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https://www.readbyqxmd.com/read/29222105/the-emergency-medical-service-microbiome
#1
Andrew J Hudson, Graeme D Glaister, Hans-Joachim Wieden
Emergency medical services (EMS) personnel are an integral component of the healthcare framework and function to transport patients from various locations to and between care facilities. In addition to physical injury, EMS personnel are expected to be at high risk to acquire and transmit healthcare associated infections (HAIs) in the workplace. However, currently little is known about EMS biosafety risk factors and the epidemiological contribution of EMS to pathogen transmission within and outside of the healthcare sector...
December 8, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/29221610/alcohol-misuse-and-injury-outcomes-in-young-people-aged-10-24
#2
Louise Lester, Ruth Baker, Carol Coupland, Elizabeth Orton
PURPOSE: The burden of alcohol-attributable disease is a global problem. Young people often present to emergency health-care services with alcohol intoxication but little is known about how best to intervene at that point to improve future health outcomes. This study aimed to assess whether young people with an alcohol-specific hospital admission are at increased risk of injury following discharge. METHODS: A cohort study was conducted using a general population of 10- to 24-year-olds identified using primary care medical records with linked hospital admission records between 1998 and 2013...
December 5, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29220618/psychological-comfort-of-paramedics-with-field-death-pronouncement-a-national-asian-study-to-prepare-paramedics-for-field-termination-of-resuscitation
#3
Desmond R H Mao, Marcus E H Ong, Chungli Bang, Mohamed D T Salim, Yih Yng Ng, Desiree A Lie
OBJECTIVES: Paramedics' decision to terminate field resuscitation without a physician present may depend on personal and external factors. This study investigates factors associated with paramedic psychological comfort with termination of resuscitation (TOR) to inform future training. METHODS: We administered an anonymous survey to all practicing paramedics in a large urban Asian Emergency Medical Services system where formal TOR training had not yet been conducted and field TOR was not routinely applied...
December 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29220603/evaluating-dispatch-assisted-cpr-using-the-cares-registry
#4
Manali Shah, Cherie Bartram, Kevin Irwin, Kimberly Vellano, Bryan McNally, Timothy Gallagher, Robert Swor
OBJECTIVES: Dispatch-assisted cardiopulmonary resuscitation (DA-CPR) has been shown to improve cardiac arrest survival. Recent literature has proposed dispatch metrics for provision of this intervention. Our objectives are to: use the Cardiac Arrest Registry to Enhance Survival (CARES) to compare current practice to proposed DA-CPR guidelines; describe barriers to DA-CPR; and assess the association of DA-CPR with out-of-hospital cardiac arrest (OHCA) survival. METHODS: We reviewed data from structured dispatch reviews of 911 OHCA calls from 1/1/14-12/31/15...
December 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29219089/health-impacts-of-climate-change-and-health-and-social-inequalities-in-the-uk
#5
REVIEW
Jouni Paavola
This article examines how social and health inequalities shape the health impacts of climate change in the UK, and what the implications are for climate change adaptation and health care provision. The evidence generated by the other articles of the special issue were interpreted using social justice reasoning in light of additional literature, to draw out the key implications of health and social inequalities for health outcomes of climate change. Exposure to heat and cold, air pollution, pollen, food safety risks, disruptions to access to and functioning of health services and facilities, emerging infections and flooding are examined as the key impacts of climate change influencing health outcomes...
December 5, 2017: Environmental Health: a Global Access Science Source
https://www.readbyqxmd.com/read/29218822/european-academy-of-neurology-european-stroke-organisation-consensus-statement-and-practical-guidance-for-pre-hospital-management-of-stroke
#6
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
Reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving chances of a favorable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations...
December 7, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29217389/competencies-for-engaging-high-needs-patients-in-primary-care
#7
Michael J Yedidia
BACKGROUND: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery. METHODS: Transcripts of in-depth interviews with 30 clinical and administrative staff at 23 complex care programs across the United States were analyzed using standard qualitative techniques...
December 4, 2017: Healthcare
https://www.readbyqxmd.com/read/29217362/rethinking-prehospital-stroke-notification-assessing-utility-of-emergency-medical-services-impression-and-cincinnati-prehospital-stroke-scale
#8
Stephen W English, Alejandro A Rabinstein, Jay Mandrekar, James P Klaas
BACKGROUND AND PURPOSE: Although prehospital stroke notification has improved stroke treatment, incorporation of these systems into existing infrastructure has resulted in new challenges. The goal of our study was to design an effective prehospital notification system that allows for early and accurate identification of patients presenting with acute stroke. METHODS: We conducted a retrospective single-center cohort study of patients presenting with suspicion of acute stroke from 2014 to 2015...
December 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29217178/factors-associated-with-advanced-cardiac-care-in-prehospital-chest-pain-patients
#9
Adam Frisch, Kenneth J Heidle, Stephanie O Frisch, Ashar Ata, Brandon Kramer, Caroline Colleran, Jestin N Carlson
INTRODUCTION: Many patients transported by emergency medical services (EMS) may require advanced cardiac care but do not have ST-segment elevation (STEMI) on the initial prehospital EKG. We sought to identify factors associated with the need for advanced cardiac care in undifferentiated EMS patients reporting chest pain in the absence of STEMI on EKG. METHODS: We performed a retrospective analysis of all adult patients, reporting atraumatic chest pain from a single EMS agency, presenting to a single, urban hospital over a 10-year period...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29214900/injury-related-hospital-admission-of-female-firefighters-in-south-korea
#10
Ji Young Song, Min-Gi Kim, Yeon-Soon Ahn
PURPOSE: The main objective of this study was to ascertain whether injury related hospital admission in all South Korea female firefighters is greater than that in the general population. METHODS: To perform this comparison, the standardized admission ratios (SARs) and their 95% confidence intervals (CI) were calculated by person-years and mortality computation software. RESULTS: Compared to the general population, the SARs of overall injury (SAR =1...
December 7, 2017: International Journal of Occupational Safety and Ergonomics: JOSE
https://www.readbyqxmd.com/read/29214743/gc-ms-ms-detects-potential-pregabalin-abuse-in-susceptible-subjects-hair
#11
Federica Ianni, Kyriaki Aroni, Alessio Gili, Roccaldo Sardella, Mauro Bacci, Massimo Lancia, Benedetto Natalini, Cristiana Gambelunghe
Pregabalin, a GABA analogue, binds to the alpha 2 delta subunit of voltage-dependent calcium channels. It is recognized as efficacious in pathologies such as epilepsy, neuropathic pain and anxiety disorders. Since pregabalin prescriptions have increased worldwide, reports of its abuse have been accumulating, mainly in patients with opioid abuse disorders. The present study investigated potential pregabalin abuse by means of hair analysis, a matrix that provides valuable retrospective information. Half of the pool of 280 susceptible patients had been occasional drug users and were being monitored for driving licence renewals...
December 7, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29210031/adjuvant-statin-therapy-for-esophageal-adenocarcinoma-a-cost-utility-analysis
#12
Rebekah Fong Soe Khioe, Chris Skedgel, Andrew Hart, Michael Philip Nelson Lewis, Leo Alexandre
BACKGROUND: Emerging preclinical evidence indicates statins, medications commonly used in the prevention of cardiovascular disease (CVD), inhibit proliferation, promote apoptosis and limit invasiveness of esophageal adenocarcinoma (EAC). Population-based observational data demonstrate statin treatment after diagnosis of EAC is associated with significant reductions in all-cause and cancer-specific mortality. A feasibility study of adjuvant statin therapy following potentially curative resection for EAC has been completed, with planned progression to a full phase III, randomized controlled trial...
December 5, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29209982/adherence-to-inhaled-medications-and-its-effect-on-healthcare-utilization-and-costs-among-high-grade-chronic-obstructive-pulmonary-disease-patients
#13
Jee-Ae Kim, Min Kyoung Lim, Kunil Kim, JuHee Park, Chin Kook Rhee
BACKGROUND: Adherence to inhaled medication regimens affects chronic obstructive pulmonary disease (COPD) prognosis and quality of life, and reduces the use of healthcare services, resulting in cost savings. OBJECTIVES: To examine the effects of adherence to inhaled medication regimens on healthcare utilization and costs in high-grade COPD patients. METHODS: We performed an observational retrospective cohort study using a longitudinal data set from the Korean Health Insurance Review and Assessment Service (2008-2013) containing healthcare services' information for 50 million beneficiaries...
December 5, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29209788/-reform-of-emergency-physician-training-in-austria-finally-up-to-date
#14
REVIEW
H Trimmel, M Baubin, J Kreutziger, G Frank, G Prause
During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29209676/fatal-butane-toxicity-and-delayed-onset-of-refractory-ventricular-fibrillation
#15
Khalid N Almulhim
A 30-year-old male was presented to the Emergency Department (ED) by the Emergency Medical Services (EMS). He was found unconscious but breathing normally, and had a seizure for more than 30 minutes. He was no previous history of systemic disease, previous operation, medication and any known allergy. According to the witnesses, he was alone in the coffee shop, and besides him was a lighter refill canister containing 250 ml extra purified butane gas, and he suddenly collapsed and had seizure. Six hours later, he developed ventricular fibrillation and he was not responding to amiodarone infusion, and 4 times defibrillation and cardioversion...
December 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29208368/the-end-of-life-costs-for-medicare-patients-with-advanced-ovarian-cancer
#16
Renata R Urban, Hao He, Raphael Alfonso, Melissa M Hardesty, Barbara A Goff
OBJECTIVE: To describe the Medicare payments at the end of life for patients with advanced ovarian cancer, and assess factors responsible for payment variation METHODS: Using the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database, we identified a cohort of women with stage III/IV epithelial ovarian cancer diagnosed between 1995 and 2007. We defined the end of life as the last 90days prior to death. Total medical costs were estimated from overall Medicare payments, and adjusted for geography and for inflation to the 2009 U...
December 3, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29208018/noise-exposure-during-prehospital-emergency-physicians-work-on-mobile-emergency-care-units-and-helicopter-emergency-medical-services
#17
Mads Christian Tofte Hansen, Jesper Hvass Schmidt, Anne C Brøchner, Jakob Kjersgaard Johansen, Stine Zwisler, Søren Mikkelsen
BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet...
December 6, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29207756/intravenous-fluid-administration-and-the-survival-of-pre-hospital-resuscitated-out-of-hospital-cardiac-arrest-patients-in-thailand
#18
Phichet Nongchang, Wongsa Laohasiri Wong, Somsak Pitaksanurat, Pairoj Boonsirik Amchai
Introduction: Out of Hospital Cardiac Arrest (OHCA) is a leading cause of death worldwide. The Emergency Medical Service (EMS) provides early care to critical OHCA patients. Pre hospital intervention has been improving OHCA survival rate, however it is still unclear for the recommendation of routine infusion of Intravenous (IV) fluids during cardiac arrest resuscitation. Aim: This study aimed to determine whether IV fluid administration was associated with increasing survival of resuscitated OHCA patients and to assess the survival rate of resuscitated OHCA patients...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29205442/palliative-care-for-end-of-life-patients-in-a-basic-emergency-service
#19
REVIEW
Maria Eduarda Diniz Pereira, António Barbosa, Maria Dos Anjos Dixe
This research sought to describe the care provided by the nursing staff of the Western Department of the Basic Emergency Service for end-of-life patients. This was a retrospective, quantitative, exploratory and descriptive (level I) study, which sought to research the nursing records of 83 patients from admission to death. Patients who met the following inclusion criteria were considered eligible: adults; had an oncological or nononcological, advanced and irreversible chronic disease; and died in the Basic Emergency Service in the period from January 2011 to December 2012...
December 5, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29204620/should-this-patient-receive-aspirin-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#20
Risa B Burns, Kelly Graham, Mandeep S Sawhney, Eileen E Reynolds
Aspirin exerts antiplatelet effects through irreversible inhibition of cyclooxygenase-1, whereas its anticancer effects may be due to inhibition of cyclooxygenase-2 and other pathways. In 2009, the U.S. Preventive Services Task Force endorsed aspirin for primary prevention of cardiovascular disease. However, aspirin's role in cancer prevention is still emerging, and no groups currently recommend its use for this purpose. To help physicians balance the benefits and harms of aspirin in primary disease prevention, the Task Force issued a guideline titled, "Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer" in 2016...
December 5, 2017: Annals of Internal Medicine
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