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https://www.readbyqxmd.com/read/29151401/evaluation-of-a-primary-care-paramedic-stemi-bypass-guideline
#1
Jonathan L Kwong, Garry Ross, Linda Turner, Chris Olynyk, Sheldon Cheskes, Adam Thurston, P Richard Verbeek
OBJECTIVE: Limited evidence supports primary care paramedic (PCP) direct transport of ST-segment elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI). The goal of this study was to evaluate an urban-based PCP STEMI bypass guideline. METHODS: We reviewed consecutive Toronto Paramedic Services call reports between April 7, 2015, and May 31, 2016, regarding STEMI patients identified by PCPs. The primary outcome was patient assignment (stable versus unstable) according to guideline criteria...
November 20, 2017: CJEM
https://www.readbyqxmd.com/read/29150970/a-family-reunion
#2
Nicholas Kluesner
She had arrived from home via ambulance for back pain in the middle of the night; elderly patients with back pain are always cases that concern me - nothing chronic seems amenable to satisfying treatment and nothing acute ends well. The paramedics' report was clear: she was the acute type. This article is protected by copyright. All rights reserved.
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#3
Stefan Heschl, Emily Andrew, Anthony de Wit, Stephen Bernard, Marcus Kennedy, Karen Smith
OBJECTIVE: The optimal volume and type of intravenous fluid for the treatment of blood loss in the prehospital setting is controversial. The use of red cell concentrates (RCCs) may be associated with improved outcomes; however, the administration of blood products is limited to physicians in many jurisdictions. We sought to describe the characteristics of RCC transfusions in a paramedic-staffed helicopter emergency medical system in Victoria, Australia. METHODS: We performed a retrospective analysis of all cases where paramedics consulted the responsible physician for approval of RCC transfusion between July 2011 and December 2015 in Victoria, Australia...
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145711/timing-of-antibiotics-in-the-management-of-community-acquired-sepsis-can-a-randomised-controlled-trial-of-prehospital-therapy-provide-answers
#4
Andrew A Udy, Karen Smith, Stephen Bernard
Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29141175/sudden-cardiac-arrest-during-participation-in-competitive-sports
#5
Cameron H Landry, Katherine S Allan, Kim A Connelly, Kris Cunningham, Laurie J Morrison, Paul Dorian
BACKGROUND: The incidence of sudden cardiac arrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiac arrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiac arrests that occurred during participation in sports activities within a specific region of Canada and to determine their causes...
November 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29140748/paramedic-initiated-home-care-referrals-and-use-of-home-care-and-emergency-medical-services
#6
Amol A Verma, John Klich, Adam Thurston, Jordan Scantlebury, Alex Kiss, Gayle Seddon, Samir K Sinha
OBJECTIVE: We examined the association between paramedic-initiated home care referrals and utilization of home care, 9-1-1, and Emergency Department (ED) services. METHODS: This was a retrospective cohort study of individuals who received a paramedic-initiated home care referral after a 9-1-1 call between January 1, 2011 and December 31, 2012 in Toronto, Ontario, Canada. Home care, 9-1-1, and ED utilization were compared in the 6 months before and after home care referral...
November 15, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29139599/adherence-to-a-multifactorial-fall-prevention-program-following-paramedic-care-predictors-and-impact-on-falls-and-health-service-use-results-from-an-rct-a-priori-subgroup-analysis
#7
A Stefanie Mikolaizak, Stephen R Lord, Anne Tiedemann, Paul Simpson, Gideon Caplan, Jason C Bendall, Kirsten Howard, Jacqueline Close
OBJECTIVE: To identify predictors and impact of adherence to a multifactorial fall-prevention program on falls and health service utilisation. METHODS: Randomised controlled trial with a priori subgroup analysis within intervention group according to adherence. Participants were community dwelling, (≥65 years), not transported to hospital following fall-related paramedic care. The Attitudes to Falls-Related Interventions Scale (AFRIS) was completed at baseline, adherence levels were measured (three-point scale) at six months, and falls and health service utilisation were recorded for 12 months...
November 15, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29133262/911-emergency-medical-services-and-re-triage-to-level-i-trauma-centers
#8
Eric Kuncir, Dean Spencer, Kelly Feldman, Cristobal Barrios, Kenneth Miller, Stephanie Lush, Matthew Dolich, Michael Lekawa
BACKGROUND: Interfacility transfer of under-triaged patients to higher level trauma centers has been found to result in a delay of appropriate care and increase in mortality. To address this, for the last 10 years, our region has utilized 911 EMS paramedics for rapid re-triage of under-triaged patients to our institution's Level I trauma center. We sought to determine if utilizing 911 EMS for re-triage (911-RT) to our institution was associated with worse outcomes-with mortality as the primary outcome-compared to direct EMS transport from point of injury...
September 27, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29132592/paramedic-clinical-ladder-development-and-implementation-at-1-institution
#9
Jeffrey Haspray
No abstract text is available yet for this article.
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29130627/temporal-trends-2002-2014-of-incidence-and-shockable-status-of-adult-emergency-medical-service-attended-out-of-hospital-cardiac-arrest-of-presumed-cardiac-aetiology-in-queensland
#10
Katherine Pemberton, Emma Bosley
OBJECTIVE: To describe trends in incidence and shockable status of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014. METHODS: The QAS cardiac arrest registry was used to collect data. Analyses included age-standardised rates by gender for all adults and older adults only (65 years+); age-specific incidence rates of young adults (18-49), middle age adults (50-64) and five groups of older adults (65-69, 70-74, 75-79, 80-84 and 85+); and proportions of shockable versus non-shockable initial rhythm together and by age group (young, middle age and older adults)...
November 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29127541/the-bargaining-of-professionalism-in-emergency-care-practice-nhs-paramedics-and-higher-education
#11
Assaf Givati, Chris Markham, Ken Street
Over the past 2 decades, as part of reforms to the National Health Service and with it organizational changes to ambulance work in the UK, paramedic education has undergone a process of academisation and a shift from in-house, apprenticeship weeks-long occupational training, to university-based undergraduate programs. While the professional regulation and standardization of Allied Health Professionals' education in high-income countries has captured scholarly attention, the study of paramedic practice is still in its infancy and there is a need to explore its evolvement in relation to the fluid societal-political circumstances affecting its provision and demand...
November 10, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29124045/dietary-diversity-score-and-its-related-factors-among-employees-of-kermanshah-university-of-medical-sciences
#12
Seyed Mostafa Nachvak, Hadi Abdollahzad, Roghayeh Mostafai, Shima Moradi, Yahya Pasdar, Mansour Rezaei, Soudabeh Esksndari
Dietary diversity score (DDS) is known as an indicator of food quality. Dietary diversity can promote health status. The aim of this study was determined DDS and its related factors in Kermanshah University of Medical Sciences (KUMS) employees. This cross-sectional study was conducted on 190 employees of KUMS in 2015. According to the population of KUMS centers which were selected randomly (Paramedical, Public Health faculties, Imam Reza Hospital and province health center), subjects were selected by convenience sampling method...
October 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/29121819/ethical-decision-making-based-on-field-assessment-the-experiences-of-prehospital-personnel
#13
Mohammad Torabi, Fariba Borhani, Abbas Abbaszadeh, Foroozan Atashzadeh-Shoorideh
INTRODUCTION: Due to the stressful nature of prehospital emergency providers' duties, as well as difficulties such as distance to information resources and insufficient time to analyze situations, ethical decision-making in prehospital services is a daily challenge. OBJECTIVES: This study aimed to describe the experiences of Iranian prehospital emergency personnel in the field of ethical decision-making. METHODS: The data were collected by semi-structured interviews (n = 15) in Iran and analyzed using the content analysis approach...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/29118588/professionalism-among-paramedic-students-achieving-the-measure-or-missing-the-mark
#14
REVIEW
L Michael Bowen, Brett Williams, Luke Stanke
Background: Professionalism is a pillar of paramedicine. Internationally paramedic curricula emphasize valid assessment of three domains: cognitive, psychomotor, and affective domains (professionalism). Little is reported on competency measures for professionalism specific to paramedicine. Literature suggests that paramedic students, paramedic practitioners, medical directors, and patients believe that professional attributes should have an increased focus. Objective: The objective of this scoping review is to outline valid and reliable assessments that evaluate professional behaviors...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29108791/improvement-of-blood-loss-volume-estimation-by-paramedics-using-a-pictorial-nomogram-a-developmental-study
#15
Chun Yu Yeung, Wai Wa Yim, Suet Yi Chan, Ronson Sze Long Lo, Ling Yan Leung, Kevin Kei Ching Hung, Colin A Graham
INTRODUCTION: To propose and evaluate a nomogram to assist paramedics to visually estimate the external blood loss on a non-absorbent surface and to identify whether the nomogram improves visual estimation. METHODS: The study was a prospective, paired-control design (pre-training control group & post-training group), utilizing Emergency Medical Assistant (EMA) I and II trainees from the Hong Kong Fire Services Ambulance Command Training School. A nomogram (blood loss volume to area on a non-absorbent surface) was prepared to aid blood loss estimation...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29103361/titrating-the-rig-how-paramedics-work-in-and-on-their-ambulance
#16
Michael K Corman
In this article, I take readers inside of an ambulance and explore how paramedics work in and on their "apparatus unit" to make it a workable fit. This taken-for-granted work is important because much is at stake in the back of the ambulance, particularly in relation to quality of care and safety. I draw on data from an institutional ethnography into the socially organized work and work settings of paramedics, which included more than 200 hr of observations and more than 100 interviews with paramedics. The findings shed light on the situated work processes of paramedics as they orient and respond to their "apparatus unit" and enact quality and safety in practice...
November 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/29095286/clinical-predictors-of-outcomes-in-patients-undergoing-emergency-air-medical-transport-from-kinmen-to-taiwan
#17
Julia Chia-Yu Chang, Hsien-Hao Huang, Shu-Hua Chang, Yin-Ru Chen, Ju-Shin Fan, Yen-Chia Chen, David Hung-Tsang Yen
Emergency air medical transport (EAMT) is indispensable for acutely or critically ill patients in remote areas. We determined patient-level and transport-specific factors associated with all-cause mortality after EAMT.We conducted a population-based, retrospective cohort study using a prospective registry consisting of clinical/medical records. Study inclusion criteria consisted of all adults undergoing EAMT from Kinmen hospital to the ED of Taipei Veterans General Hospital (TVGH) between January 1, 2006 and December 31, 2012...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29080439/the-reliability-and-validity-of-multiple-mini-interviews-mmis-in-values-based-recruitment-to-nursing-midwifery-and-paramedic-practice-programmes-findings-from-an-evaluation-study
#18
Alison Callwood, Debbie Cooke, Sarah Bolger, Agnieszka Lemanska, Helen Allan
BACKGROUND: Universities in the United Kingdom (UK) are required to incorporate values based recruitment (VBR) into their healthcare student selection processes. This reflects an international drive to strengthen the quality of healthcare service provision. This paper presents novel findings in relation to the reliability and predictive validity of multiple mini interviews (MMIs); one approach to VBR widely being employed by universities. OBJECTIVES: To examine the reliability (internal consistency) and predictive validity of MMIs using end of Year One practice outcomes of under-graduate pre-registration adult, child, mental health nursing, midwifery and paramedic practice students...
October 6, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29079933/applying-kane-s-validity-framework-to-a-simulation-based-assessment-of-clinical-competence
#19
Walter Tavares, Ryan Brydges, Paul Myre, Jason Prpic, Linda Turner, Richard Yelle, Maud Huiskamp
Assessment of clinical competence is complex and inference based. Trustworthy and defensible assessment processes must have favourable evidence of validity, particularly where decisions are considered high stakes. We aimed to organize, collect and interpret validity evidence for a high stakes simulation based assessment strategy for certifying paramedics, using Kane's validity framework, which some report as challenging to implement. We describe our experience using the framework, identifying challenges, decisions points, interpretations and lessons learned...
October 27, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29076236/choosing-public-or-private-emergency-departments-in-australia
#20
Katherine Walker, Michael Ben-Meir
Emergency medicine was once exclusively provided in public hospitals in Australia, but now over half a million consultations per annum are in private (7% total emergency consultations). Private EDs have excess capacity and are staffed by senior doctors (majority FACEM) with open access to investigations and broad specialist inpatient services. Public EDs struggle with rising attendances and overcapacity. Private hospitals have high levels of patient satisfaction and aim to optimise service provision. A major barrier to private ED attendances is out-of-pocket costs...
October 26, 2017: Emergency Medicine Australasia: EMA
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