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https://www.readbyqxmd.com/read/28541226/haptic-feedback-in-needle-insertion-modeling-and-simulation-review
#1
Gourishetti Ravali, Muniyandi Manivannan
Needle insertion being the most basic skill in medical care, training has to be imparted not only for physicians but also for nurses and paramedics. In most needle insertion procedures haptic feedback from the needle is the main stimulus that novices are to be trained in. For better patient safety, the classical methods of training the haptic skills have to be replaced with simulators based on new robotic and graphics technologies. This paper reviews the current advances in needle insertion modeling. It is classified into three sections: needle insertion models, tissue deformation models, and needle-tissue interaction models...
May 23, 2017: IEEE Reviews in Biomedical Engineering
https://www.readbyqxmd.com/read/28499680/a-systematic-review-of-the-prevalence-and-types-of-adverse-events-in%C3%A2-interfacility-critical-care-transfers-by-paramedics
#2
Abdullah Alabdali, Joanne D Fisher, Chetan Trivedy, Richard J Lilford
OBJECTIVE: The aim of this study was to investigate if paramedics can safely transfer interfacility critically ill adult patients and to determine the prevalence and types of adverse events when paramedics lead interfacility critical care transfers. METHODS: MEDLINE, Web of Science, Embase, and CINAHL databases were searched from 1990 up to February 2016. Eligibility criteria were adult patients (16 years and over), interfacility transfer (between two health care facilities), quantitative or qualitative description of adverse events, and a paramedic as the primary care provider or the sole health care provider...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28466658/a-critical-analysis-of-debates-around-mental-health-calls-in-the-prehospital-setting
#3
Polly Christine Ford-Jones, Claudia Chaufan
Paramedics, health care workers who assess and manage health concerns in the prehospital setting, are increasingly providing psychosocial care in response to a rise in mental health call volume. Observers have construed this fact as "misuse" of paramedic services, and proposed as solutions better triaging of patients, better mental health training of paramedics, and a greater number of community mental health services. In this commentary, we argue that despite the ostensibly well-intentioned nature of these solutions, they shift attention and accountability away from relevant public policies, as well as from broader economic, social, and political determinants of mental health, while placing responsibility on those requiring services or, at best, on the health care system...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28460858/analysis-of-out-of-hospital-pediatric-intubation-by%C3%A2-an-australian-helicopter-emergency-medical%C3%A2-service
#4
Brian J Burns, Joanna B Watterson, Sandra Ware, Luke Regan, Cliff Reid
STUDY OBJECTIVE: We examine first-look success in emergency pediatric intubation by a physician-staffed helicopter emergency medical service (EMS). METHODS: A database analysis of all pediatric (<16 years) intubations during a 64-month period was undertaken, using data from a prospectively enrolled electronic airway registry form. Recorded findings included patient demographics, operator background, airway intervention including intubation attempts, complications, and critical timings...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28228127/a-review-of-enhanced-paramedic-roles-during-and-after-hospital-handover-of-stroke-myocardial-infarction-and-trauma-patients
#5
Darren Flynn, Richard Francis, Shannon Robalino, Joanne Lally, Helen Snooks, Helen Rodgers, Graham McClelland, Gary A Ford, Christopher Price
BACKGROUND: Ambulance paramedics play a critical role expediting patient access to emergency treatments. Standardised handover communication frameworks have led to improvements in accuracy and speed of information transfer but their impact upon time-critical scenarios is unclear. Patient outcomes might be improved by paramedics staying for a limited time after handover to assist with shared patient care. We aimed to categorize and synthesise data from studies describing development/extension of the ambulance-based paramedic role during and after handover for time-critical conditions (trauma, stroke and myocardial infarction)...
February 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28163912/the-benefits-of-youth-are-lost-on-the-young-cardiac-arrest-patient
#6
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/27866392/drug-caused-deaths-in-australian-medical-practitioners-and-health-care-professionals
#7
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...
March 2017: Addiction
https://www.readbyqxmd.com/read/27858502/prehospital-providers-perceptions-on-providing-patient-and-family-centered-care
#8
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...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27849480/validation-of-an-assessment-tool-for-field-endotracheal-intubation
#9
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
#10
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
#11
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
#12
REVIEW
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
#13
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...
February 2017: 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
#14
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
#15
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
#16
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
#17
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...
January 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27393759/intra-aortic-balloon-pump-dependent-patient-transports-by-critical-care-paramedics
#18
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
#19
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
#20
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
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