Emmanuelle Bourrat
Despite an increase in life expectancy and quality of life for patients suffering from severe forms of hereditary epidermolysis bullosa, the occurrence of one or more cutaneous squamous cell carcinomas remains a sometimes serious complication, sometimes life-threatening as early as adolescence. These carcinomas occur preferably on chronic wounds or dystrophic scars in areas not exposed to the sun, and are generally multifocal and recurrent. Their clinical and histological diagnosis is difficult. Regular medical and paramedical monitoring of the skin during dressing repairs enables early detection and rapid, curative surgical management...
November 2023: Soins; la Revue de Référence Infirmière
Emmanuelle Bourrat
The transition from pediatrics to adult wards concerns all chronic diseases with a pediatric onset, but there are a number of specific features in the case of severe forms of hereditary epidermolysis bullosa: worsening wound surface and chronicity with age, appearance or increase in certain complications (carcinological, renal, nutritional, dental), sometimes difficult therapeutic choices, sometimes life-threatening prognosis. But one of the major problems limiting the patient's autonomy is the difficulty of finding a paramedic to take over skin care, often provided from birth by a parent who has become a caregiver through necessity...
November 2023: Soins; la Revue de Référence Infirmière
Michael Asamoah-Boaheng, Brian Grunau, Mohammad Ehsanul Karim, Tracy L Kirkham, Paul A Demers, Chris MacDonald, David M Goldfarb
This study investigated the association between previous SARS-CoV-2 infection and risk of symptoms associated with post COVID conditions among fully vaccinated paramedics in Canada. We included vaccinated paramedics who provided blood sample and questionnaire data on the same date during the study period. We examined the presence of symptoms associated with post-COVID conditions, depression severity against prior SARS-CoV-2 infection categories. Compared to "no previous SARS-CoV-2 infection" group, there was no detected association between "known prior SARS-CoV-2 infection" (OR: 1...
October 31, 2023: Journal of Infectious Diseases
David Häske, Fabian Eppler, Niklas Heinemann, Benjamin Schempf
BACKGROUND: Analgesia is a core intervention in emergency medicine. Pain is subjective, so patient-reported experience with pain and analgesia is essential for healthcare professionals. The aim of this study was to evaluate patient-reported side effects and satisfaction associated with pre-hospital analgesia with low-dose esketamine. METHODS: This is an observational cross-sectional study conducted as part of quality assurance measures of the German Red Cross Emergency Medical Service, Reutlingen, Germany...
November 4, 2023: BMC Emergency Medicine
Callahan Brebner, Michael Asamoah-Boaheng, Bianca Zaidel, Justin Yap, Frank Scheuermeyer, Valerie Mok, Michael Christian, Takahisa Kawano, Lovepreet Singh, Sean van Diepen, Jim Christenson, Brian Grunau
AIM: Humeral and tibial intraosseous (IO) vascular access can deliver resuscitative medications for out-of-hospital cardiac arrest (OHCA), however the optimal site is unclear. We examined the association between IO tibia vs. humerus as the first-attempted vascular access site with OHCA outcomes. METHODS: We used prospectively-collected data from the British Columbia Cardiac Arrest registry, including adult OHCAs treated with IO humerus or IO tibia as the first-attempted intra-arrest vascular access...
November 1, 2023: Resuscitation
Blake A E Boehme, Robyn E Shields, R Nicholas Carleton, Gordon J G Asmundson
OBJECTIVE: Public safety personnel (PSP; e.g., correctional workers, firefighters, paramedics, and police officers) are frequently exposed to potentially psychologically traumatic events (PPTEs) and report posttraumatic stress disorder (PTSD) difficulties more frequently than the general population. The PTSD checklist for DSM-5 (PCL-5) is a commonly used measure to screen PSP for PTSD. A single previous study assessed PCL-5 factorial invariance among PSP but used a small homogenous sample...
November 2, 2023: Psychological Trauma: Theory, Research, Practice and Policy
Duncan Chambers, Anna Cantrell, Louise Preston, Carl Marincowitz, Lynne Wright, Simon Conroy, Adam Lee Gordon
BACKGROUND: Care homes predominantly care for older people with complex health and care needs, who are at high risk of unplanned hospital admissions. While often necessary, such admissions can be distressing and provide an opportunity cost as well as a financial cost. OBJECTIVES: Our objective was to update a 2014 evidence review of interventions to reduce unplanned admissions of care home residents. We carried out a systematic review of interventions used in the UK and other high-income countries by synthesising evidence of effects of these interventions on hospital admissions; feasibility and acceptability; costs and value for money; and factors affecting applicability of international evidence to UK settings...
October 2023: Health Soc Care Deliv Res
Ferenc Molnar, Matyas Rendeki, Szilard Rendeki, Balint Nagy, Viktor Bacher, Peter Bogar, Adam Schlegl, Arnold Koltai, Peter Maroti, Gergely Marovics
Emergency and disaster medical care often face resource or equipment shortages. 3D printing technology has been proven to be effective in cases with insufficient supply chains. MAYO tubes and stethoscopes are essential components of ABCDE patient examinations; however, 3D-printed variants have not been fully tested. These 3D-printed instruments were substituted and validated in a simulated pre-hospital environment. In total, 26 participants were included in this study. Fifteen clinicians or paramedics with at least 3 years of professional experience and 10 medical students...
October 2023: Heliyon
Jürgen Noeske, Norbert Francis Ndi, Fabrice Honoré Minkoa Nga, Gérald Mely, Christopher Kuaban
In 2021, Cameroon held approximately 26,300 inmates in 84 prisons. The Ministry of Justice manages health services in prisons. Conclusive data concerning health care in prisons are lacking. Herein, we present the results of an assessment of health care provision and delivery in 10 central prisons. We adopted mixed methods, including document review, observations, interviews with the Ministry of Justice and prison facility officials, and inmate focus group discussions (FGDs). The 6 building blocks of the World Health Organization's health system framework guided the data collection...
October 1, 2023: Journal of Public Health in Africa
Alison Callwood, Jenny Harris, Lee Gillam, Sarah Roberts, Angela Kubacki, Angelos Christidis, Paul Alexander Tiffin
OBJECTIVES: We aimed to explore the psychometric properties of the first known online asynchronous multiple mini-interview (MMI) designed for fairness with subgroup analyses by key characteristics, usability and acceptability. DESIGN: Cross-discipline multimethod evaluation. SETTING: One UK University. PARTICIPANTS: Applicants to nursing, midwifery and paramedic science undergraduate programmes during 2021-2022. PRIMARY, SECONDARY OUTCOME MEASURES: Psychometric properties (internal consistency, construct validity, dimensionality) were assessed using Cronbach's alpha (α), parallel analysis (PA), Schmid-Leiman transformation and ordinal confirmatory factor analysis (CFA)...
October 31, 2023: BMJ Open
Enrico de Koning, Yvette van der Haas, Saguna Saguna, Esmee Stoop, Jan Bosch, Saskia Beeres, Martin Schalij, Mark Boogers
BACKGROUND: Overcrowding of hospitals and emergency departments (EDs) is a growing problem. However, not all ED consultations are necessary. For example, 80% of patients in the ED with chest pain do not have an acute coronary syndrome (ACS). Artificial intelligence (AI) is useful in analyzing (medical) data, and might aid health care workers in prehospital clinical decision-making before patients are presented to the hospital. OBJECTIVE: The aim of this study was to develop an AI model which would be able to predict ACS before patients visit the ED...
October 31, 2023: JMIR Cardio
Christopher S Sampson, Mackenzie D Maberry, Julie A Stilley
BACKGROUND: Mass gatherings are a commonly occurring event, especially on college campuses. Any mass gathering gives rise to possible small- or large-scale emergencies. Mass gathering medicine is an integral part of emergency medical services (EMS). An assessment was performed to see if collegiate stadiums possess capabilities for advanced medical care when emergencies arise among attendees. METHODS: A standardized survey was sent by a single researcher to all National Collegiate Athletic Association (NCAA) Division I programs regarding medical services they currently have in place at their stadiums during Saturday football games...
October 30, 2023: Journal of Sports Medicine and Physical Fitness
Daniel Berger, Catherine Caldwell, Meghan E Robbins, Amelia Gurley, Jessica Mann
INTRODUCTION: There has been interest in utilizing EMS to address patients' social determinants of health, which are thought to be the cause of many unnecessary transports, particularly for "super-utilizing" patients. However, existing research is limited regarding EMS clinicians' understanding of social determinants of health and attitudes toward potential interventions. METHODS: This cross-sectional study was conducted using an internet-based survey of EMS clinicians across the United States with multiple methods of recruitment...
2023: Int J Paramed
Stephen W English, Nikita Chhabra, Abigail E Hanus, Rida Basharath, Monet Miller, Richard J Butterfield, Nan Zhang, Bart M Demaerschalk
INTRODUCTION: Prehospital telestroke evaluations may improve stroke triage compared to paramedic-applied large vessel occlusion scales, but ambulance-based video National Institutes of Health Stroke Scale assessments are challenging. The accuracy of telestroke-administered large vessel occlusion scales has not been investigated, so we sought to evaluate this further. METHODS: This retrospective study included all in-hospital telestroke encounters in a large academic telestroke network from 2019 to 2020...
October 29, 2023: Journal of Telemedicine and Telecare
A G Karimov, Yu V Migunova
The article is based on the results of sociological survey of medical workers of the Republic of Bashkortostan in 2021. The approaches to issues of their professional activities are analyzed. It is argued that the COVID-19 pandemic has aggravated a number of systemic problems accumulated in health care system in last years. The main difficulties are associated with shortage of medical personnel, increased workload, low remuneration of labor of medical workers, unpractical work organization decreasing quality of medical care, etc...
September 2023: Problemy Sot︠s︡ialʹnoĭ Gigieny, Zdravookhranenii︠a︡ i Istorii Medit︠s︡iny
Mateja Škufca Sterle, Matej Podbregar
Background and Objectives: Despite advancements in modern medicine, the survival rate of patients after out-of-hospital cardiac arrest (OHCA) remains low. The proportion of OHCA patients who could be saved under ideal circumstances is unknown. A significant portion of patients experience cardiac arrest due to irreversible conditions. The survival of patients with reversible causes depends on the prompt initiation of basic life support (BLS) and early defibrillation. In order to increase the chances of survival, the motorcycle paramedic (MP) project was implemented in Ljubljana in 2003...
September 24, 2023: Medicina
Jeffrey L Pellegrino, Stephen E Smith, Abigail Nolan, Nathan Charlton, Craig Goolsby
BACKGROUND: One of the most utilized Stop the Bleed courses, the "Bleeding Control Basic (BCon) course v. 1.0," requires instructors to have a specific healthcare license or pre-hospital credential (e.g., physician or paramedic) or specific emergency medical services (EMS) instructor certification and have completed the BCon provider course. This requirement provides a level of expertise in instructors but limits the potential workforce for sharing life-saving knowledge and skills...
September 2023: Curēus
Theodore W Heyming, Chloe Knudsen-Robbins, Shelby K Shelton, Phung K Pham, Shelley Brukman, Maxwell Wickens, Brooke Valdez, Kellie Bacon, Jonathan Thorpe, Kenneth T Kwon, Carl Schultz
BACKGROUND: Pediatric patients transferred by Emergency Medical Services (EMS) from urgent care (UC) and office-based physician practices to the emergency department (ED) following activation of the 9-1-1 EMS system are an under-studied population with scarce literature regarding outcomes for these children. The objectives of this study were to describe this population, explore EMS level-of-care transport decisions, and examine ED outcomes. METHODS: This was a retrospective review of patients zero to <15 years of age transported by EMS from UC and office-based physician practices to the ED of two pediatric receiving centers from January 2017 through December 2019...
October 25, 2023: Prehospital and Disaster Medicine
Leila Haghighat, Satvik Ramakrishna, James W Salazar, Jean Feng, Joey Chiang, Ellen Moffatt, Zian H Tseng
IMPORTANCE: Over 580 000 people in the US experience homelessness, with one of the largest concentrations residing in San Francisco, California. Unhoused individuals have a life expectancy of approximately 50 years, yet how sudden death contributes to this early mortality is unknown. OBJECTIVE: To compare incidence and causes of sudden death by autopsy among housed and unhoused individuals in San Francisco County. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the Postmortem Systematic Investigation of Sudden Cardiac Death (POST SCD) study, a prospective cohort of consecutive out-of-hospital cardiac arrest deaths countywide among individuals aged 18 to 90 years...
October 23, 2023: JAMA Internal Medicine
Sucheta Parija, Koyel Chakraborty, Dinesh Prasad Sahu
PURPOSE: To assess and analyze the rate of knowledge, attitude, and practice patterns about eye donation among medical and healthcare professionals in a tertiary care hospital in eastern India. METHODS: This was a cross-sectional, descriptive study conducted on medical students, resident doctors, and nursing and paramedical staff at a tertiary institute in the year 2020. A pretested, structured questionnaire consisting of 28 questions in the three subsections based on knowledge and awareness, attitudes and beliefs, and practice patterns mainly willingness to donate eyes by pledging, was noted...
November 2023: Indian Journal of Ophthalmology
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