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https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#1
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
May 6, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29704520/trends-in-the-incidence-and-outcome-of-paediatric-out-of-hospital-cardiac-arrest-a-17-year-observational-study
#2
Ziad Nehme, Siva Namachivayam, Anri Forrest, Warwick Butt, Stephen Bernard, Karen Smith
BACKGROUND: System-based improvements to the chain of survival have yielded increases in survival from out-of-hospital cardiac arrest (OHCA) in adults. Comparatively little is known about the long-term trends in incidence and survival following paediatric OHCA. METHODS: Between 2000 and 2016, we included children aged ≤16 years who suffered a non-traumatic OHCA in the state of Victoria, Australia. Trends in incidence and unadjusted outcomes were assessed using linear regression and a non-parametric test for trend...
April 25, 2018: Resuscitation
https://www.readbyqxmd.com/read/29703219/primary-mass-casualty-incident-triage-evidence-for-the-benefit-of-yearly-brief-re-training-from-a-simulation-study
#3
Michael S Dittmar, Philipp Wolf, Marc Bigalke, Bernhard M Graf, Torsten Birkholz
BACKGROUND: Triage is a mainstay of early mass casualty incident (MCI) management. Standardized triage protocols aim at providing valid and reproducible results and, thus, improve triage quality. To date, there is little data supporting the extent and content of training and re-training on using such triage protocols within the Emergency Medical Services (EMS). The study objective was to assess the decline in triage skills indicating a minimum time interval for re-training. In addition, the effect of a one-hour repeating lesson on triage quality was analyzed...
April 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29596006/accuracy-of-prehospital-identification-of-stroke-in-a-large-stroke-belt-municipality
#4
Nee-Kofi Mould-Millman, Halea Meese, Ibthial Alattas, Moges Ido, Iasson Yi, Tolulope Oyewumi, Michael Colman, Michael Frankel, Arthur Yancey
OBJECTIVE: Strokes are a leading cause of morbidity and mortality in the United States, especially in the "stroke belt" of the southeast. Up to 65% of stroke patients access care by calling 9-1-1. The primary objective of this study is to measure the accuracy of emergency medical dispatchers (EMD) and paramedics, in the prehospital identification of stroke. METHODS: The study was based at Grady Emergency Medical Services, which is Atlanta, Georgia's public emergency medical services (EMS) provider...
March 29, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29563847/development-of-new-core-competencies-for-taiwanese-emergency-medical-technicians
#5
Yu-Tung Chang, Kuang-Chau Tsai, Brett Williams
Objectives: Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT) and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. Methods: A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29549460/success-rates-of-pre-hospital-difficult-airway-management-a-quality-control-study-evaluating-an-in-hospital-training-program
#6
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29510910/perceived-exertion-using-two-different-ems-stretcher-systems-report-from-a-swedish-study
#7
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
https://www.readbyqxmd.com/read/29485328/national-systematic-legal-review-of-state-policies-on-emergency-medical-services-licensure-levels-authority-to-administer-opioid-antagonists
#8
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
https://www.readbyqxmd.com/read/29432041/qualitative-evaluation-of-the-coach-training-within-a-community-paramedicine-care-transitions-intervention
#9
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
https://www.readbyqxmd.com/read/29423875/emergency-medicine-in-the-kingdom-of-bahrain
#10
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
https://www.readbyqxmd.com/read/29419332/alcohol-as-a-factor-in-911-calls-in-denver
#11
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
https://www.readbyqxmd.com/read/29364746/descriptive-analysis-of-mental-health-related-presentations-to-emergency-medical-services
#12
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
https://www.readbyqxmd.com/read/29364730/improving-prehospital-protocol-adherence-using-bundled-educational-interventions
#13
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...
May 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29351496/implementation-of-a-prehospital-protocol-change-for-asthmatic-children
#14
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
https://www.readbyqxmd.com/read/29345513/no-benefit-in-neurologic-outcomes-of-survivors-of-out-of-hospital-cardiac-arrest-with-mechanical-compression-device
#15
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...
May 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29340631/a-better-understanding-of-ambulance-personnel-s-attitude-towards-real-time-resuscitation-feedback
#16
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...
March 1, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29336638/prehospital-administration-of-epinephrine-in-pediatric-anaphylaxis-a-statewide-perspective
#17
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
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#18
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
https://www.readbyqxmd.com/read/29297718/evaluation-of-physiologic-alterations-during-prehospital-paramedic-performed-rapid-sequence-intubation
#19
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
https://www.readbyqxmd.com/read/29258599/transition-in-care-from-paramedics-to-emergency-department-nurses-a-systematic-review-protocol
#20
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
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