scholarly journals Simulated workplace protection factors for respirators with N95 or higher filters for health care providers in an emergency medical centre: A randomized crossover study

2017 ◽  
Vol 24 (6) ◽  
pp. 282-289 ◽  
Author(s):  
Sanghyun Lee ◽  
Hongjung Kim ◽  
Taeho Lim ◽  
Jaehoon Oh ◽  
Hyunggoo Kang ◽  
...  
Keyword(s):  
Health Care ◽  
Crossover Study ◽  
Health Care Providers ◽  
Medical Procedures ◽  
Care Providers ◽  
Emergency Medical ◽  
Fold Type ◽  
Protective Performance ◽  
Randomized Crossover Study ◽  
Normal Respiration

Introduction: Health care providers in emergency medical centres often encounter infected sources during medical procedures; these sources can generate droplets. Wearing respirators could help to protect against infection risk. However, to the best of our knowledge, no previous study has reported the efficacy of N95 or higher respirators for health care providers in emergency medical centres. Methods: A randomized, crossover study of 26 health care providers was conducted to examine the protective performance of respirators. Quantitative fit tests with three types of respirators (cup type, fold type without valve and fold type with valve) were performed using seven exercises. Primary outcomes were the fit factors. Secondary outcomes included the percentage of fit factors above 100 and respirator preference. Results: After excluding one participant, data for 25 participants were analysed. The fit factors and the percentage of fit factors above 100 were higher when participants wore a fold-type respirator (200 fit factors [38.6–200], 100% [0–100]) relative to those for the cup-type respirator (114.0 fit factors [16.0–185.2], 60% [0–100]) and valve-type respirator (84.9 fit factors [14.2–170.8], 23.8 % [0–100]) in normal respiration. There was no clear preference regarding the type of respirator. Conclusion: The type of respirator could influence protective performance for health care providers. Health care providers in emergency medical centres should be aware of and wear the type of respirator that is well-fitted for them in advance.

scholarly journals Sheet Barrier and Intubating Stylet

Encyclopedia ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 1058-1075
Author(s):  
Phil B. Tsai ◽  
Hsiang-Ning Luk
Keyword(s):  
Health Care ◽  
Tracheal Intubation ◽  
Health Care Providers ◽  
Protective Equipment ◽  
Medical Procedures ◽  
Care Providers ◽  
Risk Of Infection ◽  
Plastic Sheet ◽  
Droplet Nuclei ◽  
Respiratory Droplets

Coronavirus disease 2019 (COVID-19), a respiratory syndrome caused by SARS-CoV-2, can be transmitted through respiratory droplets and aerosols of droplet nuclei. Aerosol-generating medical procedures (AGMP) are needed to take care of critically ill patients but place health care providers at risk of infection. With limited supplies of personal protective equipment (PPE), barrier systems were developed to help protect health care providers during tracheal intubation. The video intubating stylet shows promise to become the preferred intubation device in conjunction with plastic sheet barriers during the COVID-19 pandemic.

1st Attempt Success Rate of Ultrasound-Guided Peripheral IV Access of Emergency Medical Services Health Care Providers on the Pre-Hospital Simulation Model

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S35-S39
Keyword(s):  
Health Care ◽  
Simulation Model ◽  
Emergency Medical Services ◽  
Success Rate ◽  
Health Care Providers ◽  
Work Experience ◽  
Medical Services ◽  
Care Providers ◽  
Ultrasound Guided ◽  
Emergency Medical

Background: Ultrasound guided peripheral intravenous access (USGPIV) has derived benefits for the Emergency and Pre-hospital Management. However, no studies have yet been conducted that have focused upon Emergency Medical Services (EMS) personnel in Thailand. Objective: To introduce USGPIV cannulation to the health care providers of Emergency Medical Services and to examine the success rates of the first attempts at PIV cannulation. Materials and Methods: This prospective observational study was conducted with 49 EMS providers in August 2020. All respondents had been participants in a USGPIV workshop. Afterwards, the participants’ skills were evaluated in a Pre-hospital simulation model, which was conducted in a moving ambulance. The data, which was recorded, noted the number of attempts required to successfully obtain USGPIV access, as well as the participants’ opinions about using ultrasound in this procedure. Results: Among the 49 participants, the first attempt success rate was found to be at 57.14%. The participants’ genders, their years of work experience, their experience of performing PIV with real patients, and the categories of the Emergency Medical Services health care providers were determined not to be factors that had contributed to the success rate of the first attempts at USGPIV. Our study demonstrated a “High” level of satisfaction with regard to performing USGPIV with this ultrasound device (4 out of 5). However, the participants noted that some elements of the environment in the ambulance may have affected the success rate of performing this procedure. Conclusion: In this study, the success rate of the first attempts was found to be lower than in other studies. However, in regard to this simulation, implementing this procedure represents the first step towards assisting Thai EMS personnel to perform ultrasound procedures. Keywords: Ultrasound, Peripheral IV cannulation, Emergency medicine, Emergency medical services, Emergency medical personnel

Survey of State EMS-DNR Laws and Protocols

1999 ◽  
Vol 27 (4) ◽  
pp. 297-315 ◽  
Author(s):  
Charles P. Sabatino
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Health Care Providers ◽  
National Survey ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical ◽  
Laws And Policies ◽  
Comparative Information ◽  
Dnr Orders

This article details the results of a national survey conducted in 1999 of statewide laws and protocols providing for the creation and recognition of donot- resuscitate (DNR) orders effective in nonhospital settings. Applicable primarily to emergency medical services (EMS) personnel, most of these laws and protocols have been in existence for less than ten years, and there is little current comparative information on them. Such policies are commonly called out-of-hospital or prehospital DNR orders, although one state-Virginia-recently amended its DNR law to establish a durable DNR order applicable to all health care providers and all settings. I will refer to the laws and policies examined here interchangeably as out-of hospital DNR protocols or EMS-DNR protocols. The survey produced a descriptive snapshot of such laws and protocols in effect on a statewide basis as of March 1999.

Application of three airway devices during emergency medical training by health care providers—a manikin study

2008 ◽  
Vol 26 (7) ◽  
pp. 783-788 ◽  
Author(s):  
Benedikt Trabold ◽  
Christoph Schmidt ◽  
Barbara Schneider ◽  
Derya Akyol ◽  
Marc Gutsche
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Training ◽  
Care Providers ◽  
Manikin Study ◽  
Emergency Medical ◽  
Airway Devices

Toxicology and Management of Novel Psychoactive Drugs

2014 ◽  
Vol 28 (1) ◽  
pp. 50-65 ◽  
Author(s):  
Brian P. Kersten ◽  
Megan E. McLaughlin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Drugs Of Abuse ◽  
Medical Community ◽  
Published Data ◽  
Psychoactive Drugs ◽  
Care Providers ◽  
Perceived Safety ◽  
Emergency Medical ◽  
Number Of Patients

Health care providers are seeing an increased number of patients under the influence of several new psychoactive drug classes. Synthetic cannabinoids, cathinones, and piperazines are sought by users for their psychoactive effects, perceived safety profile, minimal legal regulations, and lack of detection on routine urine drug screening. However, these drugs are beginning to be recognized by the medical community for their toxic effects. The neuropsychiatric and cardiovascular toxicities are among the most common reasons for emergency medical treatment, which in some cases, can be severe and even life-threatening. Management strategies are often limited to supportive and symptomatic care due to the limited published data on alternative treatment approaches. The purpose of this article is to offer health care providers, emergency medical personnel in particular, an awareness and understanding of the dangers related to some of the new psychoactive drugs of abuse. The background, pharmacology, toxicity, management, detection, and legal status of each class will be discussed.

scholarly journals Workplace violence among emergency medical services workers in Riyadh, Saudi Arabia

2017 ◽  
Vol 6 (3) ◽  
pp. 26 ◽  
Author(s):  
Nesrin Alharthy ◽  
Mohammed Al Mutairi ◽  
Abdullah Alsahli ◽  
Ahmed Alshehri ◽  
Abdullah Almatrafi ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Health Care Providers ◽  
Workplace Violence ◽  
Verbal Abuse ◽  
World Health ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical ◽  
Violent Acts

Background: Globally, workplace violence toward health care providers is an area of concern. The impact of workplace violence on health care providers is significant.Objectives: The study was conducted to evaluate the prevalence of workplace violence (physical and verbal) among emergency medical services (EMS) workers in Riyadh.Methods: The study used a cross-sectional design that employed a self-administered confidential questionnaire, which was distributed to all emergency medical personnel. A well-structured and validated questionnaire on workplace violence was adopted from the World Health Organization for use in the study.Results: A total of 370 EMS workers responded to the questionnaire. Workplace violence was experienced by 65% of the respondents. Verbal abuse (61%) was the most common type of violence reported. The majority of the attackers were patients’ relatives (80%) followed by patients themselves (51%). Respondents younger than 30 reported a higher percentage of violent acts than did older respondents (p = .001, Odds ratio [OR] = 2.5, 95% Confidence Interval [CI] = (1.6, 3.9)). Similarly, those who had fewer years of work experience (≤ 10 years) reported a significantly higher percentage of violent incidents than those who had 10 or more years of experience (p = .001, OR = 3.5, 95% CI = 2.1, 5.6). Only 10% of the victims reported the incident to a higher authority. Common reasons for not reporting the violent acts included feeling that it was useless (56%) and that it was not important (52%).Discussion: The study demonstrates prevalent workplace violence among EMS workers, predominantly in the form of verbal abuse. The rate of workplace violence among EMS personnel is comparable with international figures. Less than half of EMS personnel exhibit knowledge regarding the process of violence reporting. However, workers tend not to report the incidents because they often believe that reporting is useless and/or not important.Recommendation: With a high reported rate of workplace violence among EMS personnel, we recommend national preventive measures and encouragement to professionals to report violent events. We also recommend awareness programs for the identified vulnerable group.

Implementation of the Recommendations of the Institute of Medicine Report, Emergency Medical Services for Chi: Registered Nurses

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 194-199
Author(s):  
Deborah Parkman Henderson ◽  
June D. Thompson
Keyword(s):  
Health Care ◽  
Registered Nurses ◽  
Emergency Medical Services ◽  
Health Care Providers ◽  
Nursing Care ◽  
The United States ◽  
Medical Services ◽  
Institute Of Medicine ◽  
Care Providers ◽  
Emergency Medical

Registered nurses are the single largest group of health care providers in the United States. Their role in emergency medical services for chi and approaches to implementation of the Institute of Medicine recommendations as they relate to nursing care are discussed.

Evaluation of the NIO and T.A.L.O.N Intraosseous Devices as Placed by U.S. Army Conventional Force Combat Medics—A Randomized Crossover Study

2021 ◽  
Author(s):  
Pascal Lange ◽  
Mohamad Umar ◽  
Jerimiah D Walker ◽  
Mark Riddle ◽  
Paul Mochmer
Keyword(s):  
Crossover Study ◽  
Success Rate ◽  
Health Care Providers ◽  
Humeral Head ◽  
Proximal Tibia ◽  
Ease Of Use ◽  
Care Providers ◽  
Significant Difference ◽  
Combat Medics ◽  
Randomized Crossover Study

ABSTRACT Introduction In recent U.S. Military conflicts, hemorrhage remains the leading cause of preventable death with 30%-40% mortality rates. Management consists of effective bleeding control and rapid resuscitation with blood products. Rapid and accurate circulatory access is crucial in battlefield trauma management. This study evaluates the insertion success rate and time to successfully insert the NIO automatic intraosseous (IO) device and the Tactical Advanced Lifesaving IO Needle (TALON) manual IO device. The primary outcome is successful first attempt insertion. Secondary outcomes are the time taken for the successful insertion, user-reported “ease of use” for both devices, and user-reported device preference. Materials and Methods This is a prospective randomized crossover study comparing the NIO and TALON devices. As they are often the frontline health care providers, combat medics (68W) were recruited to participate in this study. They were randomized into two cohorts based on the IO device and location they would start first. Each medic performed a total of four IO cannulations on the proximal tibia and the humeral head of cadaveric human models. Results Sixty medics participated in the study, performing a total of 240 IO insertions, 120 with NIO (60 at the proximal tibia and 60 at the humeral head) and 120 with TALON (60 at the proximal tibia and 60 at the humeral head). The first attempt success rate was 89.2% for the NIO and 83.3% for the TALON, P = .19. The time to successful first attempt insertion for the NIO [M = 24.71 seconds, SD = 4.72] and the TALON, [M = 24.70 seconds, SD = 4.74] were similar, P = .98. The differences between the success of device insertion and time to successful insertion did not achieve statistical significance. The “ease of use” score (5-point Likert Scale) for the NIO [M = 4.73] and the TALON, [M = 4.11], demonstrated a significant difference, P < .001. Ninety percent [n = 54] of the combat medics preferred the NIO versus only 10% [n = 6] preferred TALON. Conclusions Our findings indicate that the overall insertion success rate and time to successful insertion were similar between NIO automatic IO device and the TALON manual IO device. In our study, Army combat medics learned how to use both devices rapidly but felt the NIO automatic IO device easier to use and overwhelmingly preferred this device.

Medical Planning for Mass Gatherings: A Retrospective Review of the San Antonio Papal Mass

1991 ◽  
Vol 6 (4) ◽  
pp. 443-450 ◽  
Author(s):  
David A. Hnatow ◽  
Donald J. Gordon
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
San Antonio ◽  
Heat Index ◽  
Medical Attention ◽  
Care Providers ◽  
Emergency Medical Care ◽  
Medical Problems ◽  
Emergency Medical

AbstractThere are limited data available and no recognized standards or guidelines for providing emergency medical care at large public event The organizational planning of emergency medical care for the 1987 San Antonio Papal Mass was reviewed. Medical care was provided using a multi-tiered system. The San Antonio EMS system played a leading role in the design, administration, and implementation of this medical care.An analysis of the types and frequencies of emergency medical problems encountered by health care providers is detailed. The total attendance was approximately 100,000, 1.5% (1553) required medical attention, and 241 were evaluated on-site by physicians. The majority of medical problems encountered were managed by non-physician, health care providers.Severe environmental conditions with a heat index exceeding 102°F were responsible for 174 cases (72%) of heat-related illness. A total of 55 patients required transport to local emergency department. There were no cardiopulmonary arrests, major injuries, or deaths.

scholarly journals Measuring Quality in Emergency Medical Services: A Review of Clinical Performance Indicators

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Mazen J. El Sayed
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Health Care Providers ◽  
Performance Indicators ◽  
Clinical Performance ◽  
Medical Services ◽  
Care Providers ◽  
Quality Initiatives ◽  
Control Programs ◽  
Emergency Medical

Measuring quality in Emergency Medical Services (EMSs) systems is challenging. This paper reviews the current approaches to measuring quality in health care and EMS with a focus on currently used clinical performance indicators in EMS systems (US and international systems). The different types of performance indicators, the advantages and limitations of each type, and the evidence-based prehospital clinical bundles are discussed. This paper aims at introducing emergency physicians and health care providers to quality initiatives in EMS and serves as a reference for tools that EMS medical directors can use to launch new or modify existing quality control programs in their systems.

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