Koji Shimizu, Masahiro Wakasugi, Toshiomi Kawagishi, Tomoya Hatano, Takamasa Fuchigami, Hiroshi Okudera
Purpose: To obtain effective systemic blood flow and coronary perfusion by chest compressions during cardiopulmonary resuscitation, it is recommended that the interruption time of chest compressions be kept to a minimum, and that the chest compression fraction (CCF) should be kept high. In this study, we examined the effects of advanced airway management by paramedics in out-of-hospital cardiac arrest (OHCA) cases on CCF and on return of spontaneous circulation (ROSC) before arrival at the hospital...
2021: Open Access Emergency Medicine: OAEM
Jae-Hwan Kang, Joon Sakong, Jung Ho Kim
BACKGROUND: Violence in emergency departments poses a threaten to both medical personnel and patients. We investigated the risk factors for high burnout status and the association between the impact of violence and burnout status of paramedics in emergency departments. METHODS: We included paramedics of emergency departments in Korea. We conducted a survey on the emotional, physical, and social responses to violence using an assault response questionnaire. Additionally, we evaluated burnout status using the Maslach Burnout Inventory...
July 17, 2021: Australasian emergency care
David J F Holstein, Judith D Holstein, Daniel Fischer, Meinhard Mende, Brian M Frier, Andreas Holstein
AIMS: To collect and analyse representative data of structural and process quality in the management of diabetic emergencies in Germany in 2020. METHODS: A standardised questionnaire comprising detailed items concerning clinically relevant parameters on the structural and process quality of out-of-hospital management of diabetic emergencies was sent nationwide to medical directors of emergency medical service districts (EMSDs). Results were compared with those from a similar study conducted in 2001...
July 20, 2021: Experimental and Clinical Endocrinology & Diabetes
Pauli E T Vuorinen, Jyrki P J Ollikainen, Pasi A Ketola, Riikka-Liisa K Vuorinen, Piritta A Setälä, Sanna E Hoppu
BACKGROUND: In acute ischemic stroke, conjugated eye deviation (CED) is an evident sign of cortical ischemia and large vessel occlusion (LVO). We aimed to determine if an emergency dispatcher can recognise LVO stroke during an emergency call by asking the caller a binary question regarding whether the patient's head or gaze is away from the side of the hemiparesis or not. Further, we investigated if the paramedics can confirm this sign at the scene. In the group of positive CED answers to the emergency dispatcher, we investigated what diagnoses these patients received at the emergency department (ED)...
July 19, 2021: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Shalinee Rao, Kusum K Rohilla, Rajesh Kathrotia, Manisha Naithani, Arun Varghese, Anupama Bahadur, Puneet Dhar, Pradeep Aggarwal, Manoj Gupta, Ravi Kant
Introduction During a large-scale disease outbreak, one needs to respond to the situation quickly towards capacity building, by identifying areas that require training and planning a workable strategy and implementing it. There are limited studies focused on fast-track workforce creation under challenging circumstances that demand mandatory social distancing and discouragement of gatherings. This study was conducted to analyze the planning process and implementation of fast-track training during the Coronavirus disease (COVID-19) pandemic, and evaluate its effectiveness in building a rapid, skilled, and massive workforce...
June 2021: Curēus
Sebahat Nacar Dogan, Ferhat Cengel, Aylin Hasanefendioglu Bayrak, Rıdvan Yazgu
Occlusion of the artery of Percheron (AoP) causes bithalamic paramedian infarct (BTPI). Although it can be diagnosed easily in its pure form, it can be underdiagnosed in cases with concomitant extrathalamic acute infarcts (plus-BTPI) as it may be difficult to determine whether BTPI is due to occlusion of AoP or two different paramedian arteries even with conventional angiography. This study was performed to highlight plus-BTPI that could result from occlusion of AoP rather than of two distinct paramedian arteries using topographic evaluation of bithalamic infarcts...
August 2021: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Tuija Rasku, Marja Kaunonen, Elizabeth Thyer, Eija Paavilainen, Katja Joronen
BACKGROUND: Primary care, the principal function of the health care system, requires effort from all local primary health care teams. Community Paramedicine (CP) has managed to reduce the use of Emergency Medical Services (EMS) for non-emergency calls, but for the paramedic to move from traditional emergency calls to non-emergency care will mean new demands. There is a paucity of research exploring nurse-paramedics' experiences and perceptions of their novel roles as community paramedics in Finland...
July 18, 2021: BMC Health Services Research
Pieter Francsois Fouche, Ben Meadley, Toby StClair, Alison Winnall, Christopher Stein, Paul Andrew Jennings, Stephen Bernard, Karen Smith
BACKGROUND: Rapid Sequence intubation (RSI) is an airway procedure that uses sedative and paralytic drugs to facilitate endotracheal intubation. It is known that RSI could impact blood pressure in the peri-intubation period. However, little is known about blood pressure changes in longer time frames. Therefore, this analysis aims to describe the changes in systolic blood pressure in a large cohort of paramedic-led RSI cases over the whole prehospital timespan. METHODS: Intensive Care Paramedics in Victoria, Australia, are authorised to use RSI in medical or trauma patients with a Glasgow Coma Scale <10...
July 16, 2021: Emergency Medicine Journal: EMJ
David L Murphy, Natalie E Bulger, Brenna M Harrington, Jillian A Skerchak, Catherine R Counts, Andrew J Latimer, Betty Y Yang, Charles Maynard, Thomas D Rea, Michael R Sayre
BACKGROUND: International guidelines emphasize advanced airway management during out-of-hospital cardiac arrest (OHCA). We hypothesized that increasing endotracheal intubation attempts during OHCA were associated with a lower likelihood of favorable neurologic survival at discharge. METHODS: This retrospective, observational cohort evaluated the relationship between number of intubation attempts and favorable neurologic survival among non-traumatic OHCA patients receiving cardiopulmonary resuscitation (CPR) from January 1, 2015 - June 30, 2019 in a large urban emergency medical services (EMS) system...
July 13, 2021: Resuscitation
Kalin Kempster, Stuart Howell, Stephen Bernard, Karen Smith, Peter Cameron, Judith Finn, Dion Stub, Peter Morley, Janet Bray
BACKGROUND: The emergency department (ED) plays an important role in out-hospital-cardiac arrest (OHCA) management. However, ED outcomes are not widely reported. This study aimed to 1) describe OHCA ED outcomes and reasons for ED deaths, and 2) whether these differed between hospitals. METHODS: Data were obtained from the Victorian Ambulance Cardiac Arrest Registry and 12 hospitals for adult, non-traumatic OHCA cases transported to ED between 2014 and 2016. Multivariable logistic regression was used to examine the association of level of cardiac arrest centre on ED survival in a subset of cases (non-paramedic witnessed OHCA who were unconscious on ED arrival with ROSC)...
July 13, 2021: Resuscitation
Emmanuel Grolleau, Véronique Fonteille, Caroline Lebourgeois, Marie Darrason, Philippe Michel, Delphine Ragonnet, Gilles Freyer, Amélie Deculty, Carine Gippet, Céline Leclercq, Carole Neugnot, Radoudja Malek, Odile Perdriolat, Michele Rigaud, Séverine Torrecillas, Maud-Catherine Barral, Pierre-Jean Souquet, Jean-Baptiste Fassier, Lénaïck Tanguy, Benjamin Rolland, Sébastien Couraud
INTRODUCTION: Smoking prevalence in the overall population in France was 27% in 2017. There are few data about smoking prevalence in hospital workers. The aim of this study was to assess prevalence of current smoking in student and staff populations at Lyon University Hospital. Secondary objectives were to identify main variables associated with current smoking and willingness to quit. METHODS: We designed a single center, cross-sectional survey, using printed questionnaires...
2021: Tobacco Prevention & Cessation
Beatrice Thielmann, Irina Böckelmann, Heiko Schumann
OBJECTIVE: The aim of this study was to identify work-related experience and behavior patterns among rescue workers in different urban and rural organizational structures. METHODS: The subjects included 276 paramedics from Germany (average age 39.3 ± 8.04 years) in 3 groups (professional fire department, aid organization in urban or rural regions). Work-related behavior and experience patterns (AVEM) were examined. Influences of age, gender, professional qualifications, frequency of operation, and organization were analyzed...
July 14, 2021: Journal of Occupational and Environmental Medicine
Gerrit Jansen, Nicole Ebeling, Eugen Latka, Stefan Krüger, Sean S Scholz, Simon Trapp, Julia J Granneman, Daniel Thaemel, Suraj Chandwani, Odile Sauzet, Sebastian W Rehberg, Rainer Borgstedt
BACKGROUND: To evaluate the effects of European Resuscitation Council (ERC) COVID-19-guidelines on resuscitation quality emphasizing advanced airway management in out-of-hospital-cardiacarrest. METHODS: In a manikin study paramedics and emergency physicians performed Advanced-Cardiac-Life-Support in three settings: ERC guidelines 2015 (Control), COVID-19-guidelines as suggested with minimum staff (COVID-19-minimal-personnel); COVID-19-guidelines with paramedics and an emergency physician (COVID-19-advanced-airway-manager)...
July 14, 2021: Minerva Anestesiologica
Tzila Zwas
Nuclear medicine (NM) in Israel started in 1952 with the use of isotopes in medicine, using I-131 for thyroid disorders, initiated by Prof. Czerniak, founder of the profession. The first institute opened in 1954. For the first three decades, NM paved the way for novel diagnoses and treatments. An increase in the number of institutes, the introduction of specially trained physicians and paramedical teams, and recognition of NM as an independent specialty, all produced increased activity. During NM's early period, functional examinations were common such as the Schilling Test (labeled vitamin B12 absorption), or blood volume in polycythemia...
July 2021: Harefuah
Mathieu Groulx, Alexandra Nadeau, Marcel Émond, Jessica Harrisson, Pierre-Gilles Blanchard, Douglas Eramian, Eric Mercier
Introduction: In 2018, a continuous flow insufflation of oxygen (CFIO) device (b-card™, Vygon (USA)) placed on a supraglottic airway (SGA) became the standard of care to ventilate patients during adult out-of-hospital cardiac arrest (OHCA) care in Quebec-Capitale-Nationale region, Canada. This study aims to assess the paramedics' perception as well as the disadvantages and the benefits relative to the use of CFIO during OHCA management. Methods: An invitation to complete an online survey (Survey Monkey™) was sent to all 560 paramedics who are working in our region...
2021: SAGE Open Medicine
Hanna Schröder, Stefan K Beckers, Klaudia Ogrodzki, Christina Borgs, Sebastian Ziemann, Andreas Follmann, Rolf Rossaint, Marc Felzen
Almost seven years ago, a telemedicine system was established as an additional component of the city of Aachen's emergency medical service (EMS). It allows paramedics to engage in an immediate consultation with an EMS physician at any time. The system is not meant to replace the EMS physician on the scene during life-threatening emergencies. The aim of this study was to analyze teleconsultations during life-threatening missions and evaluate whether they improve patient care. Telemedical EMS (tele-EMS) physician consultations that occurred over the course of four years were evaluated...
July 13, 2021: Scientific Reports
Nichole Bosson, Amy H Kaji, Marianne Gausche-Hill
OBJECTIVE: We hypothesized that implementation of a Medical Control Guideline (MCG) with a standardized formulary (fixed medication concentrations) and pre-calculated medication dosages in a large emergency medical services (EMS) system would reduce pediatric dosing errors. To assess the effectiveness of the standardized formulary to reduce errors, we chose to evaluate midazolam administration for seizures, because it is the most frequently dosed medication by EMS for children, and seizures are a time-sensitive condition...
July 13, 2021: Prehospital Emergency Care
Celal Levent Kayadelen, Ayşe Nilgün Kayadelen, Polat Durukan
BACKGROUND: This study aimed to determine the cardiopulmonary resuscitation (CPR) knowledge level and factors affecting the current CPR knowledge level among EMTs and paramedics working in the Kayseri 112 emergency health system. METHODS: This survey aimed to reach all paramedics and emergency medical technicians working in the 112 emergency health system in Kayseri province. The data collection consists of sociodemographic/occupational characteristics, CPR training and practice characteristics and 20 four-choice CPR knowledge questions...
July 12, 2021: BMC Emergency Medicine
Milan Tuček
OBJECTIVES: The aim of the study was to determine the probable places of coronavirus transmission in association with the work. METHODS: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period March-December 2020. RESULTS: 732,202 COVID-19 cases were officially confirmed, from them 64,587 (9%) represented work-related disease, 184,384 cases (25%) work-related contact, and 483,231 cases (66%) out-of-work contact...
June 2021: Central European Journal of Public Health
Ben Meadley, Alexander P Wolkow, Karen Smith, Luke Perraton, Kelly-Ann Bowles, Maxine P Bonham
Objective: Shift work is an established risk factor for poor health yet is necessary for paramedics to provide continuous care to the public. It is unknown how early into a career shift work may begin to impact health. This study sought to identify changes in cardiometabolic health, diet, aerobic capacity, physical activity and health-related quality of life (HRQoL) in graduate paramedics during the first 12-months of their career. Methods: Fifty-six paramedics with no history of regular shift work (28 female, 28 male; median age 24...
July 7, 2021: Prehospital Emergency Care
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