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https://www.readbyqxmd.com/read/28934993/can-a-single-primary-care-paramedic-configuration-safely-transport-low-acuity-patients-in-air-ambulances
#1
Homer Tien, Bruce Sawadsky, Michael Lewell, Sean Moore, Michael Peddle, Alun Ackery, Brodie Nolan, Russell D MacDonald
OBJECTIVE: To determine if utilizing a single paramedic crew configuration is safe for transporting low acuity patients requiring only a primary care paramedic (PCP) level of care in Air Ambulances. METHODS: We studied single-PCP transports of low acuity patients done by contract air ambulance carriers, organized by Ornge (Ontario's Air Ambulance Service) for one year. We only included interfacility transports. We excluded all scene calls, and all Code 4 (emergent) calls...
September 22, 2017: CJEM
https://www.readbyqxmd.com/read/28930297/estimated-radiation-exposure-of-german-commercial-airline-cabin-crew-in-the-years-1960-2003-modeled-using-dose-registry-data-for-2004-2015
#2
Daniel Wollschläger, Gaël Paul Hammer, Thomas Schafft, Steffen Dreger, Maria Blettner, Hajo Zeeb
Exposure to ionizing radiation of cosmic origin is an occupational risk factor in commercial aircrew. In a historic cohort of 26,774 German aircrew, radiation exposure was previously estimated only for cockpit crew using a job-exposure matrix (JEM). Here, a new method for retrospectively estimating cabin crew dose is developed. The German Federal Radiation Registry (SSR) documents individual monthly effective doses for all aircrew. SSR-provided doses on 12,941 aircrew from 2004 to 2015 were used to model cabin crew dose as a function of age, sex, job category, solar activity, and male pilots' dose; the mean annual effective dose was 2...
September 20, 2017: Journal of Exposure Science & Environmental Epidemiology
https://www.readbyqxmd.com/read/28926391/medical-team-training-improves-team-performance-aoa-critical-issues
#3
James E Carpenter, James P Bagian, Rebecca G Snider, Kyle J Jeray
Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28923144/in-flight-ultraviolet-radiation-on-commercial-airplanes
#4
Pascal Cadilhac, Marie-Christine Bouton, Monique Cantegril, Catherine Cardines, Alain Gisquet, Noël Kaufman, Michel Klerlein
INTRODUCTION: Epidemiological studies suggest that pilots and cabin crew have higher incidences and mortality rates of cutaneous malignant melanoma than those of the general population. Exposure to UV radiation is one of the main risk factors for this type of cancer. The aim of this study was to evaluate the level of UV radiation in an airliner in flight. METHODS: Measurements were taken with a three sensor-integrated electronics UV radiometer (A, B, and C) during 14 flights from July to October 2016...
October 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28920512/rhythmic-three-part-harmony-the-complex-interaction-of-maternal-placental-and-fetal-circadian-systems
#5
Peter J Mark, Rachael C Crew, Michaela D Wharfe, Brendan J Waddell
From the perspective of circadian biology, mammalian pregnancy presents an unusual biological scenario in which an entire circadian system (i.e., that of the fetus) is embodied within another (i.e., that of the mother). Moreover, both systems are likely to be influenced at their interface by a third player, the placenta. Successful pregnancy requires major adaptations in maternal physiology, many of which involve circadian changes that support the high metabolic demands of the growing fetus. A functional role for maternal circadian adaptations is implied by the effects of circadian disruption, which result in pregnancy complications including higher risks for miscarriage, preterm labor, and low birth weight...
September 1, 2017: Journal of Biological Rhythms
https://www.readbyqxmd.com/read/28917058/lineage-tracing-of-genome-edited-alleles-reveals-high-fidelity-axolotl-limb-regeneration
#6
Grant Parker Flowers, Lucas D Sanor, Craig M Crews
Salamanders are unparalleled among tetrapods in their ability to regenerate many structures, including entire limbs, and the study of this ability may provide insights into human regenerative therapies. The complex structure of the limb poses challenges to the investigation of the cellular and molecular basis of its regeneration. Using CRISPR/Cas, we genetically labelled unique cell lineages within the developing axolotl embryo and tracked the frequency of each lineage within amputated and fully regenerated limbs...
September 16, 2017: ELife
https://www.readbyqxmd.com/read/28892731/a-new-integrated-care-pathway-for-ambulance-attended-severe-hypoglycaemia-in-the-east-of-england-the-eastern-academic-health-science-network-eahsn-model
#7
Michael Sampson, Marcus Bailey, John Clark, Mark L Evans, Rebekah Fong, Helen Hall, Clare Hambling, Martin Hadley-Brown, Nick Morrish, Helen Murphy, Gerry A Rayman, Karunakaran Vithian, Peter Winocour, Amanda Harries
AIMS: We developed a new clinical integrated pathway linking a regional Ambulance Trust with a severe hypoglycaemia (SH) prevention team. We present clinical data from the first 2000 emergency calls taken through this new clinical pathway in the East of England. METHODS: SH patients attended by Ambulance crew receive written information on SH avoidance, and are contacted for further education through a new regional SH prevention team. All patients are contacted unless they actively decline...
September 1, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28890242/asphyxiation-death-caused-by-oxygen-depleting-cargo-on-a-ship
#8
Marjana Kjetland Sundal, Peer Kaare Lilleng, Hans Barane, Inge Morild, Merete Vevelstad
The extreme danger associated with entering enclosed spaces loaded with oxygen-depleting organic cargo in ships and tanks is obviously underestimated, both among crew and management. We present a case report to highlight this occupational hazard and to increase the knowledge about the imperative precautions, in order to prevent future accidents. An experienced customs officer was found lifeless at the bottom of the unattended cargo hold on a ship loaded with woodchips. The oxygen content in the cargo atmosphere was below 2%, which is incompatible with life...
September 1, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28889990/glandular-sources-of-pheromones-used-to-control-host-workers-apis-mellifera-scutellata-by-socially-parasitic-workers-of-apis-mellifera-capensis
#9
Olabimpe O Okosun, Christian W W Pirk, Robin M Crewe, Abdullahi A Yusuf
Pheromonal control by the honey bee queen is achieved through the use of secretions from diverse glandular sources, but the use of pheromones from a variety of glandular sources by reproductively dominant workers, has not previously been explored. Using the social parasite, Apis mellifera capensis clonal worker we studied the diversity of glandular sources used for pheromonal control of reproductively subordinate A. m. scutellata workers. To determine whether pheromones from different glandular sources are used by reproductively active workers to achieve dominance and evaluate the degree of pheromonal competition between workers of the two sub-species, we housed groups of workers of the two sub-species together in cages and analysed mandibular and tergal gland secretions as well as, ovarian activation status of each worker after 21days...
September 7, 2017: Journal of Insect Physiology
https://www.readbyqxmd.com/read/28888817/mate-choice-sexual-selection-and-endocrine-disrupting-chemicals
#10
REVIEW
Andrea C Gore, Amanda M Holley, David Crews
Humans have disproportionately affected the habitat and survival of species through environmental contamination. Important among these anthropogenic influences is the proliferation of organic chemicals, some of which perturb hormone systems, the latter referred to as endocrine-disrupting chemicals (EDCs). EDCs are widespread in the environment and affect all levels of reproduction, including development of reproductive organs, hormone release and regulation through the life cycle, the development of secondary sexual characteristics, and the maturation and maintenance of adult physiology and behavior...
September 11, 2017: Hormones and Behavior
https://www.readbyqxmd.com/read/28888812/use-of-automated-chest-compression-devices-after-out-of-hospital-cardiac-arrest-in-sweden
#11
Simon Schmidbauer, Johan Herlitz, Thomas Karlsson, Christer Axelsson, Hans Friberg
OBJECTIVE: To evaluate the implementation of automated chest compression cardiopulmonary resuscitation (ACC-CPR) after out-of-hospital cardiac arrest (OHCA) in Sweden during the years 2011 through 2015. The association between ACC-CPR and 30-day survival was studied as a secondary objective. METHODS: The Swedish cardiopulmonary resuscitation registry is a prospectively recorded nationwide registry of modified Utstein parameters including all patients with attempted resuscitation after OHCA...
September 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28886785/reducing-door-in-door-out-intervals-in-helicopter-st-segment-elevation-myocardial-infarction-interhospital-transfers
#12
Michael A Schneider, Jason T McMullan, Christopher J Lindsell, Kimberly W Hart, Diana Deimling, Debra Jump, Todd Davis, William R Hinckley
BACKGROUND: Many health systems rely on helicopter EMS (HEMS) to transfer ST-elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI) to a hospital with a catheterization laboratory. Mortality rates increase with the time to reperfusion, so reducing delays is imperative. For interhospital STEMI transfers, the time spent in the initial hospital from arrival until departure (door-in to door-out interval or DIDO) should be minimized. OBJECTIVE: To evaluate the impact of a series of process improvements to reduce DIDO intervals for STEMI patients transferred via a hospital based HEMS program...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28882750/grey-areas-new-zealand-ambulance-personnel-s-experiences-of-challenging-resuscitation-decision-making
#13
Natalie Elizabeth Anderson, Merryn Gott, Julia Slark
INTRODUCTION: When faced with a patient in cardiac arrest, ambulance personnel must rapidly make complex decisions with limited information. Much of the research examining decisions to commence, continue, withhold or terminate resuscitation has used retrospective audits of registry data and clinical documentation. This study offers a provider-perspective which characterises uncertainty and highlights clinical, cognitive, emotional and physical demands associated with decision-making in the cardiac arrest context...
September 4, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28882272/using-interactive-virtual-presence-to-support-accurate-installation-of-child-restraints-efficacy-and-parental-perceptions
#14
David C Schwebel, M Alison Tillman, Marie Crew, Matthew Muller, Anna Johnston
INTRODUCTION: Child restraint systems (car seats) reduce injury risk for young children involved in motor-vehicle crashes, but parents experience significant difficulty installing child restraints correctly. Installation by certified child passenger safety (CPS) technicians yields more accurate installation, but is impractical for broad distribution. A potential solution is use of interactive virtual presence via smartphone application (app), which permits "hands on" teaching through simultaneous and remote joint exposure to 3-dimensional images...
September 2017: Journal of Safety Research
https://www.readbyqxmd.com/read/28870719/increased-survival-from-out-of-hospital-cardiac-arrest-when-off-duty-medically-educated-personnel-perform-cpr-compared-with-laymen
#15
Anette Nord, Leif Svensson, Thomas Karlsson, Andreas Claesson, Johan Herlitz, Lennart Nilsson
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) has been proved to save lives; however, whether survival is affected by the training level of the bystander is not fully described. AIM: To describe if the training level of laymen and medically educated bystanders affect 30-day survival in out-of-hospital cardiac arrests (OHCA). METHODS: This observational study included all witnessed and treated cases of bystander CPR reported to the Swedish Registry of Cardiopulmonary Resuscitation between 2010 and 2014...
September 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28862030/eliminating-critical-incident-tracking-network-patient-safety-events-at-a-veterans-affairs-institution-through-crew-resource-management-training
#16
SreyRam Kuy, Ramon A L Romero
The objective of this study was to determine whether rates of Critical Incident Tracking Network (CITN) patient safety adverse events change after implementation of crew resource management (CRM) training at a Veterans Affairs (VA) hospital. CRM training was conducted for all surgical staff at a VA hospital. Compliance with briefing and debriefing checklists was assessed for all operating room procedures. Tracking of adverse patient safety events utilizing the VA CITN events was performed. There was 100% adherence to performance of briefings and debriefings after initiation of CRM training...
September 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28859066/the-association-between-the-first-locating-emergency-ambulance-being-single-crewed-and-cardiac-arrest-outcomes-in-new-zealand
#17
Bridget Dicker, Paul Davey, Tony Smith
AIM: This study investigated the association between the first locating emergency ambulance being single crewed on outcomes following out-of-hospital cardiac arrest in New Zealand. METHOD: Using data from the St John cardiac arrest registry for the period of 1 October 2013 to 30 June 2015, cases were included if a resuscitation attempt was made and the patient was an adult. Logistic regression modelling was used to account for confounding factors. The primary outcome was survival to hospital discharge...
September 1, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28857747/investigation-of-cerebral-venous-outflow-in-microgravity
#18
Angelo Taibi, Giacomo Gadda, Mauro Gambaccini, Erica Menegatti, Francesco Sisini, Paolo Zamboni
The gravitational gradient is the major component to face when considering the physiology of venous return and there is a growing interest in understanding the mechanisms ensuring the heart filling in the absence of gravity for astronauts who perform long-term space missions. The purpose of the Drain Brain project was to monitor the cerebral venous outflow of the crew member during an experiment on the International Space Station, so as to study the compensatory mechanisms that facilitate this essential physiological action in subjects living in a microgravity environment...
August 31, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28857001/making-time-for-person-centred-care
#19
Justin Walford
The ambulance crew tell me you have been admitted to the emergency department with a suspected femoral shaft fracture. I see a scared, frail older person, but I see a sparkle in your eyes that tells me how you made it to 101 years old.
August 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28855864/persistent-decreases-in-adult-subventricular-and-hippocampal-neurogenesis-following-adolescent-intermittent-ethanol-exposure
#20
Wen Liu, Fulton T Crews
Neurogenesis in hippocampal dentate gyrus (DG) and subventricular zone (SVZ) matures during adolescence to adult levels. Binge drinking is prevalent in adolescent humans, and could alter brain neurogenesis and maturation in a manner that persists into adulthood. To determine the impact of adolescent binge drinking on adult neurogenesis, Wistar rats received adolescent intermittent ethanol (AIE) exposure (5.0 g/kg/day, i.g., 2 days on/2 days off from postnatal day, P25-P54) and sacrificed on P57 or P95. Neural progenitor cell proliferation, differentiation, survival and maturation using immunohistochemistry was determined in the DG and SVZ...
2017: Frontiers in Behavioral Neuroscience
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