Janna Newton, Travis Carpenter, Jennifer Zwicker
PURPOSE: Emergency Medical Services (EMS) in Alberta are facing critical challenges. This qualitative study aims to describe and understand the frontline perspective regarding system level issues and propose provider-informed policy recommendations. METHODS: 19 semi-structured one-on- one interviews were conducted with Primary or Advanced Care Paramedics (PCP/ACP) across Alberta. Participants were asked to share their perspectives, experiences and recommendations in relation to EMS response times and the working environment...
April 16, 2024: BMC Emergency Medicine
Charles Beldena, Albert Kopaka, Courtney Coulesa, Tessa Friesena, Justin Hallb, Shuchin Shuklaa
INTRODUCTION: Despite sustained efforts to reduce opioid-related overdose fatalities, rates have continued to rise. In many areas, overdose response involves emergency medical service (EMS) personnel administering naloxone and transporting patients to the emergency department (ED). However, a substantial number of patients decline transport, and many EDs do not provide medication for opioid use disorder (MOUD). One approach to filling this gap involves delivering MOUD to overdose patients in the field with trained post-overdose EMS teams who can initiate buprenorphine...
April 14, 2024: J Subst Use Addict Treat
Michael Feldman, Fahad Bahaidarah, Mahbod Rahimi, Sara Howaidi, Linda Turner, P Richard Verbeek, Warren Cantor, Sheldon Cheskes, Ian Drennan, Kristen Gilmartin
OBJECTIVE: Current guidelines recommend that patients presenting with ST-elevation myocardial infarction (STEMI) to hospitals not capable of performing primary percutaneous coronary intervention (PCI) be transferred to a PCI-capable hospital if reperfusion can be accomplished within 120 minutes. Most STEMI patients are accompanied by an advanced care paramedic (ACP, equivalent to EMT-P), nurse, or physician who can manage complications should they arise. In our region, stable STEMI patients are transported by primary care paramedics (PCPs, similar scope of practice to advanced EMT) in cases where a nurse, physician, or ACP paramedic is not available...
April 15, 2024: Prehospital Emergency Care
Emine M Tunc, Derya Caglar, S Heath Ackley, Rachel Umoren
This technical report explored the feasibility and utility of virtual reality (VR) pediatric resuscitation simulations for pre-hospital providers during their scheduled shifts. To our knowledge, neither the pediatric resuscitation VR simulation nor the feasibility of in situ, on-shift training with VR had been previously evaluated in pre-hospital providers. VR headset was available at an urban city fire station for 10 days where a total of 60 pre-hospital providers were scheduled to work. Providers were made aware of the VR module but no formal demonstration was done...
March 2024: Curēus
Emily Holmes, Pete Dixon, Amy Mathieson, Leone Ridsdale, Myfanwy Morgan, Alison McKinlay, Jon Dickson, Steve Goodacre, Mike Jackson, Deborah Foster, Kristy Hardman, Steve Bell, Anthony Marson, Dyfrig Hughes, Adam J Noble
INTRODUCTION: To identify service users' preferences for an alternative care pathway for adults with epilepsy presenting to the ambulance service. METHODS: Extensive formative work (qualitative, survey and knowledge exchange) informed the design of a stated preference discrete choice experiment (DCE). This hypothetical survey was hosted online and consisted of 12 binary choices of alternative care pathways described in terms of: the paramedic's access to medical records/ 'care plan', what happens next (described in terms of conveyance), time, availability of epilepsy specialists today, general practitioner (GP) notification and future contact with epilepsy specialists...
April 10, 2024: Seizure: the Journal of the British Epilepsy Association
Sophie Peyronnet
The nurse coordinator works within a healthcare network to ensure the continuity and quality of the care provided to patients. They act as the interface between medical, paramedical and social care. In some departments, they coordinate the surgical prehabilitation and enhanced rehabilitation program, which aims to optimize the physical, nutritional and psychological state of each patient prior to major surgery. Knowing how to guide patients and their families, advise them and re-explain the medical prescription for discharge sheds light on their situation and reassures them, while enabling them to plan their discharge...
April 2024: Soins; la Revue de Référence Infirmière
Margie Burns, William Montelpare, Matthew Leÿenaar
UNLABELLED: Critically ill patients in rural areas at times require an interhospital transfer from their local hospital to an urban tertiary care centre for advanced critical care services not available locally. Family members have described this transfer window as a communication blackout and one of the most stressful times of their relative's critical illness event. OBJECTIVE: To explore what communication process would be most acceptable between family members and transfer team members (consisting of critical care nurses, paramedics, and physicians) during interhospital transfers of critically ill patients...
April 12, 2024: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Adam J Noble, Beth Morris, Pete Dixon, Amy Mathieson, Leone Ridsdale, Myfanwy Morgan, Jon Dickson, Steve Goodacre, Mike Jackson, Dyfrig Hughes, Anthony Marson, Emily Holmes
INTRODUCTION: Adults presenting to the ambulance service for diagnosed epilepsy are often transported to emergency departments (EDs) despite no clinical need. An alternative care pathway (CP) could allow paramedics to divert them from ED and instigate ambulatory care improvements. To identify the most promising CP configuration for subsequent testing, the COLLABORATE project surveyed people with epilepsy and family/friends who had recently used the English ambulance service to elicit preferences for 288 CP configurations for different seizures...
April 11, 2024: Seizure: the Journal of the British Epilepsy Association
Shadman Aziz, Kate Lachowycz, Rob Major, Paul Rees, Jon Barratt
Outcomes after out-of-hospital cardiac arrest (OHCA) remain poor in the UK. In order to increase the chances of successful resuscitation, international society guidelines on cardiopulmonary resuscitation quality have recommended titration of chest compression parameters and vasopressor administration to arterial diastolic blood pressure if invasive catheters are in situ at the time of cardiac arrest. However, prehospital initiation of arterial and central venous catheterisation is seldom undertaken due to the risks and significant technical challenges in the context of ongoing resuscitation in this environment...
April 12, 2024: Journal of Vascular Access
Léo Charrin, Nicolas Romain-Scelle, Christian Di-Filippo, Eric Mercier, Frederic Balen, Karim Tazarourte, Axel Benhamed
BACKGROUND: Shortness of breath is a common complaint among individuals contacting emergency communication center (EMCCs). In some prehospital system, emergency medical services include an advanced life support (ALS)-capable team. Whether such team should be dispatched during the phone call or delayed until the BLS-capable paramedic team reports from the scene is unclear. We aimed to evaluate the impact of delayed MMT dispatch until receiving the paramedic review compared to immediate dispatch at the time of the call on patient outcomes...
April 12, 2024: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
An-Fu Lee, Yung-Hsiang Chang, Liang-Tien Chien, Shang-Chiao Yang, Wen-Chu Chiang
INTRODUCTION: The optimal vascular access for patients with out-of-hospital cardiac arrest (OHCA) remains controversial. Increasing evidence supports intraosseous (IO) access due to faster medication administration and higher first-attempt success rates compared to intravenous (IV) access. However, the impact on patient outcomes has been inconclusive. METHODS: This retrospective cohort study in Taoyuan City, Taiwan, from January 1, 2019, to December 31, 2022, included patients aged ≥18 years with non-traumatic OHCA resuscitated by emergency medical technician paramedics (EMT-Ps) with either IVs or IOs for final vascular access...
April 9, 2024: American Journal of Emergency Medicine
Caroline C Kaufman, David H Rosmarin
Spirituality/religion is clinically relevant to patients experiencing posttraumatic stress disorder (PTSD) and/or alcohol use disorder (AUD). Despite the comorbidity of PTSD and AUD among first responders (i.e., firefighters, law enforcement, paramedics, corrections officers), relatively little research has investigated the lived experience of first responders with PTSD and AUD as it related to spirituality and religion. As such, 12 (100% cisgender men, 91.7% White/European American) first responder psychiatric patients with comorbid PTSD and AUD were recruited from a psychiatric program serving first responders in the Northeast...
April 11, 2024: Psychological Services
Bridget Dicker, Nick Garrett, Graham Howie, Aroha Brett, Tony Scott, Ralph Stewart, Gavin D Perkins, Tony Smith, Elena Garcia, Verity F Todd
BACKGROUND AND OBJECTIVES: Direct transport to a cardiac arrest centre following out-of-hospital cardiac arrest may be associated with higher survival. However, there is limited evidence available to support this within the New Zealand context. This study used a propensity score-matched cohort to investigate whether direct transport to a cardiac arrest centre improved survival in New Zealand. METHODS: A retrospective cohort study was conducted using the Aotearoa New Zealand Paramedic Care Collection (ANZPaCC) database for adults treated for out-of-hospital cardiac arrest of presumed cardiac aetiology between 1 July 2018 to 30 June 2023...
June 2024: Resuscitation plus
Lara Maria Nau, Gunter Laux, Attila Altiner, Joachim Szecsenyi, Rüdiger Leutgeb
BACKGROUND: The increasing number of requests for help for acutely ill patients and their management is a major problem in the health systems of many countries, but especially in Germany. Rescue coordination centers and ambulances in Germany are increasingly overloaded. As a result, rides as a part of rescue operations have been increasing in length for years, yet a relevant proportion of these operations represent low-acuity calls (LACs). The basic objective of this pilot study is the quantitative analysis of the potential misuse of requests to the rescue control center...
April 10, 2024: JMIR Research Protocols
Shohreh Nasri, Javad Amani, Gelayol Safavi, Sepehr Ghazinoory
INTRODUCTION: Cardiovascular diseases are a multifaceted and complex problem in the health system that can change the priorities of the economic, social, and even political systems of countries. Therefore, as a grand challenge (GC), its management requires adopting a systematic, interdisciplinary, and innovative approach. In Iran, the most common causes of death, have changed from infectious and diarrheal diseases to cardiovascular diseases since 1960. METHODS: In this study, the novel framework of the problem-oriented innovation system (PIS) has been used, and cardiovascular diseases in Iran have been selected as a case study...
2024: Frontiers in Public Health
Zahra Oulmane, Mohamed Cherkaoui, Rekia Belahsen, Mohamed Kamal Hilali, Nourdin Harich
OBJECTIVE: This study aimed to assess parental perceptions of morbidity and certain functional abilities in people with Down syndrome (DS) and their variability according to age and sex in Morocco. MATERIAL AND METHODS: A retrospective and analytical survey was conducted between May 2014 and November 2017, and addressed to the parents of 279 individuals with DS, including 161 boys (57.7%) aged 1-40 years. The sample was subdivised to tree age groups, children under 10 years old, adolescents aged 10-18 years and adults aged ≥ 18 years...
2024: Roczniki Państwowego Zakładu Higieny
Yolaine Glele Ahanhanzo, Farid Olatoundé Agnidé Ally, Pleck Dansou, Charles Sossa Jérôme, Alphonse Kpozehouen, Ghislain Emmanuel Sopoh
INTRODUCTION: Nowadays, Internet addiction is a major concern due to the growing number of Internet users and the consequences associated with this addiction. PURPOSE OF THE RESEARCH: In this study, we aimed to determine the prevalence of and factors associated with Internet addiction among health sciences students at the University of Abomey-Calavi. METHODS: A cross-sectional study was conducted among 346 students from the Faculty of Health Sciences and the National Institute of Medical and Health Sciences at the University of Abomey-Calavi...
2024: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Romain Betend, Laurent Suppan, Michele Chan, Simon Regard, François Sarasin, Christophe A Fehlmann
BACKGROUND: Clinical experience has been shown to affect many patient-related outcomes but its impact in the prehospital setting has been little studied. OBJECTIVES: To determine whether rates of discharge at scene, handover to paramedics and supervision are associated with clinical experience. DESIGN, SETTINGS AND PARTICIPANTS: A retrospective study, performed on all prehospital interventions carried out by physicians working in a mobile medical unit ("service mobile d'urgence et de réanimationˮ [SMUR]) at Geneva University Hospitals between 1 January 2010 and 31 December 2019...
December 20, 2023: Swiss Medical Weekly
Daniel Levi, Joris Hoogendoorn, Shenae Samuels, Lindsay Maguire, Ruben Troncoso, Scott Gunn, Matthew Katz, Christine VanDillen, Susan A Miller, Jay L Falk, Steven H Katz, Linda Papa
OBJECTIVE: Unlike randomized controlled trials, practical real-world studies can offer important information about implementation of prehospital interventions, particularly in community settings where there may be reluctance to adopt new practices. We present the results of a natural experiment that was driven by mandated COVID-19 pandemic-driven shift from endotracheal intubation (ETI) to the i-gel® supraglottic airway (SGA) as a primary advanced airway management device in the prehospital setting to reduce emergency medical services (EMS) personnel exposure to potentially infectious secretions...
April 2024: Journal of the American College of Emergency Physicians open
Cath Taylor, Jill Maben, Justin Jagosh, Daniele Carrieri, Simon Briscoe, Naomi Klepacz, Karen Mattick
BACKGROUND: Nurses, midwives and paramedics comprise over half of the clinical workforce in the UK National Health Service and have some of the highest prevalence of psychological ill health. This study explored why psychological ill health is a growing problem and how we might change this. METHODS: A realist synthesis involved iterative searches within MEDLINE, CINAHL and HMIC, and supplementary handsearching and expert solicitation. We used reverse chronological quota screening and appraisal journalling to analyse each source and refine our initial programme theory...
April 4, 2024: BMJ Quality & Safety
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