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https://www.readbyqxmd.com/read/28096208/improving-door-to-needle-times-for-acute-ischemic-stroke-effect-of-rapid-patient-registration-moving-directly-to-computed-tomography-and-giving-alteplase-at-the-computed-tomography-scanner
#1
Noreen Kamal, Jessalyn K Holodinsky, Caroline Stephenson, Devika Kashayp, Andrew M Demchuk, Michael D Hill, Renee L Vilneff, Erin Bugbee, Charlotte Zerna, Nancy Newcommon, Eddy Lang, Darren Knox, Eric E Smith
BACKGROUND: The effectiveness of specific systems changes to reduce DTN (door-to-needle) time has not been fully evaluated. We analyzed the impact of 4 specific DTN time reduction strategies implemented prospectively in a staggered fashion. METHODS AND RESULTS: The HASTE (Hurry Acute Stroke Treatment and Evaluation) project was implemented in 3 phases at a single academic medical center. In HASTE I (June 6, 2012 to June 5, 2013), baseline performance was analyzed...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28096207/use-of-strategies-to-improve-door-to-needle-times-with-tissue-type-plasminogen-activator-in-acute-ischemic-stroke-in-clinical-practice-findings-from-target-stroke
#2
Ying Xian, Haolin Xu, Barbara Lytle, Jason Blevins, Eric D Peterson, Adrian F Hernandez, Eric E Smith, Jeffrey L Saver, Steven R Messé, Mary Paulsen, Robert E Suter, Mathew J Reeves, Edward C Jauch, Lee H Schwamm, Gregg C Fonarow
BACKGROUND: The implementation of Target: Stroke Phase I, the first stage of the American Heart Association's national quality improvement initiative to accelerate door-to-needle (DTN) times, was associated with an average 15-minute reduction in DTN times. TARGET: Stroke phase II was launched in April 2014 with a goal of promoting further reduction in treatment times for tissue-type plasminogen activator (tPA) administration. METHODS AND RESULTS: We conducted a second survey of Get With The Guidelines-Stroke hospitals regarding strategies used to reduce delays after Target: Stroke and quantify their association with DTN times...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28096051/transitions-of-care-medication-related-barriers-identified-by-low-socioeconomic-patients-of-a-federally-qualified-health-center-following-hospital-discharge
#3
Rebecca Cope, Lauren Jonkman, Karen Quach, John Ahlborg, Sharon Connor
This article describes a qualitative research study using a semi-structured interview process to describe barriers surrounding medication access, use, and adherence for recently discharged patients of a federally qualified health center. Common themes which emerged were: 1) Team assumptions regarding patient plans to access or appropriately use discharge medications negatively impact adherence; 2) Unmet expectation for care coordination between primary care physician (PCP) and hospital; 3) Disconnect between patients and health care workers leads to disengagement; and 4) Lack of personal contact hinders access to services...
January 6, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28096039/the-impact-of-emergency-medical-services-in-acute-heart-failure
#4
Pia Harjola, James Boyd, Tuukka Tarvasmäki, Juho Mattila, Reijo Koski, Markku Kuisma, Veli-Pekka Harjola
BACKGROUND: Real-life data on the role of emergency medical services (EMS) in acute heart failure (AHF) are scarce. Our aim was to describe prehospital treatment of AHF and to compare patients using EMS with self-presented, non-EMS patients. METHODS: Data were collected retrospectively from three university hospitals in Helsinki metropolitan area between July 1, 2012 and July 31, 2013. According to the use of EMS, patients were divided into EMS and non-EMS groups...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28095934/the-effect-of-ambulance-staffing-models-in-a-metropolitan-fire-based-ems-system
#5
Eric J Cortez, Ashish R Panchal, James E Davis, David P Keseg
: Introduction The staffing of ambulances with different levels of Emergency Medical Service (EMS) providers is a difficult decision with evidence being mixed on the benefit of each model. Hypothesis/Problem The objective of this study was to describe a pilot program evaluating alternative staffing on two ambulances utilizing the paramedic-basic (PB) model (staffed with one paramedic and one emergency medical technician[EMT]). METHODS: This was a retrospective study conducted from September 17, 2013 through December 31, 2013...
January 18, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28095855/meet-us-on-the-phone-mobile-phone-programs-for-adolescent-sexual-and-reproductive-health-in-low-to-middle-income-countries
#6
REVIEW
Nicole B Ippoliti, Kelly L'Engle
INTRODUCTION: mHealth as a technical area has seen increasing interest and promise from both developed and developing countries. While published research from higher income countries on mHealth solutions for adolescent sexual and reproductive health (SRH) is growing, there is much less documentation of SRH mHealth interventions for youth living in resource-poor settings. We conducted a global landscape analysis to answer the following research question: How are programs using mHealth interventions to improve adolescent SRH in low to middle income countries (LMICs)? METHODS: To obtain the latest information about mHealth programs targeting youth SRH, a global call for project resources was issued in 2014...
January 17, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28095063/early-primary-care-follow-up-after-ed-and-hospital-discharge-does-it-affect-readmissions
#7
Sanjai Sinha, Joanna Seirup, Amanda Carmel
OBJECTIVES: After hospitalization, timely discharge follow-up has been linked to reduced readmissions in the heart failure population, but data from general inpatients has been mixed. The objective of this study was to determine if there was an association between completed follow-up appointments within 14 days of hospital discharge and 30-day readmission amongst primary care patients at an urban academic medical center. Index discharges included both inpatient and emergency room settings...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28094089/use-of-emergency-medical-transport-and-impact-on-time-to-care-in-patients-with-ischaemic-stroke
#8
A Olascoaga Arrate, M M Freijo Guerrero, C Fernández Maiztegi, I Azkune Calle, R Silvariño Fernández, M Fernández Rodríguez, P Vazquez Naveira, A Anievas Elena, I Iturraspe González, Y Pérez Díez, R Ruiz Fernández
INTRODUCTION: According to numerous studies, using emergency medical services (EMS) to transport stroke patients to hospitals decreases diagnostic and treatment delays. OBJECTIVES: To determine the frequency of use of EMS by stroke patients in Bizkaia (Spain), analyse the factors associated with using EMS, and study the impact of EMS on time to care. METHODS: We gathered data from 545 patients hospitalised for acute ischaemic stroke and recruited consecutively...
January 13, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28093867/paramedic-resuscitation-competency-a-survey-of-australian-and-new-zealand-emergency-medical-services
#9
Kylie Dyson, Janet E Bray, Karen Smith, Stephen Bernard, Lahn Straney, Judith Finn
OBJECTIVE: We have previously established that paramedic exposure to out-of-hospital cardiac arrest (OHCA) is relatively rare, therefore clinical exposure cannot be relied on to maintain resuscitation competency. We aimed to identify the current practices within emergency medical services (EMS) for developing and maintaining paramedic resuscitation competency. METHODS: We developed and conducted an online cross-sectional survey of Australian and New Zealand EMS in 2015...
January 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28093443/impact-of-advanced-autonomous-non-medical-practitioners-in-emergency-care-protocol-for-a-scoping-study
#10
Mark Sujan, Hannah Howard-Franks, Garry Swann, Kirsti Soanes, Catherine Pope, Robert Crouch, Sophie Staniszewska, Elaine Maxwell, Huayi Huang, Matthew Cooke
INTRODUCTION: Emergency care services are looking for new models of care delivery to deal with changing patient demographics and increased pressures. It has been suggested that advanced non-medical practitioners might be valuable for delivering such new models of care. However, it is not clear what the impact of the deployment of advanced non-medical practitioners in emergency care is. This scoping study addresses the following research question: What is known from the literature about the different types of impact of the deployment of advanced (autonomous) non-medical practitioners in emergency care? METHODS AND ANALYSIS: A scoping study will be undertaken to examine and map the impact of the deployment of advanced non-medical practitioners in emergency care...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28092241/-response-to-comment-on-article-reflections-concerning-the-care-process-in-the-emergency-medical-services
#11
Jorge Alberto Castañón-González, Tomás Barrientos-Fortes, Carlos Polanco-González
No abstract text is available yet for this article.
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28089281/features-of-public-healthcare-services-provided-to-migrant-patients-in-the-eastern-macedonia-and-thrace-region-greece
#12
Christos A Tsitsakis, Anastasios Karasavvoglou, Efstathios Tsaridis, Georgia Ramantani, Giannoula Florou, Persefoni Polychronidou, Stamatios Stamatakis
BACKGROUND: The influx of migrants, refugees and asylum-seekers into European Union (EU) countries, especially into Greece, in the last 20 years is an issue of growing concern and requires a rational approach. The aim of this study is to chart the use of public health services by the migrants of the Eastern Macedonia and Thrace Region, which forms the northeastern border of Greece. METHODS: We collected data from five of the six public hospitals in the specified region, and we carried out a per clinic cross tabulation analysis of admission diagnosis and citizenship variables in order to establish the frequency at which the various diagnoses emerge per distinct group of migrant and non-migrant patients in each clinic...
December 27, 2016: Health Policy
https://www.readbyqxmd.com/read/28089112/predictive-utility-of-the-total-glasgow-coma-scale-versus-the-motor-component-of-the-glasgow-coma-scale-for-identification-of-patients-with-serious-traumatic-injuries
#13
REVIEW
Roger Chou, Annette M Totten, Nancy Carney, Spencer Dandy, Rongwei Fu, Sara Grusing, Miranda Pappas, Ngoc Wasson, Craig D Newgard
STUDY OBJECTIVE: The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care...
January 11, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28089060/evaluating-services-at-a-major-trauma-center-before-helipad-construction
#14
Danny Jon Nian Wong, James Robert Bedford, Simon Luck, Roger Bloomer
INTRODUCTION: Two of the 4 hospitals designated as major trauma centers in London, UK, currently operate on-site helicopter landing pads. King's College Hospital (KCH) is constructing a third. We evaluate current trauma services at King's College Hospital, before the helipad entering service, establishing baseline workload and mortality measures. METHODS: We retrospectively analyzed data from patients admitted January 1, 2014, to December 31, 2015, to KCH after major trauma with on-scene helicopter emergency medical services involvement (N = 427) using the Trauma Audit and Research Network database...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28087286/incidence-and-survival-outcome-according-to-heart-rhythm-during-resuscitation-attempt-in-out-of-hospital-cardiac-arrest-patients-with-presumed-cardiac-etiology
#15
Shahzleen Rajan, Fredrik Folke, Steen Møller Hansen, Carolina Malta Hansen, Kristian Kragholm, Thomas A Gerds, Freddy K Lippert, Lena Karlsson, Sidsel Møller, Lars Køber, Gunnar H Gislason, Christian Torp-Pedersen, Mads Wissenberg
BACKGROUND: Knowledge about heart rhythm conversion from non-shockable to shockable rhythm during resuscitation attempt after out-of-hospital cardiac arrest (OHCA) and following chance of survival is limited and inconsistent. METHODS: We studied 13,860 patients with presumed cardiac-caused OHCA not witnessed by the emergency medical services from the Danish Cardiac Arrest Register (2005-2012). Patients were stratified according to rhythm: shockable, converted shockable (based on receipt of subsequent defibrillation) and sustained non-shockable rhythm...
January 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/28077150/the-equity-of-china-s-emergency-medical-services-from-2010-2014
#16
Ke Yan, Yi Jiang, Jingfu Qiu, Xiaoni Zhong, Yang Wang, Jing Deng, Jingxi Lian, Tingting Wang, Cheng Cao
BACKGROUND: With the depth development of health care system reform in China, emergency medical services (EMS) is confronted with challenges as well as opportunities. This study aimed to analyze the equity of China's EMS needs, utilization, and resources distribution, and put forward proposal to improve the equity. METHOD: Three emergency needs indicators (mortality rate of cardiovascular and cerebrovascular diseases, harm, and digestive system disease), two utilization indicators (emergency outpatient visits and rate of utilization) and one resource allocation indicator (number of EMS facilities) were collected after the review of the China Statistical Yearbook and the National Disease Surveillance System...
January 11, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28076746/characteristics-of-patients-presenting-to-an-after-hours-clinic-results-of-a-magnet-analysis
#17
Lyle R Turner, Christopher Pearce, Madeleine Borg, Adam McLeod, Marianne Shearer, Danielle Mazza
After-hours access to general practice (GP) is critical to supporting accessibility and reducing emergency department demand. To understand who utilises after-hours GP services, this study examined the characteristics of presentations to an Eastern Melbourne after-hours clinic between 2005 and 2014. Descriptive analyses of patient and presentation characteristics, diagnoses, medications and pathology were conducted. Across the study period, 39.1% of presentations to the clinic (N=64,800) were by patients under 18 years of age...
January 12, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28076734/effect-of-a-mass-media-campaign-on-ambulance-use-for-chest-pain
#18
Ziad Nehme, Peter A Cameron, Muhammad Akram, Harry Patsamanis, Janet E Bray, Ian T Meredith, Karen Smith
OBJECTIVES: To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain. DESIGN, SETTING AND PARTICIPANTS: A retrospective analysis of 253428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 - December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28076579/factors-that-influence-career-choice-in-primary-care-among-medical-students-starting-social-service-in-honduras
#19
E Benjamín Puertas, Tamara Y Rivera
Objective: To 1) describe patterns of specialty choice; 2) investigate relationships between career selection and selected demographic indicators; and 3) identify salary perception, factors that influence career choice in primary care, and factors that influence desired location of future medical practice. Methods: The study used a mixed-methods approach that included a cross-sectional questionnaire survey applied to 234 last-year medical students in Honduras (September 2014), and semi-structured interviews with eight key informants (October 2014)...
November 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28074571/screening-brief-intervention-and-referral-to-treatment-sbirt-implementation-barriers-facilitators-and-model-migration
#20
Janice Vendetti, Amanda Gmyrek, Donna Damon, Manu Singh, Bonnie McRee, Frances Del Boca
AIMS: To identify barriers and facilitators associated with initial implementation of a US alcohol and other substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant program, and to identify modifications in program design that addressed implementation challenges. DESIGN: A mixed-method approach used quantitative and qualitative data, including SBIRT provider ratings of implementation barriers and facilitators, staff interview responses and program documentation...
February 2017: Addiction
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