British paramedic journal最新文献

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Venous blood point-of-care testing (POCT) for paramedics in urgent and emergency care: protocol for a single-site feasibility study (POCTPara). 急诊急救护理人员静脉血护理点检测(POCT):单点可行性研究(POCTPara)方案。
British paramedic journal Pub Date : 2023-06-01 DOI: 10.29045/14784726.2023.6.8.1.34
Bryan Lightowler, Andrew Hodge, Richard Pilbery, Fiona Bell, Pete Best, Kelly Hird, Alison Walker, Beverly Snaith
{"title":"Venous blood point-of-care testing (POCT) for paramedics in urgent and emergency care: protocol for a single-site feasibility study (POCTPara).","authors":"Bryan Lightowler, Andrew Hodge, Richard Pilbery, Fiona Bell, Pete Best, Kelly Hird, Alison Walker, Beverly Snaith","doi":"10.29045/14784726.2023.6.8.1.34","DOIUrl":"10.29045/14784726.2023.6.8.1.34","url":null,"abstract":"<p><p>The COVID-19 pandemic placed the UK healthcare system under unprecedented pressure, and recovery will require whole-system investment in innovative, flexible and pragmatic solutions. Positioned at the heart of the healthcare system, ambulance services have been tasked with addressing avoidable hospital conveyance and reducing unnecessary emergency department and hospital attendances through the delivery of care closer to home. Having begun to implement models of care intended to increase 'see and treat' opportunities through greater numbers of senior clinical decision makers, emphasis has now been placed upon the use of remote clinical diagnostic tools and near-patient or point-of-care testing (POCT) to aid clinical decision making. In terms of POCT of blood samples obtained from patients in the pre-hospital setting, there is a paucity of evidence beyond its utility for measuring lactate and troponin in acute presentations such as sepsis, trauma and myocardial infarction, although potential exists for the analysis of a much wider panel of analytes beyond these isolated biomarkers. In addition, there is a relative dearth of evidence in respect of the practicalities of using POCT analysers in the pre-hospital setting. This single-site feasibility study aims to understand whether it is practical to use POCT for the analysis of patients' blood samples in the urgent and emergency care pre-hospital setting, through descriptive data of POCT application and through qualitative focus group interviews of advanced practitioners (specialist paramedics) to inform the feasibility and design of a larger study. The primary outcome measure is focus group data measuring the experiences and perceived self-reported impact by specialist paramedics. Secondary outcome measures are number and type of cartridges used, number of successful and unsuccessful attempts in using the POCT analyser, length of time on scene, specialist paramedic recruitment and retention, number of patients who receive POCT, descriptive data of safe conveyance, patient demographics and presentations where POCT is applied and data quality. The study results will inform the design of a main trial if indicated.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"8 1","pages":"34-41"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9592713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the psychological distress and mental well-being of pre-hospital care providers in Saudi Arabia during COVID-19. 评估 COVID-19 期间沙特阿拉伯院前护理人员的心理困扰和精神健康状况。
British paramedic journal Pub Date : 2023-06-01 DOI: 10.29045/14784726.2023.6.8.1.1
Abdulrhman Alghamdi, Meshal Alharbi, Abdullah Alshibani, Fahad Allohidan, Abdullah Alabdali, Nawfal Aljerian
{"title":"Evaluation of the psychological distress and mental well-being of pre-hospital care providers in Saudi Arabia during COVID-19.","authors":"Abdulrhman Alghamdi, Meshal Alharbi, Abdullah Alshibani, Fahad Allohidan, Abdullah Alabdali, Nawfal Aljerian","doi":"10.29045/14784726.2023.6.8.1.1","DOIUrl":"10.29045/14784726.2023.6.8.1.1","url":null,"abstract":"<p><strong>Background: </strong>Pre-hospital care providers are the first line of contact when emergencies occur. They are at high risk of mental health disorders associated with trauma and stress. The magnitude of their stress could increase during difficult times such as the COVID-19 pandemic.</p><p><strong>Objectives: </strong>This study reports on the state of mental well-being and the degree of psychological distress among pre-hospital care workers (paramedics, emergency medical technicians, doctors, paramedic interns and other healthcare practitioners) during the COVID-19 pandemic in Saudi Arabia.</p><p><strong>Methods: </strong>The study was a cross-sectional survey study in Saudi Arabia. A questionnaire was distributed among pre-hospital care workers in Saudi Arabia during the first wave of the COVID-19 pandemic. The questionnaire was based on the Kessler Psychological Distress Scale (K10) and the World Health Organization Well-Being Index (WHO-5).</p><p><strong>Results: </strong>In total, 427 pre-hospital care providers completed the questionnaire; 60% of the respondents had scores of more than 30 in the K10 and were likely to have a severe disorder. The WHO-5 showed a similar percentage of respondents with a score of more than 50 and coded as having poor well-being.</p><p><strong>Conclusions: </strong>The findings of this study provide evidence around mental health and well-being for pre-hospital care workers. They also highlight the need to better understand the quality of mental health and well-being for this population and to provide appropriate interventions to improve their quality of life.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"8 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9595761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Facilitated hospital-to-pre-hospital feedback for professional development (PHEM Feedback): a service evaluation using a self-reported questionnaire to understand the experiences of participating pre-hospital clinicians in the first year of operation. 促进医院到院前的专业发展反馈(PHEM反馈):使用自我报告的问卷进行服务评估,以了解参与院前临床医生在第一年的工作经验。
British paramedic journal Pub Date : 2023-06-01 DOI: 10.29045/14784726.2023.6.8.1.42
Matthew Snowsill, Gioacchino Cracolici, Talia Wieder, Grace Allen
{"title":"Facilitated hospital-to-pre-hospital feedback for professional development (PHEM Feedback): a service evaluation using a self-reported questionnaire to understand the experiences of participating pre-hospital clinicians in the first year of operation.","authors":"Matthew Snowsill,&nbsp;Gioacchino Cracolici,&nbsp;Talia Wieder,&nbsp;Grace Allen","doi":"10.29045/14784726.2023.6.8.1.42","DOIUrl":"https://doi.org/10.29045/14784726.2023.6.8.1.42","url":null,"abstract":"<p><strong>Background: </strong>Information governance and resource challenges can impede pre-hospital clinicians from accessing and reflecting upon clinical information from the hospital phase of care, to ascertain how appropriate their diagnoses and management were. The authors performed a 12-month service evaluation of a hospital-to-pre-hospital feedback system, in which clinical information was requested by pre-hospital clinicians, and returned by a small team of hospital-based clinicians, while meeting information governance standards.</p><p><strong>Method: </strong>Pre-hospital clinicians in one ambulance station and one air ambulance service accessed patient information from a hospital, via a mediating senior pre-hospital colleague (a facilitator). Case-based learning conversations between the facilitator and clinician followed, using a report from the hospital. Evidence of benefit to the pre-hospital clinicians was prospectively collected using Likert-type scales, regarding general satisfaction, likelihood to change practice and effects on well-being. Reports aimed to be generated by the hospital within 14 days.</p><p><strong>Results: </strong>All 59 appropriate requests had reports returned. Of the reports, 59.5% were returned in 14 days or less. The median duration was 11 days (interquartile range 7-25). Learning conversations were completed in 86.4% (n = 51) of these cases, and of those, clinician questionnaires were completed in 66.7% (n = 34). Of the 34 questionnaire respondents, 82.4% (n = 28) were very satisfied with the returned information. A total of 61.1% (n = 21) were either likely or very likely to change their practice following the hospital's information, and 64.7% (n = 22) reported similar or very similar impressions to the hospital's eventual diagnosis. Regarding mental health, 76.5% (n = 26) reported positively or very positively affected mental health, while 2.9% (n = 1) reported adversely affected mental health. All of the respondents, 100% (n = 34) were either satisfied or very satisfied with the learning conversation.</p><p><strong>Conclusion: </strong>While hospital-based clinical information was successfully and securely provided to pre-hospital clinicians, these pilot data suggest it is not possible to meet the self-imposed, empirical 14-day target with four to five voluntary doctors. Sustained performance may improve with allocated or paid time to report the requests. The validity of these data is limited by a poor response rate, a non-validated questionnaire and potential for selection bias. Validation using multiple hospitals and greater numbers is the appropriate next step. Responses suggest that this system identifies areas for improvement, reinforces good practice and improves the mental well-being of the participating clinicians.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"8 1","pages":"42-52"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9595760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
'Research paramedic' and 'paramedic researcher': two different sides of the same coin. 辅助医务人员研究 "和 "辅助医务人员研究员":一枚硬币的两面。
British paramedic journal Pub Date : 2023-06-01 DOI: 10.29045/14784726.2023.6.8.1.53
Caitlin Wilson, Fiona Bell
{"title":"'Research paramedic' and 'paramedic researcher': two different sides of the same coin.","authors":"Caitlin Wilson, Fiona Bell","doi":"10.29045/14784726.2023.6.8.1.53","DOIUrl":"10.29045/14784726.2023.6.8.1.53","url":null,"abstract":"","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"8 1","pages":"53"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9645614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Crossing the 'flaky bridge' - the initial transitory experiences of qualifying as a paramedic: a mixed-methods study. 跨过 "摇摆不定的桥"--获得辅助医务人员资格的最初过渡体验:一项混合方法研究。
British paramedic journal Pub Date : 2023-06-01 DOI: 10.29045/14784726.2023.6.8.1.18
Peter Phillips, Steve Trenoweth
{"title":"Crossing the 'flaky bridge' - the initial transitory experiences of qualifying as a paramedic: a mixed-methods study.","authors":"Peter Phillips, Steve Trenoweth","doi":"10.29045/14784726.2023.6.8.1.18","DOIUrl":"10.29045/14784726.2023.6.8.1.18","url":null,"abstract":"<p><strong>Introduction: </strong>Newly qualified paramedics (NQPs) may experience emotional turbulence as they transition to professional practice. This may negatively affect confidence and have an adverse effect on attrition. This study highlights the initial transitory experiences of NQPs.</p><p><strong>Methods: </strong>The study utilised a mixed-methods convergent design. Qualitative and quantitative data were collected simultaneously and triangulated to more fully interpret participants' experiences. A convenience sample of 18 NQPs from one ambulance trust was used. The Connor-Davidson Resilience 25-point Scale questionnaire (CD-RISC25) was administered and analysed using descriptive statistics. Semi-structured interviews were conducted simultaneously and analysed using Charmaz's constructivist grounded theory approach. Data were collected from September to December 2018.</p><p><strong>Results: </strong>There was a range of resilience scores, with a mean of 74.7/100 (standard deviation 9.6). Factors relating to social support were scored highly, and factors relating to determinism and spirituality were scored lower. Qualitative data constructed a process whereby participants were navigating a new identity across three spheres simultaneously: professional, social and personal identity. Attending a catalyst event such as a cardiac arrest was a trigger for starting to navigate this process. Participants had different pathways through this transitional period. Participants who found this process particularly turbulent seemed to have lower resilience scores.</p><p><strong>Conclusion: </strong>The transition from student to NQP is an emotionally turbulent time. Navigating a changing identity seems to be at the centre of this turbulence, and this is triggered by a catalyst event such as attending a cardiac arrest. Interventions which support the NQP in navigating this change in identity, such as group supervision, may improve resilience and self-efficacy and reduce attrition.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"8 1","pages":"18-27"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9645612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The clinical effectiveness of a falls rapid response service, and sex differences of patients using the service: a cross-sectional study in an English ambulance trust. 跌倒快速反应服务的临床效果以及使用该服务的患者的性别差异:在英国一家救护车托管机构进行的横断面研究。
British paramedic journal Pub Date : 2023-06-01 DOI: 10.29045/14784726.2023.6.8.1.28
Karl Charlton, Hayley Stagg, Emma Burrow
{"title":"The clinical effectiveness of a falls rapid response service, and sex differences of patients using the service: a cross-sectional study in an English ambulance trust.","authors":"Karl Charlton, Hayley Stagg, Emma Burrow","doi":"10.29045/14784726.2023.6.8.1.28","DOIUrl":"10.29045/14784726.2023.6.8.1.28","url":null,"abstract":"<p><strong>Background: </strong>Falls in older adults are an important issue internationally. They occur from complex interactions between biological, environmental and activity-related factors. As the sexes age differently, there may be sex differences regarding falls. This study aimed to determine the clinical effectiveness of a falls rapid response service (FRRS) in an English ambulance trust and to identify sex differences between patients using the service.</p><p><strong>Methods: </strong>A cross-sectional study between December 2018 and September 2020. Patients aged ≥ 60 years who had fallen within the study area were included. The FRRS comprised a paramedic and occupational therapist and responded 07:00-19:00, 7 days per week. Anonymised data regarding age, sex and conveyance were collected for all patients attended by the FRRS and standard ambulance crews. Clinical data regarding fall events were collected from consenting patients attended by the FRRS only.</p><p><strong>Results: </strong>There were 1091 patients attended by the FRRS versus 4269 by standard ambulance crews. Patient characteristics were similar regarding age and sex. The FRRS consistently conveyed fewer patients versus standard ambulance crews (467/1091 (42.8%) v. 3294/4269 (77.1%), <i>p</i> = < 0.01). Clinical data were collected from 426/1091 patients attended by the FRRS. In these patients, women were more likely to reside alone than men (181/259 (69.8%) v. 86/167 (51.4%), <i>p</i> = < 0.01), and less likely to experience a witnessed fall (16.2% v. 26.3%, <i>p</i> = 0.01). Women had a higher degree of comorbidity specific to osteoarthritis and osteoporosis, while men were more likely to report a fear of falling score of 0 (35.3% v. 22.7%, <i>p</i> = < 0.01).</p><p><strong>Conclusion: </strong>The FRRS is clinically effective regarding falls compared to standard ambulance crews. Sex differences existed between men and women using the FRRS, indicating women are further along the falls trajectory than men. Future research should focus on demonstrating the cost effectiveness of the FRRS and how to better meet the needs of older women who fall.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"8 1","pages":"28-33"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9595764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of dementia education on student paramedics' preparedness to care, knowledge, confidence and attitudes towards dementia: an analytic survey. 痴呆症教育对学生护理人员的护理准备、痴呆症知识、信心和态度的影响:分析调查。
British paramedic journal Pub Date : 2023-06-01 DOI: 10.29045/14784726.2023.6.8.1.9
Danielle Jones, Andrea Capstick, Muhammad Faisal, Joe Frankland
{"title":"The impact of dementia education on student paramedics' preparedness to care, knowledge, confidence and attitudes towards dementia: an analytic survey.","authors":"Danielle Jones, Andrea Capstick, Muhammad Faisal, Joe Frankland","doi":"10.29045/14784726.2023.6.8.1.9","DOIUrl":"10.29045/14784726.2023.6.8.1.9","url":null,"abstract":"<p><strong>Background: </strong>Paramedics play a vital role in the emergency healthcare of people living with dementia. People with dementia often have complex needs, posing challenges for paramedics. Paramedics often lack the confidence and skills to assess people with dementia appropriately, and receive little, if any, dementia education.</p><p><strong>Aims: </strong>To evaluate the impact of dementia education on student paramedics' preparedness to care, knowledge, confidence and attitudes towards dementia.</p><p><strong>Methods: </strong>A 6-hour education programme on dementia was developed, implemented and evaluated. A pre-test-post-test design using self-completion validated questionnaires was used, to evaluate first-year undergraduate student paramedics' knowledge, confidence and attitudes towards dementia, as well as their preparedness to care for people with dementia.</p><p><strong>Results: </strong>A total of 43 paramedic students attended the education programme, with 41 fully completed questionnaires being collected pre-training and 32 post-training. Students reported feeling significantly more preparedness to care for people with dementia after the education session (p < 0.001). They felt their knowledge (100%), confidence (87.5%) and attitudes (87.5%) towards dementia had significantly increased following the education session. Using validated measures, the impact of education was found to be the highest on dementia knowledge (13.8 vs 17.5; p < 0.001) and on confidence (29.14 vs 34.06; p = 0.001), with only a minimal effect on attitudes (101.5 vs 103.4; p = 0.485). The education programme itself was well-evaluated.</p><p><strong>Conclusion: </strong>As paramedics are central to the emergency healthcare of people living with dementia, it is essential that the emerging paramedic workforce is equipped with the knowledge, attitudes and confidence to provide quality care for this population. We need to ensure dementia education is embedded in undergraduate curricula, and that consideration is given to the subjects, level and pedagogic approach taken to ensure positive outcomes are maximised.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"8 1","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9645613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surviving an out-of-hospital hypothermic cardiac arrest in the United Kingdom. 英国院外低体温心脏骤停幸存者。
British paramedic journal Pub Date : 2023-03-01 DOI: 10.29045/14784726.2023.3.7.4.46
Stuart Evans
{"title":"Surviving an out-of-hospital hypothermic cardiac arrest in the United Kingdom.","authors":"Stuart Evans","doi":"10.29045/14784726.2023.3.7.4.46","DOIUrl":"10.29045/14784726.2023.3.7.4.46","url":null,"abstract":"<p><strong>Introduction: </strong>Hypothermia is an uncommon cause of cardiac arrest in the United Kingdom, and more commonly occurs in countries experiencing avalanches and significant winter climates; however, this case demonstrates that the presentation <i>can</i> occur in the United Kingdom. This case adds to a body of evidence that prolonged resuscitation can be successful in patients suffering a cardiac arrest secondary to hypothermia, leading to a good neurological outcome.</p><p><strong>Case presentation: </strong>The patient suffered a witnessed out-of-hospital cardiac arrest following rescue from a free-flowing river, and underwent prolonged resuscitation. The patient presented in persistent ventricular fibrillation, unresponsive to defibrillation attempts. An oesophageal probe recorded the patient's temperature as 24°C. Rescuers were guided by the Resuscitation Council UK advanced life support algorithm to withhold drug therapy and limit defibrillation attempts to three, until the patient had been rewarmed to above 30°C. Appropriate triage of the patient to an extracorporeal life support (ECLS) capable centre allowed specialised treatment to be initiated, and culminated in successful resuscitation once normothermia was restored. After a short stay in intensive care, the patient was discharged for rehabilitation due to a hypoxic spinal cord injury before discharge home.</p><p><strong>Conclusion: </strong>This case highlights that hypothermia is a reversible cause of cardiac arrest, which needs to be recognised and acted upon appropriately to provide the best possible chance for a positive outcome. Low-reading thermometers capable of identifying the temperature thresholds stated in the Resuscitation Council UK guidelines are required, to allow clinicians to adapt their practice according to the presenting situation. Tympanic thermometers are often limited to their lowest recordable temperature, and invasive monitoring such as oesophageal or rectal probes are not common in UK ambulance service practice. With the necessary equipment, patients can be triaged to an ECLS-capable centre, allowing them to receive the specialist rewarming that they require.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"7 4","pages":"46-50"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9412782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Defining a threshold above which an adult can be considered to frequently use ambulance services: a retrospective cross-sectional study of emergency calls to an ambulance service in England. 界定成年人经常使用救护车服务的临界值:对英格兰救护车服务紧急呼叫的回顾性横断面研究。
British paramedic journal Pub Date : 2023-03-01 DOI: 10.29045/14784726.2023.3.7.4.35
Jason Scott, Eduwin Pakpahan, Benjamin Marlow, Nathan Daxner
{"title":"Defining a threshold above which an adult can be considered to frequently use ambulance services: a retrospective cross-sectional study of emergency calls to an ambulance service in England.","authors":"Jason Scott, Eduwin Pakpahan, Benjamin Marlow, Nathan Daxner","doi":"10.29045/14784726.2023.3.7.4.35","DOIUrl":"10.29045/14784726.2023.3.7.4.35","url":null,"abstract":"<p><strong>Objective: </strong>There is no empirical definition of adult frequent use of ambulance services. This study aimed to define a threshold, and utilise this to explore characteristics of people frequently using services.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study in a single ambulance service in England. Routinely collected, pseudo-anonymised call- and patient-level data were collected for two months (January and June 2019). Incidents, defined as independent episodes of care, were analysed using a zero-truncated Poisson regression model to determine a suitable frequent-use threshold, with comparisons subsequently made between frequent and non-frequent users.</p><p><strong>Results: </strong>A total of 101,356 incidents involving 83,994 patients were included in the analysis. Two potentially appropriate thresholds were identified: five incidents per month (A); and six incidents per month (B). Threshold A produced 3137 incidents from 205 patients, with five patients likely false-positive identifications. Threshold B produced 2217 incidents from 95 patients, with no false-positive identifications but 100 false-negatives compared to threshold A. Regardless of threshold, frequent users compared to non-frequent users had relatively reduced service use between 08:00 and 15:00, were younger and were more likely to receive lower-priority responses (all p < 0.001). We identified several chief complaints indicative of increased frequent use, including chest pain, psychiatric/suicide attempt and abdominal pains/problems.</p><p><strong>Conclusions: </strong>We suggest a threshold of five incidents per month, with recognition that a small number of patients may be incorrectly identified as using ambulance services frequently. The rationale for this choice is discussed. This threshold may be applicable in wider UK settings and could be used for the routine automated identification of people using ambulance services frequently. The identified characteristics can help inform interventions. Future research should examine applicability of this threshold in other UK ambulance services and countries where patterns and determinants of frequent ambulance use may differ.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"7 4","pages":"35-45"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9412784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
For when you just can't talk to 'normal' people . . . Exploring the use of informal support structures by supernumerary university paramedic students: findings from a phenomenological study. 当你无法与 "正常 "人交谈时..........探索编外大学生辅助医务人员对非正式支持结构的使用:一项现象学研究的发现。
British paramedic journal Pub Date : 2023-03-01 DOI: 10.29045/14784726.2023.3.7.4.1
Mark Garratt
{"title":"For when you just can't talk to 'normal' people . . . Exploring the use of informal support structures by supernumerary university paramedic students: findings from a phenomenological study.","authors":"Mark Garratt","doi":"10.29045/14784726.2023.3.7.4.1","DOIUrl":"10.29045/14784726.2023.3.7.4.1","url":null,"abstract":"<p><strong>Background: </strong>In an effort to shield them from distress, pre-hospital ambulance staff may avoid discussing traumatic workplace experiences with friends and family. As a source of informal support, however, workplace camaraderie is considered important for managing occupational stress. For supernumerary university paramedic students there is limited research concerning how such experiences are managed, and whether they may benefit from similar informal support. This is a concerning deficit when contextualised by reports of higher stress levels among students undertaking work-based learning, and among paramedics / paramedic students in general. These original findings allude to how university paramedic students who are supernumerary within the pre-hospital workplace utilise informal support mechanisms.</p><p><strong>Methods: </strong>A qualitative, interpretive approach was adopted. University paramedic students were recruited via purposive sampling. Audio-recorded face-to-face semi-structured interviews were performed and transcribed verbatim. Analysis involved initial descriptive coding and then inferential pattern coding. The identification of themes and discussion topics was facilitated by a review of the literature.</p><p><strong>Results: </strong>Twelve participants were recruited aged from 19 to 27 years, and 58% (n = 7) were female. While most participants cited that they were able to enjoy the informal stress-relieving camaraderie of ambulance staff, there were perceptions that supernumerary status may leave them potentially isolated within the workplace. Participants may also compartmentalise their experiences away from friends and family in a manner similar to that found among ambulance staff. Informal student peer support networks were praised as a source of information and for emotional support. Self-organised online chat groups were ubiquitous as a means of keeping in touch with student peers.</p><p><strong>Conclusions: </strong>While undertaking pre-hospital practice placements, supernumerary university paramedic students may not have complete access to the informal support of ambulance staff, and they may feel unable to discuss stressful feelings with friends or loved ones. However, within this study, self-moderated online chat groups were used almost universally as a readily accessible means of peer support. Paramedic educators ideally need an awareness of how such groups are used to ensure that they represent a supportive and inclusive space for students. Further research into how university paramedic students utilise online chat groups for peer support may further reveal a potentially valuable informal support structure.</p>","PeriodicalId":72470,"journal":{"name":"British paramedic journal","volume":"7 4","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9395936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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