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Paramedic prescribing

Rose Crossin, Debbie Scott, Shalini Arunogiri, Karen Smith, Paul M Dietze, Dan I Lubman
OBJECTIVE: To compare changes in pregabalin prescribing and misuse-related ambulance attendances; to characterise the patients attended by paramedics for pregabalin misuse-related harms; to assess the association of pregabalin misuse with use of other sedatives and with suicidal ideation and self-harm; to compare the characteristics of pregabalin misuse-related harms in people who misuse pregabalin according to whether or not they also used other sedatives. DESIGN, SETTING, PARTICIPANTS: Retrospective analysis of data on ambulance attendances in Victoria, January 2012 - December 2017, for which pregabalin misuse-related harms were a contributing factor...
February 2019: Medical Journal of Australia
Saba Savul, Zahid Naeem, Sajida Naseem
Objective To evaluate the satisfaction levels of female patients with the availability and quality of health care services provided at the Community Health Centre (CHC) in Nurpur Shahan, a deprived peri-urban locality in Islamabad. Methods This cross-sectional study was carried out among 346 randomly selected female patients who attended the CHC in Nurpur Shahan from January to March, 2018. Data was collected by face to face interviews using a pre-tested self-designed questionnaire. Data was analysed using SPSS version 23 (IBM Corp...
August 4, 2018: Curēus
Fiona Ecarnot, Nicolas Meunier-Beillard, Marie-France Seronde, Romain Chopard, François Schiele, Jean-Pierre Quenot, Nicolas Meneveau
BACKGROUND: Professional societies call for integration of end-of-life discussions early in the trajectory of heart failure, yet it remains unclear where current practices stand in relation to these recommendations. We sought to describe the perceptions and attitudes of caregivers in cardiology regarding end-of-life situations. METHODS: We performed a qualitative study using semi-directive interviews in the cardiology department of a university teaching hospital in France...
October 5, 2018: BMC Palliative Care
Mohammed Assen Seid, Mohammed Seid Hussen
BACKGROUND: Globally, antimicrobial resistance (AMR) is a complex public problem, which is mainly fuelled by inappropriate use of antimicrobials. Rational use of antimicrobials is the main strategy for the prevention of AMR, which can be achieved by changing the prescribers' behavior and knowledge. Hence, this study aimed to assess knowledge and attitude of paramedical students regarding antimicrobial resistance, which helps to rationalize the use of antimicrobials. METHODS: An institutional based cross-sectional study was performed on 323 graduates paramedical students at the University of Gondar, Ethiopia...
July 6, 2018: BMC Infectious Diseases
Nanlesta Pilgrim, Nrupa Jani, Sanyukta Mathur, Catherine Kahabuka, Vaibhav Saria, Neema Makyao, Lou Apicella, Julie Pulerwitz
BACKGROUND: Oral pre-exposure prophylaxis (PrEP) has the potential to reduce HIV acquisition among adolescent girls and young women (AGYW) in sub-Saharan Africa. However, health care providers' (HCPs) perspectives and interactions with potential clients can substantially influence effective provision of quality health services. We examine if HCPs' knowledge, attitude, and skills, as well as their perceptions of facility readiness to provide PrEP are associated with their willingness to provide PrEP to AGYW at high risk of HIV in Tanzania...
2018: PloS One
Peter M Hawkey, Roderic E Warren, David M Livermore, Cliodna A M McNulty, David A Enoch, Jonathan A Otter, A Peter R Wilson
The Working Party makes more than 100 tabulated recommendations in antimicrobial prescribing for the treatment of infections caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) and suggest further research, and algorithms for hospital and community antimicrobial usage in urinary infection. The international definition of MDR is complex, unsatisfactory and hinders the setting and monitoring of improvement programmes. We give a new definition of multiresistance. The background information on the mechanisms, global spread and UK prevalence of antibiotic prescribing and resistance has been systematically reviewed...
March 1, 2018: Journal of Antimicrobial Chemotherapy
Belay Tafa, Adugna Endale, Desalegn Bekele
BACKGROUND: The continuing emergence, development and spread of pathogenic organisms that are resistant to antimicrobials are a cause of increasing concern. The control of antimicrobial resistance requires knowledge of factors causing antimicrobial resistance, good attitudes towards the intervention strategies as well as changes in antibiotic prescribing behavior of health workers. Hence, this study was aimed to assess paramedical staffs' knowledge and attitudes towards antimicrobial resistance and their antibiotics prescription practices in Dire Dawa, Ethiopia...
September 19, 2017: Annals of Clinical Microbiology and Antimicrobials
B Schempf, S Casu, D Häske
BACKGROUND: In some German emergency medical service districts, analgesia is performed by paramedics without support of emergency physicians on scene. With regard to safety and effectiveness, paramedics should not be overshadowed by emergency physicians. OBJECTIVES: Is prehospital analgesia performed by paramedics under medical supervision or emergency physicians comparable regarding processes and effectiveness in the case of isolated limb injury? MATERIAL AND METHODS: As a retrospective analysis of patients with isolated limb injury, analgesia performed by paramedics and by emergency physicians was analyzed...
May 2017: Der Anaesthesist
Alexia Barbelanne, Sylvie Wolf, Anne-Françoise Foiry, Caroline Guillot, Judith Aron Wisnewsky
Professional cooperation protocols have recently been developed by the French national health authority and regional health agencies. They enable paramedical staff to perform procedures usually carried out by doctors. In the framework of bariatric surgery, the follow-up of patients after surgery is thereby assured by specialist nurses. They can make a diagnosis and prescribe vitamins, minerals and tests.
December 2016: Soins; la Revue de Référence Infirmière
S A Karpishchenko, O I Dolgov
The objective of the present study was to improve the procedures for extended and restricted laser-assisted laryngoplasty in the patients presenting withparalytic laryngeal stenosis and to evaluate the outcome of the surgical interventionsdiffering in extent. The study included 51 patients (47 women and 4 men) at the age varying from 18 to 78 years. Twenty five of these patients had a tracheostoma. The examination was focused on the detection of the following characteristics: vocal fold angle, body mass index, age, specific anatomical and physiological features of the larynx, clinically significant concomitant pathologies, engagement in voice and speech professional activities as well as the influence of paramedical factors...
2016: Vestnik Otorinolaringologii
Francine M Ducharme, Alexandrine J Lamontagne, Lucie Blais, Roland Grad, Kim L Lavoie, Simon L Bacon, Martha L McKinney, Eve Desplats, Pierre Ernst
Objective. We aimed to identify key enablers of physician prescription of a long-term controller in patients with persistent asthma. Methods. We conducted a mailed survey of randomly selected Quebec physicians. We sent a 102-item questionnaire, seeking reported management regarding one of 4 clinical vignettes of a poorly controlled adult or child and endorsement of enablers to prescribe long-term controllers. Results. With a 56% participation rate, 421 physicians participated. Most (86%) would prescribe a long-term controller (predominantly inhaled corticosteroids, ICS) to the patient in their clinical vignette...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Jean Lafond
Pharmacovigilance should become a well-thought-out reflex for each of us, for any drugs taken on prescription or by self-medication. The issue of pharmacovigilance should naturally take its place in the dialogue between patients and health professionals, through advice given before medication is taken. Patients need to be told the importance of notifying any adverse drug reactions (ADRs). Pharmacovigilance would then become a post-hoc way of protecting patients. The importance of using pharmacovigilance should be promoted by emphasizing the fact that the life of a drug really starts after its marketing...
April 2016: Thérapie
Gordon Christie
Independent non-medical prescribing has made significant advances in nursing and is now being considered and developed by other professions. The role of the paramedic is evolving and there is great emphasis on managing people at home and reducing rates of conveyance to hospital. This article discusses the role of the paramedic and suggests the benefits that independent non-medical prescribing could have for both the paramedic profession and for the patients paramedics treat during their clinical practice.
August 19, 2015: Nursing Standard
J A Dauletkalieva, D B Kulov
The article demonstrates necessity of implementing principle of solidary responsibility of citizenfore one's own health with purpose of health promotion and development of health care in country and all over the world. The analysis of national and international literature proved that human health in many ways depends on life style. Nowadays, population places the responsibility for one's own health to state, employers and medical personnel. The article presents main results of anonymous questionnaire survey carried out among 723 workers of municipal polyclinics...
May 2015: Problemy Sot︠s︡ialʹnoĭ Gigieny, Zdravookhranenii︠a︡ i Istorii Medit︠s︡iny
Nazmul Alam, Malay K Mridha, Sibylle Kristensen, Sten H Vermund
Sexually transmitted infection (STI) management is considered rudimentary among rural medical practitioners (RMPs) in Bangladesh. We sought to understand the level of knowledge and skills in STI management and to assess the impact of a two-day training orientation among RMPs in Tangail district. Data were collected through a baseline survey of 225 practicing RMPs in the study area and a three-month follow-up survey of 99 RMPs who participated in a two-day STI/HIV orientation training. The level of formal training among RMPs ranged from none (22...
April 1, 2015: Open Journal of Preventive Medicine
Mhairi K Doris, Euan A Sandilands
A 19-year-old man with a history of eczema was admitted to the emergency department following collapsing at home. The paramedics found him unresponsive with poor respiratory effort and a widespread erythematous rash. Anaphylaxis, thought to be secondary to flucloxacillin he had recently been prescribed, was diagnosed. Epinephrine, steroids and antihistamines were administered without clinical improvement. On arrival to hospital, constricted pupils were noted prompting the emergency physicians to consider opiate toxicity...
April 29, 2015: BMJ Case Reports
Carol Ann Kelly, Mary R O'Brien
BACKGROUND: The role of oxygen therapy to palliate dyspnoea is controversial. Without a clear evidence base oxygen is commonly prescribed, sometimes to the detriment of patients. This use of oxygen appears to be an entrenched culture, the roots of which remain obscure. AIM: To explore healthcare professionals' perceptions of oxygen therapy in palliative care. DESIGN: Interpretative phenomenological analysis study utilising semi-structured interviews to explore beliefs and behaviours of healthcare professionals regarding palliative oxygen therapy...
December 2015: Palliative Medicine
Daniel P Wermeling
Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences...
February 2015: Therapeutic Advances in Drug Safety
Jessica K Adam, Aiden K Varan, Alice L Pong, Eric C McDonald
In August 2013, the County of San Diego Health and Human Services Agency was notified of a fatal case of rat-bite fever (RBF) in a previously healthy male, aged 10 years, who owned pet rats. Two days before his death, the patient experienced rigors, fevers, vomiting, headaches, and leg pains. His physician noted a fever of 102.6°F (39.2ºC), documented a normal examination, diagnosed viral gastroenteritis, and prescribed anti-nausea medication. During the next 24 hours, the patient experienced vomiting and persistent fever...
December 19, 2014: MMWR. Morbidity and Mortality Weekly Report
M D Piercecchi-Marti, L Tuchtan-Torrents, B Lassale, G Leonetti, C Bartoli
The act to transfuse is a prescription following basic rules similar to drug prescriptions. If harm happens, potentially linked with this prescription, the harm's responsibility is borne by the physician, the paramedics, the care organization but by the supplier laboratory too. The setting of good practice rules consistent with science data at the time when the act is performed, the respect of the patient's rights and the quality of supplied products will be assessed during the expertise. Under restorative responsibility, it is necessary to previously establish a direct and certain causation between the litigious act and the harm to enforce the vicarious liability...
November 2014: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
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