A. Carnicelli, Anne-Marie M Williams, Dale G. Edwards
Introduction The study of human anatomy forms a foundational knowledge base essential for healthcare professional practice including paramedicine. However, little is known about the experiences and perceptions of undergraduate student paramedics towards learning anatomy. The aim of this study was to investigate this, utilising a questionnaire previously validated in medical students. Methods To explore anatomy learning experiences, a 32-item anatomy learning experiences questionnaire (ALEQ) modified for use with paramedicine students was distributed online to students enrolled in the Bachelor of Paramedic Practice at the University of Tasmania. Quantitative statistics were used to identify differences in responses between student groups. Cronbach's alpha assessed the reliability of the modified ALEQ. Results Fifty-one usable responses were obtained (20% response rate). Psychometric analysis demonstrated good overall reliability (Cronbach's alpha of 0.88). The students perceived several learning activities as positive including textbooks, online learning and practical classes. However, it was generally felt the amount of content to learn was daunting. Furthermore, the students indicated working with cadavers would be highly beneficial for their learning. The relevance of anatomy was also recognised as being important to future clinical practice. Conclusion Despite the low response rate, the modified ALEQ was a reliable instrument to investigate the anatomy learning experiences and perceptions of paramedicine students. Further research with a larger cohort is required to confirm the reliability and generalisability of the results.
{"title":"Investigating the Anatomy Learning Experiences of Undergraduate Paramedic Students","authors":"A. Carnicelli, Anne-Marie M Williams, Dale G. Edwards","doi":"10.33151/ajp.19.1016","DOIUrl":"https://doi.org/10.33151/ajp.19.1016","url":null,"abstract":"Introduction The study of human anatomy forms a foundational knowledge base essential for healthcare professional practice including paramedicine. However, little is known about the experiences and perceptions of undergraduate student paramedics towards learning anatomy. The aim of this study was to investigate this, utilising a questionnaire previously validated in medical students. Methods To explore anatomy learning experiences, a 32-item anatomy learning experiences questionnaire (ALEQ) modified for use with paramedicine students was distributed online to students enrolled in the Bachelor of Paramedic Practice at the University of Tasmania. Quantitative statistics were used to identify differences in responses between student groups. Cronbach's alpha assessed the reliability of the modified ALEQ. Results Fifty-one usable responses were obtained (20% response rate). Psychometric analysis demonstrated good overall reliability (Cronbach's alpha of 0.88). The students perceived several learning activities as positive including textbooks, online learning and practical classes. However, it was generally felt the amount of content to learn was daunting. Furthermore, the students indicated working with cadavers would be highly beneficial for their learning. The relevance of anatomy was also recognised as being important to future clinical practice. Conclusion Despite the low response rate, the modified ALEQ was a reliable instrument to investigate the anatomy learning experiences and perceptions of paramedicine students. Further research with a larger cohort is required to confirm the reliability and generalisability of the results.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126288092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aidan Baron, J. Hodgson, Gerrie Beirne, A. Quinton, J. Bendall
Unlike practitioners of formal diagnostic sonography, point-of-care ultrasound users must often acquire basic ultrasound skills in far shorter time frames, with less time dedicated to obtaining mastery; therefore, they often rely on conceptual models to achieve this. There is currently no introductory model which point-of-care ultrasound users might adopt to describe the cognitive processes involved in acquiring a basic ultrasound image, and in learning point-of-care ultrasonography. We propose the ‘sonographic OODA loop’ in reference to Boyd's observe–orient–decide–act (OODA) decision loop, as a model which can be used initially by ultrasound-naive clinicians to understand the cognitive and motor processes that occur when they acquire ultrasound images, and hopefully achieve greater insight into their early practice.
{"title":"The Sonographic Ooda Loop: Proposing a Beginner's Model for Learning Point-Of-Care Ultrasound","authors":"Aidan Baron, J. Hodgson, Gerrie Beirne, A. Quinton, J. Bendall","doi":"10.33151/ajp.19.948","DOIUrl":"https://doi.org/10.33151/ajp.19.948","url":null,"abstract":"Unlike practitioners of formal diagnostic sonography, point-of-care ultrasound users must often acquire basic ultrasound skills in far shorter time frames, with less time dedicated to obtaining mastery; therefore, they often rely on conceptual models to achieve this. There is currently no introductory model which point-of-care ultrasound users might adopt to describe the cognitive processes involved in acquiring a basic ultrasound image, and in learning point-of-care ultrasonography. We propose the ‘sonographic OODA loop’ in reference to Boyd's observe–orient–decide–act (OODA) decision loop, as a model which can be used initially by ultrasound-naive clinicians to understand the cognitive and motor processes that occur when they acquire ultrasound images, and hopefully achieve greater insight into their early practice.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132348803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction The aim of this study was to provide a snapshot of Australian remote and industrial paramedics’ patient clinical presentations, experience with physician consultations and options for patient transport to tertiary care. Methods This exploratory, cross-sectional descriptive study employed a purpose-built online survey. Participants were 78 paramedics working in Australian rural and remote industrial settings recruited in 2015 using web-based, respondent-driven sampling. In addition to a series of closed ended questions, respondents were asked to recall the number of times they encountered specific clinical presentations during the past year. Data were analysed using descriptive statistics and modes were calculated for ordinal data associated with clinical presentations. Results The traumatic presentations that participants recalled encountering at least 10 times the preceding year included back pain (39.7%), minor lacerations (38.5%), joint (36.4%) and hand (30.8%) injuries. Respondents selected headache (64.1%), nausea, vomiting or diarrhoea (52.6%), respiratory infections (50%), ear, nose or throat problems (43.6%) and localised infections or rash (39.7%) as the most common medical presentations. Of the respondents, 38.4% managed patients with mental health presentations a minimum of six times in the preceding year, and 45.3% treated at least one patient in cardiac arrest. While 94.8% of participants said topside support was available, over half described consulting physicians infrequently and if they did, it was typically by telephone. Most respondents (61%) indicated that their worksite was located over 100 km from a hospital. Conclusion Survey findings indicate that paramedic participants recall encountering a wide range of clinical presentations and managing low acuity illnesses more commonly than traumatic injuries. Most respondents were located at least 100 km from the nearest hospital and although almost all had access to topside support, over half stated they consulted physicians infrequently.
{"title":"Clinical Presentations, Physician Consultations and Patient Transport Options for Australian Remote and Industrial Paramedics","authors":"Tania Johnston, Joseph Acker","doi":"10.33151/ajp.19.1011","DOIUrl":"https://doi.org/10.33151/ajp.19.1011","url":null,"abstract":"Introduction The aim of this study was to provide a snapshot of Australian remote and industrial paramedics’ patient clinical presentations, experience with physician consultations and options for patient transport to tertiary care. Methods This exploratory, cross-sectional descriptive study employed a purpose-built online survey. Participants were 78 paramedics working in Australian rural and remote industrial settings recruited in 2015 using web-based, respondent-driven sampling. In addition to a series of closed ended questions, respondents were asked to recall the number of times they encountered specific clinical presentations during the past year. Data were analysed using descriptive statistics and modes were calculated for ordinal data associated with clinical presentations. Results The traumatic presentations that participants recalled encountering at least 10 times the preceding year included back pain (39.7%), minor lacerations (38.5%), joint (36.4%) and hand (30.8%) injuries. Respondents selected headache (64.1%), nausea, vomiting or diarrhoea (52.6%), respiratory infections (50%), ear, nose or throat problems (43.6%) and localised infections or rash (39.7%) as the most common medical presentations. Of the respondents, 38.4% managed patients with mental health presentations a minimum of six times in the preceding year, and 45.3% treated at least one patient in cardiac arrest. While 94.8% of participants said topside support was available, over half described consulting physicians infrequently and if they did, it was typically by telephone. Most respondents (61%) indicated that their worksite was located over 100 km from a hospital. Conclusion Survey findings indicate that paramedic participants recall encountering a wide range of clinical presentations and managing low acuity illnesses more commonly than traumatic injuries. Most respondents were located at least 100 km from the nearest hospital and although almost all had access to topside support, over half stated they consulted physicians infrequently.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132596407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
“Change is the law of life, and those who look only to the past or present are certain to miss the future.” John F Kennedy The Australasian College of Paramedicine (ACP) has a distinguished history of supporting, promoting and disseminating research in paramedicine. Central to that outcome has been its longstanding commitment to scientific journal publishing by way of what is currently our journal, the Australasian Journal of Paramedicine. In November 2021, AJP commenced a hiatus on new submissions that will continue until mid-2022. An interim Editor in Chief, Associate Professor Paul Simpson, was appointed to oversee the operations concurrent to a transition strategy being developed. A Journal Advisory Committee (‘JAC’) with international membership was tasked to advise the College on the future direction of the College’s Journal. The JAC have consulted widely with researchers in and outside of paramedicine, and with experienced leaders in the journal publishing space, to identify best practice models that will be sustainable and give the Journal the best opportunity to grow and prosper into the future. It is expected that the new Journal will launch in early 2023, heralding a new decade of excellence and progression with a stronger international focus and a resolute commitment to progressing the scientific discourse in paramedicine. The reopening of submissions for the first edition of the relaunched journal is expected in October 2022.
{"title":"A New Era of Opportunity – Securing Excellence for Our Journal","authors":"P. Simpson","doi":"10.33151/ajp.19.1032","DOIUrl":"https://doi.org/10.33151/ajp.19.1032","url":null,"abstract":"“Change is the law of life, and those who look only to the past or present are certain to miss the future.”\u0000\u0000John F Kennedy\u0000\u0000The Australasian College of Paramedicine (ACP) has a distinguished history of supporting, promoting and disseminating research in paramedicine. Central to that outcome has been its longstanding commitment to scientific journal publishing by way of what is currently our journal, the Australasian Journal of Paramedicine.\u0000In November 2021, AJP commenced a hiatus on new submissions that will continue until mid-2022. An interim Editor in Chief, Associate Professor Paul Simpson, was appointed to oversee the operations concurrent to a transition strategy being developed. A Journal Advisory Committee (‘JAC’) with international membership was tasked to advise the College on the future direction of the College’s Journal. The JAC have consulted widely with researchers in and outside of paramedicine, and with experienced leaders in the journal publishing space, to identify best practice models that will be sustainable and give the Journal the best opportunity to grow and prosper into the future.\u0000It is expected that the new Journal will launch in early 2023, heralding a new decade of excellence and progression with a stronger international focus and a resolute commitment to progressing the scientific discourse in paramedicine. The reopening of submissions for the first edition of the relaunched journal is expected in October 2022.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"307 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114866703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The body's natural defences are breached during invasive procedures conducted during paramedic clinical care. Despite the complexity of these procedures, asepsis is a clinical goal for all invasive procedures. In doing so, it is critical that ‘key-parts’ and ‘key-sites’ are protected to decrease the risk of transmitting healthcare-associated infections (HAIs). Although a national framework in Australia for the prevention of HAIs exists, this advice needs adapting to the field of paramedicine to account for variation in practice setting and clinical practice. This project aimed to reach consensus among experts regarding how to maintain asepsis in paramedic practice. Method A modified Delphi process was used with four iterative online rounds. Participants were sought nationally using a snowball (bias) technique and included professionals within healthcare who met the inclusion criteria of extensive experience in one or more of three areas: paramedicine, infection prevention and control, and evidence-based policy development. Results Eleven experts in the field of IPC and paramedicine contributed to a consensus project regarding how to maintain asepsis in paramedic practice. Conclusion This project provides a consensus statement that will allow operational procedures to be reviewed, techniques specific to paramedic practice to be developed and implemented, and scientific research to be conducted.
{"title":"Maintaining Asepsis in Paramedicine: A Delphi Study: Asepsis in Paramedicine","authors":"N. Barr, Matthew Mason, Lisa Clegg, F. Randall","doi":"10.33151/ajp.19.954","DOIUrl":"https://doi.org/10.33151/ajp.19.954","url":null,"abstract":"Background The body's natural defences are breached during invasive procedures conducted during paramedic clinical care. Despite the complexity of these procedures, asepsis is a clinical goal for all invasive procedures. In doing so, it is critical that ‘key-parts’ and ‘key-sites’ are protected to decrease the risk of transmitting healthcare-associated infections (HAIs). Although a national framework in Australia for the prevention of HAIs exists, this advice needs adapting to the field of paramedicine to account for variation in practice setting and clinical practice. This project aimed to reach consensus among experts regarding how to maintain asepsis in paramedic practice. Method A modified Delphi process was used with four iterative online rounds. Participants were sought nationally using a snowball (bias) technique and included professionals within healthcare who met the inclusion criteria of extensive experience in one or more of three areas: paramedicine, infection prevention and control, and evidence-based policy development. Results Eleven experts in the field of IPC and paramedicine contributed to a consensus project regarding how to maintain asepsis in paramedic practice. Conclusion This project provides a consensus statement that will allow operational procedures to be reviewed, techniques specific to paramedic practice to be developed and implemented, and scientific research to be conducted.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124200217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Health care workers employed in the ambulance service should minimize their response time when responding to a medical emergency. Prehospital emergency medical services operate on a 24-h basis; hence, time management in both the work and social lives of the staff is more difficult than in other occupational groups. In the case of emergency health services, time management is no doubt the most important aspect in terms of human health. The purpose of this research was to examine the time management skills and influencing factors of health care workers employed in the ambulance service. Methods In this cross-sectional study, a questionnaire containing time management inventory (TMI) and demographics was applied. In the analysis of the data, the number, chi square, percentage, and t test were applied using SPSS statistical software. Results Of those who participated in the survey, 57.8% were male, 86.2% were working at the emergency medical service station, and 49.9% were paramedics. The average TMI was 70.49. In the time-consumption subdimension of the survey, when the genders of the health care workers who were employed in the ambulance service were compared, there was a statistically significant difference according to education status for the total time management. Conclusion A statistically significant difference was observed with regards to education status for the total time management according to gender for the time loss subdimension of the healthcare workers employed in the ambulance service. This research concluded that males working in the ambulance service managed their use of time better than the females, and that high school graduates used their time better than the undergraduates.
{"title":"Time Management Attitudes of Health Care Workers Employed in the Ambulance Service in Turkey","authors":"İ. Çelebi, Gülbahar Alkaş","doi":"10.33151/ajp.19.965","DOIUrl":"https://doi.org/10.33151/ajp.19.965","url":null,"abstract":"Introduction Health care workers employed in the ambulance service should minimize their response time when responding to a medical emergency. Prehospital emergency medical services operate on a 24-h basis; hence, time management in both the work and social lives of the staff is more difficult than in other occupational groups. In the case of emergency health services, time management is no doubt the most important aspect in terms of human health. The purpose of this research was to examine the time management skills and influencing factors of health care workers employed in the ambulance service. Methods In this cross-sectional study, a questionnaire containing time management inventory (TMI) and demographics was applied. In the analysis of the data, the number, chi square, percentage, and t test were applied using SPSS statistical software. Results Of those who participated in the survey, 57.8% were male, 86.2% were working at the emergency medical service station, and 49.9% were paramedics. The average TMI was 70.49. In the time-consumption subdimension of the survey, when the genders of the health care workers who were employed in the ambulance service were compared, there was a statistically significant difference according to education status for the total time management. Conclusion A statistically significant difference was observed with regards to education status for the total time management according to gender for the time loss subdimension of the healthcare workers employed in the ambulance service. This research concluded that males working in the ambulance service managed their use of time better than the females, and that high school graduates used their time better than the undergraduates.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122219973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Australian paramedics are frequently exposed to traumatic incidents as part of their role, and subsequently are at increased risk of mental health issues and negative impacts on psychological wellbeing. Evidence suggests student and early career paramedics are also at risk of trauma exposure during clinical placements. Increased levels of resilience are known to be protective against the risks of trauma exposure, and both age and experience may impact resilience. Self-efficacy is also known to influence resilience, however there is limited knowledge regarding the personal factors related to increased resilience in undergraduate and early career paramedic science students. This study aims to examine if resilience differs between age or experience groups, and if controlling for self-efficacy influences these differences. Methods An anonymous online survey was administered to current student paramedics and graduates from a regional Australian university. In addition to demographic characteristics, respondents completed the Brief Resilience Scale and the General Self-Efficacy Scale. Analysis of variance examined differences in resilience score based on age and clinical placement experience groups. Follow up analysis of covariance was conducted to control for self-efficacy scores. Results Analysis showed resilience scores differed between age groups (F(4,54)=3.26 p=0.02. Those 26 to 30 years of age reported significantly higher resilience compared to those 18 to 25 years of age. When controlling for self-efficacy, significant differences were found between clinical placement experience groups F(4,51)=2.72, p=0.04). Those completing 200 to 360 hours had significantly lower scores compared to those with less than 200 hours, 360 to 600 hours, or more than 600 hours. Conclusion We show that self-efficacy moderates resilience in undergraduate paramedic students. Examining the impact of self-efficacy training on resilience may be an important next step in curriculum development.
{"title":"Exploring Resilience in Undergraduate and Early Career Paramedics","authors":"Katie Mann, S. Delport, R. Stanton, D. Every","doi":"10.33151/ajp.18.894","DOIUrl":"https://doi.org/10.33151/ajp.18.894","url":null,"abstract":"Introduction Australian paramedics are frequently exposed to traumatic incidents as part of their role, and subsequently are at increased risk of mental health issues and negative impacts on psychological wellbeing. Evidence suggests student and early career paramedics are also at risk of trauma exposure during clinical placements. Increased levels of resilience are known to be protective against the risks of trauma exposure, and both age and experience may impact resilience. Self-efficacy is also known to influence resilience, however there is limited knowledge regarding the personal factors related to increased resilience in undergraduate and early career paramedic science students. This study aims to examine if resilience differs between age or experience groups, and if controlling for self-efficacy influences these differences. Methods An anonymous online survey was administered to current student paramedics and graduates from a regional Australian university. In addition to demographic characteristics, respondents completed the Brief Resilience Scale and the General Self-Efficacy Scale. Analysis of variance examined differences in resilience score based on age and clinical placement experience groups. Follow up analysis of covariance was conducted to control for self-efficacy scores. Results Analysis showed resilience scores differed between age groups (F(4,54)=3.26 p=0.02. Those 26 to 30 years of age reported significantly higher resilience compared to those 18 to 25 years of age. When controlling for self-efficacy, significant differences were found between clinical placement experience groups F(4,51)=2.72, p=0.04). Those completing 200 to 360 hours had significantly lower scores compared to those with less than 200 hours, 360 to 600 hours, or more than 600 hours. Conclusion We show that self-efficacy moderates resilience in undergraduate paramedic students. Examining the impact of self-efficacy training on resilience may be an important next step in curriculum development.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120914032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alison Coppola, M. Smyth, S. Black, Sasha Johnston, R. Endacott
Background Pulseless electrical activity (PEA) is managed in accordance with international and national guidelines. These guidelines are not fully evidenced, resulting in emergency medical services in the United Kingdom amending guidelines to support paramedics when making resuscitation decisions. This review examined the local guidelines of services to identify the local clinical management of PEA, summarise the available evidence and prioritise future research. Methods The review was conducted according to the Joanna Briggs Institute systematic review of text and opinion. The review included locally amended guidelines and cited evidence sources for the management of PEA. A three-step search strategy was applied. Textual data was extracted to form conclusions which were categorised into similar meaning and developed into synthesised findings. Results Twenty-two documents met the inclusion criteria; Twenty-seven conclusions were extracted and analysed to generate 10 categories, forming three synthesised themes: the variability in the clinical management of PEA between ambulance services; the early identification of reversible causes and appropriate treatment options to increase survivability; and the consensus for further research. Conclusion This review identified variability in the clinical management of PEA; the autonomy of paramedics, which patients to transport to hospital and the factors applied to inform resuscitation decisions. A summary of the evidence in support of the local guidelines found that the early identification and treatment to reverse the cause of PEA was important to patient survival, however, this was acknowledged as complex and challenging to achieve. There was a consensus to improve patient outcomes using prognostic research.
{"title":"The Regional Resuscitation Guidelines for Pulseless Electrical Activity in Emergency Medical Services in the United Kingdom: A Systematic Review","authors":"Alison Coppola, M. Smyth, S. Black, Sasha Johnston, R. Endacott","doi":"10.33151/ajp.18.928","DOIUrl":"https://doi.org/10.33151/ajp.18.928","url":null,"abstract":"Background Pulseless electrical activity (PEA) is managed in accordance with international and national guidelines. These guidelines are not fully evidenced, resulting in emergency medical services in the United Kingdom amending guidelines to support paramedics when making resuscitation decisions. This review examined the local guidelines of services to identify the local clinical management of PEA, summarise the available evidence and prioritise future research. Methods The review was conducted according to the Joanna Briggs Institute systematic review of text and opinion. The review included locally amended guidelines and cited evidence sources for the management of PEA. A three-step search strategy was applied. Textual data was extracted to form conclusions which were categorised into similar meaning and developed into synthesised findings. Results Twenty-two documents met the inclusion criteria; Twenty-seven conclusions were extracted and analysed to generate 10 categories, forming three synthesised themes: the variability in the clinical management of PEA between ambulance services; the early identification of reversible causes and appropriate treatment options to increase survivability; and the consensus for further research. Conclusion This review identified variability in the clinical management of PEA; the autonomy of paramedics, which patients to transport to hospital and the factors applied to inform resuscitation decisions. A summary of the evidence in support of the local guidelines found that the early identification and treatment to reverse the cause of PEA was important to patient survival, however, this was acknowledged as complex and challenging to achieve. There was a consensus to improve patient outcomes using prognostic research.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122059670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Saberian, Negin Mousaeinezhad, Parisa Hasani-Sharamin, H. Mohammadi, Mahnaz Jamshididana, Alireza Baratloo
Introduction It has been well established that if a person is aware that they are being monitored their commitment and effort will be maximised (the Hawthorne effect), which then leads to efficiency increase and optimal workflow. Objective Our aim was to evaluate the efficacy of instant feedback and the Hawthorne effect of this intervention on pre-hospital time indexes during emergency medical service (EMS) missions. Methods This is a cross-sectional auditing study on the missions of the Tehran EMS Center (performed over a 12-month period) in three phases: pre-intervention, instant feedback, and monitoring without feedback. The measured time indexes were the different parts of mission times. To collect data, a pre-prepared checklist was set up. For the first phase, data were extracted from the database of the Tehran EMS Center. In the second and third phases, the data were entered into the relevant forms for each mission by the researcher and executive colleagues. Results The data of 229,847 missions were analysed. In the instant feedback phase, compared to the pre-intervention phase, the mean activation time, response time, scene time, transfer time and hospital delay time were decreased. When we compared the mean time indexes in the monitoring phase compared to the instant feedback phase, we saw that the average activation time, response time and transfer time were increased but they were still less than that in the pre-intervention phase. However, the scene time and hospital delay time were not changed compared to the instant feedback phase but were lower than that in the pre-intervention phase. Conclusion Auditing was effective in reducing the total time of missions and this effect was largely maintained in the monitoring phase under the Hawthorne effect.
{"title":"Assessing the Usefulness of Instant Feedback and the Hawthorne Effect: An Audit of Time Indexes of Ems Missions in Tehran","authors":"P. Saberian, Negin Mousaeinezhad, Parisa Hasani-Sharamin, H. Mohammadi, Mahnaz Jamshididana, Alireza Baratloo","doi":"10.33151/ajp.18.877","DOIUrl":"https://doi.org/10.33151/ajp.18.877","url":null,"abstract":"Introduction It has been well established that if a person is aware that they are being monitored their commitment and effort will be maximised (the Hawthorne effect), which then leads to efficiency increase and optimal workflow. Objective Our aim was to evaluate the efficacy of instant feedback and the Hawthorne effect of this intervention on pre-hospital time indexes during emergency medical service (EMS) missions. Methods This is a cross-sectional auditing study on the missions of the Tehran EMS Center (performed over a 12-month period) in three phases: pre-intervention, instant feedback, and monitoring without feedback. The measured time indexes were the different parts of mission times. To collect data, a pre-prepared checklist was set up. For the first phase, data were extracted from the database of the Tehran EMS Center. In the second and third phases, the data were entered into the relevant forms for each mission by the researcher and executive colleagues. Results The data of 229,847 missions were analysed. In the instant feedback phase, compared to the pre-intervention phase, the mean activation time, response time, scene time, transfer time and hospital delay time were decreased. When we compared the mean time indexes in the monitoring phase compared to the instant feedback phase, we saw that the average activation time, response time and transfer time were increased but they were still less than that in the pre-intervention phase. However, the scene time and hospital delay time were not changed compared to the instant feedback phase but were lower than that in the pre-intervention phase. Conclusion Auditing was effective in reducing the total time of missions and this effect was largely maintained in the monitoring phase under the Hawthorne effect.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130381514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thavinee Trainarongsakul, C. Yuksen, Phonnita Nakasint, Chetsadakon Jenpanitpong, Thanakorn Laksanamapune
Introduction Early defibrillation remains the highest priority in the chain of survival for out-of-hospital cardiac arrest. Shock delivery should be performed within 5 minutes of collapse to achieve a 50% survival rate. Google Maps has been one of the most popular mobile navigation applications worldwide. Our primary objective was to assess the efficacy of Google Maps in locating nearby public automated external defibrillators (AEDs). Methods Local and non-local populations were enrolled. Participants were randomly assigned to locate AEDs with or without the assistance of Google Maps. Participants used Google Maps on the same smartphone and cellular data network, an activity tracker recorded data for distance covered and time required to retrieve the AED. AEDs were located within 150 seconds of the starting point. Results Out of 100 recruited participants there was no difference in baseline characteristics. In the local population group, Google Maps assistance did not show statistical significance in successfully locating the AED within 150 seconds. Correspondingly, the travel time also showed no difference (173.52 ± 50.99 seconds for Google Maps vs. 206.20 ± 159.53 seconds for control group). The result in the non-local population group revealed no significant difference in successfully locating AEDs within 150 seconds: Google Maps (18.52%) vs. control group (39.13%); p=0.126. The recorded travel time between the Google Maps group and control group were similar (307.59 ± 220.10 seconds vs. 284.0 ± 222.37 seconds; p=0.709). Conclusion In Thailand, using Google Maps mobile assistance was found to be unhelpful in accessing nearby public AEDs.
{"title":"The Efficacy of Using Google Maps in Accessing Nearby Public Automated External Defibrillators in Thailand","authors":"Thavinee Trainarongsakul, C. Yuksen, Phonnita Nakasint, Chetsadakon Jenpanitpong, Thanakorn Laksanamapune","doi":"10.33151/ajp.18.899","DOIUrl":"https://doi.org/10.33151/ajp.18.899","url":null,"abstract":"Introduction Early defibrillation remains the highest priority in the chain of survival for out-of-hospital cardiac arrest. Shock delivery should be performed within 5 minutes of collapse to achieve a 50% survival rate. Google Maps has been one of the most popular mobile navigation applications worldwide. Our primary objective was to assess the efficacy of Google Maps in locating nearby public automated external defibrillators (AEDs). Methods Local and non-local populations were enrolled. Participants were randomly assigned to locate AEDs with or without the assistance of Google Maps. Participants used Google Maps on the same smartphone and cellular data network, an activity tracker recorded data for distance covered and time required to retrieve the AED. AEDs were located within 150 seconds of the starting point. Results Out of 100 recruited participants there was no difference in baseline characteristics. In the local population group, Google Maps assistance did not show statistical significance in successfully locating the AED within 150 seconds. Correspondingly, the travel time also showed no difference (173.52 ± 50.99 seconds for Google Maps vs. 206.20 ± 159.53 seconds for control group). The result in the non-local population group revealed no significant difference in successfully locating AEDs within 150 seconds: Google Maps (18.52%) vs. control group (39.13%); p=0.126. The recorded travel time between the Google Maps group and control group were similar (307.59 ± 220.10 seconds vs. 284.0 ± 222.37 seconds; p=0.709). Conclusion In Thailand, using Google Maps mobile assistance was found to be unhelpful in accessing nearby public AEDs.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130526803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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