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https://www.readbyqxmd.com/read/28484212/quality-of-analgesia-in-physician-operated-telemedical-prehospital-emergency-care-is-comparable-to-physician-based-prehospital-care-a-retrospective-longitudinal-study
#1
Niklas Lenssen, Andreas Krockauer, Stefan K Beckers, Rolf Rossaint, Frederik Hirsch, Jörg C Brokmann, Sebastian Bergrath
Acute pain is a common reason for summoning emergency medical services (EMS). Yet in several countries the law restricts opioid-based analgesia administration to physicians. Telemedical support of paramedics is a novel approach to enable timely treatment under the guidance of a physician. In this retrospective observational study, conducted in the EMS of Aachen, Germany, the analgesic quality and occurrence of adverse events were compared between telemedically-supported paramedics (July-December, 2014) and a historical control group (conventional on-scene EMS physicians; January-March, 2014)...
May 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28481722/ems-provider-perceptions-on-termination-of-resuscitation-in-a-large-urban-ems-system
#2
Katie L Tataris, Christopher T Richards, Leslee Stein-Spencer, Stephanie Ryan, Pete Lazzara, Joseph M Weber
OBJECTIVE: Despite the value of out-of-hospital Termination of Resuscitation (TOR) and the scientific evidence in favor of this practice, TOR has not been uniformly adopted or consistently practiced in EMS systems. Previous focus group studies have identified multiple barriers to implementation of out of hospital TOR but existing literature on EMS provider perceptions is limited. We sought to identify EMS providers' perceived barriers to performing out-of-hospital TOR in a large urban EMS system...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28476475/lower-chest-compression-fraction-associated-with-rosc-in-ohca-patients-with-longer-downtimes
#3
Milena Talikowska, Hideo Tohira, Madoka Inoue, Paul Bailey, Deon Brink, Judith Finn
AIM: To investigate the relationship between chest compression fraction (CCF) and survival outcomes in OHCA, including whether the relationship varied based upon downtime from onset of arrest to provision of cardiopulmonary resuscitation (CPR) by emergency medical services (EMS). METHODS: Data from resuscitations performed by St John Ambulance Western Australia (SJA-WA) paramedics between July 2014 and June 2016 was captured using the Q-CPR feedback device. Logistic regression analysis was used to study the relationship between CCF and return of spontaneous circulation (ROSC)...
May 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28460858/analysis-of-out-of-hospital-pediatric-intubation-by%C3%A2-an-australian-helicopter-emergency-medical%C3%A2-service
#4
Brian J Burns, Joanna B Watterson, Sandra Ware, Luke Regan, Cliff Reid
STUDY OBJECTIVE: We examine first-look success in emergency pediatric intubation by a physician-staffed helicopter emergency medical service (EMS). METHODS: A database analysis of all pediatric (<16 years) intubations during a 64-month period was undertaken, using data from a prospectively enrolled electronic airway registry form. Recorded findings included patient demographics, operator background, airway intervention including intubation attempts, complications, and critical timings...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28366241/teammate-familiarity-teamwork-and-risk-of-workplace-injury-in-emergency-medical-services-teams
#5
Ashley M Hughes, P Daniel Patterson, Matthew D Weaver, Megan E Gregory, Shirley C Sonesh, Douglas P Landsittel, David Krackhardt, David Hostler, Elizabeth H Lazzara, Xiao Wang, John E Vena, Eduardo Salas, Donald M Yealy
Increased teammate familiarity in emergency medical services (EMS) promotes development of positive teamwork and protects against workplace injury. METHODS: Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent partnerships and tested the hypothesized role of teamwork as a mediator in the relationship between teammate familiarity and injury with the PROCESS macro...
March 30, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28356134/external-validation-of-the-rosc-after-cardiac-arrest-raca-score-in-a-physician-staffed-emergency-medical-service-system
#6
Petteri Kupari, Markus Skrifvars, Markku Kuisma
BACKGROUND: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. METHODS: We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated...
March 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28336412/a-pilot-prospective-randomized-trial-of-video-versus-direct-laryngoscopy-for-paramedic-endotracheal-intubation
#7
Scott Ducharme, Brandon Kramer, David Gelbart, Caroline Colleran, Brian Risavi, Jestin N Carlson
BACKGROUND: Prehospital intubation poses several unique challenges. Video assisted laryngoscopy has been shown to help increase intubation success in the hospital setting; however, little prospective data have examined video assisted laryngoscopy in traditional ground ambulance agencies. METHODS: We performed a randomized, cross-over, non-blinded trial in ground ambulances comparing first attempt success and overall intubation success between video assisted laryngoscopy using the King Video Laryngoscope (KVL) and direct laryngoscopy (DL)...
March 20, 2017: Resuscitation
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
#8
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/28257249/pediatric-prehospital-medication-dosing-errors-a-national-survey-of-paramedics
#9
John D Hoyle, Remle P Crowe, Melissa A Bentley, Gerald Beltran, William Fales
BACKGROUND: Pediatric drug dosing errors occur at a high rate in the prehospital environment. OBJECTIVE: To describe paramedic training and practice regarding pediatric drug administration, exposure to pediatric drug dose errors and safety culture among paramedics and EMS agencies in a national sample. METHODS: An electronic questionnaire was sent to a random sample of 10,530 nationally certified paramedics. Descriptive statistics were calculated...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28235388/factors-influencing-the-suicide-intervention-skills-of-emergency-medical-services-providers
#10
Aidana Lygnugaryte-Griksiene, Darius Leskauskas, Nedas Jasinskas, Agne Masiukiene
BACKGROUND: Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. AIMS: To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). METHOD: Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28161214/consciousness-induced-during-cardiopulmonary-resuscitation-an-observational-study
#11
Alexander Olaussen, Ziad Nehme, Matthew Shepherd, Paul A Jennings, Stephen Bernard, Biswadev Mitra, Karen Smith
BACKGROUND: Cardiopulmonary resuscitation-induced consciousness (CPRIC) is a phenomenon that has been described in only a handful of case reports. In this study, we aimed to describe CPRIC in out-of-hospital cardiac arrest (OHCA) patients and determine its association with survival outcomes. METHODS: Retrospective study of registry-based data from Victoria, Australia between January 2008 and December 2014. Adult OHCA patients treated by emergency medical services (EMS) were included...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/28126019/telemedical-support-for-prehospital-emergency-medical-service-tems-trial-study-protocol-for-a-randomized-controlled-trial
#12
Ana Stevanovic, Stefan Kurt Beckers, Michael Czaplik, Sebastian Bergrath, Mark Coburn, Jörg Christian Brokmann, Ralf-Dieter Hilgers, Rolf Rossaint
BACKGROUND: Increasing numbers of emergency calls, shortages of Emergency Medical Service (EMS), physicians, prolonged emergency response times and regionally different quality of treatment by EMS physicians require improvement of this system. Telemedical solutions have been shown to be beneficial in different emergency projects, focused on specific disease patterns. Our previous pilot studies have shown that the implementation of a holistic prehospital EMS teleconsultation system, between paramedics and experienced tele-EMS physicians, is safe and feasible in different emergency situations...
January 26, 2017: Trials
https://www.readbyqxmd.com/read/28095934/the-effect-of-ambulance-staffing-models-in-a-metropolitan-fire-based-ems-system
#13
Eric J Cortez, Ashish R Panchal, James E Davis, David P Keseg
Introduction The staffing of ambulances with different levels of Emergency Medical Service (EMS) providers is a difficult decision with evidence being mixed on the benefit of each model. Hypothesis/Problem The objective of this study was to describe a pilot program evaluating alternative staffing on two ambulances utilizing the paramedic-basic (PB) model (staffed with one paramedic and one emergency medical technician[EMT]). METHODS: This was a retrospective study conducted from September 17, 2013 through December 31, 2013...
January 18, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28093867/paramedic-resuscitation-competency-a-survey-of-australian-and-new-zealand-emergency-medical-services
#14
Kylie Dyson, Janet E Bray, Karen Smith, Stephen Bernard, Lahn Straney, Judith Finn
OBJECTIVE: We have previously established that paramedic exposure to out-of-hospital cardiac arrest (OHCA) is relatively rare, therefore clinical exposure cannot be relied on to maintain resuscitation competency. We aimed to identify the current practices within emergency medical services (EMS) for developing and maintaining paramedic resuscitation competency. METHODS: We developed and conducted an online cross-sectional survey of Australian and New Zealand EMS in 2015...
January 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28076734/effect-of-a-mass-media-campaign-on-ambulance-use-for-chest-pain
#15
Ziad Nehme, Peter A Cameron, Muhammad Akram, Harry Patsamanis, Janet E Bray, Ian T Meredith, Karen Smith
OBJECTIVES: To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain. DESIGN, SETTING AND PARTICIPANTS: A retrospective analysis of 253428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 - December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28029093/why-do-emergency-medical-services-ems-professionals-leave-ems
#16
Gary Blau, Susan A Chapman
OBJECTIVE: The objective was to determine why Emergency Medical Technician (EMT)-Basics and Paramedics leave the Emergency Medical Services (EMS) workforce. METHODS: Data were collected through annual surveys of nationally registered EMT-Basics and Paramedics from 1999 to 2008. Survey items dealing with satisfaction with the EMS profession, likelihood of leaving the profession, and likelihood of leaving their EMS job were assessed for both EMT-Basics and Paramedics, along with reasons for leaving the profession...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27928983/the-demographics-and-education-of-emergency-medical-services-ems-professionals-a-national-longitudinal-investigation
#17
Melissa A Bentley, Abigail Shoben, Roger Levine
OBJECTIVES: The objectives of this study were to assess longitudinal and cross-sectional changes in Emergency Medical Technician (EMT)-Basics and Paramedics: (1) demographics, (2) employment characteristics, and (3) initial Emergency Medical Services (EMS) education. METHODS: These data were collected between 1999 and 2008 employing survey techniques aimed at collecting valid data. A random, stratified sample was utilized to allow results to be generalizable to the nationally certified EMS population...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27928971/recruitment-and-retention-of-new-emergency-medical-technician-emt-basics-and-paramedics
#18
Susan A Chapman, Remle P Crowe, Melissa A Bentley
OBJECTIVES: The purpose of this paper is to describe factors important for the recruitment and retention of Emergency Medical Technician (EMT)-Basics and EMT-Paramedics new to the Emergency Medical Services (EMS) field (defined as two years or less of EMS employment) through an analysis of 10 years of Longitudinal EMT Attributes and Demographic Study (LEADS) data. METHODS: Data were obtained from 10 years of LEADS surveys (1999-2008). Individuals new to the profession were identified through responses to a survey item...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27922570/developing-a-simulation-based-training-program-for-the-prehospital-professionals-and-students-on-the-management-of-middle-east-respiratory-syndrome
#19
Melih Elcin, Arif Onan, Orhan Odabasi, Melahat Saylam, Handan Ilhan, Pinar Daylan Kockaya, Ilker Gurcuoglu, Yavuz Uckuyu, Duygu Cengiz, Osman Arikan Nacar
INTRODUCTION: Middle East Respiratory Syndrome (MERS) is a major global health threat. Prehospital professionals face the risk of infection as they work to save lives. They should be made aware of the disease and be prepared to handle such cases. The aims of our study are to develop a training program about the prehospital management of a MERS case using standardized patient (SP) scenarios, to evaluate the awareness and preparedness of the participants about MERS, and to evaluate the effectiveness of this training...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#20
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
May 2017: Prehospital Emergency Care
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