospital ETI attempts, partly due to the care environment and partly to the lack of consistent standardized training opportunities of prehospital providers in ETI. Hypothesis/Problem The availability of a mobile simulation laboratory (MSL) to study clinically critical interventions is needed in the prehospital setting to enhance instruction and maintain proficiency...
October 2016: Prehospital and Disaster Medicine
Thomas R Scaggs, David M Glass, Megan Gleason Hutchcraft, William B Weir
Excited delirium syndrome (ExDS) is defined by marked agitation and confusion with sympathomimetic surge and incessant physical struggle, despite futility, which may lead to profound pathophysiologic changes and sudden death. Severe metabolic derangements, including lactic acidosis, rhabdomyolysis, and hyperthermia, occur. The pathophysiology of excited delirium is a subject of ongoing basic science and clinical research. Positive associations with ExDS include male gender, mental health disorders, and substance abuse (especially sympathomimetics)...
October 2016: Prehospital and Disaster Medicine
Harry P Selker, William S Harris, Charles E Rackley, Julian B Marsh, Robin Ruthazer, Joni R Beshansky, Eric J Rashba, Inga Peter, Lionel H Opie
AIMS: In the IMMEDIATE Trial, intravenous glucose-insulin-potassium (GIK) was started as early as possible for patients with suspected acute coronary syndrome by ambulance paramedics in communities. In the IMMEDIATE Biological Mechanism Cohort substudy, reported here, we investigated potential modes of GIK action on specific circulating metabolic components. Specific attention was given to suppression of circulating oxygen-wasting free fatty acids (FFAs) that had been posed as part of the early GIK action related to averting cardiac arrest...
August 2016: American Heart Journal
Matthew Perry, Drew Carter
Ramping is the practice of requiring paramedics to continue to care for patients rather than hand over clinical responsibility to the ED. It arose as an alternative to admitting patients to EDs that are deemed to be already operating at or beyond capacity. This paper analyses the ethics of ramping. Ramping has been embraced by some ED practitioners and policymakers as a solution to the problem of ED patients suffering increased risks of harm as a result of waiting times within ED. However, this perspective fails to adequately consider the implications, especially the opportunity cost of requiring paramedics to remain at the hospital rather than make themselves available for other patients...
July 12, 2016: Emergency Medicine Australasia: EMA
Rashmi Sharma, Shailesh Prajapati, Brijesh Patel, Pradeep Kumar
BACKGROUND: Enhanced syndromic case management (ESCM) deals with reproductive tract and sexually transmitted infections. Capacity building of service providers not only boosts the program but also inputs from them improve the quality of services. OBJECTIVES: To (1) identify problem areas from providers' perspectives and the gaps in knowledge and application and (2) assess the gains (if any) through pre and post-training evaluation. MATERIALS AND METHODS: A total of 121 participants (medical/para medical) from various medical colleges, district/sub-district hospitals/ community health centers, and urban dispensaries across Gujarat were trained at a teaching institute...
July 2016: Indian Journal of Community Medicine
S Koganti, N Patel, A Seraphim, T Kotecha, M Whitbread, R D Rakhit
OBJECTIVE: To assess whether a novel 'direct access pathway' (DAP) for the management of high-risk non-ST-elevation acute coronary syndromes (NSTEACS) is safe, results in 'shorter time to intervention and shorter admission times'. This pathway was developed locally to enable London Ambulance Service to rapidly transfer suspected high-risk NSTEACS from the community to our regional heart attack centre for consideration of early angiography. METHODS: This is a retrospective case-control analysis of 289 patients comparing patients with high-risk NSTEACS admitted via DAP with age-matched controls from the standard pan-London high-risk ACS pathway (PLP) and the conventional pathway (CP)...
2016: BMJ Open
Adam Chesters, Philip H Grieve, Timothy J Hodgetts
BACKGROUND: The use of helicopter emergency medical services (HEMS) has increased significantly in the UK since 1987. To date there has been no research that addresses HEMS pilots and medical crews' own ideas on the risks that they view as inherent in their line of work and how to mitigate these risks. The aim of this survey is to describe and compare the attitudes and perceptions towards risk in HEMS operations of these staff. METHODS: A questionnaire was administered electronically to a representative selection of HEMS doctors, paramedics and pilots in the UK...
June 20, 2016: Emergency Medicine Journal: EMJ
Neil B Davids
Over the past 14 years of conflict, the Department of Defense medical community has made significant strides in patient care. As the conflicts developed, many sources identified a critical gap in en route care, specifically the need for critical care trained personnel for point of injury and intrahospital transfers, as well as improved outcomes for patients who received care from critical care trained providers. As stopgap measures were implemented, the US Army instituted the Critical Care Flight Paramedic Program in order to meet this need of life saving critical care transport...
April 2016: U.S. Army Medical Department Journal
Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Chin Yao Tan, Karen Smith, Amee Morgans, Georgia Soldatos, Helena Teede, Sophia Zoungas
AIMS: Diabetes is associated with several acute, life-threatening complications yet there are limited data on the utilisation of prehospital services for their management. This study aimed to examine the utilisation of emergency medical services (EMS) for prehospital hypoglycaemia, including patient characteristics and factors related to hospital transportation. METHODS: An observational study of patients requiring EMS for hypoglycaemia across Victoria, Australia over three years was conducted...
August 2016: Journal of Diabetes and its Complications
Yoshikazu Takinami
BACKGROUND: As of April 2013, 164 paramedics are certified to perform tracheal intubation in Fukui Prefecture. This study investigated the current situation surrounding tracheal intubation performed by paramedics in prehospital care. METHODS: Subjects were 58 paramedics who completed practical training at our hospital. Post-training duration, number of tracheal intubation cases, number of attempts before successful tracheal intubation, disease involved, rate of return of spontaneous circulation, and prognosis were examined...
March 2016: Masui. the Japanese Journal of Anesthesiology
Sylvain Bussières, Alain Tanguay, Denise Hébert, Richard Fleet
Access to health care in Canada's rural areas is a challenge. The Unité de Coordination Clinique des Services Préhospitaliers d'Urgence (UCCSPU) is a telemedicine program designed to improve health care in the Chaudiere-Appalaches and Quebec City regions of Canada. Remote medical services are provided by nurses and by an emergency physician based in a clinical unit at the Alphonse-Desjardins Community Health and Social Services Center. The interventions were developed to meet two objectives. The first is to enhance access to quality health care...
April 11, 2016: Journal of Telemedicine and Telecare
Brett Williams, Chloe Abel, Eihab Khasawneh, Linda Ross, Tracy Levett-Jones
BACKGROUND: Simulation-based education is an important part of paramedic education and training. While accessing clinical placements that are adequate in quality and quantity continues to be challenging, simulation is being recognized by paramedic academics as a potential alternative. Examining students' satisfaction of simulation, particularly cross-culturally is therefore important in providing feedback to academic teaching staff and the international paramedic community. OBJECTIVE: This study aimed to compare simulation satisfaction among paramedic students from universities in Australia and Jordan...
2016: Advances in Medical Education and Practice
Baely M Crockett, Karalea D Jasiak, Todd A Walroth, Kerri E Degenkolb, Andrew C Stevens, Carolyn M Jung
BACKGROUND: Hospital readmissions have recently gained scrutiny by health systems as a result of their high costs of care and potential for financial penalty in hospital reimbursement. Mobile-integrated health and community paramedicine (MIH-CP) programs have expanded to serve patients at high risk of hospital readmission. Pharmacists have also improved clinical outcomes for patients during in-home visits. However, pharmacists working with a MIH-CP program have not been previously described...
March 21, 2016: Journal of Pharmacy Practice
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