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2.
PLoS One ; 15(7): e0235315, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32634172

RESUMO

BACKGROUND: The effect of paramedic crew size in the resuscitation of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. We hypothesised that teams with a larger crew size have better resuscitation performance including chest compression fraction (CCF), advanced life support (ALS), and teamwork performance than those with a smaller crew size. METHODS: We conducted a randomized controlled study in a simulation setting. A total of 140 paramedics from New Taipei City were obtained by stratified sampling and were randomly allocated to 35 teams with crew sizes of 2, 3, 4, 5, and 6 (i.e. 7 teams in every paramedic crew size). A scenario involving an OHCA patient who experienced ventricular fibrillation and was attached to a cardiopulmonary resuscitation (CPR) machine was simulated. The primary outcome was the overall CCF; the secondary outcomes were the CCF in manual CPR periods, time from the first dose of epinephrine until the accomplishment of intubation, and teamwork performance. Tasks affecting the hands-off time during CPR were also analysed. RESULTS: In all 35 teams with crew sizes of 2, 3, 4, 5, and 6, the overall CCFs were 65.1%, 64.4%, 70.7%, 72.8%, and 71.5%, respectively (P = 0.148). Teams with a crew size of 5 (58.4%, 61.8%, 68.9%, 72.4%, and 68.7%, P<0.05) had higher CCF in manual CPR periods and better team dynamics. Time to the first dose of epinephrine was significantly shorter in teams with 4 paramedics, while time to completion of intubation was shortest in teams with 6 paramedics. Troubleshooting of M-CPR machine decreased the hands-off time during resuscitation (39 s), with teams comprising 2 paramedics having the longest hands-off time (63s). CONCLUSION: Larger paramedic crew size (≧4 paramedics) did not significantly increase the overall CCF in OHCA resuscitation but showed higher CCF in manual CPR period before the setup of the CPR machine. A crew size of ≧4 paramedics can also shorten the time of ALS interventions, while teams with 5 paramedics will have the best teamwork performance. Paramedic teams with a smaller crew size should focus more on the quality of manual CPR, teamwork, and training how to troubleshoot a M-CPR machine.


Assuntos
Pessoal Técnico de Saúde/estatística & dados numéricos , Reanimação Cardiopulmonar/métodos , Serviços Médicos de Emergência/métodos , Parada Cardíaca Extra-Hospitalar/prevenção & controle , Adulto , Cuidados Críticos/métodos , Auxiliares de Emergência , Medicina de Emergência/métodos , Epinefrina/administração & dosagem , Feminino , Humanos , Intubação/métodos , Masculino , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/patologia , Fibrilação Ventricular/fisiopatologia , Fibrilação Ventricular/prevenção & controle
4.
Stud Health Technol Inform ; 270: 613-617, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570456

RESUMO

Emergency medical situations are characterized by high physical, cognitive and mental demands on the paramedics on the ground. Studies suggest that crucial information such as treatments administered to patients is often documented retrospectively, during patient transport or once a patient is handed over to an emergency department. Information access may also be surprisingly difficult (e.g. patient medical history). In this paper, we focus on supporting in situ information capturing and report on a realistic laboratory-based study involving experienced paramedics that we used to explore the specific requirements and constraints of supporting in situ information capturing. Specifically, we focused on ways to use audio and visual data capture methods and how they need to be designed to better support paramedics without interfering with their work. We then use the resulting information centric perspective to argue for a roadmap towards smart emergency medical services.


Assuntos
Serviços Médicos de Emergência , Pessoal Técnico de Saúde , Auxiliares de Emergência , Serviço Hospitalar de Emergência , Hospitais , Humanos , Estudos Retrospectivos
5.
Curr Res Transl Med ; 68(3): 83-91, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32576508

RESUMO

MOTIVATION: COVID-19 is one of the most widely affecting pandemics. As for many respiratory viruses-caused diseases, diagnosis of COVID-19 relies on two main compartments: clinical and paraclinical diagnostic criteria. Rapid and accurate diagnosis is vital in such a pandemic. On one side, rapidity may enhance management effectiveness, while on the other, coupling efficiency and less costly procedures may permit more effective community-scale management. METHODOLOGY AND MAIN STRUCTURE: In this review, we shed light on the most used and the most validated diagnostic tools. Furthermore, we intend to include few under-development techniques that may be potentially useful in this context. The practical intent of our work is to provide clinicians with a realistic summarized review of the essential elements in the applied paraclinical diagnosis of COVID-19.


Assuntos
Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/tendências , Infecções por Coronavirus/diagnóstico , Auxiliares de Emergência , Pneumonia Viral/diagnóstico , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Técnicas de Laboratório Clínico/classificação , Infecções por Coronavirus/classificação , Infecções por Coronavirus/epidemiologia , Serviços Médicos de Emergência/métodos , Auxiliares de Emergência/organização & administração , Auxiliares de Emergência/tendências , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Sensibilidade e Especificidade , Fatores de Tempo
6.
Ansiedad estrés ; 26(1): 52-58, ene.-jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192302

RESUMO

INTRODUCCIÓN Y OBJETIVOS: Por su propia naturaleza, la emergencia implica situaciones de elevado riesgo. El objetivo del trabajo es analizar la relación del estrés generado y el grado de control percibido en personal de emergencias con las variables sexo, edad, nivel de estudios, rama profesional y antigüedad y, a su vez, comparar estos resultados con los datos baremados del Inventario de Respuestas de Afrontamiento en Adultos (CRI-A) en población general española. MATERIAL Y MÉTODOS: En el estudio participaron 120 profesionales y voluntarios de diferentes instituciones civiles y militares del área de emergencias. Se utilizó un cuestionario sociodemográfico y la escala baremada sobre estrés y control percibido del inventario CRI-A mediante la representación mental de una situación extrema. RESULTADOS: Ninguna de las variables sociodemográficas obtuvo diferencias significativas con relación a la intensidad de estrés generado. Respecto al grado de control percibido, los hombres reportaron mayores puntuaciones promedio que las mujeres. En la comparación de ambas muestras, el personal de emergencias mostró diferencias significativas respecto a la población española en general, con menores puntuaciones medias en el nivel de estrés y también en el grado de control percibido. CONCLUSIONES: Ante la controversia encontrada en la bibliografía respecto al sexo y al estrés generado y al grado de control percibido, la evidencia muestra diferencias en favor de los hombres. En consecuencia, se propone que se implemente formación en gestión emocional y percepción del riesgo. En cuanto a las diferencias encontradas respecto a la población general, también se propone que se establezcan planes de educación enemergencias


INTRODUCTION AND OBJECTIVES: By its very nature, emergencies involve high-risk situations. The aim of this study is to analyse the relationship between the stress generated and the degree of control perceived in emergency personnel with the variables of sex, age, level of studies, professional branch and seniority and, in turn, to compare these results with the data from the Inventory of Coping Responses in Adults (CRI-A) in the general Spanish population. MATERIAL AND METHODS: The study involved 120 professionals and volunteers from different civil and military institutions in the emergency area. A sociodemographic questionnaire was used, as well as the scale on stress and perceived control of the CRI-A Inventory through the mental representation of an extreme situation. RESULTS: None of the sociodemographic variables obtained significant differences in relation to the intensity of the stress generated. Regarding the degree of perceived control, men reported higher average scores than women. When comparing both samples, emergency personnel showed significant differences with respect to the Spanish population in general, with lower average scores in the level of stress and also in the degree of perceived control. CONCLUSIONS: Given the controversy found in the literature regarding sex and the stress generated and degree of perceived control, the evidence shows differences in favor of men. Consequently, it is suggested that training in emotional management and risk perception be implemented. As for the differences found with respect to the general population, it is also suggested that education plans be established in emergencies


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Estresse Psicológico/psicologia , Auxiliares de Emergência/psicologia , Socorristas/psicologia , Adaptação Psicológica , Fatores Socioeconômicos
9.
J Spec Oper Med ; 20(1): 141-144, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32203619

RESUMO

Battlefield medicine is constantly evolving. Wound patterns, terrain, weapons, and medical evacuation change, so surgical capabilities must adapt. With the changing environment, we must evolve by adapting to offer the best practical care, closest to the frontline. The golden hour has never been a magical number, and the most successful care is provided by the most advanced practitioners as close to the point of injury as possible. The proper placement and access of surgical teams are a key factor in access to a casualty within minutes. NATO Special Operations combat medics (NSOCMs) are highly trained medical Operators who can work as a force multiplier, not only to the Special Operations elements in which they serve but also as members of a Special Operations surgical team (SOST), and these Soldiers can provide the essential skills necessary to best employ and support the surgical asset.


Assuntos
Auxiliares de Emergência , Medicina Militar , Equipe de Assistência ao Paciente/organização & administração , Papel Profissional , Lesões Relacionadas à Guerra/cirurgia , Humanos
10.
PLoS One ; 15(3): e0229954, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155192

RESUMO

INTRODUCTION: Professional wellness is critical to developing and maintaining a health care workforce. Previous work has identified burnout as a significant challenge to professional wellness facing emergency medical technicians (EMTs) in many countries worldwide. Our study fills a critical gap by assessing the prevalence of burnout among emergency medical technicians (EMTs) in India. METHODS: This was a cross-sectional survey of EMTs within the largest prehospital care organization in India. We used the Maslach Burnout Inventory (MBI) to measure wellness. All EMTs presenting for continuing medical education between July-November 2017 from the states of Gujarat, Karnataka, and Telangana were eligible. Trained, independent staff administered anonymous MBI-Medical Personnel Surveys in local languages. RESULTS: Of the 327 EMTs eligible, 314 (96%) consented to participate, and 296 (94%) surveys were scorable. The prevalence of burnout was 28.7%. Compared to EMTs in other countries, Indian EMTs had higher levels of personal accomplishment but also higher levels of emotional exhaustion and moderate levels of depersonalization. In multivariate regression, determinants of burnout included younger age, perceived lack of respect from colleagues and administrators, and a sense of physical risk. EMTs who experienced burnout were four times as likely to plan to quit their jobs within one year. CONCLUSION: This is the first assessment of burnout in EMTs in India and adds to the limited body of literature among low- and middle-income country (LMIC) prehospital providers worldwide. Burnout was strongly associated with an EMT's intention to quit within a year, with potential implications for employee turnover and healthcare workforce shortages. Burnout should be a key focus of further study and possible intervention to achieve internationally recognized targets, including Sustainable Development Goal 3C and WHO's 2030 Milestone for Human Resources.


Assuntos
Esgotamento Profissional/epidemiologia , Auxiliares de Emergência/psicologia , Tratamento de Emergência/psicologia , Adulto , Esgotamento Profissional/psicologia , Estudos Transversais , Auxiliares de Emergência/estatística & dados numéricos , Emoções , Feminino , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Índia/epidemiologia , Satisfação no Emprego , Masculino , Reorganização de Recursos Humanos/estatística & dados numéricos , Prevalência , Inquéritos e Questionários/estatística & dados numéricos
11.
Enferm. intensiva (Ed. impr.) ; 31(1): 19-34, ene.-mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187364

RESUMO

Objetivos: El objetivo fue explorar la experiencia de médicos y técnicos en cuidados auxiliares de enfermería (TCAE) respecto al manejo de contenciones mecánicas en unidades de cuidados críticos. Método: Estudio fenomenológico multicéntrico que incluyó 14 unidades de cuidados críticos (UCC) de Madrid (España). Las UCC fueron estratificadas en función del uso de contenciones mecánicas: «uso frecuente» versus «uso escaso». Se realizaron 3 grupos de discusión: el primero compuesto por TCAE procedentes de UCC con uso frecuente de contenciones mecánicas, el segundo grupo por TCAE de UCC de uso escaso de contenciones mecánicas y el último grupo por médicos de ambos subtipos de UCC. Método de muestreo: por propósito. Análisis de datos: análisis temático de contenido. Se alcanzó la saturación de los datos. Resultados: Emergen 4 temas principales: 1) concepto de seguridad y riesgo (seguridad del paciente versus seguridad del profesional); 2) tipos de contenciones; 3) responsabilidades profesionales (prescripción, registro y roles profesionales); y 4) paradigma «contención cero». La conceptualización sobre el uso de contenciones mecánicas muestra diferencias en algunos de los temas principales dependiendo del tipo de UCC en cuanto a políticas, uso y manejo de contenciones mecánicas (uso frecuente versus uso escaso). Conclusiones: La reducción real del uso de contenciones mecánicas en UCC debe partir de un punto clave: la aceptación de la complejidad del fenómeno. El uso de contenciones mecánicas observado en las diferentes UCC está influenciado por factores individuales, grupales y organizativos. Estos factores determinan las interpretaciones que médicos y TCAE realizan sobre seguridad y riesgo, el centro del cuidado (cuidado centrado en el paciente o en el profesional), el concepto de contención, las responsabilidades e intervenciones profesionales y las interacciones del equipo y el liderazgo


Objectives: The study aim was to explore the experience of doctors and nursing assistants in the management of physical restraint (PR) in critical care units. Method; A multicentre phenomenological study that included 14 critical care units (CCU) in Madrid (Spain). The CCU were stratified according to their use of physical restraint: "frequently used" versus "seldom used". Three focus groups were formed: the first comprised nursing assistants from CCUs that frequently used physical restraint, the second comprised nursing assistants from CCUs that seldom used physical constraint, and the final group comprised doctors from both CCU subtypes. Sampling method: purposive. Data analysis: thematic content analysis. Data saturation was achieved. Results: Four principle themes emerged: 1) concept of safety and risk (patient safety versus the safety of the professional), 2) types of restraint, 3) professional responsibilities (prescription, recording, and professional roles) and 4) "zero restraint" paradigm. The conceptualisation regarding the use of physical contentions shows differences in some of the principal themes, depending on the type of CCU, in terms of policies, use and management of physical constraint (frequently used versus seldom used). Conclusions; The real reduction in the use of physical restraint in CCU must be based on one crucial point: acceptance of the complexity of the phenomenon. The use of physical restraint observed in the different CCU is influenced by individual, group and organisational factors. These factors will determine how doctors and nursing assistants interpret safety and risk, the centre of care (patient or professional-centred care), the concept of restraint, professional responsibilities and interventions, interactions of the team and the leadership


Assuntos
Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Assistentes de Enfermagem , Equipe de Assistência ao Paciente/organização & administração , Auxiliares de Emergência , Comunicação Interdisciplinar , Serviços Médicos de Emergência , Cuidados Críticos/organização & administração , Grupos Focais
13.
South Med J ; 113(2): 59-63, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32016434

RESUMO

OBJECTIVES: Interfacing with patients with sensory processing difficulties is challenging to healthcare providers and even more problematic for emergency medical services (EMS) personnel in the acute care setting. Sensory training may be an effective nonpharmacologic method to deal with these patient populations. The purpose of this study was to evaluate whether an educational session and placement sensory tools would improve the comfort of EMS providers in the prehospital setting. METHODS: EMS providers from two agencies in the Alabama Gulf EMS System were selected for this study. Preeducation questionnaires were administered to EMS providers to assess their frequency and comfort level in taking care of patients with sensory processing difficulties. The educational session included a video presentation of various topics related to sensory processing difficulties and education on sensory tools. Posteducation questionnaires were administered to EMS providers 3 months posteducational session to assess the use of sensory tools and their comfort in patient care. Comfort level was assessed on a Likert scale of 1 to 10, with 1 being not comfortable at all and 10 being extremely comfortable. We performed descriptive statistics and the nonparametric Wilcoxon signed rank test to compare medians. RESULTS: A total of 177 of 225 (78.6%) EMS providers completed the preeducation questionnaire. In the preeducation period, 159 (89.8%) EMS providers transported patients with sensory processing difficulties. The preeducation median comfort level was 7.5 (range 1-10). At postsurvey, 135 of 177 (76.3%) EMS providers received educational training; 37 (27.4%) used the sensory tools within the previous 3 months. The posteducation median comfort level was 8 (range 3-10). Pre- and post median comfort levels were significantly different using the Wilcoxon signed rank test (P = 0.006). CONCLUSIONS: Sensory training can be an effective method for EMS providers to increase comfort levels in taking care of patients with sensory difficulties. Further research with larger sample sizes is needed to confirm/refute these findings.


Assuntos
Serviços Médicos de Emergência/métodos , Auxiliares de Emergência/educação , Auxiliares de Emergência/psicologia , Medicina de Emergência/educação , Transtornos da Percepção , Adulto , Alabama , Atitude do Pessoal de Saúde , Competência Clínica , Feminino , Humanos , Masculino , Inquéritos e Questionários
14.
Ulus Travma Acil Cerrahi Derg ; 26(1): 9-14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31942745

RESUMO

BACKGROUND: The Tashkent city, the capital of the republic of Uzbekistan, started joint project with Korean emergency physicians to improve the quality of their ambulance services in 2016. Ambulance service in Tashkent city has been facing challenges in processing a large number of calls, and low competency of their staff in providing advanced prehospital emergency care. To design an appropriate capacity building training program for ambulance staff, we analyzed the current ambulance service in Tashkent concerning resources and competency of the staff. METHODS: In this study, ambulance staff participated in the constructed survey and pre-validated written test. Statistics and other information were provided by the Ministry of Health of Uzbekistan. RESULTS: Ninety-eight ambulance staff were participated in this study, and more than half (53.1%) of the participants were physicians. The average years of service in the ambulance were 8.71±6.9 years. In the ambulance, drugs were stocked in enough quantity include injections for critical care, except large volume fluids for resuscitation. Only 19 to 52 percent of the ambulances were equipped with essential monitoring devices. Competency for the basic procedure was surveyed higher than 60%, but critical care skills, such as defibrillation, were as low as 18%. The written test resulted in only 41.1% correct answer rate, though it was higher than 60% in the validation test for Korean ambulance staff. Conventional prehospital knowledge and skillset deemed to be essential for ambulance staff were found to be marginal in the test. CONCLUSION: The ambulance staff in Tashkent, Uzbekistan found to have insufficient medical knowledge and clinical decision-making abilities. Training program for ambulance staff in Tashkent should be developed on the basis of the findings in this study.


Assuntos
Ambulâncias , Serviços Médicos de Emergência , Auxiliares de Emergência/educação , Competência Clínica , Currículo , Países em Desenvolvimento , Humanos , Inquéritos e Questionários , Uzbequistão
15.
Int J Occup Med Environ Health ; 33(1): 91-105, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31942870

RESUMO

OBJECTIVES: The article presents the results of selected pilot studies conducted in medical ambulances. Their aim was to determine the working conditions and identify troublesome factors accompanying the performance of basic medical procedures by rescue teams. MATERIAL AND METHODS: The study of working conditions was carried out in Mercedes-Benz ambulances, type S and P. Fifty-one paramedics of the Emergency Medical Rescue Service in Siedlce took part in the research. The questionnaire expert survey method and the direct observation method were used. RESULTS: As a result of the applied research methods, knowledge was gained on the irregularities and difficulties that occur at the workplace of a paramedic, i.e., in an ambulance, including the lack of access to essential elements of medical equipment and their different location inside the vehicle, and the diversity of solutions for the spatial structure of ambulances, which all cause difficulties at work. Research has shown that paramedics take, on average, 33 min to familiarize themselves with the location of equipment in an ambulance other than the one in which they are usually on duty. There was no correlation between the lifeguard's length of service and the time necessary for getting acquainted with the equipment, which was studied using Pearson's correlation coefficient. In the study, rescuers also pointed to musculoskeletal ailments, mainly spinal pains resulting from taking forced positions during medical activities in an ambulance. CONCLUSIONS: The results obtained constitute the basis for the author's methodology of complex research aimed at defining the ergonomic recommendations necessary in the modification process of the operated medical fleet. The next step will be to formulate uniform guidelines for the construction of medical compartments of ambulances, the application of which will lead to the unification of their spatial structure regardless of the vehicle brand. Int J Occup Med Environ Health. 2020;33(1):91-105.


Assuntos
Ambulâncias , Auxiliares de Emergência , Ergonomia , Serviços Médicos de Emergência/métodos , Feminino , Humanos , Decoração de Interiores e Mobiliário , Masculino , Doenças Musculoesqueléticas/epidemiologia , Doenças Musculoesqueléticas/etiologia , Projetos Piloto , Polônia , Postura , Inquéritos e Questionários , Local de Trabalho
16.
Br J Nurs ; 29(2): S35-S40, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31972107

RESUMO

BACKGROUND: The DIVA score is validated for predicting success of the initial attempt at peripheral intravenous insertion by nurses and physicians. A score of 4 or greater is 50% to 60% likely to have a failed first attempt. The study objective was to assess the validity of this score for emergency department technicians. METHODS: This study used a prospective convenience sample of 181 children presenting to the emergency department with intravenous access attempt by one of 29 emergency department technicians. DIVA score, total number of attempts, and median time to successful intravenous cannulation were obtained. RESULTS: Comparing patients with a DIVA score <4 to ≥4, first-time IV placement failure rates were lower (9% [95% CI, 3-24] vs. 41% [95% CI, 33-49]) and median time to IV placement was shorter (75 [interquartile range (IQR) 42-157] vs. 254 [IQR 91-806]) seconds. In patients with scores ≥4, emergency department technicians with ≥5 years of experience were significantly more likely to be successful on the first attempt (OR 2.8; 95% CI, 1.03-7.63). For every year of technician experience, the time to catheter placement, adjusted for DIVA score, decreased by 25 minutes (P≤0.05, R2=0.05). Comparing our receiver operating curve to the derivation study, the areas were similar (0.67 vs. 0.65). CONCLUSIONS: This study provides preliminary evidence for the validity of the DIVA score when applied to IVs placed by emergency department technicians. For patients with high DIVA scores, ≥5 years of IV experience was associated with higher odds of successful first-time IV placement and shorter time to placement. HIGHLIGHTS The difficult intravenous access (DIVA) score may be generalizable to IVs placed by experienced emergency department technicians (EDTs) Higher odds of first-time success in difficult patients with ≥5 years EDT experience Early identification of difficult access may allow for aid of alternative technology Likely first study to evaluate EDTs IV skills in patients with varying DIVA scores.


Assuntos
Cateterismo Periférico , Tomada de Decisão Clínica , Técnicas de Apoio para a Decisão , Auxiliares de Emergência , Pré-Escolar , Serviço Hospitalar de Emergência , Humanos , Lactente , Estudos Prospectivos , Reprodutibilidade dos Testes
17.
Niger J Clin Pract ; 23(1): 54-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31929207

RESUMO

Objectives: The first aid implemented just after the traumatic dental injury (TDI) is of vital importance. This study aims to evaluate the attitudes of emergency medical technicians (EMTs) and paramedics toward TDI and their levels of knowledge about the issue. Subjects and Methods: A questionnaire, which comprised 14 questions, was applied to 389 EMTs and paramedics all across Turkey. The questionnaires were sent to the participants through e-mails, and the results were obtained by an online system. Results: 336 out of 389 EMTs and paramedics (86.4%) mentioned that they did not have any training about the TDI issue. On the other hand, among the ones who mentioned that they received this training, 50.9% suggested that the training was not sufficient. It was observed that 63.5% of the participants encountered cases of injuries in oral and dental regions, and in 83% of these cases the only treatment applied was bleeding intervention. About 75.6% of them think that an avulsed tooth cannot be reimplanted. Conclusion: In conclusion, it was determined that the EMTs and paramedics did not have sufficient and accurate information about the TDI. Lack of knowledge about TDI prevents rapid and accurate intervention to the cases.


Assuntos
Pessoal Técnico de Saúde/educação , Auxiliares de Emergência/educação , Conhecimentos, Atitudes e Prática em Saúde , Fraturas dos Dentes , Traumatismos Dentários , Adulto , Pessoal Técnico de Saúde/psicologia , Atitude do Pessoal de Saúde , Serviços Médicos de Emergência , Auxiliares de Emergência/psicologia , Feminino , Humanos , Masculino , Inquéritos e Questionários , Avulsão Dentária , Turquia , Adulto Jovem
18.
J Neurointerv Surg ; 12(1): 104-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31337733

RESUMO

INTRODUCTION: The shorter the time between the onset of symptoms and reperfusion using endovascular thrombectomy, the better the functional outcome of patients. A training program was designed for emergency medical technicians (EMTs) to learn the gaze-face-arm-speech-time test (G-FAST) score for initiating a prehospital bypass strategy in an urban city. This study aimed to evaluate the effect of the training program on EMTs. METHODS: All EMTs in the city were invited to join the training program. The program consisted of a 30 min lecture and a 20 min video which demonstrated the G-FAST evaluation. The participants underwent tests before and after the program. The tests included (1) a questionnaire of knowledge, attitudes, confidence, and behaviors towards stroke care; and (2) watching 10 different scenarios in a video and answering questions, including eight sub-questions of G-FAST parameters, and choosing a suitable receiving hospital. RESULTS: In total, 1058 EMTs completed the training program. After the program, significant improvement was noted in knowledge, attitudes, and confidence, as well as scenario judgement. The performance of the EMTs in evaluating G-FAST criteria in comatose patients was relatively poor in the pre-test and improved significantly after the training course. Although the participants answered the G-FAST items correctly, they tended to overtriage the patients and refer them to higher-level hospitals. CONCLUSIONS: A short training program can improve the ability to identify stroke patients and choose a suitable receiving hospital. A future training program could put further emphasis on how to evaluate comatose patients and choose a suitable receiving hospital.


Assuntos
Competência Clínica , Serviços Médicos de Emergência/métodos , Auxiliares de Emergência/educação , Acidente Vascular Cerebral/cirurgia , Trombectomia/educação , Trombectomia/métodos , Competência Clínica/normas , Serviços Médicos de Emergência/normas , Auxiliares de Emergência/normas , Feminino , Humanos , Masculino , Acidente Vascular Cerebral/diagnóstico , Trombectomia/normas
19.
Workplace Health Saf ; 68(2): 73-80, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31650905

RESUMO

Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers (p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.


Assuntos
Serviços Médicos de Emergência/métodos , Exposição Ocupacional/prevenção & controle , Precauções Universais/estatística & dados numéricos , Adulto , Patógenos Transmitidos pelo Sangue , Estudos Transversais , Auxiliares de Emergência/estatística & dados numéricos , Feminino , Humanos , Controle de Infecções/métodos , Masculino , Pessoa de Meia-Idade , População Rural , Inquéritos e Questionários , População Urbana , West Virginia
20.
Appl Ergon ; 82: 102977, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31670157

RESUMO

This study investigates how the positions of paramedic equipment bags affect paramedic performance and biomechanical loads during out-of-hospital Cardiopulmonary Resuscitation (CPR). An experiment was conducted in which 12 paramedic teams (each including two paramedics) performed in-situ simulations of a cardiac-arrest scenario. CPR quality was evaluated using five standard resuscitation measures (i.e., pre- and post-shock pauses, and compression rate, depth and fraction). The spinal loads while lifting, pulling and pushing the equipment bags were assessed using digital human modeling software (Jack) and prediction equation from previous studies. The results highlight where paramedics are currently choosing to position their equipment. They also demonstrate that the positions of the equipment bags affect CPR quality as well as the paramedics' work efficiency, physiological effort and biomechanical loads. The spinal loads ranged from 1901 to 4030N; furthermore, every occasion on which an equipment bag was lifted resulted in spinal forces higher than 3400N, thus exceeding the maximum threshold stipulated by the National Institute for Occupational Safety and Health. 72% of paramedics' postures were categorized as high or very high risk for musculoskeletal disorders by the Rapid Entire Body Assessment. Guidelines related to bag positioning and equipment handling might improve CPR quality and patient outcomes, and reduce paramedics' risk of injury.


Assuntos
Reanimação Cardiopulmonar , Serviços Médicos de Emergência , Auxiliares de Emergência , Desenho de Equipamento , Ergonomia , Parada Cardíaca Extra-Hospitalar/terapia , Adulto , Feminino , Humanos , Masculino
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