scholarly journals Evaluation of the seroprevalence of measles, rubella, mumps, and varicella and the requirement for additional vaccination based on the JSIPC guidelines among emergency medical technicians at eight fire stations in Narita, Japan: a project review

Author(s):  
Ryota Hase ◽  
Yu Niiyama ◽  
Haruki Mito
2020 ◽  
Vol 41 (S1) ◽  
pp. s143-s144
Author(s):  
Christine McGuire-Wolfe

Background: Multiple studies have demonstrated that pathogens are present in both apparatus and stations within the fire service. Pasco County Fire Rescue’s (PCFR’s) 500+ firefighters routinely wear boots to trauma scenes and into patient’s residences and then into the dormitory and living areas of the fire stations. Pasco County Fire Rescue (PCFR) recently participated in a larger effort to identify the bacteria, yeast, and mold that firefighters, emergency medical technicians, and paramedics are exposed to on apparatuses and the station living environment during a typical shift. During these efforts to swab multiple touch points within apparatus (ambulances and engines) and common areas of the stations, firefighters’ boots were identified as a significant source of bacterial contamination. Methods: Swabs of 191 surfaces in 23 vehicles and 5 fire stations were collected, including 3 swabs from the bottom of firefighter boots. Results: Firefighter boots had the highest bacterial CFUs of all locations swabbed, with >900,000 and 378,000 CFUs per boot. Disinfection with a quaternary ammonium product sprayed through an electrostatic sprayer system effectively reduced the bacterial contamination on boots. Conclusions: PCFR recognizes firefighter boots as a critical vector of contamination between the environment encountered on emergency medical calls and the fire station environment and, as a result, has started a preliminary education campaign for agency firefighters regarding the need for regular boot disinfection. These efforts include regular submissions to the biweekly employee newsletter, as well as reminders on interoffice mailing envelopes (see example below) in hopes of increasing informal, self-directed boot cleaning and disinfection efforts. The next steps include verifying the effectiveness of specific disinfectant cleaners on boots; addressing logistical and practical barriers to routine cleaning and disinfection of boots; and developing, implementing, and evaluating a protocol for regular boot cleaning and disinfection.Funding: NoneDisclosures: None


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giti Nadim ◽  
Christian B. Laursen ◽  
Pia I. Pietersen ◽  
Daniel Wittrock ◽  
Michael K. Sørensen ◽  
...  

Abstract Introduction Crowding of the emergency departments is an increasing problem. Many patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are often treated in the emergency departments for a very short period before discharged to their homes. It is possible that this treatment could take place in the patients’ homes with sufficient diagnostics supporting the treatment. In an effort to keep the diagnostics and treatment of some of these patients in their homes and thus to reduce the patient load at the emergency departments, we implemented a prehospital treat-and-release strategy based on ultrasonography and blood testing performed by emergency medical technicians (EMT) or paramedics (PM) in patients with acute exacerbation of COPD. Method EMTs and PMs were enrolled in a six-hour educational program covering ultrasonography of the lungs and point of care blood tests. During the seasonal peak of COPD exacerbations (October 2018 – May 2019) all patients who were treated by the ambulance crews for respiratory insufficiency were screened in the ambulances. If the patient had uncomplicated COPD not requiring immediate transport to the hospital, ultrasonographic examination of the lungs, measurements of C-reactive protein and venous blood gases analyses were performed. The response to the initial treatment and the results obtained were discussed via telemedical consultation with a prehospital anaesthesiologist who then decided to either release the patient at the scene or to have the patient transported to the hospital. The primary outcome was strategy feasibility. Results We included 100 EMTs and PMs in the study. During the study period, 771 patients with respiratory insufficiency were screened. Uncomplicated COPD was rare as only 41patients were treated according to the treat-and-release strategy. Twenty of these patients (49%) were released at the scene. In further ten patients, technical problems were encountered hindering release at the scene. Conclusion In a few selected patients with suspected acute exacerbations of COPD, it was technically and organisationally feasible for EMTs and PMs to perform prehospital POCT-ultrasound and laboratory testing and release the patients following treatment. None of the patients released at the scene requested a secondary ambulance within the first 48 h following the intervention.


Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Ming-Ju Hsieh ◽  
Wen-Chu Chiang ◽  
Wei-Tien Chang ◽  
Chih-Wei Yang ◽  
Yu-Chun Chien ◽  
...  

Introduction: In-hospital early warning system scores for prediction of clinical deterioration have been well-developed. However, such prediction tools in prehospital setting remain unavailable. Hypothesis: To develop a model for predicting patients with emergency medical technicians witnessed out-of-hospital cardiac arrest (EMT-witnessed OHCA) . Methods: We used the fire-based emergency medical service (EMS) data from Taipei city to develop the prediction model. Patients included in this study were those initially alive, non-traumatic, and aged ≧20 years. Data were extracted from records of ambulance run sheets and OHCA registry in Taipei. The primary outcome (i.e. EMT-witnessed OHCA) was defined as cardiac arrest occurring during EMT services before arrival at the receiving hospital. The prediction model was developed through the standard cross-validation method (i.e. divided dataset for training group and validation group). Area under the receiver operating characteristic curve (AUC) and Hosmer-Lemeshow (HL) test were used to test discrimination and calibration. The point value system with Youden’s J Index was used to find the best cut-off value for practical application. Results: From 2011 to 2015, a total of 252,771 patients were included. Of them, 660 (0.26%) were EMT-witnessed OHCA. The prediction model, including gender, respiratory rate, heart rate, systolic blood pressure, level of consciousness and oxygen saturation, showed excellent discrimination (AUC 0.94) and calibration ( p =0.42 for HL test). When applied to the validation dataset, it maintained good discriminatory ability (AUC 0.94) and calibration ( p =0.11). The optimal cut-off value (≧13) of the point value system of the tool showed high sensitivity (87.84%) and specificity (86.20%). Conclusions: The newly developed prediction model will help identify high-risk patients with EMT-witnessed OHCA and indicate potential prevention by situation awareness in EMS.


2004 ◽  
Vol 30 (3) ◽  
Author(s):  
J. L. P. Naudé ◽  
S. Rothmann

The objectives of this study were to validate the Maslach Burnout Inventory – Human Services Survey (MBI-HSS) for emergency medical technicians in the Gauteng Province of South Africa and to determine its construct equivalence and bias for different race groups. A cross-sectional survey design with an accidental sample (N = 318) was used. The MBIHSS and a biographical questionnaire were administered. Evidence of uniform bias was found for one item of the MBIHSS. Exploratory factor analyses resulted in a 3-factor model of burnout, consisting of Emotional Exhaustion, Depersonalisation and Personal Accomplishment. The scales showed acceptable internal consistencies. Exploratory factor analysis with target rotations confirmed construct equivalence of scales for the White and Black groups. Opsomming Die doelstellings van hierdie studie was om die Maslach Uitbrandingsvraelys – Menslike Dienste-Opname (MBI-HSS) te valideer vir die Nood Mediese Tegnici in die Gauteng Provinsie van Suid-Afrika en om die konstrukekwivalensie en sydigheid daarvan vir die verskillende rassegroepe te bepaal. ’n Dwarssnee opname-ontwerp met ’n beskikbaarheidsteekproef (N = 318) is gebruik. Die MBI-HSS en ’n biografiese vraelys is afgeneem. Uniforme sydigheid is gevind vir een item van die MBI-HSS. Verkennende faktorontleding met teikenrotasies het geresulteer in ’n 3-faktormodel van uitbranding bestaande uit Emosionele Uitputting, Depersonalisasie en Persoonlike Bereiking. Die skale het aanvaarbare interne konsekwentheid getoon. Verkennende faktorontleding met teikenrotasies het die konstrukekwivalensie vir die drie faktore bevestig vir die Wit en Swart groepe.


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