Wahaj Anwar A Khan, Russell Conduit, Gerard A Kennedy, Melinda L Jackson
OBJECTIVES: This study aimed to investigate the prevalence of sleep and mental health issues, the role of chronotype, and the relationship between these variables in Australian paramedics. DESIGN: A cross-sectional study. SETTINGS: Cross-sectional survey. MEASUREMENTS: Paramedics were invited to complete an online survey to assess stress, posttraumatic stress disorder (PTSD), depression, anxiety, daytime sleepiness, insomnia, sleep quality, shift-work disorder, bruxism, obstructive sleep apnea, narcolepsy, chronotype, fatigue, and well-being...
March 26, 2020: Sleep Health
Tan N Doan, Luke Adams, Brendan V Schultz, Denise Bunting, Lachlan Parker, Stephen Rashford, Emma Bosley
OBJECTIVES: To describe the characteristics and outcomes of cardiopulmonary resuscitation (CPR)-induced consciousness patients from a large database of out-of-hospital cardiac arrest (OHCA). METHODS: Included were adult patients, attended between January 2007 and December 2018 by the Queensland Ambulance Service, where resuscitation was attempted by paramedics. Manual review of records was undertaken to identify CPR-induced consciousness cases. Patients exhibiting purposeful limb/body movement during CPR, with or without displaying other signs, were considered to be CPR-induced consciousness...
March 26, 2020: Emergency Medicine Australasia: EMA
Jawad Ahmed, Farheen Malik, Zahid Ali Memon, Taha Bin Arif, Aiman Ali, Sundus Nasim, Junaid Ahmad, Muhammad A Khan
Background Hand hygiene is the cardinal step in combating various healthcare-associated infections. These infections are a cause of 37,000 deaths in Europe and 100,000 deaths in the United States annually. Thus, prevention of their spread is of utmost importance today. A study conducted in a tertiary care center in Karachi found that 17% of the medical professionals were aware of the World Health Organization (WHO) guidelines on hand hygiene while only 4.9% followed these hand-washing techniques. Lack of hand hygiene practice and awareness has raised a need to reassess infection control in hospitals...
February 18, 2020: Curēus
Jennifer Hancock, Simon Huang, Samara Zavalkoff
A 16-year-old female presents to a community emergency room following a suicide attempt by hanging. Prehospital, on arrival of paramedics, the patient was in a pulseless electrical activity rhythm. Paramedics provided advanced cardiac life support for 20 minutes before they obtained return of spontaneous circulation. In the emergency department, she had another 25-minute cardiac arrest with ultimate return of spontaneous circulation. She is now hemodynamically stable on Levophed 0.2 µg/kg/min. Her neurological exam shows pupils to be 3 mm and fixed bilaterally, absent cough and gag, and no response to central or peripheral pain...
March 2020: CJEM
Gerard G Carroll, Deena D Wasserman, Aman A Shah, Matthew S Salzman, Kaitlan E Baston, Rick A Rohrbach, Iris L Jones, Rachel Haroz
The opioid epidemic is currently a leading health crisis in the United States, and evidence supports Medication for Opioid Use Disorder (MOUD) as the most effective treatment.2 In our EMS system we are observing an ever increasing number of patients who, due to refusing transport after naloxone rescue, represent an access void at the point of overdose.We present a case series to illustrate a new treatment paradigm utilizing front line EMS Paramedic units and high dose buprenorphine to treat withdrawal symptoms with next day bridge to long term care...
March 25, 2020: Prehospital Emergency Care
Bożena Mroczek, Wioletta Łubkowska, Wojciech Jarno, Ewa Jaraczewska, Artur Mierzecki
INTRODUCTION AND OBJECTIVE: Back pain affects specific occupational groups, among which healthcare workers are the most predisposed. Therefore, the aim of this study was to determine the interdependences between subjective disability and their correlation with pain intensity and quality of life assessment among professionally active medical workers, taking into account working, socio-demographic and health conditions. MATERIAL AND METHODS: The cross-sectional study enrolled 110 professionally active medical workers (nurses, midwives, paramedics and physiotherapists)...
March 17, 2020: Annals of Agricultural and Environmental Medicine: AAEM
N Maghsoudi, K McDonald, C Stefan, D R Beriault, K Mason, L Barnaby, J Altenberg, R D MacDonald, J Caldwell, R Nisenbaum, P Leece, T M Watson, K W Tupper, L Kufner, A I Scheim, D Werb
BACKGROUND: The increasing incidence of fatal opioid overdose is a public health crisis in Canada. Given growing consensus that this crisis is related to the presence of highly potent opioid adulterants (e.g., fentanyl) in the unregulated drug supply, drug checking services (DCS) have emerged as part of a comprehensive approach to overdose prevention. In Canada's largest city, Toronto, a network of DCS launched in 2019 to prevent overdose and overdose-related risk behaviors. This network employs mass spectrometry technologies, with intake sites co-located with supervised consumption services (SCS) at three frontline harm reduction agencies...
January 28, 2020: Harm Reduction Journal
Peter S Gutierrez, Curtis Travers, Zhi Geng, Wendalyn K Little
INTRODUCTION: This study describes the experience at a level 1 pediatric trauma center before and after the centralization of prehospital trauma triage, focusing on the rate of undertriage of trauma patients. Before centralization, emergency physicians were responsible for triaging these patients with mainly physiology-based criteria; after centralization, paramedics in a communication center performed this function using the same criteria. METHODS: This retrospective study includes 10 years of pediatric trauma registry patients at our institution, 5 years before and after centralization of prehospital triage...
March 13, 2020: Pediatric Emergency Care
Luz Ramirez, Jose Diaz, Abbas Alshami, Daryelle S Varon, Sharon Einav, Salim Surani, Joseph Varon
INTRODUCTION: Television medical dramas (TVMDs) use cardiopulmonary resuscitation (CPR) as a mean of achieving higher viewing rates. TVMDs portrayal of CPR can be used to teach laypersons attempting to perform CPR and to form a shared professional and layperson mental model for CPR decisions. We studied the portrayal of CPR across a wide range of TVMDs to see whether newer series fulfill this promise. MATERIALS AND METHODS: Advanced cardiac life support (ACLS) certified healthcare providers underwent training in the use of a unique instrument based on the AHA (American Heart Association) guidelines to assess TVMD CPR scenarios...
March 9, 2020: American Journal of Emergency Medicine
Jiří Knor, Jaroslav Pekara, Jana Šeblová, David Peřan, Patrik Cmorej, Jitka Němcová
INTRODUCTION: Prehospital and emergency medical services (EMS) providers are usually the first to respond to an individual's urgent health needs, sometimes in emotionally charged circumstances. Because violence toward EMS providers in the Czech Republic is often overlooked and under-reported, we do not have a complete understanding of the extent of such violence, nor do we have recommendations from EMS professional organizations on how to resolve this problem in prehospital emergency medicine...
February 21, 2020: Western Journal of Emergency Medicine
Pin-Hui Fang, Yu-Yuan Lin, Chien-Hsin Lu, Ching-Chi Lee, Chih-Hao Lin
Paramedics can provide advanced life support (ALS) for patients with out-of-hospital cardiac arrest (OHCA). However, the impact of emergency medical technician (EMT) configuration on their outcomes remains debated. A three-year cohort study consisted of non-traumatic OHCA adults transported by ALS teams was retrospectively conducted in Tainan City using an Utstein-style population database. The EMT-paramedic (EMT-P) ratio was defined as the EMT-P proportion out of all on-scene EMTs. Among the 1357 eligible cases, the median (interquartile range) number of on-scene EMTs and the EMT-P ratio were 2 (2-2) persons and 50% (50%-100%), respectively...
March 16, 2020: International Journal of Environmental Research and Public Health
Eva Maria Noack, Evelyn Kleinert, Frank Müller
BACKGROUND: It is essential for medical treatment that patients and medical staff can communicate about acute complaints, pre-existing conditions, and the treatment procedure. Misunderstandings can have far-reaching consequences, particularly in time-critical emergencies, which require rapid assessments and decision-making and in which interpreters are rarely available. In this study, we aim to develop a digital communication tool that is to help paramedics communicate with patients who speak hardly any or no German, to monitor its implementation, and to investigate its effect on communication between foreign-language patients and staff...
March 18, 2020: BMC Health Services Research
Kegan Jianhong Lim, Zhi Xiong Koh, Yih Yng Ng, Stephanie Fook-Chong, Andrew Fu Wah Ho, Nausheen Edwin Doctor, Nur Ain Zafirah Mohd Said, Marcus Eng Hock Ong
INTRODUCTION: Treatment of pain is an important component of prehospital care. Inhalational analgesia agents have attractive strengths, but there is a paucity of studies comparing these with more conventional agents. We aimed to compare inhalational methoxyflurane and intramuscular (IM) tramadol as first-contact analgesia in the Singapore national ambulance service. METHODS: Ambulances were randomised to carry either methoxyflurane or IM tramadol for the first six months and crossed over after six months...
March 17, 2020: Singapore Medical Journal
Fatemeh Shirzad, Fatemeh Hadi, Seyede Salehe Mortazavi, Maryam Biglari, Hassan Noori Sari, Zeinab Mohammadi, Mehrdad Kazemzade Atoofi, Seyed Vahid Shariat
INTRODUCTION: This article is a report of designing a rapid and effective guide for paramedics who take care of patients in a pre-hospital setting to answer developing demands. METHODS: The relevant literature was reviewed, and the topics were extracted. Then, the extracted items were discussed in an expert panel. Finally, items were discussed in a meeting including emergency technicians and emergency technical assistants to identify implementation problems. RESULTS: Important topics for managing psychiatric patients were categorized at three levels: 1) Patient safety and security issues, 2) Patient status assessment and diagnosis, and 3) Patient management (medical, behavioral management, and referral to a treatment center)...
March 16, 2020: BMC Emergency Medicine
Shannon L Carroll, Daniel W Dye, W Andrew Smedley, Shannon W Stephens, Donald A Reiff, Jeffrey D Kerby, John B Holcomb, Jan O Jansen
BACKGROUND: Recent civilian and military data from the United States and the United Kingdom suggest that further reductions in mortality will require prehospital or pre-operating room hemorrhage control and blood product resuscitation. The aims of this study were to examine the potential preventability of prehospital and early in-hospital fatalities, and to consider the geographical location of such incidents, in order to contextualize how the use of advanced resuscitative techniques could be operationalized...
March 13, 2020: Journal of Trauma and Acute Care Surgery
Leah C Tatebe, Nandini Rajaram Siva, Sydney Pekarek, Erik Liesen, Andrew Wheeler, Carol Reese, Victoria Schlanser, Matthew Kaminsky, Thomas Messer, Frederic Starr, Justin Mis, Faran Bokhari, Andrew Dennis
BACKGROUND: Emergency responders face a crisis of rising suicide rates, and many resist seeking help due to the stigma surrounding mental health. We sought to evaluate the feasibility of an urban trauma center to screen for post-traumatic stress (PTS) among emergency responders and to provide mental health services. METHODS: Paramedics, firefighters, law enforcement, and corrections officers involved with patients in the trauma unit were asked to complete the Post-Traumatic Growth Inventory (PTGI) and Post-Traumatic Checklist for DSM-5 (PCL-5)...
March 14, 2020: Journal of Trauma and Acute Care Surgery
Dominic P Morgan, David Muscatello, Joanne Travaglia, Andrew Hayen
OBJECTIVE: This study aims to present overall survival rates to hospital discharge for out-of-hospital cardiac arrest (OHCA) in Tasmania and to identify predictors of survival. METHODS: A retrospective observational cohort study was undertaken from 1 January 2010 to 31 December 2014. A probabilistically linked data set was created from paramedic electronic medical records and hospital patient records. Logistic regression was used to assess factors associated with survival of OHCA...
March 13, 2020: Emergency Medicine Australasia: EMA
Rezaul Haque, Fardous Kabir, Kamrun Naher, Nicola Cherry, Dianna MacDonald, Adrian Wagg, Zafrullah Chowdhury
AIMS: Pelvic floor and mobility exercises were shown to be effective in managing incontinence in a cluster-randomized trial (CRT) of village women aged 60 to 75 years in Bangladesh. The present analysis examines continence 12 months after the CRT and exercise program implementation with village paramedics as preceptors. METHODS: Women from nine villages in the exercise arm of the CRT were followed-up 12 months after the 6-month intervention. They provided information about exercise since the CRT and a 3-day continence record (3DCR)...
March 12, 2020: Neurourology and Urodynamics
Kristina Tomra Nielsen, Marianne Uggen Rasmussen, Anders Foehrby Overgaard, Louise Klokker, Robin Christensen, Eva Ejlersen Wæhrens
OBJECTIVES: The main study aim was to examine the applicability of a novel method to assess the criterion of values and preferences within the Grading of Recommendation, Assessment, Development and Evaluation evidence to decision framework. The group concept mapping (GCM) approach was applied to identify, organise and prioritise values and preferences in the example of health professionals' choice of analgesia for patients with acute trauma pain. SETTING: Prehospital and emergency care centres in the Nordic countries of Denmark, Norway, Sweden, Finland and Iceland...
March 10, 2020: BMJ Open
Ian R Drennan, Joshua Gilgan, Karina Goncharenko, Steve Lin
Near-infrared spectroscopy (NIRS) provides continuous real-time measurement of regional cerebral oxygen saturation (rSO2 ) during resuscitation. We aimed to evaluate the feasibility of paramedics using NIRS during out-of-hospital cardiac arrest (OHCA) resuscitation. Paramedics were trained to record rSO2 and mark events during resuscitation. Feasibility was defined as > 70% of cases with rSO2 data and event markers. The monitor was applied on 23 patients with OHCA. Of these, 19 (83%) had rSO2 data (median duration of 17...
September 2019: CJC open
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