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https://www.readbyqxmd.com/read/28186950/qualitative-study-of-paramedics-experiences-of-managing-seizures-a-national-perspective-from-england
#1
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
#2
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
#3
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
#4
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...
January 1, 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27592495/which-patients-should-be-transported-to-the-emergency-department-a-perpetual-prehospital-dilemma
#12
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...
December 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27575363/providing-acute-care-at-home-community-paramedics-enhance-an-advanced-illness-management-program-preliminary-data
#13
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...
December 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27557895/the-chap-ems-health-promotion-program-a-qualitative-study-on-participants-views-of-the-role-of-paramedics
#14
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
https://www.readbyqxmd.com/read/27530816/creation-and-validation-of-a-novel-mobile-simulation-laboratory-for-high-fidelity-prehospital-difficult-airway-simulation
#15
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
https://www.readbyqxmd.com/read/27517801/prehospital-ketamine-is-a-safe-and-effective-treatment-for-excited-delirium-in-a-community-hospital-based-ems-system
#16
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
https://www.readbyqxmd.com/read/27502865/very-early-administration-of-glucose-insulin-potassium-by-emergency-medical-service-for-acute-coronary-syndromes-biological-mechanisms-for-benefit-in-the-immediate-trial
#17
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
https://www.readbyqxmd.com/read/27400802/the-ethics-of-ambulance-ramping
#18
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...
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27385870/evaluation-of-skill-oriented-training-on-enhanced-syndromic-case-management-escm-of-reproductive-tract-infections-sexually-transmitted-infections-rti-stis-of-care-providers-from-three-tier-health-care-system-of-gujarat
#19
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
https://www.readbyqxmd.com/read/27337832/with-some-extra-preparation-cps-are-ideally-suited-to-help-this-vulnerable-population-the-community-paramedic-s-role-in-treating-mental-and-behavioral-health-patients-with-some-extra-preparation-cps-are-ideally-suited-to-help-this-vulnerable-population
#20
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