International journal of paramedicine最新文献

{"title":"Reasons for Calling EMS","authors":"Ricardo Angeles, Brent McLeod, Janice Lee, Sabnam Mahmuda, Alix Stocic, Michelle Howard, Gina Agarwal","doi":"10.56068/alas3711","DOIUrl":"https://doi.org/10.56068/alas3711","url":null,"abstract":"Background: Frequent callers of emergency medical services comprise a disproportionate percentage of emergency department visits. This study aims to describe reasons for calling 911 and healthcare services among frequent callers in Ontario.
 Methods: Cross-sectional research design. A mailed self-administered survey was conducted. Participants were residents of an urban City in Canada, 18 years or older, and had called 911 at least 5 times in the past year. Dillman’s Total Design Method was used to implement the survey. Data was summarized using frequency distribution. Subgroup analyses were performed to assess for factors associated with reasons for calling in the past, reasons for calling in the future, and health services utilized.
 Results: Among the 67 participants, 47.8% were over 65, 50.70% were female, 85.1% were unemployed, and 38.8% lived alone. Most frequently reported reasons for having called 911 were inability to get up after a fall (41.8%), exacerbation of chronic medical conditions (37.3%), inability to get to the hospital (34.3%), experiencing severe pain (34.3%), and anxiety attacks (23.9%). Subgroup analysis showed significant associations: unemployment was associated with calling due to an alcohol or drug overdose (OR=6.50; CI: 1.16, 36.26); age over 65 had a lower odds of calling in the future for alcohol or drug overdose (OR=0.06; CI: 0.01, 0.51), for serious allergic response (OR=0.22; CI:0.081, 0.740) or for severe pain (OR=0.18; CI: 0.064, 0.518); age over 65 (OR=4.46CI=1.24-17.41) had higher odds of using Community Care Access Centers; and male participants had lower odds of using telehealth (OR=0.19; CI:0.038, 0.97).
 Conclusions: Policy makers should review these reasons for frequently calling 911 and implement a system to help frequent callers use more appropriate health care services including a non-ambulance response to calls related to falls, transport to medical care facilities, or anxiety attacks. This might free up ambulance services for more urgent calls.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Needs in the Prehospital Setting (SNIPS): EMS Attitudes Toward Addressing Patient Social Needs.","authors":"Daniel Berger, Catherine Caldwell, Meghan E Robbins, Amelia Gurley, Jessica Mann","doi":"10.56068/BNJE9301","DOIUrl":"10.56068/BNJE9301","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>This cross-sectional study was conducted using an internet-based survey of EMS clinicians across the United States with multiple methods of recruitment. Descriptive statistics and Chi Square Tests analyzed the data.</p><p><strong>Results: </strong>A total of 1,112 EMTs and paramedics completed the survey with 43.4% reporting familiarity with the term, \"social determinants of health,\" and 87.7% screening positive for burnout. Greater than 60% reported willingness to use proposed interventions to address patient social needs. Those who reported familiarity with the term, \"social determinants of health,\" were more likely to indicate willingness to utilize interventions and to believe they were responsible for addressing their patients' social needs. Burnout had no effect on clinicians' willingness to use resources.</p><p><strong>Discussion: </strong>Respondents showed substantial interest in using the proposed resources to address patient social needs, suggesting that EMS clinicians may be receptive to expanding their scope of responsibility to include socioeconomic interventions. EMS clinicians familiar with the term \"social determinants of health\" were more likely to believe they were responsible for addressing patient social needs and more willing to use interventions, suggesting a potential benefit to more education on the topic. Burnout among EMS clinicians may not be a barrier to implementing such interventions.</p><p><strong>Conclusion: </strong>Our survey suggests that EMS clinicians may be interested in helping to address their patients' social needs. EMS clinicians should be offered education on social determinants of health in their initial training and through continuing education. Partnerships with human services agencies will be important to ensure the effectiveness of prehospital interventions.</p>","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"4 ","pages":"40-51"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415804","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}

{"title":"Paramedicine Literature Search: March-May 2023","authors":"Brenda Morrissey, Shaughn Maxwell","doi":"10.56068/pwlc3336","DOIUrl":"https://doi.org/10.56068/pwlc3336","url":null,"abstract":"","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89833491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goals, Services, and Target Patient Populations of Community Paramedicine in Rural United States","authors":"Chelsea McAuslan, J. Roll, Mitchell McAuslan","doi":"10.56068/fsck6274","DOIUrl":"https://doi.org/10.56068/fsck6274","url":null,"abstract":"Introduction: Rural areas contain one-fifth of the US population and only 10% of the nation’s physicians. Community paramedicine (CP) is a growing healthcare delivery model in which emergency medical personnel provide non-emergent medical care. Community paramedics may help fill the primary healthcare gap for rural residents. This literature review provides an overview of the common goals, services, target populations, and setbacks of rural CP programs in the US. \u0000Methods: A systematic search following PRISMA protocols was completed on PubMed and Google scholar using the search terms: “community paramedicine/paramedic” and “rural, remote, frontier” between 2000-2021. \u0000Results: Rural CP program goals are to aid patients in chronic disease management and reduce emergency department visits, hospital admissions/readmissions, and healthcare costs. Programs target services toward patients who are chronically ill, post-hospital discharge, and frequent EMS users. \u0000Conclusion: CP provision of preventative and primary care services has improved health outcomes for patients with chronic disease. Programs report cost savings for the healthcare payer and patient and a reduction in ED transports and hospital readmissions. The problems identified are acquiring sustainable funding to develop CP programs and reimburse CP services, lack of consistency between CP scope of practice and educational requirements across states, role tensions with other healthcare professions, and lack of research about the safety of CP programs for patients. Future research is needed to investigate patient outcomes secondary to CP preventative and primary care services, which may identify if CPs are an effective means of helping fill the primary care gap for rural communities.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"356 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82618054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inclusion of Confined Space Rescue in EMS Physician Fellowship Programs","authors":"Michael McCartin, Katie L. Tataris, B. Heilicser, Joseph M. Weber, Lindsay Jaeger","doi":"10.56068/mofu4471","DOIUrl":"https://doi.org/10.56068/mofu4471","url":null,"abstract":"Introduction:  In July 2021, the ACGME updated the Program Requirements for Graduate Medical Education in Emergency Medical Services to include participation in special operations trainings as a required key index procedure during an EMS fellowship. These requirements now include documentation of “participation in confined space, technical rescue, or collapse/trench training”.  EMS fellowships may have limited opportunities for fellows to actively participate in these complex events.\u0000Background:  Federal or State Urban Search and Rescue (USAR) teams present a unique opportunity to meet this training requirement. USAR teams perform search and rescue operations in collapsed structures and provide emergency medical care for entrapped survivors, task force personnel, and search canines. The physician is integrated into the Incident Command Structure of the USAR teams under the Medical Branch as the “Medical Team Manager”. This provides a defined team role in training and promotes physician level knowledge and skills in rescue operations.\u0000Methods:  The University of Chicago EMS Fellowship partnered with Illinois Task Force-1 USAR team to meet the new training requirements and participate as a Medical Team Manager on the team.\u0000Results: During the 12-month fellowship period, the EMS fellow participated in monthly USAR training that included both single day and multi-day exercises. The exercises included scenarios with complex hazardous materials, confined space rescue, high angle rescue, collapsed structure and trench rescue. With a dedicated physician role on the USAR team, the EMS fellow integrates into the response structure as a Medical Team Manager and can learn how to deliver high quality patient care in an austere environment.  USAR training fulfilled several of the new ACGME key index procedure for an EMS fellow in the special operations environment including participation in hazardous materials response training, participation in confined space, technical rescue, or collapse/trench training, and participation in vehicle rescue/extrication training. \u0000Conclusions:  EMS fellowship programs can collaborate with Urban Search and Rescue teams to provide training opportunities in confined space rescue to meet ACGME requirements for key index procedures and integrate qualified EMS physicians into USAR responses. Collaboration between EMS fellowship programs and USAR teams can be mutually beneficial. \u0000 ","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90718244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Interventions During Prehospital Transport of Patients with Chest Pain and Suspected Acute Coronary Syndrome","authors":"Mitchell Cleghorn, F. Mencl, Daniel Johnson","doi":"10.56068/egzn2255","DOIUrl":"https://doi.org/10.56068/egzn2255","url":null,"abstract":"Objective: The aim of this study is to describe the frequency and type of advanced (ALS) interventions performed by emergency medical services (EMS) providers while caring for undifferentiated chest pain patients.\u0000Methods: This pilot study is a retrospective review of advanced interventions performed on consecutive adult patients transported by EMS with a provider impression of non-traumatic chest pain and treated under the suspected acute coronary syndrome statewide protocol from July 2013 through January 2022. The EMS system studied is a hospital-based agency which serves a large suburban to rural population in central Pennsylvania. Advanced interventions were defined a priori and included STEMI activation.\u0000Results: During the study period, there were 2 456 EMS transports out of 97 877 which met study inclusion criteria. A total of 121 advanced interventions were performed on 101 (4.1%) of these patients, the majority 79 (3.2%) of which were prehospital notification of STEMI activations. Intravenous medications were administered 25 times to 22 (0.9%) patients and advanced procedures were performed 17 times on 7 (0.3%) patients. Several patients received more than one intervention and/or medication. Patients between 60 and 65 years of age accounted for the highest number of activations (283, 11.5%) and received the largest number of interventions (28, 9.9%). Only eight patients were below the age of 45 and all were STEMI activations only.\u0000Conclusion: We found that less than 5% of included patients transported by EMS required advanced interventions with the majority of these being STEMI activations not requiring any additional interventions. Further investigation is required to determine if certain characteristics or risk-factors predict the need for out-of-hospital advanced interventions and ALS transport.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"26 20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83983439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dialogues","authors":"C. Hitchcock, C. Cunningham, Ryan Houser","doi":"10.56068/mhtq8016","DOIUrl":"https://doi.org/10.56068/mhtq8016","url":null,"abstract":"","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83144154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publication as a Catalyst for Professional Dialogue","authors":"Michael Gunderson","doi":"10.56068/iqkb4918","DOIUrl":"https://doi.org/10.56068/iqkb4918","url":null,"abstract":"","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82955287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe Pediatric Ground Ambulance Transport","authors":"Anne R. Stoklosa, M. Zafron, K. Bass, Denise F. Lillvis","doi":"10.56068/mesg1218","DOIUrl":"https://doi.org/10.56068/mesg1218","url":null,"abstract":"Background: Ambulance crashes that result in child injury or death are preventable with the use of proper restraints. This systematic review assesses aspects relevant to the proper use of pediatric restraints: EMS professionals’ resources and training, knowledge, attitudes, and behaviors. It also identifies barriers to using restraints. \u0000Methods: PubMed and Web of Science were searched using free-text search terms between the years 2000 and 2020. Inclusion criteria included human research, pediatric population, ambulance as the mode of transportation, peer-reviewed journals, and English full-texts. After initial screening and inclusion, a snowball methodology was used to further identify potentially relevant articles. The methodology was carried out by two independent reviewers.  \u0000Results: The original search yielded 80 publications after de-duplication between databases, and two additional articles were identified independently of the search through snowball sampling. Four publications met inclusion criteria for final analysis. Two studies were survey-based among EMS personnel aiming to identify knowledge, behaviors, and barriers to child transport. One study used qualitative data collection by interviews of ambulance personnel. The final study was a combination of survey and observational data. Of note, there were no studies that evaluated an intervention. \u0000Conclusion: Based on this review, there is a lack of research in the realm of safe pediatric ambulance transport. There is a need for quality improvement studies to address the barriers that were identified by previous literature and to improve the overall safety and compliance of pediatric safety restraints during transportation to the hospital.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83805626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matched Cohort Study of Open Thoracostomies Performed by Ground Medics","authors":"Alison A Smith, A. Ciaraglia, Benjamin Axtman, CJ Winckler, D. Wampler, Maxwell A. Braverman, C. P. Shahan, Rachelle Babbitt Jonas, Michael Shiels, B. Eastridge, Ronald M Stewart, Susannah E. Nicholson, Donald J. Jenkins","doi":"10.56068/qmbv3502","DOIUrl":"https://doi.org/10.56068/qmbv3502","url":null,"abstract":"Background: Tension pneumothorax resulting from chest trauma is a rapidly fatal condition that requires prompt treatment.  Prehospital open thoracostomy (POT) is a potentially lifesaving intervention that can be performed in the field to treat tension pneumothorax. However, the results from POT performed by ground EMS providers have not been well-studied. The objective of this study was to compare outcomes for patients with chest trauma who underwent POT performed by ground EMS providers with a matched cohort who did not undergo this procedure in the field. \u0000Methods: A retrospective chart review of consecutive adult patients presenting to a Level I trauma center with chest trauma were analyzed from 2017-2020. Outcomes were compared to a patient cohort who did not undergo POT matched by severity of injury and prehospital CPR. \u0000Results: A total of 14 POT patients were identified.  Majority of POT were bilateral (n=11/14, 78.6%) and all of these patients (n=14/14) had prehospital cardiac arrest. Return of spontaneous circulation was obtained in 2 patients with penetrating injuries (14.3%). There was no difference in total and scene EMS time compared to the matched cohort without POT (p>0.05). \u0000Conclusions: This study demonstrated that open thoracostomies could be performed by ground EMS units without increasing prehospital time for severely injured trauma patients and greater achievement of ROSC. Larger, prospective, multi-institutional analyses are needed to further evaluate outcomes.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74690588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}