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Emergency medical services

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https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#1
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28436157/real-time-teleophthalmology-video-consultation-an-analysis-of-patient-satisfaction-in-rural-western-australia
#2
Benjamin Kj Host, Angus W Turner, Josephine Muir
BACKGROUND: Teleophthalmology, particularly real-time video consultation, holds great potential in Australia and similar countries worldwide, where geography, population and medical workforce distribution make it difficult to provide specialist eye services outside of major cities. Assessment and referrals from rural optometrists are vital to the success of teleophthalmology. While there is good evidence for the efficacy of such services, there is limited evidence for patient satisfaction with video consultation...
April 23, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/28435902/emergency-medical-service-personnel-need-to-improve-knowledge-and-attitude-regarding-prehospital-sepsis-care
#3
Joongmin Park, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Hee Yoon, Tae Rim Lee, Won Chul Cha, Min Seob Sim
OBJECTIVE: We aimed to evaluate the knowledge and attitudes of emergency medical service (EMS) personnel pertaining to sepsis. We also compared EMS personnel's knowledge of sepsis and their intention to engage in prehospital sepsis management. METHODS: The survey was conducted during education conferences for EMS personnel in December 2013 and January 2015 in Seoul, Korea. The questionnaire composed of 10 questions relevant to sepsis, was distributed on-scene, and was retrieved by investigators after the conference...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28435495/areas-of-potential-impact-of-the-patient-protection-and-affordable-care-act-on-ems-a-synthesis-of-the-literature
#4
REVIEW
Daniel G Ostermayer, Charles A Brown, William G Fernandez, Emily Couvillon
INTRODUCTION: This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. METHODS: We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. RESULTS: Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#5
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435493/prehospital-care-for-the-adult-and-pediatric-seizure-patient-current-evidence-based-recommendations
#6
Eric C Silverman, Karl A Sporer, Justin M Lemieux, John F Brown, Kristi L Koenig, Marianne Gausche-Hill, Eric M Rudnick, Angelo A Salvucci, Greg H Gilbert
INTRODUCTION: We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS) agencies in California. METHODS: We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435484/outcomes-by-mode-of-transport-of-st-elevation-mi-patients-in-the-united-arab-emirates
#7
Edward L Callachan, Alawi A Alsheikh-Ali, Satish Chandrasekhar Nair, Stevan Bruijns, Lee A Wallis
INTRODUCTION: The purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities. METHODS: This multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434918/forming-and-activating-an-internal-facilitation-group-for-successful-implementation-a-qualitative-study
#8
Megan B McCullough, Chris Gillespie, Beth Ann Petrakis, Ellen A Jones, Angela M Park, Carol VanDeusen Lukas, Adam J Rose
BACKGROUND: This study focuses on an implementation facilitation strategy to improve the delivery of anticoagulation care within pharmacy-run clinics across 8 Veterans Health Administration (VA) medical centers. Other studies have explored various models of implementation facilitation, including external facilitation (EF), internal facilitation (IF), and blended facilitation (BF) combining both approaches. This study focuses on the use of an internal facilitation team of anticoagulation coordinators representing 8 VA anticoagulation clinics to enhance the implementation process...
April 9, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28434773/mstroke-mobile-stroke-improving-acute-stroke-care-with-smartphone-technology
#9
Benjamin Y Andrew, Colleen M Stack, Julian P Yang, Jodi A Dodds
OBJECTIVE: This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. METHODS: A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation...
April 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28434466/cost-effectiveness-of-acupuncture-in-an-employee-population-a-retrospective-analysis
#10
Bijan J Borah, James M Naessens, Amy E Glasgow, Brent A Bauer, Tony Y Chon
OBJECTIVES: To determine whether acupuncture is a cost-effective adjunct to usual care for Mayo Clinic employees and their dependents experiencing pain symptoms. DESIGN: Retrospective review of the medical and billing records of 466 employee-patients and their dependents who had received acupuncture as part of their care and 466 propensity score-matched control patients. INTERVENTIONS: Usual care in combination with acupuncture compared with usual care alone...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28433454/a-randomized-comparison-of-three-chest-compression-techniques-and-associated-hemodynamic-effect-during-infant-cpr-a-randomized-manikin-study
#11
Jacek Smereka, Lukasz Szarpak, Antonio Rodríguez-Núñez, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433250/public-private-implementation-of-integrated-emergency-response-services-case-study-of-gvk-emergency-management-and-research-institute-in-karnataka-india
#12
Veena M Sriram, Gopalkrishna Gururaj, Adnan A Hyder
BACKGROUND: Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public-private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru...
April 19, 2017: Surgery
https://www.readbyqxmd.com/read/28432194/diagnostic-value-of-prehospital-ecg-in-acute-stroke-patients
#13
Tobias Bobinger, Bernd Kallmünzer, Markus Kopp, Natalia Kurka, Martin Arnold, Stefan Heider, Stefan Schwab, Martin Köhrmann
OBJECTIVE: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. METHODS: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit...
April 21, 2017: Neurology
https://www.readbyqxmd.com/read/28431508/association-between-cardiopulmonary-resuscitation-duration-and-one-month-neurological-outcomes-for-out-of-hospital-cardiac-arrest-a-prospective-cohort-study
#14
Masahiro Kashiura, Yuichi Hamabe, Akiko Akashi, Atsushi Sakurai, Yoshio Tahara, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura
BACKGROUND: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. METHODS: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan...
April 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#15
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28429527/balancing-health-care-education-and-patient-care-in-the-uk-workplace-a-realist-synthesis
#16
Sarah Sholl, Rola Ajjawi, Helen Allbutt, Jane Butler, Divya Jindal-Snape, Jill Morrison, Charlotte Rees
CONTEXT: Patient care activity has recently increased without a proportionate rise in workforce numbers, impacting negatively on health care workplace learning. Health care professionals are prepared in part by spending time in clinical practice, and for medical staff this constitutes a contribution to service. Although stakeholders have identified the balance between health care professional education and patient care as a key priority for medical education research, there have been very few reviews to date on this important topic...
April 20, 2017: Medical Education
https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#17
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
April 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28423982/from-data-to-improved-decisions-operations-research-in-healthcare-delivery
#18
Muge Capan, Anahita Khojandi, Brian T Denton, Kimberly D Williams, Turgay Ayer, Jagpreet Chhatwal, Murat Kurt, Jennifer Mason Lobo, Mark S Roberts, Greg Zaric, Shengfan Zhang, J Sanford Schwartz
BACKGROUND: The Operations Research Interest Group (ORIG) within the Society of Medical Decision Making (SMDM) is a multidisciplinary interest group of professionals that specializes in taking an analytical approach to medical decision making and healthcare delivery. ORIG is interested in leveraging mathematical methods associated with the field of Operations Research (OR) to obtain data-driven solutions to complex healthcare problems and encourage collaborations across disciplines. This paper introduces OR for the non-expert and draws attention to opportunities where OR can be utilized to facilitate solutions to healthcare problems...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28423751/web-validation-service-for-ensuring-adherence-to-the-dicom-standard
#19
Jorge Miguel Silva, Tiago Marques Godinho, David Silva, Carlos Costa
The DICOM Standard has been fundamental for ensuring the interoperability of Picture Archive and Communications Systems (PACS). By compiling rigorously to the standard, medical imaging equipment and applications from different vendors can share their data, and create integrated workflows which contributes to better quality healthcare services. However, DICOM is a complex, flexible and very extensive standard. Thus, it is difficult to attest the conformity of data structures produced by DICOM applications resulting in unexpected behaviors, errors and malfunctions...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422894/impact-of-telephone-based-problem-solving-treatment-on-the-use-of-medical-and-psychological-services-in-the-military
#20
John S Richardson, Jesse R Fann, Kathleen R Bell, Nancy Temkin
OBJECTIVE: To explore the impact of problem-solving treatment (PST) for mild traumatic brain injury in active duty service members on the use of medical and psychological services. PARTICIPANTS: Service members who had a mild traumatic brain injury during their last deployment and enrolled in the CONcussion Treatment After Combat Trauma (CONTACT) study. DESIGN: Secondary analysis of a randomized clinical trial. Participants were assigned to telephone-based PST, or e-mailed or mailed education only over the course of 6 months...
April 18, 2017: Journal of Head Trauma Rehabilitation
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