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https://www.readbyqxmd.com/read/29329535/measurement-of-the-potential-geographic-accessibility-from-call-to-definitive-care-for-patient-with-acute-stroke
#1
J Freyssenge, F Renard, A M Schott, L Derex, N Nighoghossian, K Tazarourte, C El Khoury
BACKGROUND: The World Health Organization refers to stroke, the second most frequent cause of death in the world, in terms of pandemic. Present treatments are only effective within precise time windows. Only 10% of thrombolysis patients are eligible. Late assessment of the patient resulting from admission and lack of knowledge of the symptoms is the main explanation of lack of eligibility. METHODS: The aim is the measurement of the time of access to treatment facilities for stroke victims, using ambulances (firemen ambulances or EMS ambulances) and private car...
January 12, 2018: International Journal of Health Geographics
https://www.readbyqxmd.com/read/29321074/patient-and-case-characteristics-associated-with-no-paramedic-treatment-for-low-acuity-cases-referred-for-emergency-ambulance-dispatch-following-a-secondary-telephone-triage-a-retrospective-cohort-study
#2
Kathryn Eastwood, Amee Morgans, Johannes Stoelwinder, Karen Smith
BACKGROUND: Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with 'no paramedic treatment' for cases referred for emergency ambulance dispatch following secondary telephone triage. METHODS: A retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29319407/malpractice-litigation-in-acute-stroke-care-where-are-we-now
#3
Gilberto Kk Leung, Gerard Porter
Acute stroke care has undergone momentous changes in recent years with the introduction of intravenous thrombolysis, mechanical thrombectomy and integrated stroke services. While these are welcome developments, they also carry unique medico-legal challenges. In 2015, a patient from Greater Manchester was awarded over £1 million in compensation after ambulance paramedics failed to admit her to a specialist unit. This paper explores the medico-legal implications of this first but over looked thrombolysis-related claim in the United Kingdom...
January 1, 2018: Medico-legal Journal
https://www.readbyqxmd.com/read/29311034/caregiving-for-uganda-s-elders-with-disability-using-cross-sectional-surveillance-data-to-identify-healthcare-service-gaps-in-low-and-middle-income-settings
#4
Abdulgafoor M Bachani, Jacob A Bentley, Nukhba Zia, Edward Galiwango, Jeremiah Lum, Gulnar Tuli, Shuen-En Ho
BACKGROUND: Disability is highly prevalent in low-and-middle-income countries (LMICs), but there is a relative dearth of disability and caregiving research from LMICs. OBJECTIVE: To examine type and severity of disability experienced by individuals 60 years and older, caregivers and type of caregiving assistance, and the interrelationships between sociodemographic factors involved in Uganda. METHODS: Data was collected from two Eastern Ugandan districts using the WHO Disability Assessment Schedule 2...
December 31, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/29310618/epidemiology-of-unplanned-out-of-hospital-births-attended-by-paramedics
#5
Gayle McLelland, Lisa McKenna, Amee Morgans, Karen Smith
BACKGROUND: Over the previous two decades the incidence and number of unplanned out of hospital births Victoria has increased. As the only out of hospital emergency care providers in Victoria, paramedics would provide care for women having birth emergencies in the community. However, there is a lack of research about the involvement of paramedics provide for these women and their newborns. This research reports the clinical profile of a 1-year sample caseload of births attended by a state-wide ambulance service in Australia...
January 8, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29297394/appropriateness-and-timeliness-of-care-seeking-for-complications-of-pregnancy-and-childbirth-in-rural-ethiopia-a-case-study-of-the-maternal-and-newborn-health-in-ethiopia-partnership
#6
Lynn M Sibley, Yared Amare, Solomon Tesfaye Abebe, Mulusew Lijalem Belew, Kemeredin Shiffra, Danika Barry
BACKGROUND: In 2014, USAID and University Research Co., LLC, initiated a new project under the broader Translating Research into Action portfolio of projects. This new project was entitled Systematic Documentation of Illness Recognition and Appropriate Care Seeking for Maternal and Newborn Complications. This project used a common protocol involving descriptive mixed-methods case studies of community projects in six low- and middle-income countries, including Ethiopia. In this paper, we present the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) case study...
December 21, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29286502/social-safety-and-medical-maintenance-of-the-labour-pool-in-surveillance-areas-of-the-nuclear-power-plants
#7
V A Prylipko, Yu Yu Ozerova, O V Kotsubinskij, M M Morozova, O O Petrychenko, I V Bondarenko
OBJECTIVE: To study the contentment of population of NPP surveillance areas i.e. monitoring zones with specific components of quality of life, namely the social security, medical care, and socio economic compensation of risk. MATERIALS AND METHODS: A sociological study of public opinion about the specific components of quality of life has been conducted in population of the NPP monitoring zone. A questionnaire with independent question blocks was developed. A non repeatable probabilistic selection was applied in population opinion poll...
December 2017: Problemy Radiat︠s︡iĭnoï Medyt︠s︡yny Ta Radiobiolohiï
https://www.readbyqxmd.com/read/29273024/is-unplanned-out-of-hospital-birth-managed-by-paramedics-infrequent-normal-and-uncomplicated
#8
Belinda Flanagan, Bill Lord, Margaret Barnes
BACKGROUND: Unplanned out-of-hospital birth is often perceived as precipitate in nature, 'infrequent', 'normal' and 'uncomplicated'. However, international studies report unplanned out-of-hospital birth is associated with increased rates of maternal and neonatal morbidity and mortality. This research describes intrapartum, immediate postpartum and neonatal care provided by paramedics in Queensland, Australia. The objectives were to (1) determine the number of cases where the paramedic documented birth or imminent birth during the study period (2) to describe the incidence of births prior to or during paramedic care (3) to detail any risk factors and/or complications recorded by paramedics during these cases, (4) identify paramedic pain management practices for intrapartum care, and (5) to examine the maternal and neonatal outcomes as documented by paramedics...
December 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29240741/a-retrospective-audit-of-the-characteristics-and-treatment-outcomes-in-patients-with-diabetes-related-charcot-neuropathic-osteoarthropathy
#9
Joanne Dixon, Joshua Coulter, Michele Garrett, Rick Cutfield
AIMS: To review the characteristics, management and outcomes one year after diagnosis in patients with diabetes related charcot neuropathic osteoarthropathy (CN) treated at the Diabetes Podiatry service, Waitemata District Health Board (WDHB) between 2000-2014. METHODS: Patients with diabetes and recorded diagnosis of CN were identified from the podiatry service records. Clinical details were retrospectively obtained from WDHB databases and patient medical records...
December 15, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29239735/burns-centre-and-fire-services-what-information-can-be-exchanged-to-manage-the-burn-patient
#10
O Pujji, B Nizar, J Bechar, D North, S Jeffery
AIM: To describe the experience of using a "Burns Extrication Form" at a regional Burns Centre. Communication between the fire services and burns team previously has been regarded as poor. Significant information is collected by the fire services at the scene and this can aid the management of the patient. METHODS: The Burns Extrication Form was devised to provide a clear framework of communication between the two services. Information regarding time frames, exposure to heat & smoke, fire loading (potential severity of a fire in a given space by measuring amount of combustible material in confined space), building construction, chemicals involved is passed to the medical team through this form through a National Health Service mailbox...
November 24, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29233042/healthcare-utilization-characteristics-for-intranasal-midazolam-versus-rectal-diazepam
#11
Sunjay Nunley, Peter Glynn, Steve Rust, Jorge Vidaurre, Dara Vf Albert, Anup D Patel
To investigate connections between patient demographics, health care utilization, prescription use, and refills for patients using intranasal midazolam, per rectum diazepam, or both. A retrospective cohort contained patients with epilepsy prescribed intranasal midazolam, per rectum diazepam, or both. We analyzed number of emergency department visits, ambulance services, urgent care visits, and unplanned hospitalizations. A total of 5458 patients were identified. Patients on intranasal midazolam had on average 1...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29222105/the-emergency-medical-service-microbiome
#12
Andrew J Hudson, Graeme D Glaister, Hans-Joachim Wieden
Emergency medical services (EMS) personnel are an integral component of the healthcare framework and function to transport patients from various locations to and between care facilities. In addition to physical injury, EMS personnel are expected to be at high risk to acquire and transmit healthcare associated infections (HAIs) in the workplace. However, currently little is known about EMS biosafety risk factors and the epidemiological contribution of EMS to pathogen transmission within and outside of the healthcare sector...
December 8, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/29218822/european-academy-of-neurology-european-stroke-organisation-consensus-statement-and-practical-guidance-for-pre-hospital-management-of-stroke
#13
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
Reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving chances of a favorable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations...
December 7, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29208018/noise-exposure-during-prehospital-emergency-physicians-work-on-mobile-emergency-care-units-and-helicopter-emergency-medical-services
#14
Mads Christian Tofte Hansen, Jesper Hvass Schmidt, Anne C Brøchner, Jakob Kjersgaard Johansen, Stine Zwisler, Søren Mikkelsen
BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet...
December 6, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29200315/psychosocial-working-conditions-as-determinants-of-asthma-self-management-at-work-a-systematic-review
#15
Katherina Heinrichs, Peter Angerer, Adrian Loerbroks
OBJECTIVE: Asthma exerts a considerable impact on patients and their employers. While adequate self-management is able to improve patients' prognosis, its actual implementation in everyday life may depend on contextual factors. We aimed to review the literature on the potential determinants of asthma self-management at the workplace. DATA SOURCES: We systematically searched Medline and PsycINFO using terms related to the key concepts of interest (i.e., adult asthma, working conditions, and self-management)...
December 4, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29200141/effects-of-the-introduction-of-intranasal-fentanyl-on-reduction-of-pain-severity-score-in-children-an-interrupted-time-series-analysis
#16
Bill Lord, Paul A Jennings, Karen Smith
OBJECTIVES: Children are at risk of inadequate analgesia due to paramedics' inexperience in assessing children and challenges in administering analgesics when the patient is distressed and uncooperative. This study reports on the outcome of a change to practice guidelines that added intranasal fentanyl and intramuscular morphine within a large statewide ambulance service. METHODS: This retrospective study included patients younger than 15 years treated by paramedics between January 2008 and December 2011...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29198239/medical-response-to-the-tianjin-explosions-lessons-learned
#17
Jin-Jun Zhang, Tian-Bing Wang, Da Fan, Jun Zhang, Bao-Guo Jiang
BACKGROUND: On August 12, 2015, a hazardous chemical explosion occurred in the Tianjin Port of China. The explosions resulted in 165 deaths, 8 missing people, injuries to thousands of people. We present the responses of emergency medical services and hospitals to the explosions and summarize the lessons that can be learned. METHODS: This study was a retrospective analysis of the responses of emergency medical services and hospitals to the Tianjin explosions. Data on injuries, outcomes, and patient flow were obtained from the government and the hospitals...
December 4, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29196046/prehospital-antibiotics-in-the-ambulance-for-sepsis-a-multicentre-open-label-randomised-trial
#18
Nadia Alam, Erick Oskam, Patricia M Stassen, Pieternel van Exter, Peter M van de Ven, Harm R Haak, Frits Holleman, Arthur van Zanten, Hien van Leeuwen-Nguyen, Victor Bon, Bart A M Duineveld, Rishi S Nannan Panday, Mark H H Kramer, Prabath W B Nanayakkara
BACKGROUND: Emergency medical services (EMS) personnel have already made substantial contributions to improving care for patients with time-dependent illnesses, such as trauma and myocardial infarction. Patients with sepsis could also benefit from timely prehospital care. METHODS: After training EMS personnel in recognising sepsis, we did a randomised controlled open-label trial in ten large regional ambulance services serving 34 secondary and tertiary care hospitals in the Netherlands...
November 28, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29170321/24%C3%A2-an-audit-into-the-number-of-patients-suffering-out-of-hospital-cardiac-arrest-that-are-resuscitated-despite-a-high-likelihood-of-futility
#19
Mia Cokljat, Gareth Clegg, Scott Clarke
BACKGROUND: For a significant number of patients suffering out-of-hospital cardiac arrest (OHCA) cardiopulmonary resuscitation (CPR) is likely to be futile and attempting it may be the wrong thing to do. Anticipatory care plans with do-not-attempt cardiopulmonary resuscitation (DNACPR) instructions exist to prevent this. Anecdotally we felt that many patients present to our Emergency Department (ED) with ongoing resuscitation which was not in their best interests. The aim of this study was to establish the proportion of patients arriving in our ED with ongoing CPR who had low, intermediate or high risk of futility...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170320/23%C3%A2-patient-and-staff-perspectives-on-the-reasons-for-increasing-emergency-department-attendances
#20
Suzanne Ablard, Melanie Rimmer, Colin O'Keeffe, Suzanne Mason
BACKGROUND/OBJECTIVES: An NHS England review recognised that demand for Urgent and Emergency Care is unsustainable. Health practitioners and policy makers are interested in understanding the reasons why patients with low acuity problems attend the Emergency Department (ED). This should, in turn, assist the development of interventions to reduce demand.We aimed to gain an understanding about the reasons for rising ED demand and to identify possible solutions. METHODS: A self-report patient survey was administered to non-ambulance patients at 9 EDs across Yorkshire and Humber (Y and H) asking participants: reasons for attending the ED; awareness of alternative services; and perceptions of the suitability of other services to manage their health problem...
December 2017: Emergency Medicine Journal: EMJ
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