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ems, paramedic

Martin Hulldin, Jonas Kängström, Magnus Andersson Hagiwara, Andreas Claesson
BACKGROUND: Emergency medical services (EMS) facilitate out of hospital care in a wide variety of settings on a daily basis. Stretcher-related adverse events and long term musculoskeletal injuries are commonly reported. Novel stretcher mechanisms may facilitate enhanced movement of patients and reduce workload for EMS personnel. AIM: To describe EMS personnel's perceived exertion using two different stretcher systems. METHODS: The methodology of this explorative simulation study included enrolling twenty (n=20) registered nurses and paramedics who worked in ten pairs (n=10) to transport a conscious, 165lb...
February 27, 2018: American Journal of Emergency Medicine
Jeremiah M Kinsman, Kathy Robinson
OBJECTIVE: Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR)...
February 27, 2018: Prehospital Emergency Care
Hunter Singh Lau, Matthew M Hollander, Jeremy T Cushman, Eva H DuGoff, Courtney M C Jones, Amy J H Kind, Michael T Lohmeier, Eric A Coleman, Manish N Shah
OBJECTIVE: The Care Transitions Intervention (CTI) has potential to improve the emergency department (ED)-to-home transition for older adults. Community paramedics may function as the CTI coaches; however, this requires the appropriate knowledge, skills, and attitudes, which they do not receive in traditional emergency medical services (EMS) education. This study aimed to define community paramedics' perceptions regarding their training needs to serve as CTI coaches supporting the ED-to-home transition...
February 12, 2018: Prehospital Emergency Care
Feras Abuzeyad, Leena Alqasem, Mudhaffar I Al Farras, Shaikha S Al Jawder, Ghada Al Qasim, Salah Alghanem
It has been more than a decade since emergency medicine became recognized as a specialty in the Kingdom of Bahrain. In the last fifteen years emergency medicine has widely established itself and developed rapidly in the Kingdom. The three main emergency departments are: Salmanyia Medical Complex (SMC), Royal Medical Services of Bahrain Defence Force (RMS-BDF) and King Hamad University Hospital (KHUH) are now fully equipped and operated by a majority of board certified emergency physicians.Standardized protocols, and the Central National Ambulance will be established in the near future, and the ambulances will offer both basic and advanced life support by trained nurses and paramedics...
February 8, 2018: International Journal of Emergency Medicine
Daniel Joseph, Jody A Vogel, C Sam Smith, Whitney Barrett, Gary Bryskiewicz, Aaron Eberhardt, David Edwards, Lara Rappaport, Christopher B Colwell, Kevin E McVaney
BACKGROUND: Excessive alcohol consumption is associated with a substantial number of emergency department visits annually and is responsible for a significant number of lives lost each year in the United States. However, a minimal amount is known about the impact of alcohol on the EMS system. OBJECTIVES: The primary objective was to determine the proportion of 9-1-1 calls in Denver, Colorado in which (1) alcohol was a contributing factor or (2) the individual receiving EMS services had recently ingested alcohol...
February 8, 2018: Prehospital Emergency Care
Renee Roggenkamp, Emily Andrew, Ziad Nehme, Shelley Cox, Karen Smith
OBJECTIVE: In many developed countries, a lack of community-based mental health services is driving increased utilization of emergency medical services (EMS). In this descriptive study, we sought to describe the demographic and clinical characteristics of mental health-related EMS presentations in Victoria, Australia. METHODS: A retrospective observational study of EMS presentations occurring between January and December 2015. Computer Aided Dispatch and electronic patient care record data were extracted from an electronic data warehouse...
January 24, 2018: Prehospital Emergency Care
Megan C Marino, Daniel G Ostermayer, Juan A Mondragon, Elizabeth A Camp, Elizabeth M Keating, Louis B Fornage, Charles A Brown, Manish I Shah
BACKGROUND: Seizures and anaphylaxis are life-threatening conditions that require immediate treatment in the prehospital setting. There is variation in treatment of pediatric prehospital patients for both anaphylaxis and seizures. This educational study was done to improve compliance with pediatric prehospital protocols, educate prehospital providers and decrease variation in care. OBJECTIVE: To improve the quality of care for children with seizures and anaphylaxis in the prehospital setting using a bundled, multifaceted educational intervention...
January 24, 2018: Prehospital Emergency Care
Anriada Nassif, Daniel G Ostermayer, Kim B Hoang, Mary K Claiborne, Elizabeth A Camp, Manish I Shah
BACKGROUND: Respiratory distress due to asthma is a common reason for pediatric emergency medical services (EMS) transports. Timely initiation of asthma treatment, including glucocorticoids, improves hospital outcomes. The impact of EMS-administered glucocorticoids on hospital-based outcomes for pediatric asthma patients is unknown. OBJECTIVE: The objective of this study was to evaluate the effect of an evidence-based pediatric EMS asthma protocol update, inclusive of oral glucocorticoid administration, on time to hospital discharge...
January 19, 2018: Prehospital Emergency Care
Ryan Newberry, Ted Redman, Elliot Ross, Rachel Ely, Clayton Saidler, Allyson Arana, David Wampler, David Miramontes
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a major cause of death and morbidity in the United States. Quality cardiopulmonary resuscitation (CPR) has proven to be a key factor in improving survival. The aim of our study was to investigate the outcomes of OHCA when mechanical CPR (LUCAS 2 Chest Compression System™) was utilized compared to conventional CPR. Although controlled trials have not demonstrated a survival benefit to the routine use of mechanical CPR devices, there continues to be an interest for their use in OHCA...
January 18, 2018: Prehospital Emergency Care
Peter Brinkrolf, Roman Lukas, Ulf Harding, Sebastian Thies, Joachim Gerss, Hugo Van Aken, Hans Lemke, Udo Schniedermeier, Andreas Bohn
Objective: High-quality chest compressions during cardiopulmonary resuscitation (CPR) play a significant role in surviving cardiac arrest. Chest-compression quality can be measured and corrected by real-time CPR feedback devices, which are not yet commonly used. This article looks at the acceptance of such systems in comparison of equipped and unequipped personnel. Design: Two groups of emergency medical services' (EMS) personnel were interviewed using standardized questionnaires...
January 11, 2018: International Journal for Quality in Health Care
Leslie M Cristiano, Brian Hiestand, Jason W Caldwell, W Adam Gower, Antonio R Fernandez, Katherine Gilbert, James E Winslow
OBJECTIVE: Timely administration of epinephrine is critical in the treatment of anaphylaxis. This study sought to determine the frequency of administration of epinephrine by EMS providers caring for pediatric patients in the prehospital setting. METHODS: We examined data from the NC EMS database (PreMIS) from 2010-3 to determine frequency of epinephrine administration in pediatric patients with anaphylaxis. We studied patients <18 years of age with an EMS provider impression of "allergic reaction...
January 16, 2018: Prehospital Emergency Care
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
Robert G Walker, Lynn J White, Geneva N Whitmore, Alexander Esibov, Michael K Levy, Gregory C Cover, Joel D Edminster, James M Nania
OBJECTIVE: Physiologic alterations during rapid sequence intubation (RSI) have been studied in several emergency airway management settings, but few data exist to describe physiologic alterations during prehospital RSI performed by ground-based paramedics. To address this evidence gap and provide guidance for future quality improvement initiatives in our EMS system, we collected electronic monitoring data to evaluate peri-intubation vital signs changes occurring during prehospital RSI...
January 3, 2018: Prehospital Emergency Care
Gudrun Reay, Jill M Norris, K Alix Hayden, Joanna Abraham, Katherine Yokom, Lorelli Nowell, Gerald C Lazarenko, Eddy S Lang
BACKGROUND: Effective and efficient transitions in care between emergency medical services (EMS) practitioners and emergency department (ED) nurses is vital as poor clinical transitions in care may place patients at increased risk for adverse events such as delay in treatment for time sensitive conditions (e.g., myocardial infarction) or worsening of status (e.g., sepsis). Such transitions in care are complex and prone to communication errors primarily caused by misunderstanding related to divergent professional perspectives leading to misunderstandings that are further susceptible to contextual factors and divergent professional lenses...
December 19, 2017: Systematic Reviews
Mathew Mercuri, Katherine Connolly, Madhu K Natarajan, Michelle Welsford, J D Schwalm
RATIONALE, AIMS, AND OBJECTIVES: Access to timely ST-elevation myocardial infarction (STEMI) care is facilitated by paramedics and emergency medical services (EMS). However, a large proportion of STEMI patients do not access care through EMS. This study sought to identify patient-reported factors for their decision to use (or not use) EMS. METHODS: Semi-structured interviews were conducted with a sample of STEMI patients admitted to a large tertiary care centre between November 2011 and January 2012...
December 13, 2017: Journal of Evaluation in Clinical Practice
Cassandra Barnette Donnelly, Karen Andrea Armstrong, Molly M Perkins, Danielle Moulia, Tammie E Quest, Arthur H Yancey
BACKGROUND: Growing numbers of emergency medical services (EMS) providers respond to patients who receive hospice care. The objective of this investigation was to assess the knowledge, attitudes, and experiences of EMS providers in the care of patients enrolled in hospice care. METHODS: We conducted a survey study of EMS providers regarding hospice care. We collected quantitative and qualitative data on EMS provider's knowledge, attitudes, and experiences in responding to the care needs of patients in hospice care...
March 2018: Prehospital Emergency Care
Maximilian Scharonow, Timo Alberding, Wolfgang Oltmanns, Christian Weilbach
Background: In patients with serious illness or trauma, reduction of severe pain is a key therapeutic goal of emergency medical service (EMS) teams. In Germany, only physicians are allowed to use opioid analgesics. In the rural EMS area studied, the mean arrival time for paramedics is 8 minutes, 23 seconds, and for the rescue physician between 10 minutes, 30 seconds and 16 minutes, 59 seconds, depending on EMS site. In cases of parallel callouts, rescue-physician arrival times may be considerably longer...
2017: Journal of Pain Research
Eric Kuncir, Dean Spencer, Kelly Feldman, Cristobal Barrios, Kenneth Miller, Stephanie Lush, Matthew Dolich, Michael Lekawa
BACKGROUND: Interfacility transfer of under-triaged patients to higher level trauma centers has been found to result in a delay of appropriate care and increase in mortality. To address this, for the last 10 years, our region has utilized 911 EMS paramedics for rapid re-triage of under-triaged patients to our institution's Level I trauma center. We sought to determine if utilizing 911 EMS for re-triage (911-RT) to our institution was associated with worse outcomes-with mortality as the primary outcome-compared to direct EMS transport from point of injury...
September 27, 2017: Journal of the American College of Surgeons
Adeline Dozois, Lorrie Hampton, Carlene W Kingston, Gwen Lambert, Thomas J Porcelli, Denise Sorenson, Megan Templin, Shellie VonCannon, Andrew W Asimos
BACKGROUND AND PURPOSE: The recently proposed American Heart Association/American Stroke Association EMS triage algorithm endorses routing patients with suspected large vessel occlusion (LVO) acute ischemic strokes directly to endovascular centers based on a stroke severity score. The predictive value of this algorithm for identifying LVO is dependent on the overall prevalence of LVO acute ischemic stroke in the EMS population screened for stroke, which has not been reported. METHODS: We performed a cross-sectional study of patients transported by our county's EMS agency who were dispatched as a possible stroke or had a primary impression of stroke by paramedics...
December 2017: Stroke; a Journal of Cerebral Circulation
David H Wang
Currently, 1 out of 6 Americans lives within a jurisdiction in which physician-assisted dying is legally authorized. In most cases, patients ingest lethal physician-assisted dying medications at home without involvement of emergency medical services (EMS) or the emergency department (ED). However, occasionally the dying process is interrupted as a result of incomplete ingestion or vomiting of medications, confusion about timing of dying trajectory, familial emotional distress, and other variables. A case is presented here of a patient who arrived by ambulance to an urban ED after ingesting physician-assisted dying medication...
October 12, 2017: Annals of Emergency Medicine
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