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https://www.readbyqxmd.com/read/29792462/extreme-teams-toward-a-greater-understanding-of-multiagency-teamwork-during-major-emergencies-and-disasters
#1
Nicola Power
Major emergencies are extreme team decision making environments. They are complex, dynamic, high-stakes and fast paced events, wherein successful resolution is contingent upon effective teamwork. Not only do emergency teams coordinate at the intrateam level (e.g., police team), but they are increasingly required to operate at the interteam level (e.g., police, fire and ambulance teams). This is in response to the desire for networked and cost-effective practice and due to the evolving nature of modern threats, such as extreme weather events and terrorist attacks, which require a multi- rather than single-agency response...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29735228/direct-air-versus-ground-transport-predictors-for-rural-pediatric-trauma
#2
Andrew B Starnes, Babawale Oluborode, Curtis Knoles, Boyd Burns, Henderson McGinnis, Kenneth Stewart
OBJECTIVE: Traumatic injury is the leading cause of mortality in children and the most common cause of emergency medical services transport in pediatric populations. We aimed to identify what factors are currently associated with selection for helicopter transport (HEMS) over ground ambulance (GEMS) in a primarily rural state. METHODS: We performed a retrospective case-control study of trauma patients younger than 18 years old reported to the Oklahoma State Trauma Registry between 2005 and 2014 who received direct transport from the scene of injury to a tertiary trauma center within the state...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29696107/comparing-the-effect-of-adding-fentanyl-sufentanil-and-placebo-with-intrathecal-bupivacaine-on-duration-of-analgesia-and-complications-of-spinal-anesthesia-in-patients-undergoing-cesarean-section
#3
Farnoush Farzi, Ali Mirmansouri, Bahram Naderi Nabi, Zahra Atrkar Roushan, Samaneh Ghazanfar Tehran, Mona Nematollahi Sani, Soodabe Makhlooghi Azad, Maryam Nemati
Background: Spinal anesthesia is the method of choice for most elective and emergency Cesarean sections. To increase the duration of anesthesia and improve the quality of analgesia during and after surgery, intrathecal opioids, as adjuvant drugs, are used in combination with local anesthetics. Methods: This was a double-blind clinical trial performed on 99 patients. Women were divided into 3 groups of fentanyl, sufentanil, and placebo. For fentanyl group, 12.5 mg of bupivacaine and 25 micrograms of fentanyl; for sufentanil group, 12...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29666145/development-of-sustainable-community-paramedicine-programmes-a-case-study-in-pennsylvania
#4
Yuan-Han Huang, Linlin Ma, Luke A Sabljak, Zachary A Puhala
BACKGROUND: Community paramedicine (CP) models have been applied across rural and urban communities in support of healthcare delivery systems for nearly two decades. However, there is still insufficient information regarding the development of sustainable CP programmes. This study explores the strategies used by active CP programmes and investigates their operational statuses, community demographics, financial models and challenges for programme development. METHODS: A series of interviews was conducted with four CP programmes in Pennsylvania, USA, which are affiliated with a local government, a health system, an ambulance service and an emergency medical service, respectively...
April 17, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29652166/ambulance-use-distance-and-outcomes-in-patients-with-suspected-cardiovascular-disease-a-registry-based-geographic-information-system-study
#5
Nariman Sepehrvand, Wendimagegn Alemayehu, Padma Kaul, Rick Pelletier, Aminu K Bello, Robert C Welsh, Paul W Armstrong, Justin A Ezekowitz
BACKGROUND: Despite guideline recommendations, the majority of patients with symptoms suggestive of acute coronary syndrome do not use emergency medical services to reach the emergency department (ED). The aim of this study was to investigate the factors associated with EMS utilisation and subsequent patient outcomes. METHODS: Using administrative data, all patients who presented to an ED in the metropolitan areas of Edmonton and Calgary in the years of 2007-2013 with main ED diagnosis of acute coronary syndrome, stable angina or chest pain were included...
April 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29618709/-factors-related-to-frequent-emergency-hospital-refusal-of-ambulance-transport-calls
#6
Mika Kumagai, Naomi Kitano, Erika Komatsu, Hiroyuki Doba, Masami Ueno
Purpose Among the factors that adversely affect the time needed for ambulance transport, one factor for which intervention is possible is the time it takes to choose a medical receiving facility. This research clarified the characteristics of the time, location, and severity of medical emergencies in which the choice of hospital was difficult.Methods The research covered a 1-year period from January 1 through December 31, 2014, investigating all incidents of ambulance transport for patients in Wakayama Prefecture, except for those involving pediatric patients, amounting to a total of 41,574 incidents...
2018: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/29581229/low-level-of-knowledge-of-heart-attack-symptoms-and-inappropriate-anticipated-treatment-seeking-behaviour-among-older-chinese-a-cross-sectional-survey
#7
Pui Hing Chau, Gordon Moe, Siu Yin Lee, Jean Woo, Angela Y M Leung, Chi-Ming Chow, Cecilia Kong, Wing Tung Lo, Ming Hay Yuen, Julie Zerwic
BACKGROUND: Prehospital delay of acute myocardial infarction (AMI) is common globally, and Hong Kong-home of a rapidly ageing Chinese population-is not an exception. Seeking emergency medical care promptly is important for patients. Treatment-seeking behaviours have been shown to be associated with knowledge of AMI symptoms and specific cultural beliefs. This study aimed to assess the level of knowledge of AMI symptoms and expected treatment-seeking behaviour among older Chinese in Hong Kong...
March 26, 2018: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/29551622/treatment-of-behavior-disturbances-with-ketamine-in-a-patient-diagnosed-with-major-neurocognitive-disorder
#8
Douglas Steenblock
A 77-year-old woman who had been previously diagnosed with a major neurocognitive disorder became highly agitated and aggressive in a long-term care facility. She did not respond to intramuscular (IM) haloperidol plus lorazepam and had to be transported to the local emergency department (ED). In the ambulance, she remained highly agitated and was given 200 mg IM ketamine. Within minutes of receiving this, she de-escalated dramatically with no apparent adverse effects and remained stable for several days. Although ketamine has been used recently in pre-hospital settings and EDs to reduce agitated behavior, there has been little if any investigation of its potential for reducing behavior disturbances in patients who suffer from major neurocognitive disorders...
February 26, 2018: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29469993/asthma-among-adult-patients-presenting-with-dyspnea-to-the-emergency-department-an-observational-study
#9
Win Sen Kuan, Simon Craig, Anne-Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
INTRODUCTION: Shortness of breath is a common presenting symptom to the emergency department (ED) that can arise from a myriad of possible diagnoses. Asthma is one of the major causes. OBJECTIVE: The aim of this study was to describe the demographic features, clinical characteristics, management and outcomes of adults with an ED diagnosis of asthma who presented to an ED in the Asia Pacific region with a principal symptom of dyspnea. METHODS: Planned sub-study of patients with an ED diagnosis of asthma identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study...
February 22, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29450701/burden-characteristics-and-process-of-care-among-the-pediatric-and-adult-trauma-patients-in-botswana-s-main-hospitals
#10
Michael B Mwandri, Timothy C Hardcastle
BACKGROUND: Botswana is notable among countries with high rates of Road Traffic Collisions (RTC); like many other lower-middle-income countries (LMICs), it lacks trauma systems. The World Health Organization recommends 'Essential Trauma Care' in countries with no formal trauma systems. The proportion of injuries in Emergency Departments and the care process were investigated to gain an overview for enabling the design of a relevant LMICs trauma system. METHOD: Blunt and penetrating trauma patients were included from three major hospitals, examining the proportion of injuries, patient characteristics, the care process and comparing these between pediatrics and adults...
February 15, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29423875/emergency-medicine-in-the-kingdom-of-bahrain
#11
Feras Abuzeyad, Leena Alqasem, Mudhaffar I Al Farras, Shaikha S Al Jawder, Ghada Al Qasim, Salah Alghanem
It has been more than a decade since emergency medicine became recognized as a specialty in the Kingdom of Bahrain. In the last fifteen years emergency medicine has widely established itself and developed rapidly in the Kingdom. The three main emergency departments are: Salmanyia Medical Complex (SMC), Royal Medical Services of Bahrain Defence Force (RMS-BDF) and King Hamad University Hospital (KHUH) are now fully equipped and operated by a majority of board certified emergency physicians.Standardized protocols, and the Central National Ambulance will be established in the near future, and the ambulances will offer both basic and advanced life support by trained nurses and paramedics...
February 8, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29404658/-miscommunication-as-a-risk-focus-in-patient-safety-work-process-analysis-in-prehospital-emergency-care
#12
S Wilk, L Siegl, K Siegl, C Hohenstein
BACKGROUND: In an analysis of a critical incident reporting system (CIRS) in out-of-hospital emergency medicine, it was demonstrated that in 30% of cases deficient communication led to a threat to patients; however, the analysis did not show what exactly the most dangerous work processes are. Current research shows the impact of poor communication on patient safety. OBJECTIVES: An out-of-hospital workflow analysis collects data about key work processes and risk areas...
April 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29395774/a-mathematical-model-for-efficient-emergency-transportation-in-a-disaster-situation
#13
Takwa Tlili, Sofiene Abidi, Saoussen Krichen
This work focuses on a real-life patient transportation problem derived from emergency medical services (EMS), whereby providing ambulatory service for emergency requests during disaster situations. Transportation of patients in congested traffic compounds already time sensitive treatment. An urgent situation is defined as individuals with major or minor injuries requiring EMS assistance simultaneously. Patients are either (1) slightly injured and treated on site or (2) are seriously injured and require transfer to points of care (PoCs)...
January 29, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29383055/intern-as-patient-a-patient-experience-simulation-to-cultivate-empathy-in-emergency-medicine-residents
#14
Sara W Nelson, Carl A Germann, Casey Z MacVane, Rebecca B Bloch, Timothy S Fallon, Tania D Strout
Introduction: Prior work links empathy and positive physician-patient relationships to improved healthcare outcomes. The objective of this study was to analyze a patient experience simulation for emergency medicine (EM) interns as a way to teach empathy and conscientious patient care. Methods: We conducted a qualitative descriptive study on an in situ, patient experience simulation held during EM residency orientation. Half the interns were patients brought into the emergency department (ED) by ambulance and half were family members...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29381111/neighborhood-poverty-and-9-1-1-ambulance-response-time
#15
Josh Seim, Melody J Glenn, Joshua English, Karl Sporer
BACKGROUND: Are 9-1-1 ambulances relatively late to poorer neighborhoods? Studies suggesting so often rely on weak measures of neighborhood (e.g., postal zip code), limit the analysis to particular ambulance encounters (e.g., cardiac arrest responses), and do little to account for variations in dispatch priority or intervention severity. METHODS: We merged EMS ambulance contact records in a single California county (n = 87,554) with tract-level data from the American Community Survey (n = 300)...
January 30, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29363100/non-transport-emergency-medical-service-missions-a-retrospective-study-based-on-medical-charts
#16
S Pekanoja, M Hoikka, H Kyngäs, S Elo
BACKGROUND: In Finland, approximately 40% of emergency medical service (EMS) missions do not result in transport of the patient to a hospital by ambulance, and there is wide variability in the reasons underlying non-transport decisions. The aim of this study was to describe the context of these EMS non-transport missions. METHODS: The data were collected retrospectively between 3 September and 20 October 2014 by investigating non-transport EMS charts (n = 1154)...
May 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29361856/catheterization-laboratory-activations-and-time-intervals-for-patients-with-pre-hospital-ecgs
#17
Josephine Muhrbeck, Jonas Persson, Claes Hofman-Bang
OBJECTIVE: The use of pre-hospital ECGs (PH-ECG) reduces time to reperfusion for patients with ST-segment elevation myocardial infarction (STEMI). The feasibility of reperfusion therapy within 60 minutes for hospitals with 24/7 PCI capability has been questioned, and current guidelines have set time targets to 90 minutes. Our primary objective was to investigate the proportion of false-positive catheterization laboratory activations by PH-ECG. Our secondary objective was to describe the time intervals from first medical contact to reperfusion and to establish the proportion of patients receiving reperfusion within 60 minutes...
April 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29351496/implementation-of-a-prehospital-protocol-change-for-asthmatic-children
#18
Anriada Nassif, Daniel G Ostermayer, Kim B Hoang, Mary K Claiborne, Elizabeth A Camp, Manish I Shah
BACKGROUND: Respiratory distress due to asthma is a common reason for pediatric emergency medical services (EMS) transports. Timely initiation of asthma treatment, including glucocorticoids, improves hospital outcomes. The impact of EMS-administered glucocorticoids on hospital-based outcomes for pediatric asthma patients is unknown. OBJECTIVE: The objective of this study was to evaluate the effect of an evidence-based pediatric EMS asthma protocol update, inclusive of oral glucocorticoid administration, on time to hospital discharge...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29345508/response-by-twin-italian-hub-hospitals-in-a-double-seismic-event-a-retrospective-observational-investigation
#19
Alberto Barbieri, Gabriele Melegari, Valentina Lob, Lorenzo Mazzali, Luca D'Amelio, Andrea Giovannoni, Enrico Giuliani
INTRODUCTION: The objectives of this study were to compare prevalence rates of different pathologies, ambulance system and emergency department management times, and patient survival and hazard ratios for codes 2 and 3 in two hub hospitals in Modena in the 36-month period across the stages of two major earthquakes in short sequence in Northern Italy in 2012. METHODS: Clinical records pertaining to the emergency care of patients were analyzed and only those assigned status codes 2 and 3 by ambulance professionals were included (if the assessment was confirmed by emergency department triage)...
January 18, 2018: Prehospital Emergency Care
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
#20
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
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