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https://www.readbyqxmd.com/read/29340631/a-better-understanding-of-ambulance-personnel-s-attitude-towards-real-time-resuscitation-feedback
#1
Peter Brinkrolf, Roman Lukas, Ulf Harding, Sebastian Thies, Joachim Gerss, Hugo Van Aken, Hans Lemke, Udo Schniedermeier, Andreas Bohn
Objective: High-quality chest compressions during cardiopulmonary resuscitation (CPR) play a significant role in surviving cardiac arrest. Chest-compression quality can be measured and corrected by real-time CPR feedback devices, which are not yet commonly used. This article looks at the acceptance of such systems in comparison of equipped and unequipped personnel. Design: Two groups of emergency medical services' (EMS) personnel were interviewed using standardized questionnaires...
January 11, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29336638/prehospital-administration-of-epinephrine-in-pediatric-anaphylaxis-a-statewide-perspective
#2
Leslie M Cristiano, Brian Hiestand, Jason W Caldwell, W Adam Gower, Antonio R Fernandez, Katherine Gilbert, James E Winslow
OBJECTIVE: Timely administration of epinephrine is critical in the treatment of anaphylaxis. This study sought to determine the frequency of administration of epinephrine by EMS providers caring for pediatric patients in the prehospital setting. METHODS: We examined data from the NC EMS database (PreMIS) from 2010-3 to determine frequency of epinephrine administration in pediatric patients with anaphylaxis. We studied patients <18 years of age with an EMS provider impression of "allergic reaction...
January 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29335831/quality-of-inter-hospital-transportation-in-431-transport-survivor-patients-suffering-from-acute-respiratory-distress-syndrome-referred-to-specialist-centers
#3
Sebastian Blecha, Frank Dodoo-Schittko, Susanne Brandstetter, Magdalena Brandl, Michael Dittmar, Bernhard M Graf, Christian Karagiannidis, Christian Apfelbacher, Thomas Bein
BACKGROUND: The acute respiratory distress syndrome (ARDS) is a life-threatening condition. In special situations, these critically ill patients must be transferred to specialized centers for escalating treatment. The aim of this study was to evaluate the quality of inter-hospital transport (IHT) of ARDS patients. METHODS: We evaluated medical and organizational aspects of structural and procedural quality relating to IHT of patients with ARDS in a prospective nationwide ARDS study...
January 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29331194/-specificities-of-nursing-care-in-neurological-intensive-care
#4
REVIEW
Christelle Garijo, Flavien Chabert, Cécile Armonia, Perrine Boucheix
In the acute phase of the treatment of patients with brain injuries, the management of secondary brain injuries of systemic origin is a priority. A neurosurgical intensive care paramedical team shares their experience of the care delivered and the constant monitoring carried out to optimise, with the medical team, the patient's outcome and to innovate practices.
January 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29321074/patient-and-case-characteristics-associated-with-no-paramedic-treatment-for-low-acuity-cases-referred-for-emergency-ambulance-dispatch-following-a-secondary-telephone-triage-a-retrospective-cohort-study
#5
Kathryn Eastwood, Amee Morgans, Johannes Stoelwinder, Karen Smith
BACKGROUND: Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with 'no paramedic treatment' for cases referred for emergency ambulance dispatch following secondary telephone triage. METHODS: A retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29319741/verbal-abuse-and-mobbing-in-pre-hospital-care-services-in-chile
#6
Varinia Rodríguez Campo, Tatiana Paravic Klijn
OBJECTIVE: to determine the perception of verbal abuse and mobbing and the associated factors of paramedic technicians (nursing assistants) and professionals (nurses, midwives, kinesiologists) in the pre-hospital care areas of three regions in the south of Chile. METHODS: descriptive and correlational study was performed within the professional community and a two-stage sample of the paramedic technician population in three regions. The questionnaire "workplace violence in the health sector" (spanish version) was applied after signing the informed consent...
January 8, 2018: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29319407/malpractice-litigation-in-acute-stroke-care-where-are-we-now
#7
Gilberto Kk Leung, Gerard Porter
Acute stroke care has undergone momentous changes in recent years with the introduction of intravenous thrombolysis, mechanical thrombectomy and integrated stroke services. While these are welcome developments, they also carry unique medico-legal challenges. In 2015, a patient from Greater Manchester was awarded over £1 million in compensation after ambulance paramedics failed to admit her to a specialist unit. This paper explores the medico-legal implications of this first but over looked thrombolysis-related claim in the United Kingdom...
January 1, 2018: Medico-legal Journal
https://www.readbyqxmd.com/read/29317347/using-virtual-reality-to-control-preoperative-anxiety-in-ambulatory-surgery-patients-a-pilot-study-in-maxillofacial-and-plastic-surgery
#8
L Ganry, B Hersant, M SidAhmed-Mezi, G Dhonneur, J P Meningaud
INTRODUCTION: Preoperative anxiety may lead to medical and surgical complications, behavioral problems and emotional distress. The most common means of prevention are based on using medication and, more recently, hypnosis. The aim of our study was to determine whether a virtual reality (VR) program presenting natural scenes could be part of a new therapy to reduce patients' preoperative anxiety. MATERIALS AND METHODS: Our prospective pilot study consisted of a single-blind trial in skin cancer surgery at the Henri Mondor Teaching Hospital in France...
January 6, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#9
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patient patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29310869/intraosseous-vascular-access-is-associated-with-lower-survival-and-neurologic-recovery-among-patients-with-out-of-hospital-cardiac-arrest
#10
Takahisa Kawano, Brian Grunau, Frank X Scheuermeyer, Koichiro Gibo, Christopher B Fordyce, Steve Lin, Robert Stenstrom, Robert Schlamp, Sandra Jenneson, Jim Christenson
STUDY OBJECTIVE: We seek to determine the effect of intraosseous over intravenous vascular access on outcomes after out-of-hospital cardiac arrest. METHODS: This secondary analysis of the Resuscitation Outcomes Consortium Prehospital Resuscitation Using an Impedance Valve and Early Versus Delayed (PRIMED) study included adult patients with nontraumatic out-of-hospital cardiac arrests treated during 2007 to 2009, excluding those with any unsuccessful attempt or more than one access site...
January 6, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29310618/epidemiology-of-unplanned-out-of-hospital-births-attended-by-paramedics
#11
Gayle McLelland, Lisa McKenna, Amee Morgans, Karen Smith
BACKGROUND: Over the previous two decades the incidence and number of unplanned out of hospital births Victoria has increased. As the only out of hospital emergency care providers in Victoria, paramedics would provide care for women having birth emergencies in the community. However, there is a lack of research about the involvement of paramedics provide for these women and their newborns. This research reports the clinical profile of a 1-year sample caseload of births attended by a state-wide ambulance service in Australia...
January 8, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29305280/challenges-for-environmental-hygiene-practices-in-australian-paramedic-led-health-care-a-brief-report
#12
Nigel Barr, Mark Holmes, Anne Roiko, Peter Dunn, Bill Lord
This study explored the self-reported behaviors and perceptions of Australian paramedics in relation to their environmental hygiene practices. A national online survey was conducted with Paramedics Australasia members (N = 417). Participants reported working in ambulances often contaminated with body fluids. Widespread noncompliance with routine and deep cleaning of ambulances, and misunderstandings about environmental hygiene practices were apparent. Improvements to environmental hygiene practices of Australian paramedics are recommended to avoid pathogen transmission and ensure patient safety...
January 3, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29302729/color-change-after-paramedical-pigmentation-of-the-nipple-areola-complex
#13
Shoichi Tomita, Katsuya Mori, Takeshi Miyawaki
BACKGROUND: Reconstruction of the nipple-areola complex is the final process in breast reconstruction. Local flaps and paramedical pigmentation is one of the major procedures for this. However, fading after paramedical pigmentation leads to a color difference between the selected pigment and its color in the skin. The aim of this study is to make a proposition in color choice of paramedical pigmentation for nipple-areola complex. METHODS: Our research focused on investigating the color changes over time after unilateral nipple-areola complex reconstruction using paramedical pigmentation in 25 patients to propose suitable color selections...
January 4, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29301973/association-between-hyperacute-stage-blood-pressure-variability-and-outcome-in-patients-with-spontaneous-intracerebral-hemorrhage
#14
Pil-Wook Chung, Joon-Tae Kim, Nerses Sanossian, Sidney Starkmann, Scott Hamilton, Jeffrey Gornbein, Robin Conwit, Marc Eckstein, Frank Pratt, Sam Stratton, David S Liebeskind, Jeffrey L Saver
BACKGROUND AND PURPOSE: Increased blood pressure (BP) variability, in addition to high BP, may contribute to adverse outcome in intracerebral hemorrhage. However, degree and association with outcome of BP variability (BPV) in the hyperacute period, 15 minutes to 5 hours after onset, have not been delineated. METHODS: Among consecutive patients with intracerebral hemorrhage enrolled in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium), BPs were recorded by paramedics in the field and during the first 24 hours of hospital course...
January 4, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29298245/emergency-medical-responders-and-adolescents-with-autism-spectrum-disorder
#15
Viola Cheung, Madeline L McCarthy, Mark X Cicero, John M Leventhal, Carol Weitzman
OBJECTIVES: Because of the high prevalence of Autism Spectrum Disorder (ASD) and wandering behavior, emergency medical responders (EMRs) will likely encounter children and adolescents with ASD. The objectives were to describe interactions between EMRs and children and adolescents with ASD, to evaluate EMRs' ability to recognize ASD in a simulated trauma setting, and to determine if EMRs' demographic characteristics affected their interactions with ASD youth. METHODS: A study of 75 videos of a simulated school bus crash was performed...
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29297718/evaluation-of-physiologic-alterations-during-prehospital-paramedic-performed-rapid-sequence-intubation
#16
Robert G Walker, Lynn J White, Geneva N Whitmore, Alexander Esibov, Michael K Levy, Gregory C Cover, Joel D Edminster, James M Nania
OBJECTIVE: Physiologic alterations during rapid sequence intubation (RSI) have been studied in several emergency airway management settings, but few data exist to describe physiologic alterations during prehospital RSI performed by ground-based paramedics. To address this evidence gap and provide guidance for future quality improvement initiatives in our EMS system, we collected electronic monitoring data to evaluate peri-intubation vital signs changes occurring during prehospital RSI...
January 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29290894/drug-calculation-ability-of-qualified-paramedics-a-pilot-study
#17
Malcolm J Boyle, Kathryn Eastwood
BACKGROUND: The inability of paramedics to perform accurate calculations may result in a compromise of patient safety which may result from under or over dosing of drugs, incorrect joules for defibrillation, or a major adverse event such as death. The objective of this study was to identify the drug calculation and mathematical ability of qualified operational paramedics. METHODS: The study used a cross-sectional design with a paper-based calculation questionnaire...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29289460/risk-management-for-surgical-energy-driven-devices-used-in-the-operating-room
#18
F Borie, M Mathonnet, A Deleuze, B Millat, J-F Gravié, H Johanet, J-P Lesage, J Gugenheim
Complications related to energy sources in the operating room are not well-recognized or published, despite occasionally dramatic consequences for the patient and the responsible surgeon. The goal of this study was to evaluate the risks and consequences related to use of energy sources in the operating room. PATIENTS AND METHODS: Between 2009 and 2015, 876 adverse events related to health care (AERHC) linked to energy sources in the operating room were declared in the French experience feedback data base "REX"...
December 27, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29273612/interprofessional-care-collaboration-for-patients-with-heart-failure
#19
Amanda Boykin, Danielle Wright, Lydia Stevens, Lauren Gardner
PURPOSE: An innovative collaborative care model to improve transitions of care (TOC) for patients with heart failure (HF) is described. SUMMARY: As part of a broad effort by New Hanover Regional Medical Center (NHRMC) to reduce avoidable 30-day hospital readmissions and decrease associated healthcare costs through a team-centered, value-based approach to patient care, an interprofessional team was formed to help reduce hospital readmissions among discharged patients with HF...
January 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29273024/is-unplanned-out-of-hospital-birth-managed-by-paramedics-infrequent-normal-and-uncomplicated
#20
Belinda Flanagan, Bill Lord, Margaret Barnes
BACKGROUND: Unplanned out-of-hospital birth is often perceived as precipitate in nature, 'infrequent', 'normal' and 'uncomplicated'. However, international studies report unplanned out-of-hospital birth is associated with increased rates of maternal and neonatal morbidity and mortality. This research describes intrapartum, immediate postpartum and neonatal care provided by paramedics in Queensland, Australia. The objectives were to (1) determine the number of cases where the paramedic documented birth or imminent birth during the study period (2) to describe the incidence of births prior to or during paramedic care (3) to detail any risk factors and/or complications recorded by paramedics during these cases, (4) identify paramedic pain management practices for intrapartum care, and (5) to examine the maternal and neonatal outcomes as documented by paramedics...
December 22, 2017: BMC Pregnancy and Childbirth
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