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https://www.readbyqxmd.com/read/27871770/ptsd-in-those-who-care-for-the-injured
#1
Kevin Luftman, Jayson Aydelotte, Kevin Rix, Sadia Ali, Katherine Houck, Thomas B Coopwood, Pedro Teixeira, Alex Eastman, Brian Eastridge, Carlos V R Brown, Matthew Davis
BACKGROUND: Post Traumatic Stress Disorder (PTSD) has become a focus for the care of trauma victims, but the incidence of PTSD in those who care for injured patients has not been well studied. Our hypothesis was that a significant proportion of health care providers involved with trauma care are at risk of developing PTSD. METHODS: A system-wide survey was applied using a modified version of the Primary Care PTSD Screen [PC-PTSD], a validated PTSD screening tool currently being used by the VA to screen veterans for PTSD...
November 10, 2016: Injury
https://www.readbyqxmd.com/read/27834561/relative-contribution-of-lower-body-work-as-a-biomechanical-determinant-of-spine-sparing-technique-during-common-paramedic-lifting-tasks
#2
Paul J Makhoul, Kathryn E Sinden, Renée S MacPhee, Steven L Fischer
Paramedics represent a unique occupational group where the nature of their work providing pre-hospital emergency care makes workplace modifications to manage and control injury risks, difficult. Therefore, the provision of workplace education and training to support safe lifting remains a viable and important approach. There is, however, a lack of evidence describing movement strategies that may be optimal for paramedic work. The purpose of this study was to determine if a strategy leveraging a greater contribution of work from the lower body relative to the torso was associated with lower biomechanical exposures on the spine...
November 11, 2016: Journal of Applied Biomechanics
https://www.readbyqxmd.com/read/27747839/falls-and-injuries-to-polo-players-risk-perception-mitigation-and-risk-factors
#3
C M Inness, K L Morgan
Polo, one of the world's oldest sports, is played in over 80 countries. It is unique in combining the skills of a person with the agility and performance of an animal in a contact sport. There is only one report of the frequency and type of injuries in this population. Here we report risk perception, mitigation and risk factors for injuries and falls in UK polo players. Data were collected retrospectively from a random sample of 112 UK polo players by telephone questionnaire. Injuries (commonly to a shoulder or wrist) requiring a hospital visit were sustained by 17...
December 2015: Sports Medicine—Open
https://www.readbyqxmd.com/read/27747560/the-epidemiology-of-pre-hospital-potential-spinal-cord-injuries-in-victoria-australia-a-six-year-retrospective-cohort-study
#4
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27738897/methoxyflurane-a-review-in-trauma-pain
#5
Hannah A Blair, James E Frampton
Methoxyflurane (Penthrox(®)) is a halogenated ether first used clinically as a volatile inhalational anaesthetic. It has been used as an analgesic in Australia and New Zealand for the past 30 years. In the UK and Europe, methoxyflurane has been approved for the emergency relief of moderate to severe trauma pain in conscious adult patients. Methoxyflurane is self-administered using a hand-held inhaler. This article reviews the pharmacological properties of methoxyflurane and its clinical efficacy and tolerability in these patients...
December 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27685491/pre-hospital-fast-positive-cases-identified-by-dfb-ambulance-paramedics-final-clinical-diagnosis
#6
A Feeney, T Barry, D Hayden, L Higgins, E Kavanagh, P MacMahon, M O'Reilly, S P Teeling, P J Kelly, S Murphy
Ischaemic stroke clinical outcomes are improved by earlier treatment with intravenous thrombolysis. An existing pathway at the Mater University Hospital for assessment of suspected acute stroke in the Emergency Department was updated, aiming to shorten door-to-needle time. This study examines the final clinical diagnosis of Dublin Fire Brigade Ambulance Paramedic identified Face-Arm-Speech-Test (FAST) positive patients presenting to the Emergency Department over a 7 month period. A retrospective analysis was carried out of 177 consecutive FAST positive patients presenting between March and November 2014...
April 11, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27650864/pre-hospital-assessment-of-the-role-of-adrenaline-measuring-the-effectiveness-of-drug-administration-in-cardiac-arrest-paramedic-2-trial-protocol
#7
Gavin D Perkins, Tom Quinn, Charles D Deakin, Jerry P Nolan, Ranjit Lall, Anne-Marie Slowther, Matthew Cooke, Sarah E Lamb, Stavros Petrou, Felix Achana, Judith Finn, Ian G Jacobs, Andrew Carson, Mike Smyth, Kyee Han, Sonia Byers, Nigel Rees, Richard Whitfield, Fionna Moore, Rachael Fothergill, Nigel Stallard, John Long, Susie Hennings, Jessica Horton, Charlotte Kaye, Simon Gates
Despite its use since the 1960s, the safety or effectiveness of adrenaline as a treatment for cardiac arrest has never been comprehensively evaluated in a clinical trial. Although most studies have found that adrenaline increases the chance of return of spontaneous circulation for short periods, many studies found harmful effects on the brain and raise concern that adrenaline may reduce overall survival and/or good neurological outcome. The PARAMEDIC-2 trial seeks to determine if adrenaline is safe and effective in out-of-hospital cardiac arrest...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/27638418/introduction-of-paramedic-led-echo-in-life-support-into-the-pre-hospital-environment-the-puca-study
#8
Matthew J Reed, Louise Gibson, Alistair Dewar, Steven Short, Polly Black, Gareth R Clegg
OBJECTIVES: Can pre-hospital paramedic responders perform satisfactory pre-hospital Echo in Life Support (ELS) during the 10-second pulse check window, and does pre-hospital ELS adversely affect the delivery of cardiac arrest care. METHODS: Prospective observational study of a cohort of ELS trained paramedics using saved ultrasound clips and wearable camera videos. RESULTS: Between 23rd June 2014 and 31st January 2016, seven Resuscitation Rapid Response Unit (3RU) paramedics attended 45 patients in Lothian suffering out-of-hospital CA where resuscitation was attempted and ELS was available and performed...
September 13, 2016: Resuscitation
https://www.readbyqxmd.com/read/27625737/the-medical-duty-officer-an-attempt-to-mitigate-the-ambulance-at-hospital-interval
#9
Megan H Halliday, Andrew J Bouland, Benjamin J Lawner, Angela C Comer, Daniel C Ramos, Mark Fletcher
INTRODUCTION: A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27586065/does-the-presence-of-an-emergency-physician-influence-pre-hospital-time-pre-hospital-interventions-and-the-mortality-of-severely-injured-patients-a-matched-pair-analysis-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu-%C3%A2
#10
Dan Bieler, Axel Franke, Rolf Lefering, Sebastian Hentsch, Arnulf Willms, Martin Kulla, Erwin Kollig
PURPOSE: The role of emergency physicians in the pre-hospital management of severely injured patients remains controversial. In Germany and Austria, an emergency physician is present at the scene of an emergency situation or is called to such a scene in order to provide pre-hospital care to severely injured patients in approximately 95% of all cases. By contrast, in the United States and the United Kingdom, paramedics, i.e. non-physician teams, usually provide care to an injured person both at the scene of an incident and en route to an appropriate hospital...
August 28, 2016: Injury
https://www.readbyqxmd.com/read/27562972/induction-of-therapeutic-hypothermia-during-out-of-hospital-cardiac-arrest-using-a-rapid-infusion-of-cold-saline-the-rinse-trial-rapid-infusion-of-cold-normal-saline
#11
Stephen A Bernard, Karen Smith, Judith Finn, Cindy Hein, Hugh Grantham, Janet E Bray, Conor Deasy, Michael Stephenson, Teresa A Williams, Lahn D Straney, Deon Brink, Richard Larsen, Chris Cotton, Peter Cameron
BACKGROUND: Patients successfully resuscitated by paramedics from out-of-hospital cardiac arrest often have severe neurologic injury. Laboratory and observational clinical reports have suggested that induction of therapeutic hypothermia during cardiopulmonary resuscitation (CPR) may improve neurologic outcomes. One technique for induction of mild therapeutic hypothermia during CPR is a rapid infusion of large-volume cold crystalloid fluid. METHODS: In this multicenter, randomized, controlled trial we assigned adults with out-of-hospital cardiac arrest undergoing CPR to either a rapid intravenous infusion of up to 2 L of cold saline or standard care...
September 13, 2016: Circulation
https://www.readbyqxmd.com/read/27547282/geospatial-and-clinical-analyses-on-pediatric-related-road-traffic-injury-in-malaysia
#12
Nik Hisamuddin Rahman, Ruslan Rainis, Syed Hatim Noor, Sharifah Mastura Syed Mohamad
BACKGROUND: The main aim of this study is to utilize the geographical information system (GIS) software and perform the spatial analysis in relation to clinical data for road traffic injury (RTI) pediatric cases attending the emergency department. METHODS: The study sample included pediatric patients (age less than 18 years) with road-related injuries within a district in Malaysia who attended emergency departments of two tertiary hospitals within the district. In addition to injury, pre-hospital care and outcome data, the coordinate of the locations were obtained by the ambulance paramedics by using portable handheld GPS unit brand Garmin(®) model GPS 72 H...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27508353/prehospital-application-of-the-canadian-triage-and-acuity-scale-by-emergency-medical-services
#13
Murdoch Leeies, Cheryl Ffrench, Trevor Strome, Erin Weldon, Michael Bullard, Rob Grierson
OBJECTIVES: Triage is fundamental to emergency patient assessment. Effective triage systems accurately prioritize patients and help predict resource utilization. CTAS is a validated five-level triage score utilized in Emergency Departments (EDs) across Canada and internationally. Historically CTAS has been applied by triage nurses in EDs. Observational evidence suggests that the CTAS might be implemented reliably by paramedics in the prehospital setting. This is the first system-wide assessment of CTAS interrater reliability between paramedics and triage nurses during clinical practice...
August 10, 2016: CJEM
https://www.readbyqxmd.com/read/27465767/pre-hospital-thrombolysis-in-st-segment-elevation-myocardial-infarction-a-regional-australian-experience
#14
Arshad A Khan, Trent Williams, Lindsay Savage, Paul Stewart, Asma Ashraf, Allan J Davies, Steven Faddy, John Attia, Christopher Oldmeadow, Rohan Bhagwandeen, Peter J Fletcher, Andrew J Boyle
OBJECTIVE: The system of care in the Hunter New England Local Health District for patients with ST-segment elevation myocardial infarction (STEMI) foresees pre-hospital thrombolysis (PHT) administered by paramedics to patients more than 60 minutes from the cardiac catheterisation laboratory (CCL), and primary percutaneous coronary intervention (PCI) at the CCL for others. We assessed the safety and effectiveness of the pre-hospital diagnosis strategy, which allocates patients to PHT or primary PCI according to travel time to the CCL...
August 1, 2016: Medical Journal of Australia
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
#15
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/27377669/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-the-pre-hospital-setting-an-additional-resuscitation-option-for-uncontrolled-catastrophic-haemorrhage
#16
Samy Sadek, David J Lockey, Robbie A Lendrum, Zane Perkins, Jonathan Price, Gareth Edward Davies
This report describes the first use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the pre-hospital setting to control catastrophic haemorrhage. The patient, who had fallen 15 meters, suffered catastrophic internal haemorrhage associated with a pelvic fracture. He was treated by London's Air Ambulance's Physician-Paramedic team. This included insertion of a REBOA balloon catheter at the scene to control likely fatal exsanguination. The patient survived transfer to hospital, emergency angio-embolization and subsequent surgery...
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27313806/pre-hospital-assessment-with-ultrasound-in-emergencies-implementation-in-the-field
#17
Kevin P Rooney, Sari Lahham, Shadi Lahham, Craig L Anderson, Bryan Bledsoe, Bryan Sloane, Linda Joseph, Megan B Osborn, John C Fox
BACKGROUND: Point-of-care ultrasound (US) is a proven diagnostic imaging tool in the emergency department (ED). Modern US devices are now more compact, affordable and portable, which has led to increased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outcome of this pilot study was to determine if paramedics could perform cardiac ultrasound in the field and obtain images that were adequate for interpretation...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27184824/utilisation-of-emergency-medical-services-for-severe-hypoglycaemia-an-unrecognised-health-care-burden
#18
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
https://www.readbyqxmd.com/read/27154472/does-the-norwegian-emergency-medical-dispatch-classification-as-non-urgent-predict-no-need-for-pre-hospital-medical-treatment-an-observational-study
#19
Eystein Grusd, Jo Kramer-Johansen
BACKGROUND: The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current dispatch triage tools could reliably identify patients who only required transport, and not pre-hospital medical care. This could allow selection of such patients for designated transport units, freeing up highly trained ambulance staff to attend patients in greater need...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27138486/student-midwives-and-paramedic-students-experiences-of-shared-learning-in-pre-hospital-childbirth
#20
Christina Feltham, Julie Foster, Tom Davidson, Stewart Ralph
AIM: To explore the experiences of midwifery and paramedic students undertaking interprofessional learning. METHOD: A one day interprofessional learning workshop incorporating peer assisted learning for undergraduate pre-registration midwifery and paramedic students was developed based on collaborative practice theory and simulation based learning. Twenty-five student midwives and thirty-one paramedic students participated in one of two identical workshops conducted over separate days...
June 2016: Nurse Education Today
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