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https://www.readbyqxmd.com/read/29049861/mifepristone-misoprostol-for-menstrual-regulation-in-public-sector-facilities-in-bangladesh
#1
Anadil Alam, Tatyana Lotarevich, Tapash R Das, Laura Reichenbach, Hillary Bracken
OBJECTIVE: To examine the use of mifepristone and misoprostol for menstrual regulation among Bangladeshi women attending public sector facilities. METHODS: In a prospective study, women (aged ≥18 years) with up to 9 weeks of amenorrhea were enrolled at 24 government health facilities in Bangladesh from November 2012 to June 2015. Paramedics or female welfare visitors provided most menstrual regulation care. Participants took 200 mg mifepristone followed by 800 μg buccal misoprostol after 24 hours, and were asked to return to the clinic 10-14 days later for clinical assessment and an exit interview...
October 19, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29049005/beliefs-attitudes-and-activities-of-healthcare-personnel-about-influenza-and-pneumococcal-vaccines
#2
Fatma Çiftci, Elif Şen, Nalan Demir, Orçun Çiftci, Serhat Erol, Oya Kayacan
OBJECTIVES: Vaccination of healthcare personnel (HCP) is an effective measure for preventing the spread of influenza among at-risk patients. This study was conducted to determine influenza vaccination rates and activities among HCP working at a tertiary healthcare setting. METHODS: This study included 470 HCP (85 physicians, 134 nurses, 53 healthcare assistants, 44 paramedics, 47 medical secretaries, and 107 auxillary staff members) working at the emergency, cardiology, chest diseases, and internal medicine departments with the largest volume of patients with vaccination indication of two large university hospitals with similar medical practices and work environment...
October 19, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29033297/no-easy-way-out-a-case-of-physician-assisted-dying-in-the-emergency-department
#3
David H Wang
Currently, 1 out of 6 Americans lives within a jurisdiction in which physician-assisted dying is legally authorized. In most cases, patients ingest lethal physician-assisted dying medications at home without involvement of emergency medical services (EMS) or the emergency department (ED). However, occasionally the dying process is interrupted as a result of incomplete ingestion or vomiting of medications, confusion about timing of dying trajectory, familial emotional distress, and other variables. A case is presented here of a patient who arrived by ambulance to an urban ED after ingesting physician-assisted dying medication...
October 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29023167/state-regulation-of-community-paramedicine-programs-a-national-analysis
#4
Melody Glenn, Olivia Zoph, Kim Weidenaar, Leila Barraza, Warren Greco, Kylie Jenkins, Pooja Paode, Jonathan Fisher
BACKGROUND: Community Paramedicine (CP) is a rapidly evolving field within prehospital care where paramedics step outside of their traditional roles of treating acute conditions to provide elements of primary and preventive care. It is unclear if current state oversight regarding the scope of practice (SOP) for paramedics provides clear guidance on the novel functions provided and skills performed by CP programs. OBJECTIVE: To determine the process and authority, as currently defined by state laws and regulations in the United States, to expand paramedic SOP in order to perform CP roles and to assess state EMS agencies' interpretation of paramedic SOP as it applies to CP...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29021720/burn-injury-review-of-pathophysiology-and-therapeutic-modalities-in-major-burns
#5
I Kaddoura, G Abu-Sittah, A Ibrahim, R Karamanoukian, N Papazian
Despite a considerable decrease in their incidence worldwide, burn injuries remain one of the commonest forms of trauma and account for a weighty proportion of trauma cases in health-care emergencies around the globe. Although the latest data reveal a substantial decline in burn-related mortality and hospital admissions in the US over the past three decades, severe thermal injuries continue to trigger devastating morbidity and significant mortality while their management remains a dynamic challenge for the entire medical and paramedical community...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29020951/paramedic-literature-search-filters-optimised-for-clinicians-and-academics
#6
Alexander Olaussen, William Semple, Alaa Oteir, Paula Todd, Brett Williams
BACKGROUND: Search filters aid clinicians and academics to accurately locate literature. Despite this, there is no search filter or Medical Subject Headings (MeSH) term pertaining to paramedics. Therefore, the aim of this study was to create two filters to meet to different needs of paramedic clinicians and academics. METHODS: We created a gold standard from a reference set, which we measured against single terms and search filters. The words and phrases used stemmed from selective exclusion of terms from the previously published Prehospital Search Filter 2...
October 11, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29019723/accidental-hanging-injuries-in-children-recognition-and-management
#7
Siba P Paul, Ruby Paul, Paul A Heaton
Accidental hanging is rare in childhood but is often fatal. Window blind cords pose a particular and unique risk to young children in the UK, accounting for one to two deaths annually. These accidents are frequently associated with non-adherence to the safety instructions provided by the manufacturers. Early discovery of the child and initiation of effective cardiopulmonary resuscitation at the site of the incident are likely to improve the outcome. Prolonged suspension, children who are pulseless at first contact by the emergency paramedic responder, and patients with prolonged periods of remaining in asystole before return of spontaneous circulation after starting cardiopulmonary resuscitation are unlikely to have intact neurological survival...
October 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29019350/influenece-of-the-cprmeter-on-angular-position-of-elbows-and-generated-forces-during-cardiopulmonary-resuscitation
#8
Karolina Kopacz, Magdalena Fronczek-Wojciechowska, Anna Jaźwińska, Gianluca Padula, Dariusz Nowak, Tomasz Gaszyński
OBJECTIVES: It is commonly known that ergonomics in emergency medical services (EMS) is very important. Emergency medical services workers are exposed to different conditions and they should perform a variety of tasks. MATERIAL AND METHODS: The aim of the work has been to analyze the angular position of elbows and forces generated by the upper limbs during cardiopulmonary resuscitation with and without the CPRmeter based on feedback technology. Ten male paramedics and 10 male non-paramedics, in a kneeling position, performed cardiopulmonary resuscitation (CPR) on an Ambu Megacode manikin placed on the ground...
October 6, 2017: International Journal of Occupational Medicine and Environmental Health
https://www.readbyqxmd.com/read/29016592/availability-of-life-support-equipment-and-its-utilization-by-ambulance-drivers
#9
Rija Acharya, Angur Badhu, Tara Shah, Sharmila Shrestha
BACKGROUND: An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers. METHODS: Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28994646/envisioning-eye-care-from-a-rural-perspective-a-photovoice-project-from-india
#10
Padmaja Kumari Rani, Rajita Kasoju, Venkatiah Komara, Raju Kothapalli, Devichandar Choudary, Jyothi Korani, Jachin D Williams, Clifton M Schor, Nance Wilson
Background To understand barriers and promoters for accessing eye care by rural communities, we used a modified approach to Photovoice, a community-based participatory action research approach Methods Community members took photographs and wrote or spoke stories based upon a series of questions intended to facilitate deeper thinking. Fifteen rural paramedical team members who were affiliated with the rural network of L V Prasad Eye Institute, and 60 people from four villages reported barriers and promoters for eye care access for 20 villages Results Important barriers for accessing eye care included the following: no caretaker at home for grandchildren except for the grandparent(s), alcoholism, uncontrolled blood pressure, inadequate diabetes management, lack of escort for blind people and elders, affordability, and inadequate clinic staffing during summer season when farming villagers were available...
January 1, 2017: International Quarterly of Community Health Education
https://www.readbyqxmd.com/read/28988962/prehospital-cooling-to-improve-successful-targeted-temperature-management-after-cardiac-arrest-a-randomized-controlled-trial
#11
D C Scales, S Cheskes, P R Verbeek, R Pinto, D Austin, S C Brooks, K N Dainty, K Goncharenko, M Mamdani, K E Thorpe, L J Morrison
RATIONALE: Targeted temperature management (TTM) improves survival with good neurological outcome after out-of-hospital cardiac arrest (OHCA), but is delivered inconsistently and often with delay. OBJECTIVE: To determine if prehospital cooling by paramedics leads to higher rates of 'successful TTM', defined as achieving a target temperature of 32-34°C within 6h of hospital arrival. METHODS: Pragmatic RCT comparing prehospital cooling (surface ice packs, cold saline infusion, wristband reminders) initiated 5min after return of spontaneous circulation (ROSC) versus usual resuscitation and transport...
October 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28983829/mechanical-ventilation-during-resuscitation-how-manual-chest-compressions-affect-a-ventilator-s-function
#12
Tillmann Speer, Wolfgang Dersch, Björn Kleine, Christian Neuhaus, Clemens Kill
INTRODUCTION: Guidelines for resuscitation recommend positive-pressure ventilation with a fixed ventilation rate as provided by an automated transport ventilator during cardiopulmonary resuscitation (CPR) with a secured airway. We investigated the influence of manual chest compressions (CC) on the accuracy of ventilator presets and the quality of CC with intermittent positive-pressure ventilation (IPPV), bilevel ventilation (BiLevel), and the novel ventilation mode chest compression synchronized ventilation (CCSV) in a simulation model...
October 5, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28977468/opioid-crisis-at-the-jersey-shore-special-report
#13
Larissa S Dudley, Dorothy Konomos, Vince Robbins, Linda Qiu, Robert Bauter, Mark A Merlin
The USA is experiencing an epidemic of drug overdoses and deaths with a 200% increase in overdose deaths involving opioids including heroin. Legislation since 2013 has created paths to reduce opioid overdose deaths and since, basic life support (BLS) and police agencies have been administering naloxone to patients with suspected opioid overdoses as part of standard treatment protocols. Charts were reviewed from 1 January 2016 to 15 April 2016 on the de-identified electronic medical records of patients in a two-county system comprising the 'Jersey Shore' who received naloxone to determine the number of naloxone administrations and heroin overdoses...
August 31, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28973818/incremental-costs-in-giant-cell-arteritis
#14
Michael Mounié, Nadège Costa, Laurent Sailler, Maryse Lapeyre-Mestre, Robert Bourrel, Nicolas Savy, Laurent Molinier, Grégory Pugnet
OBJECTIVES: To assess and compare direct costs between giant cell arteritis (GCA) patients and matched-controls and identify incremental cost drivers. METHODS: We carried out a population-based, retrospective, cohort study using the French National Health Insurance System Database. Cost analysis was performed from the French health insurance perspective and took into account direct medical and non-medical costs (€, 2014). Costs were evaluated according to different cost components and divided into periods of 6 months for the accurate assessment of care consumption...
October 3, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28969123/prevalence-of-specific-helicobacter-pyloricaga-vaca-icea-urec-genotypes-and-its-clinical-relevance-in-the-patients-with-acid-peptic-diseases
#15
Himani Bhardwaj Pandya, Harihar Hardas Agravat, Jagdish Shantilal Patel
INTRODUCTION: Virulent markers of H. pylori, the vacuolating cytotoxin (vacA), cytotoxin-associated gene A (cagA), induced by contact with epithelium factor antigen (iceA gene) and the urease C gene (ureC) may plays a major role in determining the clinical outcome of Helicobacter infections. AIM: To detect the prevalence of the cagA, vacA, ureC and iceA genotypes of H. pylori from antral biopsy specimens of patients and to associate its role in specific disease...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28967605/-22q11-2%C3%A2-microdeletion-syndrome-analysis-of-the-care-pathway-before-the-genetic-diagnosis
#16
T Ingrao, L Lambert, M Valduga, G Bosser, E Albuisson, B Leheup
BACKGROUND: 22q11.2 deletion syndrome (22q11.2DS) is a very broad phenotypic spectrum disorder. It can affect many organs or systems. 22q11.2DS is the most common microdeletion syndrome in humans, with a prevalence ranging from one in every 2000 to one in 4000 newborns. It seems to be more prevalent than reported and under-recognized or undiagnosed because of its inherent clinical variability and heterogeneity. In France, 15,000 patients may be affected by this disease, more than half without knowing it...
September 26, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28967516/the-effect-of-successful-intubation-on-patient-outcomes-after-out-of-hospital-cardiac-arrest-in%C3%A2-taipei
#17
Wen-Chu Chiang, Ming-Ju Hsieh, Hsin-Lan Chu, Albert Y Chen, Shin-Yi Wen, Wen-Shuo Yang, Yu-Chun Chien, Yao-Cheng Wang, Bin-Chou Lee, Huei-Chih Wang, Edward Pei-Chuan Huang, Chih-Wei Yang, Jen-Tang Sun, Kah-Meng Chong, Hao-Yang Lin, Shu-Hsien Hsu, Shey-Ying Chen, Matthew Huei-Ming Ma
STUDY OBJECTIVE: The effect of out-of-hospital intubation in patients with out-of-hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out-of-hospital intubation among Asian areas. This study evaluates the association between successful intubation and out-of-hospital cardiac arrest survival in Taipei. METHODS: We analyzed 6 years of Utstein-based registry data from nontrauma adult patients with out-of-hospital cardiac arrest who underwent out-of-hospital airway management including intubation, laryngeal mask airway, or bag-valve-mask ventilation...
September 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28965434/psychosocial-support-issues-affecting-older-patients-a-cross-sectional-paramedic-perspective
#18
Linda Ross, Paul Jennings, Brett Williams
This research aimed to gain an understanding of the psychosocial support needs of older patients in the out-of-hospital setting from the perspective of paramedics. Specifically, we investigate if and how paramedics are able to meet the needs of older adults, and the barriers preventing them from achieving this. This study was a cross-sectional study utilizing a sequential design with both quantitative and qualitative methodologies. All participants agreed or strongly agreed that older patients have needs beyond the physical and that they would like to do more for older patients...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28957368/the-burden-of-alcohol-related-morbidity-and-mortality-in-ottawa-canada
#19
Jacqueline Willmore, Terry-Lynne Marko, Darcie Taing, Hugues Sampasa-Kanyinga
OBJECTIVES: Alcohol-related morbidity and mortality are significant public health issues. The purpose of this study was to describe the prevalence and trends over time of alcohol consumption and alcohol-related morbidity and mortality; and public attitudes of alcohol use impacts on families and the community in Ottawa, Canada. METHODS: Prevalence (2013-2014) and trends (2000-2001 to 2013-2014) of alcohol use were obtained from the Canadian Community Health Survey...
2017: PloS One
https://www.readbyqxmd.com/read/28952660/medical-emergencies-on-large-passenger-ships-without-doctors-the-oslo-kiel-oslo-ferry-experience
#20
Thor-Erik Holt, Agnar Tveten, Eilif Dahl
BACKGROUND: The Oslo-Kiel-Oslo route is currently the only direct ferry crossing between Norway and Germany, covered by 2 cruise-and-cars ferries carrying about 2,600 passengers each and sailing every day (20 h at sea, 4 h in port). Unlike most ocean going cruise vessels, they are not required to carry a physician but an on-board paramedic handles medical emergencies. The aim of the study was to provide data on medical emergencies leading to helicopter evacuations (helivacs) or other urgent transfers to facilities ashore from the two ferries during a 3-year period...
2017: International Maritime Health
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