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https://www.readbyqxmd.com/read/29759099/procedural-sedation-by-advanced-care-paramedics-for-emergency-gastrointestinal-endoscopy
#1
Hana M Wiemer, Michael B Butler, Patrick C Froese, Allan Lapierre, Chris Carriere, Glen R Etsell, Dana Farina, Jennifer Jones, Jock Murray, Samuel G Campbell
CLINICIAN'S CAPSULE What is known about the topic? Advanced care paramedics (ACPs) in our emergency department (ED) successfully perform procedural sedation and analgesia (PSA) for several procedures, including orthopedic manipulations. What did this study ask? How does the novel practice of ACP-led ED PSA for upper gastrointestinal (UGI) endoscopy compare to that for orthopedic procedures? What did this study find? Adverse events occurred more frequently during UGI endoscopy sedations than orthopedic sedations (41...
May 15, 2018: CJEM
https://www.readbyqxmd.com/read/29742283/vaccination-practices-in-dialysis-patients-a-narrative-review
#2
REVIEW
Georges Kosmadakis, Julie Albaret, Enrique Da Costa Correia, Frederic Somda, Didier Aguilera
In a period of turmoil concerning vaccination practices, there is a serious conflict between scientifically reasonable, evidence-based guidelines and the far-fetched rumors or misconceptions concerning the vaccination practices in the general population. When a significant portion of the medical and paramedical personnel may be deliberately unvaccinated against common biological agents, achieving effective vaccination rates in the dialysis population may be complicated. Vaccination rates are unacceptably low in dialysis patients and seroconversion rates are even lower; further, serological follow-up is generally poor...
May 9, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#3
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/29720300/chronic-obstructive-pulmonary-disease-and-heart-failure-self-management-kits-for-outpatient-transitions-of-care
#4
Paul Boylan, Tina Joseph, Genevieve Hale, Cynthia Moreau, Matthew Seamon, Renee Jones
OBJECTIVE: To develop heart failure (HF) and chronic obstructive pulmonary disease (COPD) self-management kits in an accountable care organization (ACO) to facilitate patients' self-care and prevent hospital readmissions. SETTING: Pharmacists practice in an outpatient-based ACO. They participate in interprofessional office visits with providers and independently manage maintenance pharmacotherapies. PRACTICE DESCRIPTION: Pharmacists collaborate with an interprofessional team within the ACO including physicians, nurses, case managers, and paramedics...
March 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29688646/-the-significance-of-the-legal-perspective-the-legal-world-s-contribution-to-the-medical-world
#5
REVIEW
Alona Sigler-Harcavi, Limor Cohen Ashkenazi
Working with medical and paramedical teams has taught us that the medical staff does not fully utilize the potential of judicial decisions and precedents as a source for learning, drawing conclusions and motivating progress. Judicial ruling is an essential part of the toolbox used by medical administrators in general, and healthcare risk managers in particular. Knowing the relevant legal rulings, before you embark on any given path, is the equivalent of looking before you leap. This is not necessarily an issue of "holy scripture", but should mainly be considered as a source for expanding your perspective...
April 2018: Harefuah
https://www.readbyqxmd.com/read/29672202/setting-the-scene-for-paramedics-in-general-practice-what-can-we-expect
#6
Kamal R Mahtani, Georgette Eaton, Matthew Catterall, Alice Ridley
No abstract text is available yet for this article.
January 1, 2018: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/29626354/second-regional-plasmapheresis-conference-and-workshop-for-southeast-asia-sea-on-the-immunomodulatory-role-of-plasma-exchange-in-central-and-peripheral-nervous-system-disorders-kuala-lumpur-malaysia-9th-december-2017
#7
Shanthi Viswanathan, Stefanie Kar Yan Hung, Vinay Goyal, Metha Apiwattanakul, Umapathi N Thirugnanam, Suhailah Abdullah, Seinn Mya Mya Aye, Ohnmar Ohnmar, Le Tri Si, Saysavath Keosodsay, Riwanti Estiasari, Najib Khalife, Fu Liong Hiew
In December 2017, 79 delegates attended the 2nd regional plasmapheresis conference and workshop for Southeast Asia (SEA) on the immunomodulatory role of plasma exchange in central and peripheral nervous system disorders in Kuala Lumpur, Malaysia. This meeting featured 6 plenary lectures, interactive sessions dedicated for experience sharing, case presentations, and a practical session for paramedics. Clinical experts and researchers from 7 SEA countries and India shared experience and challenges in treating autoimmune neurological disorders...
April 6, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29611865/patient-experience-in-primary-care-association-with-patient-physician-and-practice-characteristics-in-a-fee-for-service-system
#8
Christine Cohidon, Pascal Wild, Nicolas Senn
INTRODUCTION: Nowadays we typically use patient experience as a quality of care indicator, although this has some limitations. The aim of this study was to investigate to what extent patient, physician and practice characteristics were associated with patient-reported experience of care in the major dimensions in family medicine in a fee-for-service system. METHODS: The data came from the Swiss part of the Quality and Costs of Primary Care (QUALICOPC) study, an international cross-sectional survey...
April 3, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29563671/human-immunodeficiency-virus-acquired-immune-deficiency-syndrome-a-survey-on-the-knowledge-attitude-and-practice-among-medical-professionals-at-a-tertiary-health-care-institution-in-uttarakhand-india
#9
Ananya Doda, Gita Negi, Dushyant Singh Gaur, Meena Harsh
INTRODUCTION: Health-care professionals are trained health-care providers who occupy a potential vanguard position in human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention programs and the management of AIDS patients. This study was performed to assess HIV/AIDS-related knowledge, attitude, and practice (KAP) and perceptions among health-care professionals at a tertiary health-care institution in Uttarakhand, India, and to identify the target group where more education on HIV is needed...
January 2018: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/29549460/success-rates-of-pre-hospital-difficult-airway-management-a-quality-control-study-evaluating-an-in-hospital-training-program
#10
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/29506968/the-impact-of-a-small-private-online-course-as-a-new-approach-to-teaching-oncology-development-and-evaluation
#11
Charlotte Vaysse, Elodie Chantalat, Odile Beyne-Rauzy, Louise Morineau, Fabien Despas, Jean-Marc Bachaud, Nathalie Caunes, Muriel Poublanc, Elie Serrano, Roland Bugat, Marie-Eve Rougé Bugat, Anne-Laure Fize
BACKGROUND: Oncology involves complex care and multidisciplinary management of patients; however, misinformation and ineffective communication remain problematic. OBJECTIVE: The educational objective of our study was to develop a new teaching method to improve cancer treatment and management by emphasizing the link between hospitals (inpatients) and their surrounding communities (outpatients). METHODS: A team of 22 professionals from public and private institutions developed a small private online course (SPOC)...
March 5, 2018: JMIR Medical Education
https://www.readbyqxmd.com/read/29485328/national-systematic-legal-review-of-state-policies-on-emergency-medical-services-licensure-levels-authority-to-administer-opioid-antagonists
#12
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/29473297/promoting-collaboration-in-emergency-medicine
#13
Shobhana Nagraj, Juliet Harrison, Lawrence Hill, Lesley Bowker, Susanne Lindqvist
BACKGROUND: Collaborative practice between paramedics and medical staff is essential for ensuring the safe handover of patients. Handover of care is a critical time in the patient journey, when effective communication and collaborative practice are central to promoting patient safety and to avoiding medical error. To encourage effective collaboration between paramedic and medical students, an innovative, practice-based simulation exercise, known as interprofessional clinical skills (ICS) was developed at the University of East Anglia, UK...
February 23, 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29405806/delayed-sequence-intubation-by-intensive-care-flight-paramedics-in-victoria-australia
#14
Jacinta Waack, Matthew Shepherd, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Delayed sequence intubation (DSI) involves the administration of ketamine to facilitate adequate preoxygenation in the agitated patient. DSI was introduced into the Clinical Practice Guideline for Intensive Care Flight Paramedics in Victoria in late 2013. We aimed to describe the clinical characteristics of patients receiving DSI. METHODS: A retrospective analysis was undertaken of patients who received DSI between January 1, 2014, and December 31, 2016, during both primary response and retrieval missions...
February 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29405803/prehospital-rapid-sequence-intubation-by-intensive-care-flight-paramedics
#15
Ashleigh Delorenzo, Toby St Clair, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Rapid sequence intubation (RSI) is an advanced airway procedure for critically ill or injured patients. Paramedic-performed RSI in the prehospital setting remains controversial, as unsuccessful or poorly conducted RSI is known to result in significant complications. In Victoria, intensive care flight paramedics (ICFPs) have a broad scope of practice including RSI in both the adult and pediatric population. We sought to describe the success rates and characteristics of patients undergoing RSI by ICFPs in Victoria, Australia...
February 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29392483/crossing-the-death-threshold-experiencing-multi-disciplinary-end-of-life-integrative-oncology-training
#16
Eran Ben-Arye, Yael Keshet, Maria Livas, Thomas Breitkreuz
OBJECTIVE: Complementary and integrative medicine (CIM) is acknowledged in more and more oncology-care centers as part of supportive and palliative cancer care. However, only limited research is available on medical training of CIM practitioners regarding end-of-life (EOL) care. In this study, we assess the impact of multi-disciplinary EOL training on cultural-diverse groups of CIM-trained healthcare practitioners (HCPs) working in integrative oncology care settings in Germany and Israel...
February 1, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29383079/interprofessional-emergency-training-leads-to-changes-in-the-workplace
#17
Dorothea Eisenmann, Fabian Stroben, Jan D Gerken, Aristomenis K Exadaktylos, Mareen Machner, Wolf E Hautz
Introduction: Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29382398/comparison-of-unmanned-aerial-vehicle-technology-versus-standard-practice-in-identification-of-hazards-at-a-mass-casualty-incident-scenario-by-primary-care-paramedic-students
#18
Trevor Jain, Aaron Sibley, Henrik Stryhn, Ives Hubloue
Introduction The proliferation of unmanned aerial vehicles (UAV) has the potential to change the situational awareness of incident commanders allowing greater scene safety. The aim of this study was to compare UAV technology to standard practice (SP) in hazard identification during a simulated multi-vehicle motor collision (MVC) in terms of time to identification, accuracy and the order of hazard identification. METHODS: A prospective observational cohort study was conducted with 21 students randomized into UAV or SP group, based on a MVC with 7 hazards...
January 31, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29374478/operation-and-challenges-of-home-based-medical-practices-in-the-us-findings-from-six-aggregated-case-studies
#19
Gregory J Norman, Kristann Orton, Amy Wade, Andrea M Morris, Jill C Slaboda
BACKGROUND: Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC...
January 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29331194/-specificities-of-nursing-care-in-neurological-intensive-care
#20
REVIEW
Christelle Garijo, Flavien Chabert, Cécile Armonia, Perrine Boucheix
In the acute phase of the treatment of patients with brain injuries, the management of secondary brain injuries of systemic origin is a priority. A neurosurgical intensive care paramedical team shares their experience of the care delivered and the constant monitoring carried out to optimise, with the medical team, the patient's outcome and to innovate practices.
January 2018: Revue de L'infirmière
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