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Babaei HA, Ferdosi M, Masoumi G, Rezaei F. A comparative study on specialized services in pre-hospital emergencies in Iran and selected countries. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:414. [PMID: 38333162 PMCID: PMC10852191 DOI: 10.4103/jehp.jehp_232_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/01/2023] [Indexed: 02/10/2024]
Abstract
The quality of emergency services is one of the indicators describing the health status of countries. Moreover, the specialization of services and targeted response to any accident or disease has been the priority of pre-hospital emergency operations in some leading countries. This study aimed to compare the special services provided in the emergency department of several selected countries. This was a comparative study that was done in Isfahan in 2022. Data were collected by reviewing the literature provided by libraries and emergency websites of selected countries. We selected countries based on the accessibility of information in two groups of developed countries and countries with the same income and population as Iran including Germany, France, The United States, Australia, Britain, Malaysia, and Turkey. Data were classified and compared based on staff, vehicles, and specialized services. Emergency staffs in most countries were of different skill and training levels. Ambulances varied in equipment types in various land, air, and sea forms and dimensions. Developed countries had more modern ambulances and equipment. France and Germany were operating more especially. Specialized teams are dispatched only in the United States and Germany. Existing studies have shown the adequacy and effectiveness of these teams in reducing complications and mortality and improving the prognosis of patients. The use of specialized teams appropriate to each emergency based on the specific and targeted response is effective in improving the prognosis of patients. The results of this study are suggested to beneficiaries to improve the quality of emergency care and reduce complications and potential causalities.
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Affiliation(s)
- Habib Allah Babaei
- Department of Health in Disasters and Emergencies, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Ferdosi
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamraza Masoumi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Emergency Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rezaei
- Department of Health in Disasters and Emergencies, Health Management and Economics Research Centers, Isfahan University of Medical Sciences, Isfahan, Iran
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Schultz BV, Watt K, Rashford S, Wylie J, Bosley E. Epidemiology of open limb fractures attended by ambulance clinicians in the out-of-hospital setting: A retrospective analysis. Australas Emerg Care 2023; 26:216-220. [PMID: 36621412 DOI: 10.1016/j.auec.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/25/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND Open limb fractures are a time-critical orthopaedic emergency that present to jurisdictional ambulance services. This study describes the demographic characteristics and epidemiological profile of these patients METHODS: We undertook a retrospective analysis of all patients that presented to Queensland Ambulance Service with an open limb fracture (fracture to the humerus, radius/ulna, tibia/fibula or femur) over a two-year period (January 2018 - December 2019). RESULTS Overall, 1020 patients were included. Patients were mainly male (65.9%) and middle-aged (age 41 years, IQR 22-59). Fractures predominately occurred in the lower extremities (64.9%) with transport crashes the primary mechanism of injury (47.8%). The location of the fracture varied depending on the cause of injury, with femur fractures associated with motorcycle crashes, and fractures to the radius/ulna attributed to falls of greater than one metre (p = 0.001). The median prehospital episode of care was 83 min (IQR 62-144) with aeromedical air ambulance involvement and the attendance of a critical care paramedic or emergency physician, both independent factors that increased this time interval. CONCLUSION Open limb fractures are a relatively infrequent injury presentation encountered by ambulance clinicians. The characteristics of these patients is consistent with previously described national and international out-of-hospital trauma cohorts.
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Affiliation(s)
- Brendan V Schultz
- Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, QLD, Australia.
| | - Kerrianne Watt
- Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, QLD, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD Australia
| | - Stephen Rashford
- Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, QLD, Australia
| | - James Wylie
- Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, QLD, Australia
| | - Emma Bosley
- Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, QLD, Australia; School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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The prehospital management of ambulance-attended adults who fell: A scoping review. Australas Emerg Care 2023; 26:45-53. [PMID: 35909044 DOI: 10.1016/j.auec.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The ageing population is requiring more ambulance attendances for falls. This scoping review aimed to map and synthesise the evidence for the prehospital management of Emergency Medical Services (EMS) attended adult patients who fall. METHODS The Joanna Briggs Institute methods for scoping reviews were used. Six databases were searched (Medline, Scopus, CINAHL, Cochrane, EMBASE, ProQuest), 1st August 2021. Included sources reported: ambulance attended (context), adults who fell (population), injuries, interventions or disposition data (concept). Data were narratively synthesised. RESULTS One-hundred and fifteen research sources met the inclusion criteria. Detailed information describing prehospital delivered EMS interventions, transport decisions and alternative care pathways was limited. Overall, adults< 65 years were less likely than older adults to be attended repeatedly and/or not transported. Being male, falling from height and sustaining severe injuries were associated with transport to major trauma centres. Older females, falling from standing/low height with minor injuries were less likely to be transported to major trauma centres. CONCLUSION The relationship between patient characteristics, falls and resulting injuries were well described in the literature. Other evidence about EMS management in prehospital settings was limited. Further research regarding prehospital interventions, transport decisions and alternative care pathways in the prehospital setting is recommended.
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Prabhakar Abhilash K, Abraham S, Hazra D, Nekkanti A. Head and neck trauma: Profile and factors associated with severe head injury. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_3_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Survival outcomes in emergency medical services witnessed traumatic out-of-hospital cardiac arrest after the introduction of a trauma-based resuscitation protocol. Resuscitation 2021; 168:65-74. [PMID: 34555487 DOI: 10.1016/j.resuscitation.2021.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/09/2021] [Accepted: 09/12/2021] [Indexed: 01/25/2023]
Abstract
AIM In this study, we examine the impact of a trauma-based resuscitation protocol on survival outcomes following emergency medical services (EMS) witnessed traumatic out-of-hospital cardiac arrest (OHCA). METHODS We included EMS-witnessed OHCAs arising from trauma and occurring between 2008 and 2019. In December 2016, a new resuscitation protocol for traumatic OHCA was introduced prioritising the treatment of potentially reversible causes before conventional cardiopulmonary resuscitation. The effect of the new protocol on survival outcomes was assessed using adjusted multivariable logistic regression models. RESULTS Paramedics attempted resuscitation on 490 patients, with 341 (69.6%) and 149 (30.4%) occurring during the control and intervention periods, respectively. A reduction in the proportion of cases receiving cardiopulmonary resuscitation and epinephrine administration were found in the intervention period compared to the control period, whereas trauma-based interventions increased significantly, including blood administration (pre-arrest: 17.9% vs 3.7%; intra-arrest: 24.1% vs 2.7%), splinting (pre-arrest: 38.6% vs 17.1%; intra-arrest: 20.7% vs 5.2%), and finger thoracostomy (pre-arrest: 13.1% vs 0.6%; intra-arrest: 22.8% vs 0.9%), respectively, with p-values < 0.001 for all comparisons. After adjustment, the trauma-based resuscitation protocol was not associated with an improvement in survival to hospital discharge (AOR 1.29, 95% CI: 0.51-3.23), event survival (AOR 0.72, 95% CI: 0.41-1.28) or prehospital return of spontaneous circulation (AOR 0.63, 95% CI: 0.39-1.03). CONCLUSION In our region, the introduction of a trauma-based resuscitation protocol led to an increase in the delivery of almost all trauma interventions; however, this did not translate into better survival outcomes following EMS-witnessed traumatic OHCA.
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Jyothirmayi C, Fernandes J, Hazra D, Abhilash KP. Adolescent trauma: Patterns and outcomes. INTERNATIONAL JOURNAL OF ACADEMIC MEDICINE 2021. [DOI: 10.4103/ijam.ijam_103_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Psarros C, Theleritis C, Kokras N, Lyrakos D, Koborozos A, Kakabakou O, Tzanoulinos G, Katsiki P, Bergiannaki JD. Personality characteristics and individual factors associated with PTSD in firefighters one month after extended wildfires. Nord J Psychiatry 2018; 72:17-23. [PMID: 28871848 DOI: 10.1080/08039488.2017.1368703] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Firefighters participate in activities with intense physical and psychological stress and are constantly at risk to develop various psychopathological reactions. AIMS To investigate psychological reactions in firefighters one month after devastating wildfires in Greece, during August 2007, which lead to the devastation of large areas and the death of 43 people among whom three were firefighters. METHODS One month after the wildfires, a joint task force of mental health clinicians was organized in order to provide psychological support and to investigate the psychological consequences of wildfires to firefighters. One hundred and two firefighters, living within the fire-devastated area, who were on duty for the whole period of wildfires were interviewed and assessed with the use of several questionnaires and inventories. RESULTS Post-traumatic stress disorder (PTSD) was detected in 18.6% of firefighters. Multiple logistic regression found that existence of fear of dying during firefighting, insomnia and increased scores in neuroticism, as well as in depression subscale of the SCL-90, were significantly associated with greater likelihood for having PTSD. Additionally those firefighters who worked permanently had 70% lower probability of having PTSD vs. those seasonally employed. CONCLUSIONS Insomnia, depressive symptoms, as well as personality characteristics as neuroticism and the perception of fear of imminent death during firefighting operations may precipitate the development of PTSD in firefighters. Within this context, mental health clinicians should be aware that the early detection of these predisposing factors may facilitate the prevention and mitigation of PTSD in firefighters particularly those who are seasonally employed.
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Affiliation(s)
- Constantin Psarros
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Christos Theleritis
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Nikolaos Kokras
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Dimitris Lyrakos
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Angelos Koborozos
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Olga Kakabakou
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Georgios Tzanoulinos
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Panagiota Katsiki
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Joanna Despoina Bergiannaki
- a 1st Department of Psychiatry , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece.,b University Mental Health Research Institute (UMHRI) , Athens , Greece
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Ota Y, Korshunova N, Demura M, Katsuyama M, Katsuyama H, Rahayu SR, Saijoh K. Association between posttraumatic stress disorder (PTSD) severity and ego structure of the Nanai people. Environ Health Prev Med 2017; 22:59. [PMID: 29165146 PMCID: PMC5664442 DOI: 10.1186/s12199-017-0666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A man-made chemical disaster occurred in the Amur River, leading to posttraumatic stress disorder (PTSD) in the Nanai people indigenous to the river's surrounding area. PTSD severity measured by the total scores of Impact of Event Scale-Revised (IES-R) (Total-I) and Clinician-Administered PTSD Scale (CAPS) (Total-C) were not always identical in terms of demographic and ethnocultural characters. It is possible that the results derived using the Total-I and Total-C may differ for persons with different backgrounds and/or individual characteristics. In this study, the associations between PTSD severity and personal characteristics were evaluated. METHODS The study was a field-type survey including 187 randomly selected participants (75 males and 112 females). In addition to Total-I/Total-C, scores for each IES-R/CAPS item, Intrusion, Avoidance, and Hyperarousal, and Ego Structure Test by Ammon (ISTA) score were examined to evaluate their personal characteristics. RESULTS No specific trends in ISTA score were obvious among four groups defined according to Total-I/Total-C. The results of principal component analysis showed that all IES-R/CAPS items contributed positively to the 1st axis but to the 2nd axis in a different manner. ISTA items did not always show correlations to each other, but principal component analysis suggested that Construct contributed positively and Destruct and Deficient (with the exception of Destruct sexuality) contributed negatively. High IES-R scores were associated with Construct Aggression and Deficient Inner demarcation, but high CAPS score was less likely to exhibit Construct Narcissism. CONCLUSION To avoid the misdiagnosis of PTSD, usage of both IES-R/CAPS may be required. Simultaneous application of personality/ego tests may be helpful, but appropriate numbers of their questions would be important.
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Affiliation(s)
- Yoko Ota
- Department of Hygiene, School of Medicine, Kanazawa University, Kanazawa, Japan
| | - Natalia Korshunova
- Department of Hygiene, School of Medicine, Kanazawa University, Kanazawa, Japan
| | - Masashi Demura
- Department of Hygiene, School of Medicine, Kanazawa University, Kanazawa, Japan
| | - Midori Katsuyama
- Department of Hygiene, School of Medicine, Kanazawa University, Kanazawa, Japan
| | - Hironobu Katsuyama
- Department of Public Health, Kawasaki Medical University, Kurashiki, Japan
| | - Sri Ratna Rahayu
- Department of Hygiene, School of Medicine, Kanazawa University, Kanazawa, Japan
| | - Kiyofumi Saijoh
- Department of Hygiene, School of Medicine, Kanazawa University, Kanazawa, Japan.
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Oteir AO, Smith K, Stoelwinder JU, Cox S, Middleton JW, Jennings PA. The epidemiology of pre-hospital potential spinal cord injuries in Victoria, Australia: a six year retrospective cohort study. Inj Epidemiol 2016; 3:25. [PMID: 27747560 PMCID: PMC5065940 DOI: 10.1186/s40621-016-0089-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI. Data was extracted from the AV data warehouse, including demographic details, trauma aetiology, paramedic assessment, management and other event characteristics. RESULTS A total of 106,059cases were included in the study, representing 2.3 % of all emergency transports by AV. Subjects had a median age of 51 years (interquartile range; 29-78) and 52.4 % were males (95 % CI 52-52.7). Males were significantly younger than females (M: 43 years [26-65] vs. F: 64 years [36-84], p =0.001). Falls and traffic accidents were the leading causes of injuries, comprising 46.9 and 39.4 % of cases, respectively. Other causes included accidents due to sport, animals, industrial work and diving, as well as violence and hanging. 29.9 % of patients were transported to a Major Trauma Service (MTS). A proportion of 48.8 % of the study population met the Pre-hospital Major Trauma criteria. CONCLUSION This is the first study to describe the epidemiology of potential TSCI in Australia and is based on a large, state-wide sample. It provides background knowledge and a baseline for future research, as well as a reference point for future in policy. Falling and traffic related injuries were the leading causes of potential SCI. Future research is required to identify the proportion of confirmed TSCI among the potentials and factors associated with TSCI in prehospital settings.
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Affiliation(s)
- Ala'a O Oteir
- Department of Community Emergency Health and Paramedic Practice, Monash University, Building 3, 270 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Karen Smith
- Research and Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Emergency Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Johannes U Stoelwinder
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shelley Cox
- Research and Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, St Leonards and Sydney Medical School-Northern, The University of Sydney, New South Wales, Australia
| | - Paul A Jennings
- Department of Community Emergency Health and Paramedic Practice, Monash University, Building 3, 270 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia. .,Ambulance Victoria, Melbourne, Victoria, Australia. .,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia. .,College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia.
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Kaddis M, Stockton K, Kimble R. Trauma in children due to wheeled recreational devices. J Paediatr Child Health 2016; 52:30-3. [PMID: 26302989 DOI: 10.1111/jpc.12986] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2015] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to describe trauma in children secondary to the use of wheeled recreational devices (WRDs). METHODS This study retrospectively described trauma secondary to use of WRDs sustained by children 16 years or younger over a period of 12 months at two tertiary paediatric hospitals in Brisbane, Queensland. Data were analysed from the Paediatric Trauma Registry at these two facilities. Data were also retrieved from The Commission for Children and Young People and Child Guardian to provide information regarding deaths in Queensland from the use of WRDs for the period January 2004 to September 2013. Outcome measures included age, gender, types of injuries, Injury Severity Scores, admission to Intensive Care, and length of hospital stay for all hospital admissions greater than 24 h. RESULTS A total number of 45 children were admitted with trauma relating to WRDs during the 12 months, representing 5.3% of all trauma admissions of greater than 24 h during this time period. Of these, 34 were male with a median age of 11.0 years (IQR = 9-13). Limbs accounted for the majority (54.5%) of injuries, with other common injuries being spine/cranial fractures (14.5%), lacerations (12.7%), internal organ injuries (9.1%), and intracranial bleeds (9.1%). There were six admissions to the Paediatric Intensive Care Unit and one death. CONCLUSIONS WRDs contribute significantly to injuries sustained by children. A large proportion of these injuries may be preventable, suggesting that mandating the use of protective equipment in Queensland may be of great benefit.
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Affiliation(s)
- Mina Kaddis
- Department of Surgery, The Royal Children's Hospital, Brisbane, Queensland, Australia.,Department of Surgery, Mater Children's Hospital, South Brisbane, Queensland, Australia
| | - Kellie Stockton
- Department of Surgery, The Royal Children's Hospital, Brisbane, Queensland, Australia.,Department of Surgery, Mater Children's Hospital, South Brisbane, Queensland, Australia
| | - Roy Kimble
- Department of Surgery, The Royal Children's Hospital, Brisbane, Queensland, Australia.,Department of Surgery, Mater Children's Hospital, South Brisbane, Queensland, Australia
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Abhilash KPP, Chakraborthy N, Pandian GR, Dhanawade VS, Bhanu TK, Priya K. Profile of trauma patients in the emergency department of a tertiary care hospital in South India. J Family Med Prim Care 2016; 5:558-563. [PMID: 28217583 PMCID: PMC5290760 DOI: 10.4103/2249-4863.197279] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Trauma is an increasing cause of morbidity and mortality in India. This study was done to improve the understanding of the mode of trauma, severity of injuries, and outcome of trauma victims in our hospital. MATERIALS AND METHODS This was a retrospective observational study of all adult trauma patients more than 18-year-old presenting to our emergency department (ED). Details of the incident, injuries, and outcome were noted. RESULTS The ED attended to 16,169 patients during the 3-month study period with 10% (1624/16,169) being adult trauma incidents. The gender distribution was 73.6% males and 26.4% females. The mean age was 40.2 ± 16.7 years. The median duration from time of incident to time of arrival to the ED was 3 h (interquartile range [IQR]: 1.5-6.5) for priority one patients, 3 h (IQR: 1.5-7.7) for priority two patients, and 1.5 h (IQR: 1-7) for priority three patients. The average number of trauma incidents increased by 28% during the weekends. Road traffic accident (RTA) (65%) was the most common mode of injury, followed by fall on level ground (13.5%), fall from height (6.3%), work place injuries (6.3%), and others. Traumatic brain injury was seen in 17% of patients while 13.3% had polytrauma with two-wheeler accidents contributing to the majority. The ED team alone managed 23.4% of patients while the remaining 76.6% required evaluation and treatment by the trauma, surgical teams. The in-hospital mortality rate was 2.3%. Multivariate analysis showed low Glasgow coma score (odds ratio [OR]: 0.65, 95% confidence interval [CI]: 0.55-0.76, P < 0.001) and high respiratory rate (OR: 1.15, 95% CI: 1.07-1.24, P < 0.001) to be independent predictors of mortality among polytrauma victims. CONCLUSIONS RTA and falls are the predominant causes of trauma. A simple physiological variable-based scoring system such as the revised trauma score may be used to prioritize patients with polytrauma.
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Affiliation(s)
| | | | - Gautham Raja Pandian
- Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Thomas Kurien Bhanu
- Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Krishna Priya
- Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India
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Kevric J, O’Reilly GM, Gocentas RA, Hasip O, Pilgrim C, Mitra B. Management of haemodynamically stable patients with penetrating abdominal stab injuries: review of practice at an Australian major trauma centre. Eur J Trauma Emerg Surg 2015; 42:671-675. [DOI: 10.1007/s00068-015-0605-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
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Mills BW, Carter OBJ, Rudd CJ, Mills JK, Ross NP, Ruck JD. Quantification of opportunities for early-stage paramedicine students to practice clinical skills during clinical placements compared with an equal dose of simulation-based workshops. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2015; 1:24-28. [DOI: 10.1136/bmjstel-2015-000040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/19/2015] [Indexed: 12/30/2022]
Abstract
IntroductionA reported advantage of simulation-based learning environments (SLE) over clinical placements (CPs) is that the former can provide a greater number and breadth of opportunities to practice level-appropriate clinical skills compared with the random patient presentations provided during the latter. Although logical and widely accepted as fact, we find no published evidence to demonstrate the magnitude, nor indeed veracity, of this assumption. We therefore sought to quantify the clinical skills practiced by entry-level paramedicine students attending a well-selected CP compared with an equal dosage of SLE.MethodsN=37 first-year paramedicine students completed activity diaries during 3 days of CP and 3 days of SLE. Opportunities to practice clinical skills were quantified and coded as either: level-appropriate, beyond-level or of non-discipline relevance.ResultsDuring SLE, the average student was exposed 226 times to 11 level-appropriate clinical procedures. During CP the average student was exposed 48 times to 24 clinical procedures, the majority relevant to paramedicine (63%), but a minority level-appropriate (38%). Students’ opportunities for supervised, ‘hands on’ practice represented only 10% of exposures in either SLE or CP but in terms of raw numbers of level-appropriate opportunities, SLE provided more than CP (n=23 vs 2).DiscussionOur results confirm that SLE provides substantially more opportunities than CP for students to practice level-appropriate skills and is therefore more appropriate for repetitive practice. However, CP is likely to remain useful to students for practicing interpersonal skills and contextualisation of knowledge within the broader health system. Educators should therefore carefully articulate learning objectives before choosing between SLE and CP.
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Cantwell K, Morgans A, Smith K, Livingston M, Spelman T, Dietze P. Time of Day and Day of Week Trends in EMS Demand. PREHOSP EMERG CARE 2015; 19:425-31. [DOI: 10.3109/10903127.2014.995843] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Korshunova N, Katsuyama H, Demura M, Tanii H, Katsuyama M, Rahayu SR, Bogdanov NA, Solokhina LV, Saijoh K. Posttraumatic stress disorders in the Nanai after pollution of the Amur River: ethnocultural analysis. Environ Health Prev Med 2013; 18:485-93. [PMID: 23780747 PMCID: PMC3824732 DOI: 10.1007/s12199-013-0346-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 05/30/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Chemical pollution of the Amur River has seriously damaged traditions and caused posttraumatic stress disorder (PTSD) among the Nanai, the indigenous people living along this river. This study was performed to clarify the ethnographic characteristics of PTSD in this unique population. METHODS The study group consisted of 75 male and 112 female randomly selected volunteers. PTSD severity measured using scores of the Impact of Event Scale--Revised (Total-I) and Clinical-Administered PTSD Scale (Total-C) was estimated according to demographic and ethnocultural backgrounds, clinical status, and ethnopsychological attitudes toward the Amur River. RESULTS The differences in averages of Total-I and Total-C were not always the same in the groups divided by ethnographic information. Logistic regression analysis with a dependent variable, possibly without PTSD (Total-I <34 and Total-C <40)/possibly with PTSD (either Total-I ≥34 or Total-C ≥40), and categorical independent variables using ethnographic information extracted a low score when 'priority values' and 'the Amur River for me is' was "profession" and a high score when 'dominant role in spousal relationship' was "self," when 'predominant forms of response in stressful situations' was "try to organize," when 'preferred method of medical treatment' was specific for the Nanai, when "rely on something mystical" was manifested, and when the Amur River was believed to be "sacred". CONCLUSION Those with a pragmatic attitude were less likely to have PTSD. However, those who were required to make decisions within close relationships and were intimate with the Nanai tradition and the Amur River had increased likelihood of PTSD.
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Affiliation(s)
- Natalia Korshunova
- />Department of Hygiene, Kanazawa University School of Medicine, Kanazawa, 920-8640 Japan
| | - Hironobu Katsuyama
- />Department of Public Health, Kawasaki Medical University, Kurashiki, Japan
| | - Masashi Demura
- />Department of Hygiene, Kanazawa University School of Medicine, Kanazawa, 920-8640 Japan
| | - Hideji Tanii
- />Department of Hygiene, Kanazawa University School of Medicine, Kanazawa, 920-8640 Japan
| | - Midori Katsuyama
- />Department of Hygiene, Kanazawa University School of Medicine, Kanazawa, 920-8640 Japan
| | - Sri Ratna Rahayu
- />Department of Hygiene, Kanazawa University School of Medicine, Kanazawa, 920-8640 Japan
| | | | - Lyudmila Vasilyevna Solokhina
- />Department of Public Health and Healthcare System Organization, Far Eastern State Medical University, Khabarovsk, Russia
| | - Kiyofumi Saijoh
- />Department of Hygiene, Kanazawa University School of Medicine, Kanazawa, 920-8640 Japan
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Prediction of visual outcomes after open globe injury in children: a 17-year Canadian experience. J AAPOS 2013; 17:43-8. [PMID: 23363881 DOI: 10.1016/j.jaapos.2012.10.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 09/14/2012] [Accepted: 10/10/2012] [Indexed: 01/10/2023]
Abstract
PURPOSE To analyze the predictive value of ocular trauma scoring systems for open globe injury in children, to determine risk factors for poor visual outcome, and to assess circumstances under which trauma occurs. METHODS The medical records of patients <18 years of age who presented with open globe injuries from January 1992 to December 2009 were examined retrospectively. Information recorded included demographic profile; date, time, and place of injury; cause and extent of injury; complications; and final best-corrected visual acuity. Injuries were classified by Ocular Trauma Classification Group guidelines. RESULTS A total of 131 patients were included. Final best-corrected visual acuity was ≥20/40 in 74 patients (56.5%) after mean follow-up of 24.8 months. Injuries occurred more commonly in boys (98/131), and 45% of injuries occurred in children aged ≤5 years (P = 0.001). Injuries were more common indoors (P = 0.003), in the afternoon (P < 0.001), and on Saturdays and Mondays (P = 0.004). Multiple regression analysis identified risk factors for final best-corrected visual acuity <20/40: age <5 years, injuries with retrolimbal involvement, wound length >5 mm, globe rupture, vitreous hemorrhage, and retinal detachment (P < 0.05). CONCLUSIONS Visual outcomes after pediatric open globe injury in this study compare favorably to results reported previously. Knowledge of weekly fluctuations in occurrence may help guide development of prevention strategies. Age <5 years is an independent risk factor for a poorer outcome. The ocular trauma score is useful in assessing prognosis after pediatric open globe injury.
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Abstract
BACKGROUND Occupational, social and recreational routines follow temporal patterns, as does the onset of certain acute medical diseases and injuries. It is not known if the temporal nature of injury and disease transfers into patterns that can be observed in ambulance demand. This review examines eligible study findings that reported temporal (time of day, day of week and seasonal) patterns in ambulance demand. METHODS Electronic searches of Medline and Cumulative Index of Nursing and Allied Health Literature were conducted for papers published between 1980 and 2011. In addition, hand searching was conducted for unpublished government and ambulance service documents and reports for the same period. RESULTS 38 studies examined temporal patterns in ambulance demand. Six studies reported trends in overall workload and 32 studies reported trends in a subset of ambulance demand, either as a specific case type or demographic group. Temporal patterns in overall demand were consistent between jurisdictions for time of day but varied for day of week and season. When analysed by case type, all jurisdictions reported similar time of day patterns, most jurisdictions had similar day of week patterns except for out-of-hospital cardiac arrest and similar seasonal patterns, except for trauma. Temporal patterns in case types were influenced by age and gender. CONCLUSIONS Temporal patterns are present in ambulance demand and importantly these populations are distinct from those found in hospital datasets suggesting that variation in ambulance demand should not be inferred from hospital data alone. Case types seem to have similar temporal patterns across jurisdictions; thus, research where demand is broken down into case types would be generalisable to many ambulance services. This type of research can lead to improvements in ambulance service deliverables.
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Affiliation(s)
- Kate Cantwell
- Department of Epidemiology and Preventive Medicine, Monash University, , Melbourne, Victoria, Australia
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Comparison Overview of Prehospital Errors Involving Road Traffic Fatalities in Victoria, Australia. Prehosp Disaster Med 2012; 24:254-61. [DOI: 10.1017/s1049023x00006890] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIntroduction:Until early 2003, the Consultative Committee on Road Traffic Fatalities (CCRTF) in Victoria, Australia was the main body investigating and publishing data about prehospital errors resulting from road traffic fatalities. The objective of this study was to identify and interpret prehospital error rate trends associated with road traffic fatalities during a 10-year period of the CCRTF reports.Methods:This study is a review of the prehospital errors defined in Victorian CCRTF reports of preventable deaths of road traffic fatalities over a 10-year period.Results:Six CCRTF reports contained prehospital data for errors associated with road traffic fatalities. From 1992 to 1998, system errors decreased.However, over the same timeframe, management, technical, and diagnostic errors increased. There was a marked jump in system, technique, and diagnosis errors from 1998 to 2001–2003. However, management errors declined over the same timeframe. The jump in errors in the 1998 to 2001–2003 timeframe coincided with the introduction of advanced life support (ALS) for Victorian paramedics in 2000.The number of preventable deaths decreased from 1992 to 1998, however, there was an increase from 1999 onwards, coinciding with the introduction of the state trauma system and ALS for paramedics.Conclusions:This study demonstrates that there has been an increase in prehospital error rates, especially from 2000, which coincided with the introduction of ALS for paramedics and the state trauma system in Victoria, even though the state trauma system had an overall decrease in error rates.
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Boyle MJ, Williams B, Dousek S. Do mannequin chests provide an accurate representation of a human chest for simulated decompression of tension pneumothoraxes? World J Emerg Med 2012; 3:265-9. [PMID: 25215075 DOI: 10.5847/wjem.j.issn.1920-8642.2012.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 09/20/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Tension pneumothorax (TPX) is an uncommon but life-threatening condition. It is important that this uncommon presentation, managed by needle decompression, is practised by paramedics using a range of educationally sound and realistic mannequins. The objective of this study is to identify if the chest wall thickness (CWT) of training mannequins used for chest decompression is an anatomically accurate representation of a human chest. METHODS This is a two-part study. A review of the literature was conducted to identify chest wall thickness in humans and measurement of chest wall thickness on two commonly used mannequins. The literature search was conducted using the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, and EMBASE databases from their beginning until the end of May 2012. Key words included chest wall thickness, tension pneumothorax, pneumothorax, thoracostomy, needle thoracostomy, decompression, and needle test. Studies were included if they reported chest wall thickness. RESULTS For the literature review, 4 461 articles were located with 9 meeting the inclusion criteria. Chest wall thickness in adults varied between 1.3 cm and 9.3 cm at the area of the second intercostal space mid clavicular line. The Laerdal(®) manikin in the area of the second intercostal space mid clavicular line, right side of the chest was 1.1 cm thick with the left 1.5 cm. The MPL manikin in the same area or on the right side of the chest was 1.4 cm thick but on the left 1.0 cm. CONCLUSION Mannequin chests are not an accurate representation of the human chest when used for decompressing a tension pneumothorax and therefore may not provide a realistic experience.
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Affiliation(s)
- Malcolm J Boyle
- Department of Community Emergency Health and Paramedic Practice, Frankston 3199, Australia
| | - Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Frankston 3199, Australia
| | - Simon Dousek
- Department of Community Emergency Health and Paramedic Practice, Frankston 3199, Australia
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Introduction of a prehospital critical incident monitoring system--final results. Prehosp Disaster Med 2011; 25:515-20. [PMID: 21181685 DOI: 10.1017/s1049023x00008694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Incident monitoring has been shown to improve patient care and has been adopted widely in the hospital care setting. There are limited data on incident monitoring in the prehospital setting. HYPOTHESIS A high-yield, systems-oriented, incident monitoring process can be implemented successfully in a prehospital setting. METHODS This prospective, descriptive study outlines the implementation of an incident monitoring process in a regional prehospital setting. Both trauma care and non-trauma care were monitored by a system of anonymous reporting and chart review with debriefing for trauma cases that met major trauma criteria. A committee reviewed all identified cases and coded and logged all incidents and provider recommendations. RESULTS There were 454 incidents identified from 230 cases (mean=2.0; 95% CI 1.8-2.1 per case). Anonymous reporting resulted in the identification of 113 incidents from 69 cases (1.6l per case 95% CI=1.4-1.9 per case) Major trauma cases generated 266 incidents from 134 cases (mean=2.0; 95% CI=1.8-2.2 per case), and there were 74 incidents from 26 combined cases (mean=2.9; 95% CI=2.2-3.5 per case). One incident was uncategorized. There were 315 (69.4%) incidents categorized as management problems and 123 (27.1%) were system problems. Prolonged scene time was the most common incident in both management and system categories; 56 (17.8%) and 18 (14.6%) respectively. Mitigating circumstances were found in 111 (24.4%) incidents. The most common incident-related patient outcome was none/near miss (127 (28%)). Incident monitoring most commonly led to generalized feedback (105 (23.1%)) or specific trend analysis (140 (30.8%)). Reports to higher or external bodies occurred in 18 incidents (4.0%). CONCLUSIONS The project has been implemented successfully in a regional prehospital settling. The methodology, utilizing a number of incident detection techniques, results in a high yield of incidents over a broad range of error types. The large proportion of "near miss" type incidents allows for incident assessment without demonstrable patient harm. Many incidents were mitigated and the majority represented management-type issues.
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Michau R, Roberts S, Williams B, Boyle M. An investigation of theory-practice gap in undergraduate paramedic education. BMC MEDICAL EDUCATION 2009; 9:23. [PMID: 19445726 PMCID: PMC2694182 DOI: 10.1186/1472-6920-9-23] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Accepted: 05/18/2009] [Indexed: 05/25/2023]
Abstract
BACKGROUND Bachelor of Emergency Health (Paramedic) (BEH) students at Monash University undertake clinical placements to assist with the transition from student to novice paramedic. Anecdotally, students report a lack of opportunity to practise their clinical skills whilst on placements. The barriers to participation and the theory-practice gap have not been previously documented in Australian paramedic literature. The purpose of this study was to investigate the theory-practice gap for paramedic students by linking education and skill level to case exposure and skills praxis during clinical placements. METHODS A cross-sectional retrospective study using a convenience sample of second and third year BEH undergraduate students. Ethics approval was granted. RESULTS Eighty four second and third year BEH students participated. 59.5% were female (n = 50), 40.5% were male (n = 34). Overall, students most commonly reported exposure to cardiac and respiratory cases and were satisfied with the number of cases encountered during placement. However, over half (n = 46) reported being exposed to < 50% of cases that allowed skills praxis. The most common barrier to participation (34.5%) was the opportunity to participate in patient care and 68% of student's were unsure if paramedics understood their role during clinical placements. CONCLUSION This study demonstrates that the majority of students were satisfied with their clinical placement experience; even though they were exposed to < 50% of cases that allowed skills practice. Identifying these educational barriers will assist in improving the quality and theory-practice gap of paramedic clinical education.
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Affiliation(s)
- Rebecca Michau
- Monash University, Department of Community Emergency Health and Paramedic Practice, PO Box 527, Frankston 3199, Victoria, Australia
| | - Samantha Roberts
- Monash University, Department of Community Emergency Health and Paramedic Practice, PO Box 527, Frankston 3199, Victoria, Australia
| | - Brett Williams
- Monash University, Department of Community Emergency Health and Paramedic Practice, PO Box 527, Frankston 3199, Victoria, Australia
| | - Malcolm Boyle
- Monash University, Department of Community Emergency Health and Paramedic Practice, PO Box 527, Frankston 3199, Victoria, Australia
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Boyle MJ. The experience of linking Victorian emergency medical service trauma data. BMC Med Inform Decis Mak 2008; 8:52. [PMID: 19014622 PMCID: PMC2596105 DOI: 10.1186/1472-6947-8-52] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 11/17/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The linking of a large Emergency Medical Service (EMS) dataset with the Victorian Department of Human Services (DHS) hospital datasets and Victorian State Trauma Outcome Registry and Monitoring (VSTORM) dataset to determine patient outcomes has not previously been undertaken in Victoria. The objective of this study was to identify the linkage rate of a large EMS trauma dataset with the Department of Human Services hospital datasets and VSTORM dataset. METHODS The linking of an EMS trauma dataset to the hospital datasets utilised deterministic and probabilistic matching. The linking of three EMS trauma datasets to the VSTORM dataset utilised deterministic, probabilistic and manual matching. RESULTS There were 66.7% of patients from the EMS dataset located in the VEMD. There were 96% of patients located in the VAED who were defined in the VEMD as being admitted to hospital. 3.7% of patients located in the VAED could not be found in the VEMD due to hospitals not reporting to the VEMD. For the EMS datasets, there was a 146% increase in successful links with the trauma profile dataset, a 221% increase in successful links with the mechanism of injury only dataset, and a 46% increase with sudden deterioration dataset, to VSTORM when using manual compared to deterministic matching. CONCLUSION This study has demonstrated that EMS data can be successfully linked to other health related datasets using deterministic and probabilistic matching with varying levels of success. The quality of EMS data needs to be improved to ensure better linkage success rates with other health related datasets.
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Affiliation(s)
- Malcolm J Boyle
- Monash University, Department of Community Emergency Health and Paramedic Practice, PO Box 527, Frankston 3199, Victoria, Australia.
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Boyle MJ, Smith EC, Archer F. A review of patients who suddenly deteriorate in the presence of paramedics. BMC Emerg Med 2008; 8:9. [PMID: 18655721 PMCID: PMC2516520 DOI: 10.1186/1471-227x-8-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Accepted: 07/26/2008] [Indexed: 11/10/2022] Open
Abstract
Background The report of the Ministerial Review of Trauma and Emergency Services in Victoria, Australia, recommended that paramedics be permitted to divert to the closest hospital in incidences of life threatening situations prior to and during transport. An audit of patients that suddenly deteriorated in paramedic care was recommended by the Ministerial Review. The objective of the study was to identify the number and outcome of patients who suddenly deteriorated in the presence of paramedics. Methods A retrospective cohort study of trauma patients who suddenly deteriorated in the presence of paramedics during 2002. As there was no standard definition, sudden deterioration was defined using a predetermined set of physiological criteria. Patient care record data of patients who suddenly deteriorated were compared with the State Trauma Registry to determine those who sustained hospital defined major trauma. Patient care records where hospital bypass was undertaken were identified and analysed. Ethics committee approval was obtained. Results There were 2,893 patients that suddenly deteriorated according to predefined criteria. 2,687 (5.1% of the total trauma patients for 2002) were suitable for further analysis. The majority of patients had a sudden decrease in BP (n = 2,463) with 4.3% having hospital defined major trauma. For patients with a sudden decrease in conscious state or a total GCS score of less than 13 (n = 77), 37.7% had hospital defined major trauma; and a sudden increase/decrease in pulse rate and sudden decrease in BP (n = 65), 26.2% had hospital defined major trauma. Only 28 documented incidents of hospital bypass were identified. Conclusion This study suggests that the incidents of patients suddenly deteriorating in the presence of paramedics are low and the incidence of hospital bypass is not well documented.
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Affiliation(s)
- Malcolm J Boyle
- Monash University, Department of Community Emergency Health and Paramedic Practice, P.O. Box 527, Frankston 3199, Victoria, Australia.
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Boyle MJ, Williams B, Cooper J, Adams B, Alford K. Ambulance clinical placements--a pilot study of students' experience. BMC MEDICAL EDUCATION 2008; 8:19. [PMID: 18400111 PMCID: PMC2330039 DOI: 10.1186/1472-6920-8-19] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Accepted: 04/10/2008] [Indexed: 05/25/2023]
Abstract
BACKGROUND Undergraduate paramedic students undertake clinical placements in a variety of locations. These placements are considered an essential element for paramedic pre-employment education. However, anecdotal evidence suggests some students have not had positive experiences on their emergency ambulance placements. The objective of this study was to identify the type of experiences had by students during ambulance clinical placements and to provide feedback to the ambulance services. METHODS In this pilot study we employed a cross-sectional study methodology, using a convenience sample of undergraduate paramedic students available in semester one of 2007 to ascertain the students' views on their reception by on-road paramedics and their overall experience on emergency ambulance clinical placements. Ethics approval was granted. RESULTS There were 77 students who participated in the survey, 64% were females, with 92% of students < 25 years of age and 55% < 65 Kg in weight. There was a statistically significant difference in average height between the genders (Male 179 cm vs Female 168 cm, p < 0.001). Clinical instructors were available to 44% of students with 30% of students excluded from patient management. Thirty percent of students felt there was a lot of unproductive down time during the placement. Paramedics remarked to 40% of students that they doubted their ability to perform the physical role of a paramedic, of this group 36% were advised this more than once. CONCLUSION This study demonstrates that for a small group of students, emergency ambulance clinical placements were not a positive experience clinically or educationally. Some qualified paramedics doubt if a number of female students can perform the physical role of a paramedic.
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Affiliation(s)
- Malcolm J Boyle
- Monash University, Department of Community Emergency Health and Paramedic Practice, P.O. Box 527, Frankston 3199, Victoria, Australia
| | - Brett Williams
- Monash University, Department of Community Emergency Health and Paramedic Practice, P.O. Box 527, Frankston 3199, Victoria, Australia
| | - Jennifer Cooper
- Monash University, Department of Community Emergency Health and Paramedic Practice, P.O. Box 527, Frankston 3199, Victoria, Australia
| | - Bridget Adams
- Monash University, Department of Community Emergency Health and Paramedic Practice, P.O. Box 527, Frankston 3199, Victoria, Australia
| | - Kassie Alford
- Monash University, Department of Community Emergency Health and Paramedic Practice, P.O. Box 527, Frankston 3199, Victoria, Australia
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Lesson from Simeulue Island. Prehosp Disaster Med 2005. [DOI: 10.1017/s1049023x00015338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Terror Australis Redux: Revisiting Australian Emergency Department Preparedness for Terrorism. Prehosp Disaster Med 2005. [DOI: 10.1017/s1049023x00014229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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