Objectives: Overcrowding in emergency departments (EDs) is an international issue and ambulance bypass is seen as one element of the solution to a complex problem. Irish EDs are not immune to this healthcare crisis, which, together with increased off-load delays for ambulances, is one catalyst for the introduction of Treat and Referral (paramedic non-ED disposition decision). The confidence of consultants in emergency medicine in paramedics and advanced paramedics offering Treat and Referral to patients presenting with hypoglycaemia or seizure was explored. Other specific clinical presentations were also investigated for suitability for Treat and Referral and a consensus was sought on an upper age limit for such patients. Methods: Public-sector consultants in emergency medicine in Ireland at the time of the study, were invited to complete an online survey. A 62% response was received from the targeted population. Results: Confidence was expressed in advanced paramedics offering Treat and Referral to patients with hypoglycaemia or seizure by the majority (78%) of respondents. However, confidence was reduced for paramedics (53%). Six of the twelve specific clinical presentations received clear support as suitable for Treat and Referral, with the remaining receiving reducing support and ‘falls in the elderly (without injury)’ was opposed. There was no consensus on an upper age limit for patients being offered Treat and Referral. Conclusions: Support for the highest level of EMS practitioner in Ireland, advanced paramedic, to expand their scope of practice to include Treat and Referral was identified. Clinical presentations have been identified that would be conducive to a Treat and Referral clinical care pathway. A trial implementation period may be essential to build confidence in the programme before a universal roll out.
{"title":"Clinical presentations and practitioner levels appropriate for the introduction of ‘Treat and Referral’ into the Irish Emergency Medical Service: A survey of Consultants in emergency medicine.","authors":"B. Power, J. Ryan, G. Bury","doi":"10.32378/ijp.v5i1.233","DOIUrl":"https://doi.org/10.32378/ijp.v5i1.233","url":null,"abstract":"Objectives: Overcrowding in emergency departments (EDs) is an international issue and ambulance bypass is seen as one element of the solution to a complex problem. Irish EDs are not immune to this healthcare crisis, which, together with increased off-load delays for ambulances, is one catalyst for the introduction of Treat and Referral (paramedic non-ED disposition decision). The confidence of consultants in emergency medicine in paramedics and advanced paramedics offering Treat and Referral to patients presenting with hypoglycaemia or seizure was explored. Other specific clinical presentations were also investigated for suitability for Treat and Referral and a consensus was sought on an upper age limit for such patients. Methods: Public-sector consultants in emergency medicine in Ireland at the time of the study, were invited to complete an online survey. A 62% response was received from the targeted population. Results: Confidence was expressed in advanced paramedics offering Treat and Referral to patients with hypoglycaemia or seizure by the majority (78%) of respondents. However, confidence was reduced for paramedics (53%). Six of the twelve specific clinical presentations received clear support as suitable for Treat and Referral, with the remaining receiving reducing support and ‘falls in the elderly (without injury)’ was opposed. There was no consensus on an upper age limit for patients being offered Treat and Referral. Conclusions: Support for the highest level of EMS practitioner in Ireland, advanced paramedic, to expand their scope of practice to include Treat and Referral was identified. Clinical presentations have been identified that would be conducive to a Treat and Referral clinical care pathway. A trial implementation period may be essential to build confidence in the programme before a universal roll out.","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129579503","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}
In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.
{"title":"Wellbeing series: Meditation for paramedics","authors":"Marc Colbeck","doi":"10.32378/ijp.v4i2.212","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.212","url":null,"abstract":"In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133510083","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}
In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.
{"title":"Wellbeing series: Empathy and paramedic wellbeing","authors":"A. Batt","doi":"10.32378/ijp.v4i2.210","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.210","url":null,"abstract":"In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019. ","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128621766","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}
In this wellbeing series we present practical advice for prehospital care providers, responders, and all shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.
{"title":"Wellbeing Series: Sleep practices for shift worker","authors":"M. Varghese","doi":"10.32378/ijp.v4i2.204","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.204","url":null,"abstract":"In this wellbeing series we present practical advice for prehospital care providers, responders, and all shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124135376","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}
In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.
{"title":"Wellbeing Series: Shifting the Focus to Nutrition","authors":"G. Kent","doi":"10.32378/ijp.v4i2.200","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.200","url":null,"abstract":"In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115753700","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}
In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019
{"title":"Wellbeing Series: Building Mental Health Resilience for Emergency Personnel","authors":"S. Gallagher","doi":"10.32378/ijp.v4i2.202","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.202","url":null,"abstract":"In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121154263","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}
In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.
{"title":"Wellbeing Series: Compassion Fatigue.","authors":"J. Reidy","doi":"10.32378/ijp.v4i2.206","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.206","url":null,"abstract":"In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"517 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123098588","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}
In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.
{"title":"Wellbeing Series: The patient is ready for you…but are you ready for the patient? The health status of paramedics and its effect on job performance.","authors":"A. MacQuarrie","doi":"10.32378/ijp.v4i2.208","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.208","url":null,"abstract":"In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134433614","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}
BackgroundUndertreatment of pain has been reported in the paramedic literature, and reasons for these disparities are not well understood.AimsAs the qualification level of the paramedic may affect analgesia administration, the primary aim of this study was to determine the impact of paramedic qualification on the provision of any analgesia for patients reporting pain.MethodsRetrospective study of de-identified patient care records from one Australian ambulance service over a period of 6 months. Inclusion criteria were age was > 17 years, initial pain severity score was > 3/10 and Glasgow Coma Score >13. Data were descriptively analysed for analgesia administration and type of analgesic by predictor variables: age, sex, pain score and case nature. Pearson’s chi-square test was used to test for associations between the outcome of interest and predictor variables. Adjusted logged odds of patients receiving analgesia was tested with binomial logistic regression.Findings3173 patient records met the inclusion criteria. ICP treated 86% of the sample population. Of those treated by an AP, 76.2% (n=340) received analgesia, whereas 71.6% (n=1952) of patients treated by an ICP received analgesia (p=0.042). Methoxyflurane was the most frequently administered analgesic, with 39.9% of the patients (n=1,264) receiving this agent; 31.1% of patients (n=988) received morphine, and 14.2% (n=452) received fentanyl. The unadjusted regression model found that AP have higher odds of administering analgesia than ICP paramedics (OR 1.264, p <0.05). However, once other covariates are included in the logistic regression, the significance no longer exists.ConclusionParamedic qualification is not associated with the administration of analgesia in this setting. This study contributes to the gap in knowledge regarding disparities in analgesia for adults experiencing pain and may inform future research that aims to identify and reduce barriers to appropriate pain management in the paramedic practice setting.
背景:在护理文献中有关于疼痛治疗不足的报道，而造成这些差异的原因尚不清楚。由于护理人员的资格水平可能会影响镇痛药的给药，本研究的主要目的是确定护理人员资格对报告疼痛的患者提供任何镇痛药的影响。方法回顾性研究来自澳大利亚一家救护车服务机构6个月的去识别病人护理记录。纳入标准为年龄> 17岁，初始疼痛严重程度评分> 3/10，格拉斯哥昏迷评分>13。通过预测变量:年龄、性别、疼痛评分和病例性质，对镇痛药和镇痛药类型的数据进行描述性分析。使用Pearson卡方检验来检验兴趣结果与预测变量之间的相关性。采用二项logistic回归对接受镇痛治疗的患者进行校正后的记录赔率检验。结果:s3173例患者符合纳入标准。ICP治疗了86%的样本人群。在AP治疗的患者中，76.2% (n=340)出现了镇痛，而ICP治疗的患者中有71.6% (n=1952)出现了镇痛(p=0.042)。甲氧基氟醚是最常用的镇痛药，有39.9%的患者(n=1,264)使用该药物;31.1% (n=988)的患者使用吗啡，14.2% (n=452)的患者使用芬太尼。未经调整的回归模型发现，AP给予镇痛的几率高于ICP护理人员(OR 1.264, p <0.05)。然而，一旦在逻辑回归中包含其他协变量，显著性就不再存在。结论在这种情况下，护理人员资格与镇痛药的使用无关。这项研究有助于了解关于成人疼痛镇痛差异的知识差距，并可能为未来的研究提供信息，旨在识别和减少护理人员实践中适当疼痛管理的障碍。
{"title":"The influence of paramedic qualification level on the administration of analgesia in the prehospital setting","authors":"B. Lord, Toby Keene, C. Luck","doi":"10.32378/ijp.v4i2.187","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.187","url":null,"abstract":"BackgroundUndertreatment of pain has been reported in the paramedic literature, and reasons for these disparities are not well understood.AimsAs the qualification level of the paramedic may affect analgesia administration, the primary aim of this study was to determine the impact of paramedic qualification on the provision of any analgesia for patients reporting pain.MethodsRetrospective study of de-identified patient care records from one Australian ambulance service over a period of 6 months. Inclusion criteria were age was > 17 years, initial pain severity score was > 3/10 and Glasgow Coma Score >13. Data were descriptively analysed for analgesia administration and type of analgesic by predictor variables: age, sex, pain score and case nature. Pearson’s chi-square test was used to test for associations between the outcome of interest and predictor variables. Adjusted logged odds of patients receiving analgesia was tested with binomial logistic regression.Findings3173 patient records met the inclusion criteria. ICP treated 86% of the sample population. Of those treated by an AP, 76.2% (n=340) received analgesia, whereas 71.6% (n=1952) of patients treated by an ICP received analgesia (p=0.042). Methoxyflurane was the most frequently administered analgesic, with 39.9% of the patients (n=1,264) receiving this agent; 31.1% of patients (n=988) received morphine, and 14.2% (n=452) received fentanyl. The unadjusted regression model found that AP have higher odds of administering analgesia than ICP paramedics (OR 1.264, p <0.05). However, once other covariates are included in the logistic regression, the significance no longer exists.ConclusionParamedic qualification is not associated with the administration of analgesia in this setting. This study contributes to the gap in knowledge regarding disparities in analgesia for adults experiencing pain and may inform future research that aims to identify and reduce barriers to appropriate pain management in the paramedic practice setting.","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129694484","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}
William J Leggio, Joseph Lippert, I. Kozlowski, A. Meyer, M. L. Miller, E. Ernest
This brief report introduces and provides a reflection on the interprofessional role of an annual cadaver laboratory experience in the paramedic program at Creighton University, United States. Similar experiences in paramedic education have been noted to be beneficial in increasing paramedic student’s knowledge of anatomy and ability to perform procedures. Learners that participated in this report and reflection reported gains in their education and appreciation of other professions that support previous research on the topic and the value of this distinct experience.
{"title":"Interprofessional Role of Cadaver Laboratory Experience in Paramedic Education at Creighton University","authors":"William J Leggio, Joseph Lippert, I. Kozlowski, A. Meyer, M. L. Miller, E. Ernest","doi":"10.32378/ijp.v4i2.179","DOIUrl":"https://doi.org/10.32378/ijp.v4i2.179","url":null,"abstract":"This brief report introduces and provides a reflection on the interprofessional role of an annual cadaver laboratory experience in the paramedic program at Creighton University, United States. Similar experiences in paramedic education have been noted to be beneficial in increasing paramedic student’s knowledge of anatomy and ability to perform procedures. Learners that participated in this report and reflection reported gains in their education and appreciation of other professions that support previous research on the topic and the value of this distinct experience. ","PeriodicalId":367364,"journal":{"name":"Irish Journal of Paramedicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123319153","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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