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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
#1
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
#2
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...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918863/ems-providers-beliefs-regarding-spinal-precautions-for-pediatric-trauma-transport
#3
Cindy D Chang, Remle P Crowe, Melissa A Bentley, Alyssa R Janezic, Julie C Leonard
OBJECTIVE: Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. METHODS: We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors. RESULTS: We received 5,400 responses (17%)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918858/d10-in-the-treatment-of-prehospital-hypoglycemia-a-24-month-observational-cohort-study
#4
H Gene Hern, Matthew Kiefer, Derex Louie, Joseph Barger, Harrison J Alter
INTRODUCTION: Prehospital first responders historically have used an IV bolus of 50 mL of 50% dextrose solution (D50) for the treatment of hypoglycemia in the field. A local Emergency Medical Services (EMS) system recently approved a hypoglycemia treatment protocol of IV 10% dextrose solution (D10) due to occasional shortages and higher cost of D50. We use the experience of this EMS system to report the feasibility, safety, and efficacy of this approach. METHODS: Over the course of 104 weeks, paramedics treated 1,323 hypoglycemic patients with D10 and recorded patient demographics and clinical outcomes...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27914232/resuscitation-attempts-and-duration-in-traumatic-out-of-hospital-cardiac-arrest
#5
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: This study aimed to understand factors associated with paramedics' decision to attempt resuscitation in traumatic out-of-hospital cardiac arrest (OHCA) and to characterise resuscitation attempts ≤10min in patients who die at the scene. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all cases of traumatic OHCA between July 2008 and June 2014. We excluded cases <16 years of age or with a mechanism of hanging or drowning...
November 30, 2016: Resuscitation
https://www.readbyqxmd.com/read/27909851/brief-report-knowledge-and-confidence-of-emergency-medical-service-personnel-involving-treatment-of-an-individual-with-autism-spectrum-disorder
#6
David Wachob, Louis J Pesci
In order to best respond to an emergency situation, professionals need to have an understanding about Autism Spectrum Disorder (ASD) and techniques that will ensure proper care. The purpose of this study was to determine the knowledge and confidence of EMS personnel on interacting and treating an individual with ASD. Emergency Medical Technicians (EMT), and Paramedics were surveyed on their knowledge of ASD; familiarity or experience with ASD, and level of comfort responding to emergencies involving an individual with ASD...
December 1, 2016: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/27908843/treatment-of-acute-coronary-syndrome-by-telemedically-supported-paramedics-compared-with-physician-based-treatment-a-prospective-interventional-multicenter-trial
#7
Jörg C Brokmann, Clemens Conrad, Rolf Rossaint, Sebastian Bergrath, Stefan K Beckers, Miriam Tamm, Michael Czaplik, Frederik Hirsch
BACKGROUND: Prehospital treatment of acute coronary syndrome (ACS) in German emergency medical services (EMSs) is reserved for EMS physicians due to legal issues. OBJECTIVE: The objective of this prospective, interventional, multicenter trial was to evaluate the quality of telemedically-delegated therapy and the possible complications in patients with ACS. METHODS: After approval by the ethics committee and trial registration, a one-year study phase was started in August 2012 with 5 ambulances, telemedically equipped and staffed with paramedics, in 4 German EMS districts...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27890030/longitudinal-emergency-medical-technician-attributes-and-demographic-study-leads-design-and-methodology
#8
Roger Levine
OBJECTIVES: The objective of this study is to describe the Longitudinal Emergency Medical Technician (EMT) Attributes and Demographic Study (LEADS) design, instrument development, pilot testing, sampling procedures, and data collection methodology. Response rates are provided, along with results of follow-up surveys of non-responders (NRs) and a special survey of Emergency Medical Services (EMS) professionals who were not nationally certified. METHODS: Annual surveys from 1999 to 2008 were mailed out to a random, stratified sample of nationally registered EMT-Basics and Paramedics...
November 28, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27890027/a-longitudinal-description-of-emergency-medical-services-professionals-by-race-ethnicity
#9
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...
November 28, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27890018/compensation-of-emergency-medical-technician-emt-basics-and-paramedics
#10
Jonathan R Studnek
OBJECTIVES: The objective of this paper is to identify factors associated with compensation for Emergency Medical Technician (EMT)-Basics and Paramedics and assess whether these associations have changed over the period 1999-2008. METHODS: Data obtained from the Longitudinal EMT Attributes and Demographic Study (LEADS) surveys, a mail survey of a random, stratified sample of nationally certified EMT-Basics and Paramedics, were analyzed. For the 1999-2003 period, analyses included all respondents providing Emergency Medical Services (EMS)...
November 28, 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
#11
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/27884215/public-perception-of-emergency-medical-services-in-the-united-states
#12
Remle P Crowe, Roger Levine, Severo Rodriguez, Ashley D Larrimore, Ronald G Pirrallo
OBJECTIVE: The objective of this study was to assess the public's experience, expectations, and perceptions related to Emergency Medical Services (EMS). METHODS: A population-based telephone interview of adults in the United States was conducted. The survey instrument consisted of 112 items. Demographic variables including age, race, political beliefs, and household income were collected. Data collection was performed by trained interviewers from Kent State University's (Kent, Ohio USA)Social Research Laboratory...
November 25, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27858502/prehospital-providers-perceptions-on-providing-patient-and-family-centered-care
#13
Emily M Ayub, Esther M Sampayo, Manish I Shah, Cara B Doughty
BACKGROUND: A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. METHODS: We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27836871/patient-safety-events-in-out-of-hospital-paediatric-airway-management-a-medical-record-review-by-the-csi-ems
#14
Matthew Hansen, Garth Meckler, William Lambert, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: To describe the frequency and characterise the nature of patient safety events in paediatric out-of-hospital airway management. METHODS: We conducted a retrospective cross-sectional medical record review of all 'lights and sirens' emergency medicine services transports from 2008 to 2011 in patients <18 years of age in the Portland Oregon metropolitan area. A chart review tool (see online supplementary appendix) was adapted from landmark patient safety studies and revised after pilot testing...
November 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27833674/alternative-destination-transport-the-role-of-paramedics-in-optimal-use-of-the-emergency-department
#15
Michael M Neeki, Fanglong Dong, Leigh Avera, Tan Than, Rodney Borger, Joe Powell, Reza Vaezazizi, Richard Pitts
INTRODUCTION: Alternative destination transportation by emergency medical services (EMS) is a subject of hot debate between those favoring all patients being evaluated by an emergency physician (EP) and those recognizing the need to reduce emergency department (ED) crowding. This study aimed to determine whether paramedics could accurately assess a patient's acuity level to determine the need to transport to an ED. METHODS: We performed a prospective double-blinded analysis of responses recorded by paramedics and EPs of arriving patients' acuity level in a large Level II trauma center between April 2015 and November 2015...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27818421/emergency-medical-service-based-care-coordination-for-three-rural-communities
#16
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/27791428/cpr-induced-consciousness-during-out-of-hospital-cardiac-arrest-a-case-report-on-an-emerging-phenomenon
#17
Joshua Pound, P Richard Verbeek, Sheldon Cheskes
BACKGROUND: High quality cardiopulmonary resuscitation (CPR) has produced a relatively new phenomenon of consciousness in patients with vital signs absent. Further research is necessary to produce a viable treatment strategy during and post resuscitation. OBJECTIVE: To provide a case study done by paramedics in the field illustrating the need for sedation in a patient whose presentation was consistent with CPR induced consciousness. Resuscitative challenges are provided as well as potential future treatment options to minimize harm to both patients and prehospital providers...
October 28, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27743926/improving-transfer-times-for-acute-ischemic-stroke-patients-to-a-comprehensive-stroke-center
#18
Thomas V Kodankandath, Paul Wright, Paul M Power, Marcella De Geronimo, Richard B Libman, Thomas Kwiatkowski, Jeffrey M Katz
BACKGROUND AND OBJECTIVE: The transfer of acute ischemic stroke (AIS) patients to a comprehensive stroke center (CSC) must be rapid. Delays pose an obstacle to time-sensitive stroke treatments and, therefore, increase the likelihood of exclusion from endovascular stroke therapy. This study aims to evaluate the impact of the Stroke Rescue Program, with its goal of minimizing interfacility transfer delays and increasing the number of transport times completed within 60 minutes. METHODS: The Stroke Rescue Program was initiated to facilitate the rapid transfer of AIS patients from regional primary stroke centers (PSCs) to the network's CSC...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27718162/impact-of-the-use-of-regional-poison-control-centers-in-an-urban-ems-dispatch-system
#19
Michael Levine, John Flores, Seth A Seabury, Stephen Sanko, Marc Eckstein
BACKGROUND: The public commonly calls 911 for unintentional ingestions, rather than calling the local poison center. By utilizing a series of scripted questions, 911 dispatchers in Los Angeles determine if an ingestion meets "omega-1" classification. Under such circumstances, the regional poison center is contacted prior to dispatch of paramedics. If the poison center advises that the patient can remain at home, EMS is not dispatched and the patient is followed at home by the poison center...
October 7, 2016: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/27700209/development-of-a-child-abuse-checklist-to-evaluate-prehospital-provider-performance
#20
Aimee Alphonso, Marc Auerbach, Kirsten Bechtel, Kyle Bilodeau, Marcie Gawel, Jeannette Koziel, Travis Whitfill, Gunjan Kamdar Tiyyagura
OBJECTIVES: To develop and provide validity evidence for a performance checklist to evaluate the child abuse screening behaviors of prehospital providers. METHODS: Checklist Development: We developed the first iteration of the checklist after review of the relevant literature and on the basis of the authors' clinical experience. Next, a panel of six content experts participated in three rounds of Delphi review to reach consensus on the final checklist items. Checklist Validation: Twenty-eight emergency medical services (EMS) providers (16 EMT-Basics, 12 EMT-Paramedics) participated in a standardized simulated case of physical child abuse to an infant followed by one-on-one semi-structured qualitative interviews...
October 4, 2016: Prehospital Emergency Care
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