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https://www.readbyqxmd.com/read/27866392/drug-caused-deaths-in-australian-medical-practitioners-and-health-care-professionals
#1
Jennifer L Pilgrim, Rhyse Dorward, Olaf H Drummer
BACKGROUND AND AIMS: There are numerous factors putting health-care professionals (HCP) at a higher risk of substance abuse and premature death, including high-stress jobs, access to controlled substances, long hours of practice and constant contact with the critically ill. This study aimed to examine fatal drug toxicity in this high-risk cohort, in order to: (1) estimate the rate of drug-caused deaths of Australian HCPs; (2) describe the key characteristics of the cohort; and (3) examine the relationship between HCP occupation and drug type, or intent...
November 20, 2016: Addiction
https://www.readbyqxmd.com/read/27858502/prehospital-providers-perceptions-on-providing-patient-and-family-centered-care
#2
Emily M Ayub, Esther M Sampayo, Manish I Shah, Cara B Doughty
BACKGROUND: A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. METHODS: We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27849480/validation-of-an-assessment-tool-for-field-endotracheal-intubation
#3
Danielle Hart, Joseph Clinton, Shilo Anders, Troy Reihsen, Mary Ann McNeil, Gregory Rule, Robert Sweet
OBJECTIVES: Endotracheal intubation (ETI) is an important skill for all emergency providers; our ability to train and assess our learners is integral to providing optimal patient care. The primary aim of this study was to assess the inter-rater reliability (IRR) and discriminant validity of a novel field ETI assessment tool using a checklist-derived performance score (PS) and critical failure (CF) rate. METHODS: Forty-three participants (18 paramedic students, 11 paramedics, and 14 emergency physicians [EPs]) performed ETI during a simulated trauma scenario on a pseudo-ventilated cadaver...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27795775/-prioperative-adverse-events-critical-reading-of-the-data-registry-used-in-the-surgery-department-of-military-hospital-moulay-ismail-meknes
#4
Hicham Kechna, Omar Ouzzad, Khalid Chkoura, Jaouad Loutid, Moulay Ahmed Hachimi, Sidi Mohamed Hanafi
INTRODUCTION: Despite significant progress made in the field of safety in anesthesia, morbidity (serious or not, completely or partially related to anesthesia) remains common and no health practitioner is immune from accidents. In the current context where priority is given to training programmes, to quality and safety improvement in health care, the occurrence of an anesthesia-related accident in the surgery department is an extremely traumatic event. The fear of prosecution, the emotional context make it difficult to manage...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27782012/emergency-data-management-overcoming-information-borders
#5
Judith Born, Jürgen Albert, Elizabeth M Borycki, Norbert Butz, Kendall Ho, Josh Koczerginski, Andre W Kushniruk, Johannes Schenkel, Christian Juhra
BACKGROUND: In order to improve access to critical patient data in case of emergency, many countries have begun or intend to implement emergency datasets. In Germany, the German Medical Association developed a medical emergency dataset (MED), which provides the possibility to store information on prior diagnoses, medications, allergies and other emergency-relevant information on the German Electronic Health Card. OBJECTIVES: The aim of the study is to evaluate how the MED can be used internationally...
2016: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/27640217/can-paramedics-safely-refuse-transport-of-non-urgent-patients
#6
Alex J Fraess-Phillips
OBJECTIVE: The goal of this search was to review the current literature regarding paramedic triage of primary care patients and the safety of paramedic-initiated non-transport of non-urgent patients. METHODS: A narrative literature review was conducted using the Medline (Medline Industries, Inc.; Mundelein, Illinois USA) database and a manual search of Google Scholar (Google; Mountain View, California USA). RESULTS: Only 11 studies were found investigating paramedic triage and safety of non-transport of non-urgent patients...
December 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27625421/the-importance-of-ground-critical-care-transport-a-case-series-and-literature-review
#7
Susan R Wilcox, Michael Ries, Ted A Bouthiller, E Dean Berry, Travis L Dowdy, Sharon DeGrace
Critical care transport (CCT) teams are specialized transport services, comprised of highly trained paramedics, nurses, and occasionally respiratory therapists, offering an expanded scope of practice beyond advanced life support (ALS) emergency medical service teams. We report 4 cases of patients with severe acute respiratory distress syndrome from influenza in need of extracorporeal membrane oxygenation evaluation at a tertiary care center, transported by ground. Our medical center did not previously have a ground CCT service, and therefore, in these cases, a physician and/or a respiratory therapist was sent with the paramedic team...
September 13, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27530816/creation-and-validation-of-a-novel-mobile-simulation-laboratory-for-high-fidelity-prehospital-difficult-airway-simulation
#8
Jason J Bischof, Ashish R Panchal, Geoffrey I Finnegan, Thomas E Terndrup
UNLABELLED: Introduction Endotracheal intubation (ETI) is a complex clinical skill complicated by the inherent challenge of providing care in the prehospital setting. Literature reports a low success rate of prehospital ETI attempts, partly due to the care environment and partly to the lack of consistent standardized training opportunities of prehospital providers in ETI. Hypothesis/Problem The availability of a mobile simulation laboratory (MSL) to study clinically critical interventions is needed in the prehospital setting to enhance instruction and maintain proficiency...
October 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27505717/frequency-composition-and-predictors-of-in-transit-critical-events-during-pediatric-critical-care-transport
#9
Jeffrey M Singh, Anna C Gunz, Sonny Dhanani, Mahvareh Aghari, Russell D MacDonald
OBJECTIVES: Transport of pediatric patients is common due to healthcare regionalization. We set out to determine the frequency of in-transit critical events during pediatric critical care transport and identify factors associated with these events. DESIGN: Retrospective cohort study using administrative and clinical data. SETTING: Single pediatric critical care transport provider in Ontario, Canada. PATIENTS: All pediatric care transports between January 1, 2005, and December 31, 2010...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27491742/in-transit-telemedicine-speeds-ischemic-stroke-treatment-preliminary-results
#10
Gary H Belt, Robert A Felberg, Jane Rubin, John J Halperin
BACKGROUND AND PURPOSE: Time to treatment is critically important in ischemic stroke. We compared the efficacy and cost of teleneurology evaluation during patient transport with that of mobile stroke transport units. METHODS: Using cellular-connected telemedicine devices, we assessed 89 presumptive stroke patients in ambulances in transit. Paramedics assisted remote teleneurologists in obtaining a simplified history and examination, then coordinating care with the receiving emergency department...
September 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27420753/quantitative-analysis-of-the-content-of-ems-handoff-of-critically-ill-and-injured-patients-to-the-emergency-department
#11
Scott A Goldberg, Avital Porat, Christopher G Strother, Nadine Q Lim, H R Sagara Wijeratne, Greisy Sanchez, Kevin G Munjal
OBJECTIVES: Patient handoff occurs when responsibility for patient diagnosis, treatment, or ongoing care is transferred from one healthcare professional to another. Patient handoff is an integral component of quality patient care and is increasingly identified as a potential source of medical error. However, evaluation of handoff from field providers to ED personnel is limited. We here present a quantitative analysis of the information transferred from EMS providers to ED physicians during handoff of critically ill and injured patients...
July 15, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27393759/intra-aortic-balloon-pump-dependent-patient-transports-by-critical-care-paramedics
#12
Russell D MacDonald, Felipe Allendes
OBJECTIVE: Transport of intra-aortic balloon pump (IABP)-dependent patients between hospitals is increasingly common. The transports are typically time-sensitive and require personnel familiar with IABP operation and management of a potentially unstable patient. This study examined transports performed by specially trained critical care paramedics in a large air medical and land critical care transport service. METHODS: This retrospective, descriptive review prospectively collected data for IABP-dependent patient transports in Ontario, Canada in a 10-year interval beginning September 2003...
July 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27255875/airway-management-a-structured-curriculum-for-critical-care-transport-providers
#13
Michele L Kuszajewski, John M O'Donnell, Paul E Phrampus, Walter C Robey, Patricia K Tuite
OBJECTIVE: Airway assessment and management are vital skills for the critical care transport provider. Nurses and paramedics often enter a transport program with limited or no exposure to airway management. Many programs lack a structured curriculum to show skill competence. Optimal methods in the development of airway management competence and the frequency of training needed to maintain skills have not been clearly defined. Because of this lack of standardization, the actual level of competence in both new and experienced critical care transport providers is unknown...
May 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27215866/shaping-the-flight-paramedic-program
#14
Neil B Davids
Over the past 14 years of conflict, the Department of Defense medical community has made significant strides in patient care. As the conflicts developed, many sources identified a critical gap in en route care, specifically the need for critical care trained personnel for point of injury and intrahospital transfers, as well as improved outcomes for patients who received care from critical care trained providers. As stopgap measures were implemented, the US Army instituted the Critical Care Flight Paramedic Program in order to meet this need of life saving critical care transport...
April 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27166622/nurses-versus-physician-led-interhospital-critical-care-transport-a-randomized-non-inferiority-trial
#15
Erik Jan van Lieshout, Jan Binnekade, Elmer Reussien, Dave Dongelmans, Nicole P Juffermans, Rob J de Haan, Marcus J Schultz, Margreeth B Vroom
PURPOSE: Regionalization and concentration of critical care increases the need for interhospital transport. However, optimal staffing of ground critical care transport has not been evaluated. METHODS: In this prospective, randomized, open-label, blinded-endpoint non-inferiority trial, critically ill patients on mechanical ventilation transported by interhospital ground critical care transport were randomized between transport staffed by a dedicated team comprising a critical care nurse and paramedic (nurses group) or a dedicated team including a critical care physician (nurses + physician group)...
July 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27138673/hypoxaemia-on-arrival-in-a-multidisciplinary-intensive-care-unit
#16
Kim De Vasconcellos, David Lee Skinner, Dhivendra Singh
BACKGROUND: Transport of the critically ill patient poses the risk of numerous complications. Hypoxaemia is one such serious adverse event and is associated with potential morbidity and mortality. It is, however, potentially preventable. OBJECTIVE: To determine the incidence of hypoxaemia on arrival in a tertiary multidisciplinary intensive care unit (ICU) and to identify risk factors for this complication. METHOD: A retrospective observational study was conducted at King Edward VIII Hospital, Durban, South Africa, from May 2013 to February 2014...
May 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27080747/improved-technical-performance-of-a-multifunctional-prehospital-telemedicine-system-between-the-research-phase-and-the-routine-use-phase-an-observational-study
#17
Marc Felzen, Jörg C Brokmann, Stefan K Beckers, Michael Czaplik, Frederik Hirsch, Miriam Tamm, Rolf Rossaint, Sebastian Bergrath
INTRODUCTION: Telemedical concepts in emergency medical services (EMS) lead to improved process times and patient outcomes, but their technical performance has thus far been insufficient; nevertheless, the concept was transferred into EMS routine care in Aachen, Germany. This study evaluated the system's technical performance and compared it to a precursor system. METHODS: The telemedicine system was implemented on seven ambulances and a teleconsultation centre staffed with experienced EMS physicians was established in April 2014...
April 13, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/26920605/incidence-and-characteristics-of-inappropriate-and-false-positive-cardiac-catheterization-laboratory-activations-in-a-regional-primary-percutaneous-coronary-intervention-program
#18
MULTICENTER STUDY
Jonathan Lu, Akshay Bagai, Chris Buller, Asim Cheema, John Graham, Michael Kutryk, Jo-Ann Christie, Neil Fam
BACKGROUND: The implementation of regional primary percutaneous coronary intervention (PCI) programs has been critical in achieving timely intervention in patients with ST-segment elevation myocardial infarction (STEMI). However, 1 consequence has been inappropriate and false-positive cardiac catheterization laboratory (CCL) activations where either angiography is cancelled or no culprit lesion is found, respectively. METHODS: We performed a retrospective cohort study of 1,391 patients referred for primary PCI to a single academic center from November 2007 to August 2013...
March 2016: American Heart Journal
https://www.readbyqxmd.com/read/26903672/incident-reporting-in-post-operative-patients-managed-by-acute-pain-service
#19
Syeda Fauzia Hasan, Mohammad Hamid
BACKGROUND AND AIMS: Incident reporting is a reliable and inexpensive tool used in anaesthesia to identify errors in patient management. A hospital incident reporting system was already present in our hospital, but we were unable to find any incident related to acute pain management. Hence, acute pain service (APS) was started for voluntary incident reporting in post-operative patients to identify critical incidents, review the root cause and suggest remedial measures. METHODS: All post-operative patients managed by APS were included in this observational study...
December 2015: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/26897379/adaptive-leadership-curriculum-for-indian-paramedic-trainees
#20
Aditya Mantha, Nathaniel L Coggins, Aditya Mahadevan, Rebecca N Strehlow, Matthew C Strehlow, S V Mahadevan
BACKGROUND: Paramedic trainees in developing countries face complex and chaotic clinical environments that demand effective leadership, communication, and teamwork. Providers must rely on non-technical skills (NTS) to manage bystanders and attendees, collaborate with other emergency professionals, and safely and appropriately treat patients. The authors designed a NTS curriculum for paramedic trainees focused on adaptive leadership, teamwork, and communication skills critical to the Indian prehospital environment...
December 2016: International Journal of Emergency Medicine
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