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https://www.readbyqxmd.com/read/29762299/effectiveness-of-mitigation-interventions-on-occupational-violence-against-emergency-service-workers-a-mixed-methods-systematic-review-protocol
#1
Peter Drew, Vivienne Tippett, Scott Devenish
The objective of this review is to develop an aggregated synthesis of qualitative and quantitative data on occupational violence (OV) mitigation interventions for Emergency Service Workers (ESW), to cultivate useful conclusions and recommendations for paramedic occupational safety and policy development. Emergency Service Worker is a broad term encompassing all elements of community-based emergency support and includes paramedics, firefighters, and police.The objective of the quantitative component of this review is to quantify the effectiveness of OV mitigation interventions for ESW...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29760924/extensive-subcutaneous-emphysema-following-lobectomy
#2
Fiqry Fadhlillah, Wei Jia
We present a case report of extensive subcutaneous emphysema secondary to an elective left upper lobectomy. A 65-year-old gentleman was brought into a London teaching hospital's Accident and Emergency department following report of severe swelling. He was mistakenly treated by the paramedics as an allergic reaction and given hydrocortisone and salbutamol nebulisers with no effect. Upon arrival, the patient had widespread crepitus extending from his peri-orbital muscles down to mid-torso. A computer tomography scan revealed a pleuro-cutaneous fistula at the site of a recently sited chest drain, with extensive emphysema and a pneumothorax...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29759099/procedural-sedation-by-advanced-care-paramedics-for-emergency-gastrointestinal-endoscopy
#3
Hana M Wiemer, Michael B Butler, Patrick C Froese, Allan Lapierre, Chris Carriere, Glen R Etsell, Dana Farina, Jennifer Jones, Jock Murray, Samuel G Campbell
CLINICIAN'S CAPSULE What is known about the topic? Advanced care paramedics (ACPs) in our emergency department (ED) successfully perform procedural sedation and analgesia (PSA) for several procedures, including orthopedic manipulations. What did this study ask? How does the novel practice of ACP-led ED PSA for upper gastrointestinal (UGI) endoscopy compare to that for orthopedic procedures? What did this study find? Adverse events occurred more frequently during UGI endoscopy sedations than orthopedic sedations (41...
May 15, 2018: CJEM
https://www.readbyqxmd.com/read/29756588/toward-a-shared-care-model-of-relapsing-remitting-multiple-sclerosis-role-of-the-primary-care-practitioner
#4
Jiwon Oh, Marie-Sarah Gagné-Brosseau, Melanie Guenette, Catherine Larochelle, François Lemieux, Suresh Menon, Sarah A Morrow, Laurence Poliquin-Lasnier, Chantal Roy-Hewitson, Carolina Rush, Anne-Marie Trudelle, Paul S Giacomini
The objective of this study was to develop a shared-care model to enable primary-care physicians to participate more fully in meeting the complex, multidisciplinary healthcare needs of patients with multiple sclerosis (MS). DESIGN: The design consisted of development of consensus recommendations and a shared-care algorithm. PARTICIPANTS: A working group of 11 Canadian neurologists involved in the management of patients with MS were included in this study. MAIN MESSAGE: The clinical management of patients with multiple sclerosis is increasing in complexity as new disease-modifying therapies (DMTs) become available, and ongoing safety monitoring is required...
May 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29748230/senior-doctor-triage-sdt-a-qualitative-study-of-clinicians-views-on-senior-doctors-involvement-in-triage-and-early-assessment-of-emergency-patients
#5
Maysam Ali Abdulwahid, Janette Turner, Suzanne M Mason
INTRODUCTION: Despite the focus during the last decade on introducing interventions such as senior doctor initial assessment or senior doctor triage (SDT) to reduce emergency department (ED) crowding, there has been little attempt to identify the views of emergency healthcare professionals on such interventions. The aim of this study was to gain an understanding of SDT from the perspective of emergency hospital staff. A secondary aim of this study was to develop a definition of SDT based on the interview findings and the available literature on this process...
May 10, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29742283/vaccination-practices-in-dialysis-patients-a-narrative-review
#6
REVIEW
Georges Kosmadakis, Julie Albaret, Enrique Da Costa Correia, Frederic Somda, Didier Aguilera
In a period of turmoil concerning vaccination practices, there is a serious conflict between scientifically reasonable, evidence-based guidelines and the far-fetched rumors or misconceptions concerning the vaccination practices in the general population. When a significant portion of the medical and paramedical personnel may be deliberately unvaccinated against common biological agents, achieving effective vaccination rates in the dialysis population may be complicated. Vaccination rates are unacceptably low in dialysis patients and seroconversion rates are even lower; further, serological follow-up is generally poor...
May 9, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29735235/transport-of-a-prone-position-acute-respiratory-distress-syndrome-patient
#7
David Hersey, Tobias Witter, George Kovacs
We report the case of a non-physician based critical care transport team (registered nurse and paramedic) that successfully initiated prone positioning of a severe acute respiratory distress patient prior to transport to an extracorporeal membrane oxygenation capable teaching hospital. With the increasing use of advanced treatments such as extracorporeal membrane oxygenation, prone positioning, and continuous renal replacement therapy for severe acute respiratory distress syndrome (ARDS), the necessity to transport these patients to specialized hospitals will correspondingly increase...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29735232/the-effect-of-team-configuration-on-the-incidence-of-adverse-events-in-pediatric-critical-care-transport
#8
Emily Colyer, Megan Sorensen, Shirley Wiggins, Leeza Struwe
OBJECTIVE: Specialty pediatric transport teams are widely used for pediatric interfacility transport in the United States, with little industry consensus on optimal team configuration. The aim of this study is to assess the quality of the nurse/paramedic specialty team configuration as indirectly measured by the rate of adverse events in these transports. METHODS: Retrospective analysis of pediatric transport data from a hospital-based dedicated pediatric/neonatal transport team was conducted for patients transported in 2016...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29735227/care-of-the-injured-patients-at-nursing-stations-and-during-air-medical-transport
#9
Brodie Nolan, Alun Ackery, Sol Mamakwa, Shari Glenn, David VanderBurgh, Aaron Orkin, Michael Kirlew, Evelyn Dell, Homer Tien
INTRODUCTION: Nursing stations are the only access point into the health care system for some communities and have limited capabilities and resources. We describe characteristics of patients injured in Northern Ontario who present to nursing stations and require transport by air ambulance. Secondary objectives are to compare interventions performed at nursing stations with those performed by flight paramedics and to identify systemic gaps in trauma care. METHODS: A retrospective cohort study was performed of all injured patients transported by air ambulance from April 1, 2014, to March 31, 2015...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29731647/ambulance-vehicles-as-a-source-of-multidrug-resistant-infections-a-multicenter-study-in-assiut-city-egypt
#10
Mohamed A El-Mokhtar, Helal F Hetta
Background: Ambulances may represent a potential source of infection to patients, patients' relatives, and paramedical staffs. In this study, we analyzed the extent of bacterial contamination in ambulance vehicles and measured the degree of antimicrobial resistance among isolated pathogens. Materials and methods: Twenty-five vehicles were included and 16 sampling points were swabbed in each vehicle. Then the swabs were immediately transferred to the laboratory to identify bacterial contaminants utilizing standard microbiological procedures and API® systems...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29731391/outcomes-and-provider-perspectives-on-geriatric-care-by-a-nurse-practitioner-led-community-paramedicine-program
#11
Rebecca E Kant, Maria Vejar, Bennett Parnes, Joy Mulder, Andrea Daddato, Daniel D Matlock, Hillary D Lum
This study explores the use of a nurse practitioner-led paramedicine program for acute, home-based care of geriatric patients. This case series describes patients, outcomes, and geriatric primary care provider perspectives related to use of this independent paramedicine program. There were 40 patient visits from August 2016-May 2017. We reviewed patient demographics, medical conditions, healthcare utilization, and communication processes and used semi-structured interviews and content analysis to explore staff perspectives...
May 3, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29731285/prehospital-acute-st-elevation-myocardial-infarction-identification-in-san-diego-a-retrospective-analysis-of-the-effect-of-a-new-software-algorithm
#12
Christanne Coffey, John Serra, Mat Goebel, Sarah Espinoza, Edward Castillo, James Dunford
BACKGROUND: A significant increase in false positive ST-elevation myocardial infarction (STEMI) electrocardiogram interpretations was noted after replacement of all of the City of San Diego's 110 monitor-defibrillator units with a new brand. These concerns were brought to the manufacturer and a revised interpretive algorithm was implemented. OBJECTIVES: This study evaluated the effects of a revised interpretation algorithm to identify STEMI when used by San Diego paramedics...
May 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29729684/paramedics-perspectives-on-factors-impacting-on-scene-times-for-trauma-calls
#13
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
May 6, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29724172/a-randomized-controlled-trial-testing-the-effectiveness-of-a-paramedic-delivered-care-transitions-intervention-to-reduce-emergency-department-revisits
#14
Ranran Mi, Matthew M Hollander, Courtney M C Jones, Eva H DuGoff, Thomas V Caprio, Jeremy T Cushman, Amy J H Kind, Michael Lohmeier, Manish N Shah
BACKGROUND: Approximately 20% of community-dwelling older adults discharged from the emergency department (ED) return to an ED within 30 days, an occurrence partially resulting from poor care transitions. Prior published interventions to improve the ED-to-home transition have either lacked feasibility or effectiveness. The Care Transitions Intervention (CTI) has been validated to decrease rehospitalization among patients transitioning from the hospital to the home but has never been tested for patients transitioning from the ED to the home...
May 3, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29720300/chronic-obstructive-pulmonary-disease-and-heart-failure-self-management-kits-for-outpatient-transitions-of-care
#15
Paul Boylan, Tina Joseph, Genevieve Hale, Cynthia Moreau, Matthew Seamon, Renee Jones
OBJECTIVE: To develop heart failure (HF) and chronic obstructive pulmonary disease (COPD) self-management kits in an accountable care organization (ACO) to facilitate patients' self-care and prevent hospital readmissions. SETTING: Pharmacists practice in an outpatient-based ACO. They participate in interprofessional office visits with providers and independently manage maintenance pharmacotherapies. PRACTICE DESCRIPTION: Pharmacists collaborate with an interprofessional team within the ACO including physicians, nurses, case managers, and paramedics...
March 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29709976/tuberculosis-disease-among-healthcare-workers-clinical-microbiological-characteristics-and-treatment-outcomes-at-chiang-mai-university-hospital-thailand
#16
Juthamas Inchai, Chalerm Liwsrisakun, Chaiwat Bumroongkit, Juntima Eauthrongchit, Pattraporn Tajareunmuang, Chaicharn Pothirat
Tuberculosis (TB) among healthcare workers (HCWs) highly impacts morbidity and TB transmission in hospital. A retrospective cohort study of TB among HCWs (HCW-TB) was conducted using a registered database from 2003 to 2016 at Chiang Mai University Hospital to determine clinical and microbiological characteristics and treatment outcomes of HCW-TB. Seventy-six cases of HCWs, 54 nurses (71.1%), 12 physicians (15.8%) and 10 paramedics (13.2%), were diagnosed with TB disease. Female to male ratio of 51:25, mean age of 37...
April 27, 2018: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29708085/weekly-checks-improve-real-time-prehospital-ecg-transmission-in-suspected-stemi
#17
Nicole T D'Arcy, Nichole Bosson, Amy H Kaji, Quang T Bui, William J French, Joseph L Thomas, Yvonne Elizarraraz, Natalia Gonzalez, Jose Garcia, James T Niemann
IntroductionField identification of ST-elevation myocardial infarction (STEMI) and advanced hospital notification decreases first-medical-contact-to-balloon (FMC2B) time. A recent study in this system found that electrocardiogram (ECG) transmission following a STEMI alert was frequently unsuccessful.HypothesisInstituting weekly test ECG transmissions from paramedic units to the hospital would increase successful transmission of ECGs and decrease FMC2B and door-to-balloon (D2B) times. METHODS: This was a natural experiment of consecutive patients with field-identified STEMI transported to a single percutaneous coronary intervention (PCI)-capable hospital in a regional STEMI system before and after implementation of scheduled test ECG transmissions...
April 30, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29704520/trends-in-the-incidence-and-outcome-of-paediatric-out-of-hospital-cardiac-arrest-a-17-year-observational-study
#18
Ziad Nehme, Siva Namachivayam, Anri Forrest, Warwick Butt, Stephen Bernard, Karen Smith
BACKGROUND: System-based improvements to the chain of survival have yielded increases in survival from out-of-hospital cardiac arrest (OHCA) in adults. Comparatively little is known about the long-term trends in incidence and survival following paediatric OHCA. METHODS: Between 2000 and 2016, we included children aged ≤16 years who suffered a non-traumatic OHCA in the state of Victoria, Australia. Trends in incidence and unadjusted outcomes were assessed using linear regression and a non-parametric test for trend...
April 25, 2018: Resuscitation
https://www.readbyqxmd.com/read/29703219/primary-mass-casualty-incident-triage-evidence-for-the-benefit-of-yearly-brief-re-training-from-a-simulation-study
#19
Michael S Dittmar, Philipp Wolf, Marc Bigalke, Bernhard M Graf, Torsten Birkholz
BACKGROUND: Triage is a mainstay of early mass casualty incident (MCI) management. Standardized triage protocols aim at providing valid and reproducible results and, thus, improve triage quality. To date, there is little data supporting the extent and content of training and re-training on using such triage protocols within the Emergency Medical Services (EMS). The study objective was to assess the decline in triage skills indicating a minimum time interval for re-training. In addition, the effect of a one-hour repeating lesson on triage quality was analyzed...
April 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29702659/provider-perspectives-on-prep-for-adolescent-girls-and-young-women-in-tanzania-the-role-of-provider-biases-and-quality-of-care
#20
Nanlesta Pilgrim, Nrupa Jani, Sanyukta Mathur, Catherine Kahabuka, Vaibhav Saria, Neema Makyao, Lou Apicella, Julie Pulerwitz
BACKGROUND: Oral pre-exposure prophylaxis (PrEP) has the potential to reduce HIV acquisition among adolescent girls and young women (AGYW) in sub-Saharan Africa. However, health care providers' (HCPs) perspectives and interactions with potential clients can substantially influence effective provision of quality health services. We examine if HCPs' knowledge, attitude, and skills, as well as their perceptions of facility readiness to provide PrEP are associated with their willingness to provide PrEP to AGYW at high risk of HIV in Tanzania...
2018: PloS One
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