scholarly journals Advanced paramedics and nurses can deliver safe and effective pre‐hospital and in‐hospital emergency care: An integrative review

Nursing Open ◽  
2021 ◽  
Author(s):  
Jörgen Jansson ◽  
Maria Larsson ◽  
Jan Nilsson
2021 ◽  
Author(s):  
Marciane Mueller ◽  
Rejane Frozza ◽  
Liane Mählmann Kipper ◽  
Ana Carolina Kessler

BACKGROUND This article presents the modeling and development of a Knowledge Based System, supported by the use of a virtual conversational agent called Dóris. Using natural language processing resources, Dóris collects the clinical data of patients in care in the context of urgency and hospital emergency. OBJECTIVE The main objective is to validate the use of virtual conversational agents to properly and accurately collect the data necessary to perform the evaluation flowcharts used to classify the degree of urgency of patients and determine the priority for medical care. METHODS The agent's knowledge base was modeled using the rules provided for in the evaluation flowcharts comprised by the Manchester Triage System. It also allows the establishment of a simple, objective and complete communication, through dialogues to assess signs and symptoms that obey the criteria established by a standardized, validated and internationally recognized system. RESULTS Thus, in addition to verifying the applicability of Artificial Intelligence techniques in a complex domain of health care, a tool is presented that helps not only in the perspective of improving organizational processes, but also in improving human relationships, bringing professionals and patients closer. The system's knowledge base was modeled on the IBM Watson platform. CONCLUSIONS The results obtained from simulations carried out by the human specialist allowed us to verify that a knowledge-based system supported by a virtual conversational agent is feasible for the domain of risk classification and priority determination of medical care for patients in the context of emergency care and hospital emergency.


Resuscitation ◽  
2007 ◽  
Vol 72 (3) ◽  
pp. 386-393 ◽  
Author(s):  
Seth C. Hawkins ◽  
Alan H. Shapiro ◽  
Adrianne E. Sever ◽  
Theodore R. Delbridge ◽  
Vincent N. Mosesso

Nutrition ◽  
2019 ◽  
Vol 66 ◽  
pp. 142-146 ◽  
Author(s):  
C. Bolado Jiménez ◽  
H. Fernádez Ovalle ◽  
MF Muñoz Moreno ◽  
R. Aller de la Fuente ◽  
DA de Luis Román

2020 ◽  
Author(s):  
Gabriele Ciminelli ◽  
Sílvia Garcia-Mandicó

This paper draws from daily death registry data on 4,000 Italian municipalities to investigate two crucial policies that can dramatically affect the toll of COVID-19: the shutdown of non-essential businesses and the management of the emergency care system. Our results, which are robust to controlling for a host of co-factors, offer strong evidence that the closure of service activities is very effective in reducing COVID-19 mortality - this was about 15% lower in municipalities with a 10 percentage points higher employment share in shut down services. Shutting down factories, instead, is much less effective, plausibly because factory workers engage in more limited physical interactions relative to those in the consumer-facing service sector. Concerning the management of the health care system, we find that mortality strongly increases with distance from the intensive care unit (ICU). Municipalities at 10 km from the closest ICU experienced up to 50% higher mortality. This effect - which is largest within the epicenter and in days of abnormally high volumes of calls to the emergency line - underscores the importance of improving pre-hospital emergency services and building ambulance capacity to ensure timely transportation of critical patients to the ICU.


2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Chris O'Connor ◽  
Joe O'Hara

<p><strong>Background</strong></p><p>Since the mid 1980’s, reflective practice has become formally acknowledged and adopted as a key strategy for learning and has become one of the cornerstones of medical education for doctors, nurses, and many of the allied healthcare professions. In the education of pre-hospital emergency care practitioners in Ireland, it is only in the last decade that the notion of reflective practice has been tentatively approached.  Indeed until recently it has largely been ignored by practitioners and educators alike, who have been slow to engage with this new way of learning. This paper explores the attitudes of practitioners to the use of a reflective discussion forum to encourage and support reflection and reflective practice among pre-hospital emergency care practitioners in Ireland.  It also examines the experiences of practitioners who participated in a collaborative reflective discussion forum.</p><p><strong>Literature</strong></p><p>The research was informed by reviewing literature from a number of areas including:  Adult Learning, Reflective Practice, Educational Research directly relating to Emergency Medical Services (EMS), and EMS &amp; Nursing Journals and publications.</p><p><strong>Methodologies</strong></p><p>This paper is part of a larger project which consisted of three cycles of action research.  Data was collected via an online survey questionnaire, and by conducting a series of semi-structured interviews with participants in the reflective discussion forum.  These included all three clinical levels of pre-hospital emergency care practitioners and the three hierarchical levels within the organisation.</p><p><strong>Findings</strong></p><p>The collaborative reflective discussion forum was found to be beneficial.  Among the benefits cited were, the opportunity to draw on the experience of more experienced colleagues, the development of critical thinking skills, and the potential for use as part of a mentoring process.  It was also felt that the collaborative nature of the forum had the potential to improve workplace relationships through the empowerment of the staff. Concerns were raised regarding the potential for abuse and misuse, particularly in relation to the areas of patient confidentiality and a lack of trust within organisations.</p><p><strong>Recommendations</strong></p><p>The establishment of a regular Reflective Discussion Forum within organisations as a key learning strategy. Any collaborative forum must be chaired by a trusted, experienced and highly skilled facilitator. A learning contract for all participants and faculty, including a confidentiality agreement, must be in place prior to the establishment of any collaborative forum.</p>


Medical Care ◽  
1971 ◽  
Vol 9 (5) ◽  
pp. 415-427 ◽  
Author(s):  
JOHN H. NOBLE ◽  
MARGARET E. LAMONTAGKE ◽  
CAROLE BELLOTTI ◽  
HENRY WECHSLER

2016 ◽  
Vol 6 (3) ◽  
pp. 158-161 ◽  
Author(s):  
Christopher Stein ◽  
Nee-Kofi Mould-Millman ◽  
Shaheem De Vries ◽  
Lee Wallis

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