Pub Date : 2025-10-01Epub Date: 2025-10-08DOI: 10.56068/ewfw9489
Grace Wang, Kalpana N Shankar, Anita Chary, Kei Ouchi, Emily M Hayden, Shan W Liu
Introduction: Falls are the leading cause of fatal and nonfatal injury for older adults. We created the Emergency Department Virtual Observation Unit (EDVOU) to provide observation level care for older ED patients in their homes and better assess their fall risks. Mobile integrated health (MIH) paramedics visited patients' homes where they conducted a multicomponent fall evaluation and facilitated an emergency medicine telemedicine consult. We aimed to understand paramedics' experiences in our EDVOU Fall Program.
Methods: We conducted a qualitative study through semi-structured interviews of EDVOU Fall prevention paramedics to determine how comfortable they were with implementing the EDVOU fall program. Interviews were transcribed, independently reviewed by multiple team members, and subsequently coded into themes.
Results: Fifteen of thirty-six (42%) paramedics were interviewed. Three main themes emerged: 1) learning new skills otherwise not included in paramedic training, 2) having unique perspectives and interactions with patients in the home environment where most other clinicians do not have insight, and 3) being more integrated in a team to play a bigger role in patient care.
Discussion: MIH paramedics had an overwhelmingly positive experience with the program. Paramedics felt they played a pivotal role in fall prevention, as the program allowed them to learn more skills, form and share unique relationships and clinical perspectives given their role, and feel more valued as part of a patient team/care continuum. Paramedics' unique role of entering the home to provide medical care are an untapped resource in preventative care, particularly as part of a virtual fall program.
{"title":"ASSESSING PARAMEDICS' PERSPECTIVES ON AN EMERGENCY DEPARTMENT VIRTUAL OBSERVATION UNIT FALL PREVENTION PROGRAM.","authors":"Grace Wang, Kalpana N Shankar, Anita Chary, Kei Ouchi, Emily M Hayden, Shan W Liu","doi":"10.56068/ewfw9489","DOIUrl":"10.56068/ewfw9489","url":null,"abstract":"<p><strong>Introduction: </strong>Falls are the leading cause of fatal and nonfatal injury for older adults. We created the Emergency Department Virtual Observation Unit (EDVOU) to provide observation level care for older ED patients in their homes and better assess their fall risks. Mobile integrated health (MIH) paramedics visited patients' homes where they conducted a multicomponent fall evaluation and facilitated an emergency medicine telemedicine consult. We aimed to understand paramedics' experiences in our EDVOU Fall Program.</p><p><strong>Methods: </strong>We conducted a qualitative study through semi-structured interviews of EDVOU Fall prevention paramedics to determine how comfortable they were with implementing the EDVOU fall program. Interviews were transcribed, independently reviewed by multiple team members, and subsequently coded into themes.</p><p><strong>Results: </strong>Fifteen of thirty-six (42%) paramedics were interviewed. Three main themes emerged: 1) learning new skills otherwise not included in paramedic training, 2) having unique perspectives and interactions with patients in the home environment where most other clinicians do not have insight, and 3) being more integrated in a team to play a bigger role in patient care.</p><p><strong>Discussion: </strong>MIH paramedics had an overwhelmingly positive experience with the program. Paramedics felt they played a pivotal role in fall prevention, as the program allowed them to learn more skills, form and share unique relationships and clinical perspectives given their role, and feel more valued as part of a patient team/care continuum. Paramedics' unique role of entering the home to provide medical care are an untapped resource in preventative care, particularly as part of a virtual fall program.</p>","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"2025 12","pages":"100-114"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12614092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paramedic work can be stressful. Encountering clinically unwell patients, long shift hours and dealing with the unknown expose paramedics to mental, physical and emotional stress. In the learning environment, these types of stresses are difficult for educators to replicate. Traditionally, students have been tested under pressure in scenario-based situations as a means of stress inoculation. However, the literature is unclear as to whether this enhances or hinders learning. A recent scoping review identified an acceptable level of stress during simulation can be beneficial, although a level of a balance is required. Too much stress can hinder learning and lead to underperformance. Ideally, high-acuity patient scenarios should be designed to invoke a challenging state of appraisal in the student to support both their learning and knowledge retention. To obtain an understanding of how students appraise these types of scenarios, quantitative physiological and psychometric data needs to be obtained and analyzed. However, across the health care education literature, inconsistent methodologies and a variety of physiological and cognitive measures make it challenging to draw firm conclusions. This narrative review searched three prominent databases using common search terms to produce a subset of high-quality publications that we thought were most pertinent and insightful. Our paper establishes recommendations for appropriate physiological assessment and interpterion of challenge appraisal in students undertaking high-stress, low-frequency clinical scenarios.
{"title":"Quantifying Threat or Challenge Response of Undergraduate Paramedicine Students During High-Stress Clinical Scenarios","authors":"J. Betson, Erich Fein, David Long, Peter Horrocks","doi":"10.56068/qhqm3379","DOIUrl":"https://doi.org/10.56068/qhqm3379","url":null,"abstract":"Paramedic work can be stressful. Encountering clinically unwell patients, long shift hours and dealing with the unknown expose paramedics to mental, physical and emotional stress. In the learning environment, these types of stresses are difficult for educators to replicate. Traditionally, students have been tested under pressure in scenario-based situations as a means of stress inoculation. However, the literature is unclear as to whether this enhances or hinders learning. A recent scoping review identified an acceptable level of stress during simulation can be beneficial, although a level of a balance is required. Too much stress can hinder learning and lead to underperformance. Ideally, high-acuity patient scenarios should be designed to invoke a challenging state of appraisal in the student to support both their learning and knowledge retention. To obtain an understanding of how students appraise these types of scenarios, quantitative physiological and psychometric data needs to be obtained and analyzed. However, across the health care education literature, inconsistent methodologies and a variety of physiological and cognitive measures make it challenging to draw firm conclusions. This narrative review searched three prominent databases using common search terms to produce a subset of high-quality publications that we thought were most pertinent and insightful. Our paper establishes recommendations for appropriate physiological assessment and interpterion of challenge appraisal in students undertaking high-stress, low-frequency clinical scenarios.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"2 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816282","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: In the United States, research has found that emergency medical service (EMS) clinicians contemplate and attempt suicide at a rate approximately 10 times higher than the general population. However, prior to this study, no comprehensive data existed on the mental health status and needs of Virginia’s EMS clinicians. Objective: To evaluate mental health conditions, substance use, COVID-19 stress, and job satisfaction among Virginia’s EMS clinicians and to assess the perceived mental health cultures, services, and barriers to seeking help within clinicians’ agencies. Methods: The [redacted institution name] constructed a comprehensive EMS clinician mental health cross-sectional survey during the spring of 2022. The survey was sent to every certified EMS clinician over the age of 18 with a working email address within the Commonwealth (N=36,376) as of April 15, 2022. Results: A total of 2,930 EMS clinicians who actively served in EMS within the past 12 months responded to the survey. On average, clinicians reported 9.9 days of perceived poor mental health out of a 30-day period, with 9.1% of clinicians seriously contemplating suicide within the past year. Almost 60% of respondents reported heavy alcohol consumption at least once in the year prior to the survey, while 6.5% had taken prescription drugs for non-medical reasons and 3.7% had used illegal drugs. Approximately 66% of clinicians felt the coronavirus pandemic increased workplace stress. More than half of respondents (57.3%) indicated they had intentions to quit working in EMS. Finally, 31.1% of clinicians disagreed or strongly disagreed that EMS clinician mental health is important to their agency. Conclusion: Virginia’s EMS clinicians experience a greater number of perceived poor mental health days, higher levels of suicide contemplation, and increased substance use as compared to the general population. Further health promotion actions are needed to address these disparities among Virginia’s EMS clinicians.
{"title":"The State of Emergency Medical Services Clinician Mental Health in Virginia","authors":"Vincent P. Valeriano, Karen Owens, Jessica Rosner","doi":"10.56068/uxzx1939","DOIUrl":"https://doi.org/10.56068/uxzx1939","url":null,"abstract":"Background: In the United States, research has found that emergency medical service (EMS) clinicians contemplate and attempt suicide at a rate approximately 10 times higher than the general population. However, prior to this study, no comprehensive data existed on the mental health status and needs of Virginia’s EMS clinicians. \u0000Objective: To evaluate mental health conditions, substance use, COVID-19 stress, and job satisfaction among Virginia’s EMS clinicians and to assess the perceived mental health cultures, services, and barriers to seeking help within clinicians’ agencies. \u0000Methods: The [redacted institution name] constructed a comprehensive EMS clinician mental health cross-sectional survey during the spring of 2022. The survey was sent to every certified EMS clinician over the age of 18 with a working email address within the Commonwealth (N=36,376) as of April 15, 2022. \u0000Results: A total of 2,930 EMS clinicians who actively served in EMS within the past 12 months responded to the survey. On average, clinicians reported 9.9 days of perceived poor mental health out of a 30-day period, with 9.1% of clinicians seriously contemplating suicide within the past year. Almost 60% of respondents reported heavy alcohol consumption at least once in the year prior to the survey, while 6.5% had taken prescription drugs for non-medical reasons and 3.7% had used illegal drugs. Approximately 66% of clinicians felt the coronavirus pandemic increased workplace stress. More than half of respondents (57.3%) indicated they had intentions to quit working in EMS. Finally, 31.1% of clinicians disagreed or strongly disagreed that EMS clinician mental health is important to their agency. \u0000Conclusion: Virginia’s EMS clinicians experience a greater number of perceived poor mental health days, higher levels of suicide contemplation, and increased substance use as compared to the general population. Further health promotion actions are needed to address these disparities among Virginia’s EMS clinicians.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"121 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666454","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}
{"title":"Paramedicine Literature Surveillance","authors":"Shaughn Maxwell, Brenda Morrisey","doi":"10.56068/hgpv8747","DOIUrl":"https://doi.org/10.56068/hgpv8747","url":null,"abstract":"","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"11 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667929","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 and Aim: Data suggests that finger palpation of the carotid and/or femoral pulses is significantly less sensitive than 100%. In some cases, a patient who does, in fact, have organized cardiac function, may be identified as being in Pulseless Electrical Activity (PEA). Chest compressions performed as indicated by these circumstances may not provide significant therapeutic benefit to those patients and may, in fact, distract from better directed therapies. Doppler Ultrasonography (DUSG) has been shown to be more sensitive than human fingers. This research aims to assess whether EMT-Basics and Paramedics can be quickly and inexpensively trained to use DUSG as a tool for pulse detection. Methods: Participants viewed a recorded video 4 minutes 18 seconds in length which detailed an anterior-to-posterior fanning technique for assessing presence of a carotid pulse using a doppler ultrasound device. The participants were given a short period of time to practice and familiarize themselves with the device. Participants were then timed while demonstrating application of ultrasound-conducting gel to a volunteer and using the device to detect a carotid pulse. The time recording ceased when the participant verbalized confirmation of the pulse, and their success or failure was annotated. Results: Credentialed EMT-Basics and Paramedics, with minimal training, consistently demonstrated the ability to accurately and rapidly assess a carotid pulse using a doppler ultrasound device. Conclusions: This research suggests that prehospital personnel can be efficiently trained to use available and inexpensive doppler ultrasound devices to determine cardiac pulse status. Furthermore, it suggests that the technique itself can be used to detect the carotid pulse quickly and accurately. Further research in patient care settings should be undertaken to evaluate the utility of doppler ultrasound devices in distinguishing PEA from Pseudo-PEA.
背景和目的：数据表明，用手指触摸颈动脉和/或股动脉搏动的灵敏度明显低于 100%。在某些情况下，病人实际上具有有组织的心脏功能，但可能被认定为处于无脉搏电活动（PEA）状态。在这种情况下进行的胸外按压可能不会给这些患者带来明显的治疗效果，反而会分散他们对更好的治疗方法的注意力。多普勒超声（DUSG）已被证明比人的手指更灵敏。本研究旨在评估是否可以快速、低成本地培训急救员和辅助医务人员使用多普勒超声波检查仪作为脉搏检测工具：方法：参与者观看一段时长为 4 分 18 秒的录制视频，视频详细介绍了使用多普勒超声设备评估颈动脉脉搏的前后扇动技术。参与者有短暂的时间练习和熟悉设备。然后，参赛者在向一名志愿者演示涂抹超声传导凝胶和使用设备检测颈动脉脉搏时被计时。当参与者口头确认脉搏时，时间记录停止，并标注其成功或失败：结果：经过最低限度培训的合格急救员和辅助医务人员一致表现出有能力使用多普勒超声设备准确、快速地评估颈动脉脉搏。结论：这项研究表明，可以对院前人员进行有效培训，使其能够使用现有的廉价多普勒超声设备来确定心脏脉搏状态。此外，研究还表明该技术本身可用于快速准确地检测颈动脉脉搏。应在患者护理环境中开展进一步研究，以评估多普勒超声设备在区分 PEA 和假性 PEA 方面的实用性。
{"title":"Demonstration of Doppler Ultrasound Pulse Detection by Trained Prehospital Personnel","authors":"Daniel Martin","doi":"10.56068/qggb1958","DOIUrl":"https://doi.org/10.56068/qggb1958","url":null,"abstract":"Background and Aim: Data suggests that finger palpation of the carotid and/or femoral pulses is significantly less sensitive than 100%. In some cases, a patient who does, in fact, have organized cardiac function, may be identified as being in Pulseless Electrical Activity (PEA). Chest compressions performed as indicated by these circumstances may not provide significant therapeutic benefit to those patients and may, in fact, distract from better directed therapies. Doppler Ultrasonography (DUSG) has been shown to be more sensitive than human fingers. This research aims to assess whether EMT-Basics and Paramedics can be quickly and inexpensively trained to use DUSG as a tool for pulse detection.\u0000Methods: Participants viewed a recorded video 4 minutes 18 seconds in length which detailed an anterior-to-posterior fanning technique for assessing presence of a carotid pulse using a doppler ultrasound device. The participants were given a short period of time to practice and familiarize themselves with the device. Participants were then timed while demonstrating application of ultrasound-conducting gel to a volunteer and using the device to detect a carotid pulse. The time recording ceased when the participant verbalized confirmation of the pulse, and their success or failure was annotated.\u0000Results: Credentialed EMT-Basics and Paramedics, with minimal training, consistently demonstrated the ability to accurately and rapidly assess a carotid pulse using a doppler ultrasound device. \u0000Conclusions: This research suggests that prehospital personnel can be efficiently trained to use available and inexpensive doppler ultrasound devices to determine cardiac pulse status. Furthermore, it suggests that the technique itself can be used to detect the carotid pulse quickly and accurately. Further research in patient care settings should be undertaken to evaluate the utility of doppler ultrasound devices in distinguishing PEA from Pseudo-PEA.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"115 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666584","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: Asthma is a significant contributor of respiratory illness throughout Australia, taking a toll on all genders and age groups. The rural healthcare workforce is currently undersupplied, and this worsens with the degree of rurality posing disadvantages in healthcare access. Lower asthma-related mortality rates in metropolitan cities than other areas of Australia indicate a need to explore the extent of the impact that residing rurally has on access to emergency healthcare for asthma-related emergencies. Methods: A scoping review of literature was conducted utilising the steps articulated in Peters et al. (2020)methodological approach. The databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Emcare, Medline and PubMed were searched using key words. After screening 20 articles were included. Results: Four main themes emerged including the impact of access to resources; individual behaviours and attitudes; education and health literacy; and rural clinician adherence to guidelines. Conclusion: Several challenges are associated with living in rural areas which may impact patients ability to access emergency healthcare during an asthma-related emergency. Further research is recommended to determine the extent to which these challenges influence access to emergency healthcare and explore strategies to break down these barriers to ensure equitable emergency healthcare.
{"title":"Influence of Rurality When Accessing Emergency Healthcare During Exacerbation of Asthma","authors":"Alannah Stoneley, Judith Anderson, Clare Sutton","doi":"10.56068/qiwm3456","DOIUrl":"https://doi.org/10.56068/qiwm3456","url":null,"abstract":"Background: Asthma is a significant contributor of respiratory illness throughout Australia, taking a toll on all genders and age groups. The rural healthcare workforce is currently undersupplied, and this worsens with the degree of rurality posing disadvantages in healthcare access. Lower asthma-related mortality rates in metropolitan cities than other areas of Australia indicate a need to explore the extent of the impact that residing rurally has on access to emergency healthcare for asthma-related emergencies. \u0000Methods: A scoping review of literature was conducted utilising the steps articulated in Peters et al. (2020)methodological approach. The databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Emcare, Medline and PubMed were searched using key words. After screening 20 articles were included. \u0000Results: Four main themes emerged including the impact of access to resources; individual behaviours and attitudes; education and health literacy; and rural clinician adherence to guidelines. \u0000Conclusion: Several challenges are associated with living in rural areas which may impact patients ability to access emergency healthcare during an asthma-related emergency. Further research is recommended to determine the extent to which these challenges influence access to emergency healthcare and explore strategies to break down these barriers to ensure equitable emergency healthcare.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"119 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666768","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}
Purpose: Buprenorphine is a lifesaving medication in opioid use disorder (OUD). Emergency Medical Services (EMS) play a crucial role in responding to opioid overdoses. The pre-hospital use of buprenorphine by EMS can expand access to this important medication. This article aims to provide a narrative review of the use of buprenorphine in the pre-hospital setting. Methods: This is a narrative review of recent publications that describe the use of buprenorphine to treat opioid withdrawal in the pre-hospital setting. Results: There are a few well done studies that describe protocols, safety, and efficacy of the administration of buprenorphine in the pre-hospital setting by EMS providers. The pharmacology of buprenorphine makes it advantageous in treating opioid use disorder. Proper patient selection and protocols for the administration of buprenorphine are key to the success of implementing pre-hospital buprenorphine programs. Conclusions: The pre-hospital administration of buprenorphine for opioid use disorder should be considered by EMS agencies.
{"title":"Use of Buprenorphine in the Prehospital Setting","authors":"Anthony Spadaro, Samantha Huo, Johnathan Bar","doi":"10.56068/crde9788","DOIUrl":"https://doi.org/10.56068/crde9788","url":null,"abstract":"Purpose: Buprenorphine is a lifesaving medication in opioid use disorder (OUD). Emergency Medical Services (EMS) play a crucial role in responding to opioid overdoses. The pre-hospital use of buprenorphine by EMS can expand access to this important medication. This article aims to provide a narrative review of the use of buprenorphine in the pre-hospital setting.\u0000Methods: This is a narrative review of recent publications that describe the use of buprenorphine to treat opioid withdrawal in the pre-hospital setting.\u0000Results: There are a few well done studies that describe protocols, safety, and efficacy of the administration of buprenorphine in the pre-hospital setting by EMS providers. The pharmacology of buprenorphine makes it advantageous in treating opioid use disorder. Proper patient selection and protocols for the administration of buprenorphine are key to the success of implementing pre-hospital buprenorphine programs.\u0000Conclusions: The pre-hospital administration of buprenorphine for opioid use disorder should be considered by EMS agencies.","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141670481","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}
The prevalence of Helicobacter Pylori (H. Pylori) remains globally high, with an estimated 50% of the words population believed to be infected. Despite the continually high incident rates of infection 90% of those infected remain asymptomatic. H.Pylori is a gram-negative, microaerophilic bacteria, mostly found in stomach of affected individuals that causes inflammation and ulceration. Definitive routes of transmission and subsequent infection are still debated. The most likely mechanism of transmission is thought to be intrafamilliar, this encapsulates fecal-oral, gastric-oral, oral-oral and sexual vectors. Contaminated foods and water sources are also highly likely mechanisms of transmission. Therefore in developing countries with poor sanitation, potentially contaminated water sources and regions with social-economic hardship experience increased symptomatic cases of H.Pylori.
{"title":"Assessment and Empirical Treatment of Chronic Abdominal Pain from Suspected Helicobacter Pylori Infection In a Remote Setting","authors":"Sean Ferguson","doi":"10.56068/tyij2188","DOIUrl":"https://doi.org/10.56068/tyij2188","url":null,"abstract":"The prevalence of Helicobacter Pylori (H. Pylori) remains globally high, with an estimated 50% of the words population believed to be infected. Despite the continually high incident rates of infection 90% of those infected remain asymptomatic. H.Pylori is a gram-negative, microaerophilic bacteria, mostly found in stomach of affected individuals that causes inflammation and ulceration. \u0000Definitive routes of transmission and subsequent infection are still debated. The most likely mechanism of transmission is thought to be intrafamilliar, this encapsulates fecal-oral, gastric-oral, oral-oral and sexual vectors. Contaminated foods and water sources are also highly likely mechanisms of transmission. Therefore in developing countries with poor sanitation, potentially contaminated water sources and regions with social-economic hardship experience increased symptomatic cases of H.Pylori. ","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668493","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}
{"title":"Paramedicine Contents","authors":"Brad Buck, Julius McAdams","doi":"10.56068/pcbn7731","DOIUrl":"https://doi.org/10.56068/pcbn7731","url":null,"abstract":"","PeriodicalId":73465,"journal":{"name":"International journal of paramedicine","volume":"107 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667005","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}
Bryan Harmer, Melissa Ivey, John Hoyle, Jr., Kieran Fogarty
Background: Cognitive aids are an essential aspect of patient care within emergency medical services (EMS). Despite their availability in EMS, these aids are underutilized. Understanding factors associated with increased use of cognitive aids can help guide the development of effective implementation strategies. This study examines the association between the frequency of cognitive aid use in EMS and three factors: the use of these aids into initial education programs, policies mandating their use, and clinicians’ perceptions of cognitive aid usefulness. Methods: This study used a cross-sectional survey examining the use, previous training, policy, and perceived usefulness of 15 selected cognitive aids. The survey was emailed to 136,093 EMS clinicians in six participating states (TX, ME, MI, LA, SC, and AR). Descriptive statistics were used to describe the examined factors. Bivariate analysis was used to examine the relationship between the use of each cognitive aid and previous training with the aid, requirements for use, and perceived usefulness. Results: A total of 2,251 respondents met inclusion criteria and were included in the study. The length-based tape was the most common aid used during initial education programs (n=1724, 77.0%) and to have policy requiring its use during patient care (n=1194, 53.0%). Aids associated with pediatric medication administration were perceived as most useful. Clinicians were more likely to use a specific aid if there was policy requiring its use, if they used the aid during their initial education programs, or if they perceived it to be useful. Conclusions: The results of this study suggest that integrating a cognitive aid into EMS initial education programs, having policy requiring its use, and the aid being perceived as useful are all associated with increased use the aid during patient care. These results may provide valuable insights for devising more effective implementation strategies for cognitive aids.
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