Beeda Suokonautio, Anne Kouvonen, Hilla Nordquist
BACKGROUND: The scope of emergency medical services (EMS) has expanded from the urgent care of emergency patients to on-call healthcare services provided in the field with a holistic view of the patient's wellbeing. This challenges EMS to find solutions to cover all demands, while simultaneously setting high skill requirements for EMS personnel. Understanding personnel is a critical element in developing functional and resistant EMS. The aim of this study was to investigate how Finnish EMS personnel emphasize the Emergency Medical Services Role Identity Scale aspects of caregiving, thrill-seeking, duty, and capacity; and if these role identities are associated with intention to leave the profession...
June 5, 2024: BMC Emergency Medicine
Eliott Mazar, Thomas Schmutz, Youcef Guechi
A 50-year-old individual identified as a 'frequent user' of emergency services due to chronic abdominal pain was transported to the emergency department by ambulance during a new episode of abdominal pain. Despite being initially deemed stable by paramedics, the patient was not reassessed by the triage nurse upon arrival. Subsequently, the patient presented with severe pain, arterial hypotension, and tachycardia. Following a multidisciplinary protocol for pain management, analgesic treatment was initiated. Despite several hours of management and repeated assessments, an abdominal CT-scan was eventually conducted, revealing a perforated small intestine...
June 5, 2024: Revue Médicale Suisse
Susan Wiltrakis, Ruth Hwu, Sherita Holmes, Srikant Iyer, Nandranie Goodwin, Claire Mathai, Scott Gillespie, Kiran B Hebbar, Nora Colman
BACKGROUND: Cognitive load impacts performance of debriefers and learners during simulations, but limited data exists examining debriefer cognitive load. The aim of this study is to compare the cognitive load of the debriefers during simulation-based team training (SbTT) with Rapid Cycle Deliberate Practice (RCDP) debriefing and Traditional Reflective Debriefing (TRD). We hypothesize that cognitive load will be reduced during RCDP compared to TRD. METHODS: This study was part of a large-scale, interdisciplinary team training program at Children's Healthcare of Atlanta Egleston Pediatric Emergency Department, with 164 learners (physicians, nurses, medical technicians, paramedics, and respiratory therapists (RTs))...
June 4, 2024: Advances in Simulation
Silke Piedmont, Luisa Baier, Nastja Ullrich, Isabell Fitz, Erin Sprünken, Evjenia Toubekis, Valentina Albrecht, Edmund Neugebauer
BACKGROUND: Sepsis is a life-threatening and relatively common emergency which is often recognized too late or not at all. Therefore, the "SepsisWissen" (SepsisKnowledge) project aimed to bring about changes in health care professionals' behavior in the area of sepsis prevention and early detection. It addressed the health care professionals themselves (e. g., their own vaccination, hygiene and early detection behavior) and their patient counseling behavior. To promote this behavior, the SepsisWissen campaign included offers such as trainings or print products...
June 3, 2024: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Shadman Aziz, Christopher T Edmunds, Jon Barratt
INTRODUCTION: There has been a rapid expansion in the use of point-of-care ultrasonography (POCUS) by emergency medical services (EMS). However, less than a third of UK EMS utilise imaging archiving for POCUS, and fewer review saved images as part of a clinical governance structure. This paper describes the implementation of a novel image archiving system and a robust clinical governance framework in our UK physician-paramedic staffed helicopter emergency medical service (HEMS). METHODS: A retrospective database review was conducted of all patients attended by East Anglian Air Ambulance (EAAA) between the introduction of a new POCUS device and image archiving system on 1 December 2020 to 31 January 2024...
June 3, 2024: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Humera Noreen, Rahila Yasmeen, Shabana Ali Mohammad
INTRODUCTION: Professional behaviour is the first manifestation of professionalism. In teaching hospitals, the residents can be considered vulnerable to lapses in professional behaviour when they fail to meet the set standards of professionalism. Residents of some specialties are more at risk of lapses in professional behaviour due to the demanding nature of work. Research focusing on the behaviour of residents in the field of Gynae and the underlying factors contributing to such behaviour is notably lacking in the literature...
June 3, 2024: BMC Medical Education
Daniel F Malone, Alan Sims, Christopher Irwin, Darren Wishart, Alexander MacQuarrie, Andrew Bell, Matthew J Stainer
Paramedics face various unconventional and secondary task demands while driving ambulances, leading to significant cognitive load, especially during lights-and-sirens responses. Previous research suggests that high cognitive load negatively affects driving performance, increasing the risk of accidents, particularly for inexperienced drivers. The current study investigated the impact of anticipatory treatment planning on cognitive load during emergency driving, as assessed through the use of a driving simulator...
June 2, 2024: Accident; Analysis and Prevention
Pieter Francsois Fouche, Martin Nichols, Raquel Abrahams, Kristina Maximous, Jason Bendall
OBJECTIVE: Out-of-hospital seizures demand rapid management. Midazolam plays a key role in stopping seizures. At times the first dose of midazolam proves insufficient, necessitating additional doses. Within the New South Wales Ambulance (NSWA) service, the upper limit for midazolam administration is set at 15 mg. However, the outcomes and safety of using midazolam at this maximum dosage have not been thoroughly investigated. METHODS: A retrospective analysis of out of hospital electronic health records from New South Wales, Australia, over the year 2022, was conducted...
June 3, 2024: Emergency Medicine Australasia: EMA
Uma Kelekar, Debasree Das Gupta, Nicole Theis-Mahon, Emily Fashingbauer, Boyen Huang
BACKGROUND: The use of Emergency Departments (EDs) for non-urgent medical conditions is a global public health concern. OBJECTIVES: A systematic review, guided by a registered protocol (PROSPERO: CRD42023398674), was conducted to interpret the association between distance as a measure of healthcare access and the utilization of EDs for non-urgent care in high- and middle-income countries. METHODS: The search was conducted on 22 August 2023 across five databases using controlled vocabulary and natural language keywords...
December 31, 2024: Global Health Action
Ketankumar Hitendra Patil, Nitin Sanjay Tawar, Abhay Machindra Kudale
OBJECTIVES: To assess the resilience of primary healthcare workers (HCWs) by determining the factors associated with developing resilience post-coronavirus disease 2019 (COVID-19). STUDY DESIGN: A cross-sectional study in selected municipal hospitals. METHODS: Connor-Davidson Resilience Scale was used to assess the resilience of the 245 HCWs, including the nurses and paramedics working in Pune Municipal Corporation (PMC) hospitals in Pune City...
April 2024: Journal of Family Medicine and Primary Care
Hiroki Tateishi, Youhei Yano, Takao Goto, Daisuke Miyazu, Hiroyuki Watanabe
In Japan, only few hospitals have pharmacists in their secondary emergency rooms to record medication history and provide drug information in real time. In this study, we investigated the benefits of pharmacist intervention in secondary emergency rooms by comparing the time taken by the pharmacists and non-pharmacists in the emergency room to record the medication history in the electronic medical record and the accuracy of its content. The study period was from September 1 to September 30, 2022, and included patients who were transported to our hospital for emergency care between 9:00 and 16:30...
2024: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Cody L Dunne, Julia Cirone, Ian E Blanchard, Jayna Holroyd-Leduc, Todd A Wilson, Khara Sauro, Andrew D McRae
AIM: To quantify the associations of foreign body airway obstruction (FBAO) basic life support (BLS) interventions with FBAO relief and survival to discharge. METHODS: We identified prehospital FBAO patient encounters in Alberta, Canada between Jan 1,2018 and Dec 31,2021 using the provincial emergency medical services' medical records, deterministically linked to hospital data. Two physicians reviewed encounters to determine cases and extract data. Multivariable logistic regression determined the adjusted odds ratio of FBAO relief (primary outcome) and survival to discharge for the exposure of BLS interventions (abdominal thrusts [AT], chest compressions/thrusts [CC], or combinations) relative to back blows [BB]...
May 31, 2024: Resuscitation
David J Olvera, Michael Lauria, Jeremy Norman, M David Gothard, Andrew D Gothard, William Bradley Weir
OBJECTIVE: Rapid sequence intubation (RSI) is a critical skill commonly performed by air medical teams in the United States. To improve safety and reduce potential patient harm, checklists have been implemented by various institutions in intensive care units, emergency departments, and even prehospital air medical programs. However, the literature suggests that checklist use before RSI has not shown improvement in clinically important outcomes in the hospital. It is unclear if RSI checklist use by air medical crews in prehospital environments confers any clinically important benefit...
2024: Air Medical Journal
Benjamin N Meadley, Joanne Caldwell-Odgers
BACKGROUND: Paramedics working in helicopter teams undertake water and land rescues. Historical assessments of role-related fitness were not developed using physical employment standards methodology. OBJECTIVE: To compare the historical selection tests with new tests developed via contemporary scientific methodology. METHODS: Candidates undergoing selection to the role of flight paramedic (n = 14; age 37±5 yrs, body mass index [BMI] 26±4 kg...
May 29, 2024: Work: a Journal of Prevention, Assessment, and Rehabilitation
Elspeth Pennington, Steve Bell, James E Hill
The safety and utility of endotracheal intubation by paramedics in the United Kingdom is a matter of debate. Considering the controversy surrounding the safety of paramedic-performed endotracheal intubation, any interventions that enhance patient safety should be evaluated for implementation based on solid evidence of their effectiveness. A systematic review performed by Hansel and colleagues (2022) sought to assess compare video laryngoscopes against direct laryngoscopes in clinical practice. This commentary aims to critically appraise the methods used within the review by Hansel et al (2022) and expand upon the findings in the context of clinical practice...
June 2, 2023: Journal of paramedic practice: the clinical monthly for emergency care professionals
Rob Forsyth, Maria Allen, Emma Bedson, Alice Downes, Chris Gough, Stuart Hartshorn, Kelly Lawton, Mark D Lyttle, Shrouk Messahel, Niall Mullen, Joseph Raper, Anna Rosala-Harris, Leigh Taggart, Jason Urron, Emily Walton, Carrol Gamble
BACKGROUND: Paediatric convulsive status epilepticus is the most common neurological emergency presenting to emergency departments. Risks of resultant neurological morbidity and mortality increase with seizure duration. If the seizure fails to stop within defined time-windows, standard care follows an algorithm of stepwise escalation to more intensive treatments, ultimately resorting to induction of general anaesthesia and ventilation. Additionally, ventilatory support may also be required to treat respiratory depression, a common unwanted effect of treatment...
May 29, 2024: Trials
Shadrack Muma, Kovin Shunmugam Naidoo, Rekha Hansraj
INTRODUCTION: Even though the burden of uncorrected refractive error could potentially be addressed through innovative and cost-effective approaches, integration of the services into the National Health Services (NHS) is desirable. However, minimal information exists on the current situation warranting the need for evidence about the integration of refractive error service provided by optometrists into the national health services in Kenya. METHODS: A situation analysis of the Kenyan refractive error services provided by optometrists within the NHS was undertaken based on access to service delivery, service coverage, and human resource...
May 29, 2024: BMC Public Health
Ursula Howarth, Peta-Anne Zimmerman, Thea F van de Mortel, Nigel Barr
BACKGROUND: Paramedics' work, even pre-pandemic, can be confronting and dangerous. As pandemics add extra stressors, the study explored paramedics' lived experience of the barriers to, and enablers of, responding to suspected or confirmed Coronavirus Disease 2019 (COVID-19) cases. METHODS: This exploratory-descriptive qualitative study used semi-structured interviews to investigate Queensland metropolitan paramedics' experiences of responding to cases during the COVID-19 pandemic...
May 29, 2024: BMC Health Services Research
Eva Maria Noack, Anke Bramesfeld, Sybille Schmid, Dominik Schröder, Frank Müller
OBJECTIVE: Characterization of medical emergencies of patients with psychiatric symptoms or in psychosocial crisis. METHODS: Analysis of emergency medical services (EMS) mission logs from four German EMS stations of patients aged 12-65 from 2019 to 2020. RESULTS: 23.4% of missions involved patients with psychiatric or psychosocial symptoms (1.6% psychotic, 3.0% suicidal, 7.1% psychosocial crisis, 15.7% intoxicated). On average, these patients were younger than those with other symptoms...
May 29, 2024: Psychiatrische Praxis
Nicholas S Simpson, Alexander M Schin, Michael C Perlmutter, Alec J Bunting, Gregg A Jones, Holly M Drone, Florian Merkle, Timothy M Kummer, Brian E Driver, Jon B Cole, Aaron E Robinson
Objective: Agitation is a common prehospital problem and frequently presents without a clear etiology. Given the dynamic environment of the prehospital setting, there has historically been a varied approach to treating agitation with a heavy reliance on parenteral medications. Newer best practice guidelines recommend the incorporation of oral medications to treat patients experiencing agitation. Therefore, we evaluated the use of oral risperidone in a single system after a change in protocol occurred. Methods: This was conducted as a retrospective chart review of an urban/suburban Emergency Medical Services system over the period of 8 months...
May 29, 2024: Prehospital Emergency Care
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