| 1. |
- Abelsson, Anna, 1971-, et al.
(författare)
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Ambulance Nurses' Competence and Perception of Competence in Prehospital Trauma Care
- 2018
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Ingår i: Emergency Medicine International. - : Hindawi Publishing Corporation. - 2090-2840 .- 2090-2859.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. We focus on trauma care conducted in the context of a simulated traumatic event. This is in this study defined as a four-meter fall onto a hard surface, resulting in severe injuries to extremities in the form of bilateral open femur fractures, an open tibia fracture, and a closed pelvic fracture, all fractures bleeding extensively. Methods. The simulated trauma care competence of 63 ambulance nurses in prehospital emergency care was quantitatively evaluated along with their perception of their sufficiency. Data was collected by means of simulated trauma care and a questionnaire. Results. Life-saving interventions were not consistently performed. Time to perform interventions could be considered long due to the life-threatening situation. In comparison, the ambulance nurses' perception of the sufficiency of their theoretical and practical knowledge and skills for trauma care scored high. In contrast, the perception of having sufficient ethical training for trauma care scored low. Discussion. This study suggests there is no guarantee that the ambulance nurses' perception of theoretical and practical knowledge and skill level corresponds with their performed knowledge and skill. The ambulance nurses rated themselves having sufficient theoretical and practical knowledge and skills while the score of trauma care can be considered quite low.
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| 2. |
- Beyramijam, M, et al.
(författare)
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Disaster Preparedness among Emergency Medical Service Providers: A Systematic Review Protocol
- 2020
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Ingår i: Emergency medicine international. - : Hindawi Limited. - 2090-2840 .- 2090-2859. ; 2020, s. 6102940-
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Tidskriftsartikel (refereegranskat)abstract
- Background. The emergency medical service (EMS) provides first-line medical care to people who require urgent medical care in emergency and disaster situations. Preparedness is the most effective approach for the management of disaster risks, and it is essential for the emergency medical service (EMS) providers, such as paramedics, emergency medical technicians (EMT), and other EMS personnel. This systematic review will explore evidence on the preparedness of emergency medical service providers in emergency and disaster situations by reviewing peer-reviewed journal articles. Methods/Design. This study will be conducted on peer-reviewed articles published between 2005 and 2019 to explore the preparedness of emergency medical service providers in emergencies and disasters. Scopus, Web of Science, PubMed, and Google Scholar will be thoroughly searched to identify published studies on emergency and disaster preparedness. The following keywords will be used for searching the databases: “Medical Technician,” “Paramedic,” “Emergency Paramedic,” “Emergency Medicine Technician,” “Emergency Medical Technician,” “Emergency Prehospital Provider,” “Emergency Preparedness,” “Disaster Preparedness,” “Hospital Preparedness,” “Disaster management,” “Disaster Competencies,” “Disaster Readiness,” “Disaster,” “Disaster Role,” “Readiness, Preparedness, Terrorist,” “Mass Casualty Incident,” “Major incidents,” “Mass Casualty,” “Mass Gathering,” “CBRNE,” “Weapons of Mass Destruction,” and “Chemical, Biological, Radiological, Nuclear, and Explosive Event.” Discussion. To the best of our knowledge, no comprehensive review study has been conducted on the preparedness of emergency medical service providers in disaster situations. This study is the first attempt to address this gap. It will also explore the key dimensions in disaster preparedness of EMS providers and the strategies to enhance their preparedness. Identifying the key dimensions of disaster preparedness is the first step in designing and developing valid instruments to evaluate EMS provider’s disaster preparedness and as well as adopting appropriate strategies to improve the level of their preparedness (This systematic review is registred in PROSPERO with CRD42020149689).
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| 3. |
- Beyramijam, M, et al.
(författare)
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Work-Family Conflict among Iranian Emergency Medical Technicians and Its Relationship with Time Management Skills: A Descriptive Study
- 2020
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Ingår i: Emergency medicine international. - : Hindawi Limited. - 2090-2840 .- 2090-2859. ; 2020, s. 7452697-
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Tidskriftsartikel (refereegranskat)abstract
- Background. Work-Family Conflict (WFC) is a form of interrole conflict in which an active participation in occupational activities causes strain and interferes with family roles of workers and vice versa. It is a major source of occupational stress among workers and personnel. Emergency Medical Technicians (EMTs) are an important part of the healthcare system that respond to emergencies. The EMTs experience high level of job stress, which may affect their ability to perform their family roles, and, on the other hand, actively performing their family responsibilities may interfere with the effective delivery of the already stressful activities at workplace. Objective. The aim of this study was to determine the prevalence of WFC among Emergency Medical Technicians in Iran and its relationship with time management skills. Methods. This was a descriptive study. In this study, 271 EMTs from the western part of Iran completed the questionnaire for the assessment of WFC. The Carlson Family-Conflict Questionnaire and the “Time Management Behaviors Scale” developed by Macan were used as evaluation instruments. The data were analyzed by SPSS software version 16. Appropriate statistical analysis such as mean and standard deviation, Pearson correlation, and Spearman rank correlation was applied for analyzing the data in SPSS. Results. The majority of the participants reported some degrees of WFC. Statistical analysis showed a significant inverse correlation between total WFC score and total “Time Management Behaviors scale” score (r = −0/381، p<0/0001). In the present study, there was no significant correlation between total WFC score and demographic factors such as educational level, age, sex, marital status, number of family members, need for family member care, and work experience (p>0.05). Conclusions. The findings of this study indicate that time management behaviors and skills can reduce WFC among Emergency Medical Technicians. Therefore, it is recommended that prehospital emergency authorities and policymakers plan and implement measures such as reducing the duration of shift-work schedules, decreasing shift-change restrictions, and organizing regular time management courses. Also, employment of local inhabitants is preferred to geographically distant individuals with similar qualification as this will reduce the distance between home and workplace.
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| 4. |
- Hvarfner, Anna, et al.
(författare)
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Vital Signs Directed Therapy for the Critically Ill : Improved Adherence to the Treatment Protocol Two Years after Implementation in an Intensive Care Unit in Tanzania
- 2020
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Ingår i: Emergency Medicine International. - : HINDAWI LTD. - 2090-2840 .- 2090-2859. ; 2020
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Tidskriftsartikel (refereegranskat)abstract
- Treating deranged vital signs is a mainstay of critical care throughout the world. In an ICU in a university hospital in Tanzania, the implementation of the Vital Signs Directed Therapy Protocol in 2014 led to an increase in acute treatments for deranged vital signs. The mortality rate for hypotensive patients decreased from 92% to 69%. In this study, the aim was to investigate the sustainability of the implementation two years later. An observational, patient-record-based study was conducted in the ICU in August 2016. Data on deranged vital signs and acute treatments were extracted from the patients' charts. Adherence to the protocol, defined as an acute treatment in the same or subsequent hour following a deranged vital sign, was calculated and compared with before and immediately after implementation. Two-hundred and eighty-nine deranged vital signs were included. Adherence was 29.8% two years after implementation, compared with 16.6% (p<0.001) immediately after implementation and 2.9% (p<0.001) before implementation. Consequently, the implementation of the Vital Signs Directed Therapy Protocol appears to have led to a sustainable increase in the treatment of deranged vital signs. The protocol may have potential to improve patient safety in other settings where critically ill patients are managed.
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| 5. |
- Jemt, Erik, et al.
(författare)
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Outcomes in Emergency Department Patients with Dyspnea versus Chest Pain : A Retrospective Consecutive Cohort Study
- 2022
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Ingår i: Emergency Medicine International. - : Hindawi Limited. - 2090-2840 .- 2090-2859. ; 2022, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Dyspnea and chest pain are major and important causes of contact at the emergency department (ED). Dyspnea is associated with high morbidity and mortality, but data on characteristics and outcomes compared with chest pain in the ED are limited. This was a retrospective cohort study of consecutive patients with contact causes of dyspnea or chest pain at two Swedish EDs from 2010 to 2014. Hospital admittance, ED revisits, and mortality were analyzed using multivariable regression models, adjusted for ED and markers of disease severity (age, sex, centre, Charlson comorbidity index, c-reactive protein, troponin T, and arrival by ambulance). 29,291 patients (mean age 58.3 years; 48.9% women) with dyspnea (n = 8,812) or chest pain (n = 20,479) were included. Dyspnea patients were older than patients with chest pain (64 vs. 56 years, p < 0.001) and had more comorbidity and higher average blood troponin T and c-reactive protein levels. Dyspnea patients also had higher hospitalization rates (48% vs. 30%; adjOR (95% CI) 2.1-2.3), including the intensive care unit (1.4% vs. 0.1%; adjOR 6.9-15.9), and more ED revisits (11% vs. 7%; adjOR 1.2-1.7) in 30 days. Dyspnea patients had five-fold increased mortality compared to those with chest pain; hazard ratio (HR) 5.1 (4.8-5.4), adjusted for markers of disease severity, the mortality was two-fold higher, HR 2.2 (2.0-2.4). Compared with chest pain patients, ED dyspnea patients are older, have more comorbidity, and have worse outcomes in terms of hospitalization, morbidity, and mortality.
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| 6. |
- Kayambankadzanja, Raphael Kazidule, et al.
(författare)
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Inability to Walk Predicts Death among Adult Patients in Hospitals in Malawi
- 2019
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Ingår i: Emergency Medicine International. - : HINDAWI LTD. - 2090-2840 .- 2090-2859.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Vital signs are often used in triage, but some may be difficult to assess in low-resource settings. A patient's ability to walk is a simple and rapid sign that requires no equipment or expertise. This study aimed to determine the predictive performance for death of an inability to walk among hospitalized Malawian adults and to compare its predictive value with the vital signs-based National Early Warning Score (NEWS).Methods: It is a prospective cohort study of adult in-patients on selected days in two hospitals in Malawi. Patients were asked to walk five steps with close observation and their vital signs were assessed. Sensitivities, specificities, and predictive values for in-patient death of an inability to walk were calculated and an inability to walk was compared with NEWS.Results: Four-hundred and forty-three of the 1094 participants (40.5%) were unable to walk independently. In this group, 70 (15.8 %) died in-hospital compared to 16 (2.5%) among those who could walk: OR 7.4 (95% CI 4.3-13.0 p<0.001). Inability to walk had a sensitivity for death of 81.4%, specificity of 63.0%, positive predictive value (PPV) of 15.8%, and negative predictive value (NPV) of 97.5%. NEWS>6 had sensitivity 70.9%, specificity 70.6%, PPV 17.1%, and NPV 96.6%. An inability to walk had a fair concordance with NEWS>6 (kappa 0.21).Conclusion: Inability to walk predicted mortality as well as NEWS among hospitalized adults in Malawi. Patients who were able to walk had a low risk of death. Walking ability could be considered an additional vital sign and may be useful for triage.
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| 7. |
- Khankeh, H, et al.
(författare)
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National Health-Oriented Hazard Assessment in Iran Based on the First Priority for Action in Sendai Framework for Disaster Risk Reduction 2015-2030
- 2021
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Ingår i: Emergency medicine international. - : Hindawi Limited. - 2090-2840 .- 2090-2859. ; 2021, s. 5593223-
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Tidskriftsartikel (refereegranskat)abstract
- Background. Understanding disaster risk is the first priority for action based on the Sendai Framework for Disaster Risk Reduction 2015–2030 (SFDRR), and hazard assessment is the first step in the assessment of disaster risks. Therefore, assessing health-oriented hazards is the first measure in disaster risk assessment in the medical universities area in Iran. This article introduces a national experience and results obtained from designing a national tool for defining and assessment of health-oriented hazards in Iran. Methods. In the present study, a National Health-Oriented Hazard Assessment tool (NHHAT) was developed by experts and implemented by the Iranian Ministry of Health for gathering data according to frequency, probability, magnitude, and vulnerability of the hazards to identify the first ten hazards of medical universities in the two decades ago (2000–2021). Finally, the top 20 health-oriented hazards were identified among the ten hazards reported by each university. Results. According to the findings, the four most important hazards were road traffic accidents, earthquakes, drought, and seasonal floods. Nevertheless, the hazards such as desertification, tunnel events, soil liquefaction, mass population movement, and sea progression were among the rarest ones reported in the medical universities in Iran. Conclusion. Many functional aspects of disaster risk management depend on the realistic and accurate information related to the main elements of risk, especially the probable hazards in the communities. The comprehensive hazard assessment can only provide such information using context-bond tools. This is an applied study and a national implementation to fulfill the priority of the Sendai framework (i.e., understanding disasters risk) in Iran. It is suggested that other countries should also compile standard tools to explore the hazards for designing up-to-date hazard maps.
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| 8. |
- Makinen, M, et al.
(författare)
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Trainers' Attitudes towards Cardiopulmonary Resuscitation, Current Care Guidelines, and Training
- 2016
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Ingår i: Emergency medicine international. - : Hindawi Limited. - 2090-2840 .- 2090-2859. ; 2016, s. 3701468-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Studies have shown that healthcare personnel hesitate to perform defibrillation due to individual or organisational attitudes. We aimed to assess trainers’ attitudes towards cardiopulmonary resuscitation and defibrillation (CPR-D), Current Care Guidelines, and associated training.Methods. A questionnaire was distributed to CPR trainers attending seminars in Finland (N=185) focusing on the updated national Current Care Guidelines 2011. The questions were answered using Likert scale (1 = totally disagree, 7 = totally agree). Factor loading of the questionnaire was made using maximum likelihood analysis and varimax rotation. Seven scales were constructed (Hesitation,Nurse’s Role,Nontechnical Skill,Usefulness,Restrictions,Personal, andOrganisation). Cronbach’s alphas were 0.92–0.51. Statistics were Student’st-test, ANOVA, stepwise regression analysis, and Pearson Correlation.Results. The questionnaire was returned by 124/185, 67% CPR trainers, of whom two-thirds felt that their undergraduate training in CPR-D had not been adequate. Satisfaction with undergraduate defibrillation training correlated with theNontechnical Skillsscale (p<0.01). Participants scoring high onHesitationscale (p<0.01) were less confident about theirNurse’s Role(p<0.01) andNontechnical Skills(p<0.01).Conclusion. Quality of undergraduate education affects the work of CPR trainers and some feel uncertain of defibrillation. The train-the-trainers courses and undergraduate medical education should focus more on practical scenarios with defibrillators and nontechnical skills.
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| 9. |
- Pikwer, Andreas, et al.
(författare)
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The Patient's Gender Influencing the Accuracy of Diagnosis and Proposed Sepsis Treatment in Constructed Cases
- 2020
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Ingår i: Emergency Medicine International. - : HINDAWI LTD. - 2090-2840 .- 2090-2859. ; 2020
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Tidskriftsartikel (refereegranskat)abstract
- Background. Male sex is an independent risk factor for sepsis development. In addition to immunological gender differences, women less often receive sepsis treatment once diagnosed. Gender differences have also been described in other medical conditions, such as acute coronary syndrome.Aim. To study whether the gender of patients influenced physicians' tendency to suspect sepsis and propose correct initial sepsis treatment in constructed cases.Method. Four cases were constructed to fulfil the sepsis-3 criteria as well as raise clinical suspicions of other common medical differential diagnoses. Two of the cases were drafted in two versions, only differing in the gender of the patient. The two versions were randomly distributed to all clinical physicians in a medical region in Sweden. The responding physicians were asked to state the three most important diagnoses and the three most important initial treatments for each case. If sepsis were among the stated diagnoses together with fluids and antibiotics, the case was considered as correctly identified and initially treated sepsis.Results. 120 hospital physicians answered the cases. In the case the patient was a female, the respondents correctly identified and treated sepsis significantly more often than if the patient was of the male sex (Case 1: 12/58 vs 2/62,p<0.01and Case 2: 25/62 vs 13/58,p<0.05).Conclusion. A low proportion of Swedish physicians identified and proposed treatment for sepsis in four constructed cases. In the case the patient strongly mimicked other diagnoses common in the male sex, the male cases were less often correctly identified and treated for sepsis.
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| 10. |
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