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https://www.readbyqxmd.com/read/28399846/palliative-sedation-challenging-the-professional-competency-of-health-care-providers-and-staff-a-qualitative-focus-group-and-personal-written-narrative-study
#1
Danièle Leboul, Régis Aubry, Jean-Michel Peter, Victor Royer, Jean-François Richard, Frédéric Guirimand
BACKGROUND: Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation...
April 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28397649/support-and-assessment-for-fall-emergency-referrals-safer-2-a-cluster-randomised-trial-and-systematic-review-of-clinical-effectiveness-and-cost-effectiveness-of-new-protocols-for-emergency-ambulance-paramedics-to-assess-older-people-following-a-fall-with-referral
#2
Helen A Snooks, Rebecca Anthony, Robin Chatters, Jeremy Dale, Rachael Fothergill, Sarah Gaze, Mary Halter, Ioan Humphreys, Marina Koniotou, Phillipa Logan, Ronan Lyons, Suzanne Mason, Jon Nicholl, Julie Peconi, Ceri Phillips, Judith Phillips, Alison Porter, A Niroshan Siriwardena, Graham Smith, Alun Toghill, Mushtaq Wani, Alan Watkins, Richard Whitfield, Lynsey Wilson, Ian T Russell
BACKGROUND: Emergency calls are frequently made to ambulance services for older people who have fallen, but ambulance crews often leave patients at the scene without any ongoing care. We evaluated a new clinical protocol which allowed paramedics to assess older people who had fallen and, if appropriate, refer them to community-based falls services. OBJECTIVES: To compare outcomes, processes and costs of care between intervention and control groups; and to understand factors which facilitate or hinder use...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28393757/prehospital-randomised-assessment-of-a-mechanical-compression-device-in-out-of-hospital-cardiac-arrest-paramedic-a-pragmatic-cluster-randomised-trial-and-economic-evaluation
#3
Simon Gates, Ranjit Lall, Tom Quinn, Charles D Deakin, Matthew W Cooke, Jessica Horton, Sarah E Lamb, Anne-Marie Slowther, Malcolm Woollard, Andy Carson, Mike Smyth, Kate Wilson, Garry Parcell, Andrew Rosser, Richard Whitfield, Amanda Williams, Rebecca Jones, Helen Pocock, Nicola Brock, John Jm Black, John Wright, Kyee Han, Gary Shaw, Laura Blair, Joachim Marti, Claire Hulme, Christopher McCabe, Silviya Nikolova, Zenia Ferreira, Gavin D Perkins
BACKGROUND: Mechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA). OBJECTIVE: Evaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28392248/creating-authentic-video-scenarios-for-use-in-prehospital-research
#4
Christopher Preston, Bernie Carter, Barbara Jack, Lucy Bray
Video scenarios have been used to explore clinical reasoning during interviews in Think Aloud studies. This study used nominal group technique with experts to create video scenarios to explore the ways paramedics think and reason when caring for children who are sick or injured. At present there is little research regarding paramedics' clinical reasoning with respect to performing non-urgent procedures on children. A core expert panel identified the central structure of a prehospital clinical interaction and the range of contextual factors that may influence a paramedic's clinical reasoning [the way in which information is gathered, interpreted and analysed by clinicians]...
April 6, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28385466/self-reported-behaviors-and-perceptions-of-australian-paramedics-in-relation-to-hand-hygiene-and-gloving-practices-in-paramedic-led-health-care
#5
Nigel Barr, Mark Holmes, Anne Roiko, Peter Dunn, Bill Lord
BACKGROUND: Noncompliance with recommended hand hygiene and gloving practices by workers in the emergency medical services may contribute to the transmission of health care-associated infections and lead to poor patient outcomes. The aim of this study was to explore the self-reported behaviors and perceptions of Australian paramedics in relation to their hand hygiene and gloving practices in paramedic-led health care. METHODS: A national online survey (n = 417; 17% response rate) and 2 semistructured focus groups (6 per group) were conducted with members of Paramedics Australasia...
April 3, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28367581/drowning-in-swimming-pools-clinical-features-and-safety-recommendations-based-on-a-study-of-descriptive-records-by-emergency-medical-services-attending-to-995-calls
#6
Joanna Shi-En Chan, Marie Xin Ru Ng, Yih Yng Ng
INTRODUCTION: This study was a descriptive analysis of national ambulance case records, aimed at making practical safety recommendations in order to reduce the incidence of drowning in swimming pools. METHODS: A search was performed on a national database of descriptive summaries by first responder paramedics of all 995 calls made to the Singapore Civil Defence Force between 1 January 2012 and 31 December 2014. We included all cases of submersion in both public and private pools for which emergency medical services were activated...
April 3, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28361828/knowledge-attitude-practice-on-human-papillomavirus-vaccination-a-cross-sectional-study-among-healthcare-providers
#7
P Cheena Chawla, Anil Chawla, Seema Chaudhary
BACKGROUND & OBJECTIVES: Cervical cancer is a major health problem and a leading cause of death among women in India. Of all the associated risk factors, high-risk human papillomavirus (HPV) infections being the principal aetiologic agent, two HPV vaccines are in use for the control of cervical cancer. The present study was undertaken to explore the knowledge, attitude and practice (KAP) on HPV vaccination among the healthcare providers in India. METHODS: A cross-sectional study was conducted among 590 healthcare professionals from 232 hospitals and 80 PHCs of nine districts of Delhi-NCR (National Capital Region)...
November 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28356134/external-validation-of-the-rosc-after-cardiac-arrest-raca-score-in-a-physician-staffed-emergency-medical-service-system
#8
Petteri Kupari, Markus Skrifvars, Markku Kuisma
BACKGROUND: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. METHODS: We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated...
March 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28340247/usability-testing-of-the-iphone-app-to-improve-pain-assessment-for-older-adults-with-cognitive-impairment-prehospital-setting-a-qualitative-study
#9
Rachael E Docking, Matthew Lane, Pat A Schofield
Objectives. : Pain assessment in older adults with cognitive impairment is often challenging, and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28318455/airway-management-in-disaster-response-a-manikin-study-comparing-direct-and-video-laryngoscopy-for-endotracheal-intubation-by-prehospital-providers-in-level-c-personal-protective-equipment
#10
Sami Yousif, Jason T Machan, Yasser Alaska, Selim Suner
Introduction Airway management is one of many challenges that medical providers face in disaster response operations. The use of personal protective equipment (PPE), in particular, was found to be associated with higher failure rates and a prolonged time to achieve airway control. Hypothesis/Problem The objective of this study was to determine whether video laryngoscopy could facilitate the performance of endotracheal intubation by disaster responders wearing Level C PPE. METHODS: In this prospective, randomized, crossover study, a convenience sample of practicing prehospital providers were recruited...
March 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28315858/how-does-culture-affect-experiential-training-feedback-in-exported-canadian-health-professional-curricula
#11
Kerry Wilbur, Rasha Mousa Bacha, Somaia Abdelaziz
Objectives: To explore feedback processes of Western-based health professional student training curricula conducted in an Arab clinical teaching setting. Methods: This qualitative study employed document analysis of in-training evaluation reports (ITERs) used by Canadian nursing, pharmacy, respiratory therapy, paramedic, dental hygiene, and pharmacy technician programs established in Qatar. Six experiential training program coordinators were interviewed between February and May 2016 to explore how national cultural differences are perceived to affect feedback processes between students and clinical supervisors...
March 17, 2017: International Journal of Medical Education
https://www.readbyqxmd.com/read/28300525/disaster-preparedness-among-health-professionals-and-support-staff-what-is-effective-an-integrative-literature-review
#12
Jeremy R Gowing, Kim N Walker, Shandell L Elmer, Elizabeth A Cummings
Introduction It is important that health professionals and support staff are prepared for disasters to safeguard themselves and the community during disasters. There has been a significantly heightened focus on disasters since the terrorist attacks of September 11, 2001 in New York (USA); however, despite this, it is evident that health professionals and support staff may not be adequately prepared for disasters. Report An integrative literature review was performed based on a keyword search of the major health databases for primary research evaluating preparedness of health professionals and support staff...
March 16, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28290958/comparative-assessment-of-three-approaches-of-teaching-nonmedically-trained-persons-in-the-handling-of-supraglottic-airways-a-randomized-controlled-trial
#13
Mario Hensel, Willi Schmidbauer, Michael Benker, Paula Schmieder, Thoralf Kerner
BACKGROUND: The use of supraglottic airways has been recommended in combat trauma airway management. To ensure an adequate airway management on the battlefield, suitable training concepts are sought to efficiently teach as many soldiers as possible. Our aim was to compare three approaches of teaching laypersons in the handling of supraglottic airways in a mannequin model. METHODS: In this prospective randomized blinded study, 285 military service men without any medical background were divided into three groups and trained in the use of the Laryngeal Mask Airway Supreme (LMA) and the Laryngeal Tube Disposable (LT-D)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28266888/self-efficacy-perceptions-of-interprofessional-education-and-practice-in-undergraduate-healthcare-students
#14
Brett Williams, Bronwyn Beovich, Linda Ross, Caroline Wright, Dragan Ilic
Self-efficacy is an individual's perception of their ability to be successful in a given endeavour and it has been shown to have an important role in successful university education and clinical performance of healthcare workers. This article examines the self-efficacy beliefs of undergraduate healthcare students (n = 388) for the skills required for interprofessional education and interprofessional collaboration. The students were enrolled at an Australian university from the disciplines of public health, social work, and paramedic practice...
May 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28257249/pediatric-prehospital-medication-dosing-errors-a-national-survey-of-paramedics
#15
John D Hoyle, Remle P Crowe, Melissa A Bentley, Gerald Beltran, William Fales
BACKGROUND: Pediatric drug dosing errors occur at a high rate in the prehospital environment. OBJECTIVE: To describe paramedic training and practice regarding pediatric drug administration, exposure to pediatric drug dose errors and safety culture among paramedics and EMS agencies in a national sample. METHODS: An electronic questionnaire was sent to a random sample of 10,530 nationally certified paramedics. Descriptive statistics were calculated...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28213079/-patients-players-in-healthcare-research
#16
Olivia Gross, Anne Muller, Monique Rothan-Tondeur, Jean-Charles Verheye
Healthcare research is developing in France, notably through hospital nursing and paramedical research programmes. Few research projects involve the patients as investigators as part of collaborative studies. These approaches favour the involvement of all the players concerned. Thereby, healthcare research, due to its holistic dimension, encourages the development of collaborative practices between researchers, patients and caregivers.
January 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/28169135/case-study-and-case-based-research-in-emergency-nursing-and-care-theoretical-foundations-and-practical-application-in-paramedic-pre-hospital-clinical-judgment-and-decision-making-of-patients-with-mental-illness
#17
Ramon Z Shaban, Julie Considine, Margaret Fry, Kate Curtis
Generating knowledge through quality research is fundamental to the advancement of professional practice in emergency nursing and care. There are multiple paradigms, designs and methods available to researchers to respond to challenges in clinical practice. Systematic reviews, randomised control trials and other forms of experimental research are deemed the gold standard of evidence, but there are comparatively few such trials in emergency care. In some instances it is not possible or appropriate to undertake experimental research...
February 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28163912/the-benefits-of-youth-are-lost-on-the-young-cardiac-arrest-patient
#18
REVIEW
Brian Griffith, Patrick Kochanek, Cameron Dezfulian
Children and young adults tend to have reduced mortality and disability after acquired brain injuries such as trauma or stroke and across other disease processes seen in critical care medicine. However, after out-of-hospital cardiac arrest (OHCA), outcomes are remarkably similar across age groups. The consistent lack of witnessed arrests and a high incidence of asphyxial or respiratory etiology arrests among pediatric and young adult patients with OHCA account for a substantial portion of the difference in outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28112989/airway-management-proficiency-checklist-for-assessing-paramedic-performance
#19
David P Way, Ashish R Panchal, Geoffrey I Finnegan, Thomas E Terndrup
OBJECTIVE: To develop and derive an instrument for assessing airway management proficiency for paramedics. METHODS: Using a validated difficult airway model simulation, we recorded responses to a standard traumatic brain injury scenario requiring airway management in 197 certified paramedics. Discrete items (N = 131) were developed by an expert panel, and referenced to three performance standard subscales (i.e., intubation, ventilation, and backup airway). Responses were scored and subjected to an iterative process to create a more practical number of items for the final Airway Management Proficiency Checklist (AMPC)...
January 23, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28103119/iatrogenic-spinal-cord-injury-in-a-trauma-patient-with-ankylosing-spondylitis
#20
Ahmad Maarouf, Colleen M McQuown, Jennifer A Frey, Rami A Ahmed, Lisa Derrick
BACKGROUND: The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients...
January 19, 2017: Prehospital Emergency Care
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