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https://www.readbyqxmd.com/read/28635451/delivering-person-centred-care-in-police-custody
#1
Matt Peel
The custody nurse role was introduced in 2003 following changes to legislation, which allowed nurses and paramedics to care for people in police custody. Before this, the work was done solely by doctors.
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28633090/pulmonary-and-cardiac-pathology-in-sudden-unexpected-death-in-epilepsy-sudep
#2
REVIEW
Fábio A Nascimento, Zian H Tseng, Cristian Palmiere, Joseph J Maleszewski, Takayuki Shiomi, Aileen McCrillis, Orrin Devinsky
OBJECTIVE: To review studies on structural pulmonary and cardiac changes in SUDEP cases as well as studies showing pulmonary or cardiac structural changes in living epilepsy patients. METHODS: We conducted electronic literature searches using the PubMed database for articles published in English, regardless of publication year, that included data on cardiac and/or pulmonary structural abnormalities in SUDEP cases or in living epilepsy patients during the postictal period...
June 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28631343/exploration-of-difficult-conversations-among-australian-paramedics
#3
Brett Williams, Bronwyn Beovich, Geoff Flemming, Grant Donovan, Ian Patrick
Previous studies indicate that healthcare professionals find it challenging to engage in difficult conversations regarding concerning behavior of colleagues. As a result, these conversations are often avoided. The inability to have these difficult conversations is associated with poorer patient outcomes, staff commitment, discretionary effort, and employee satisfaction. This descriptive study used an online questionnaire to examine responses of paramedics employed by Ambulance Victoria (Australia) regarding difficult conversations between colleagues about concerning behavior of co-workers...
June 20, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/28623905/educational-standards-for-training-paramedics-in-ultrasound-a-scoping-review
#4
Ben Meadley, Alexander Olaussen, Ashleigh Delorenzo, Nick Roder, Caroline Martin, Toby St Clair, Andrew Burns, Emma Stam, Brett Williams
BACKGROUND: Paramedic-performed out-of-hospital ultrasound is a novel skill that has gained popularity in some services in recent years. In this setting point-of care ultrasound (POCUS) can provide additional information that can assist with management and guide transport to the most appropriate facility. We sought to explore the different educational approaches used for training paramedics in ultrasound in the out-of-hospital setting. METHODS: Ovid MEDLINE, EMBASE, EBM Reviews, The Cochrane Library, CINAHL plus, The Monash University Research Repository and the British Thesis Library were searched from the 1(st) of January 1990 to the 6(th) of April 2016...
June 17, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28622155/triad-ix-can-a-patient-testimonial-safely-help-ensure-prehospital-appropriate-critical-versus-end-of-life-care
#5
Ferdinando Mirarchi, Christopher Cammarata, Timothy E Cooney, Kristin Juhasz, Stanley A Terman
OBJECTIVE: The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM). METHODS: Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM...
June 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28622071/survival-in-out-of-hospital-rapid-sequence-intubation-of-non-traumatic-brain-pathologies
#6
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28619858/ptsd-acute-stress-performance-and-decision-making-in-emergency-service-workers
#7
Cheryl Regehr, Vicki R LeBlanc
Despite research identifying high levels of stress and traumatic stress symptoms among those in the emergency services, the impact of these symptoms on performance and hence public safety remains uncertain. This review paper discusses a program of research that has examined the effects of prior critical incident exposure, acute stress, and current post-traumatic symptoms on the performance and decision-making during an acutely stressful event among police officers, police communicators, paramedics and child protection workers...
June 2017: Journal of the American Academy of Psychiatry and the Law
https://www.readbyqxmd.com/read/28616613/comparison-of-the-airway-access-skills-of-prehospital-staff-in-moving-and-stationary-ambulance-simulation-a-randomized-crossover-study
#8
Onur Karaca, Basak Bayram, Nese Colak Oray, Asli Acerer, Zeynep Sofuoglu
OBJECTIVES: We aimed to compare the procedural success and intervention durations regarding various airway access skills in moving and stationary ambulance simulations. MATERIAL AND METHODS: An ambulance simulator was used to simulate the moving ambulance environment, and a standard manikin was used for airway simulation. The study included 38 paramedics and paramedic students. In stationary and moving environments, a classical endotracheal intubation with a stylet, an intubation with a gum elastic bougie (GEB), a laryngeal mask airway (LMA), and a laryngeal tube (LT) were applied randomly...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611888/efficacy-and-safety-of-tranexamic-acid-in-prehospital-traumatic-hemorrhagic-shock-outcomes-of-the-cal-pat-study
#9
Michael M Neeki, Fanglong Dong, Jake Toy, Reza Vaezazizi, Joe Powell, Nina Jabourian, Alex Jabourian, David Wong, Richard Vara, Kathryn Seiler, Troy W Pennington, Joe Powell, Chris Yoshida-McMath, Shanna Kissel, Katharine Schulz-Costello, Jamish Mistry, Matthew S Surrusco, Karen R O'Bosky, Daved Van Stralen, Daniel Ludi, Karl Sporer, Peter Benson, Eugene Kwong, Richard Pitts, John T Culhane, Rodney Borger
INTRODUCTION: The California Prehospital Antifibrinolytic Therapy (Cal-PAT) study seeks to assess the safety and impact on patient mortality of tranexamic acid (TXA) administration in cases of trauma-induced hemorrhagic shock. The current study further aimed to assess the feasibility of prehospital TXA administration by paramedics within the framework of North American emergency medicine standards and protocols. METHODS: This is an ongoing multi-centered, prospective, observational cohort study with a retrospective chart-review comparison...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611884/emergency-medical-services-professionals-attitudes-about-community-paramedic-programs
#10
Robert J Steeps, Denise A Wilfong, Michael W Hubble, Daniel L Bercher
INTRODUCTION: The number of community paramedic (CP) programs has expanded to mitigate the impact of increased patient usage on emergency services. However, it has not been determined to what extent emergency medical services (EMS) professionals would be willing to participate in this model of care. With this project, we sought to evaluate the perceptions of EMS professionals toward the concept of a CP program. METHODS: We used a cross-sectional study method to evaluate the perceptions of participating EMS professionals with regard to their understanding of and willingness to participate in a CP program...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28602229/diagnosis-and-following-up-of-m%C3%A3-ni%C3%A3-re-s-disease-using-multifrequency-tympanometry-cutoff-values-and-temporal-changes-in-measurements
#11
Kazuyuki Ishizu, Akihiro Tamae, Kazuhiko Kubo, Takamasa Yoshida, Nozomu Matsumoto, Tetsurou Yasui, Takashi Nakagawa
OBJECTIVE: This study aimed to verify cutoff values for G width (the width of bimodal peaks for the waveform obtained when measuring conductance at 2000Hz) in Japanese individuals diagnosed with Ménière's disease (MD) using multifrequency tympanometry (MFT) and to determine the relationship between the G width and ability to hear low-pitched sounds using measurements over time. METHODS: The study included 51 patients with clinically diagnosed MD, who had not undergone endolymphatic sac surgery, but had no other known ear disease (57 ears in patients aged 22-80 years were affected, and 45 ears in patients aged 18-83 years were unaffected; mean age: 53...
June 8, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28599999/-tell-me-exactly-what-s-happened-when-linguistic-choices-affect-the-efficiency-of-emergency-calls-for-cardiac-arrest
#12
Marine Riou, Stephen Ball, Teresa A Williams, Austin Whiteside, Kay L O'Halloran, Janet Bray, Gavin D Perkins, Karen Smith, Peter Cameron, Daniel M Fatovich, Madoka Inoue, Paul Bailey, Deon Brink, Judith Finn
BACKGROUND: Clear and efficient communication between emergency caller and call-taker is crucial to timely ambulance dispatch. We aimed to explore the impact of linguistic variation in the delivery of the prompt "okay, tell me exactly what happened" on the way callers describe the emergency in the Medical Priority Dispatch System(®). METHODS: We analysed 188 emergency calls for cases of paramedic-confirmed out-of-hospital cardiac arrest. We investigated the linguistic features of the prompt "okay, tell me exactly what happened" in relation to the format (report vs...
June 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28596659/patterns-of-adverse-transfusion-reactions-in-a-tertiary-care-centre-of-north-india-a-step-towards-hemovigilance
#13
Rajni Bassi, Shikha Aggarwal, Kanchan Bhardwaj, Kusum K Thakur
Transfusion of blood and blood products is a double edged sword, so it should be used judiciously. The primary aim of the centralized Haemovigilance Program is to improve transfusion safety. To determine the incidence of adverse transfusion reactions (ATRs) in recipients of blood and blood components. Prospective study from January 2014 till April 2015 was done. ATRs reported to the Department of Transfusion Medicine were recorded and analyzed on the basis of their clinical features and lab tests. During the study period 25,099 units of blood and blood components were transfused and 100 ATRs (0...
June 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28592181/grappling-with-the-future-the-messiness-of-pilot-implementation-in-information-systems-design
#14
Morten Hertzum, Maria Ie Manikas, Arnvør Á Torkilsheyggi
Pilot implementation is a method for avoiding unintended consequences of healthcare information systems. This study investigates how learning from pilot implementations is situated, messy, and therefore difficult. We analyze two pilot implementations by means of observation and interviews. In the first pilot implementation, the involved porters saw their improved overview of pending patient transports as an opportunity for more self-organization, but this opportunity hinged on the unclear prospects of extending the system with functionality for the porters to reply to transport requests...
June 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28587694/a-survey-of-front-line-paramedics-examining-the-professional-relationship-between-paramedics-and-physician-medical-oversight
#15
Christopher R Foerster, Walter Tavares, Ilkka Virkkunen, Antti Kämäräinen
OBJECTIVE: Paramedicine is often dependent on physician medical directors and their associated programs for direction and oversight. A positive relationship between paramedics and their oversight physicians promotes safety and quality care while a strained or ineffective one may threaten these goals. The objective of this study was to explore and understand the professional relationship between paramedics and physician medical oversight as viewed by front-line paramedics. METHODS: All active front-line paramedics from four municipal paramedic services involving three medical oversight groups in Ontario were invited to complete an online survey...
June 7, 2017: CJEM
https://www.readbyqxmd.com/read/28583999/paramedic-initiation-of-neuroprotective-agent-infusions-successful-achievement-of-target-blood-levels-and-attained-level-effect-on-clinical-outcomes-in-the-fast-mag-pivotal-trial-field-administration-of-stroke-therapy-magnesium
#16
Kristina Shkirkova, Sidney Starkman, Nerses Sanossian, Marc Eckstein, Samuel Stratton, Frank Pratt, Robin Conwit, Scott Hamilton, Latisha Sharma, David Liebeskind, Lucas Restrepo, Miguel Valdes-Sueiras, Jeffrey L Saver
BACKGROUND AND PURPOSE: Paramedic use of fixed-size lumen, gravity-controlled tubing to initiate intravenous infusions in the field may allow rapid start of neuroprotective therapy for acute stroke. In a large, multicenter trial, we evaluated its efficacy in attaining target serum levels of candidate neuroprotective agent magnesium sulfate and the relation of achieved magnesium levels to outcome. METHODS: The FAST-MAG phase 3 trial (Field Administration of Stroke Therapy - Magnesium) randomized 1700 patients within 2 hours of onset to paramedic-initiated, a 15-minute loading intravenous infusion of magnesium or placebo followed by a 24-hour maintenance dose...
June 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28570313/the-cost-of-burn-transfers-a-retrospective-review-of-7-years-of-admissions-to-a-regional-burn-center
#17
Ryan E Austin, Sofie Schlagintweit, Marc G Jeschke, Russell MacDonald, Mahvareh Ahghari, Shahriar Shahrokhi
The transport of thermally injured patients can involve significant costs; however, not all thermally injured patients necessitate transfer to a burn center. The purpose of this study was to review transfers to an American Burn Association-verified regional burn center to determine whether the transfers were necessary and the cost associated with unnecessary transfers. A retrospective chart review identified 707 patients transferred to an American Burn Association-verified burn center with an acute burn injury during a 7-year period...
May 19, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28562145/exploring-educational-interventions-to-facilitate-health-professional-students-professionally-safe-online-presence
#18
Marcus A Henning, Susan Hawken, Joanna MacDonald, Judy McKimm, Menna Brown, Helen Moriarty, Sue Gasquoine, Kwong Chan, Jo Hilder, Tim Wilkinson
OBJECTIVE: To establish the most effective approach and type of educational intervention for health professional students, to enable them to maintain a professionally safe online presence. METHOD: This was a qualitative, multinational, multi-institutional, multiprofessional study. Practical considerations (availability of participants) led us to use a combination of focus groups and individual interviews, strengthening our findings by triangulating our method of data collection...
May 31, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28559038/nonphysician-out-of-hospital-rapid-sequence-intubation-success-and-adverse-events-a%C3%A2-systematic-review-and-meta-analysis
#19
REVIEW
Pieter F Fouche, Christopher Stein, Paul Simpson, Jestin N Carlson, Suhail A Doi
STUDY OBJECTIVE: Rapid sequence intubation performed by nonphysicians such as paramedics or nurses has become increasingly common in many countries; however, concerns have been stated in regard to the safe use and appropriateness of rapid sequence intubation when performed by these health care providers. The aim of our study is to compare rapid sequence intubation success and adverse events between nonphysician and physician in the out-of-hospital setting. METHODS: A systematic literature search of key databases including MEDLINE, EMBASE, and the Cochrane Library was conducted...
May 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28553450/calf-compartment-syndrome-associated-with-the-use-of-an-intra-osseous-line-in-an-adult-patient-a-case-report
#20
R Malhotra, W L Chua, G O'Neill
We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement...
November 2016: Malaysian Orthopaedic Journal
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