scholarly journals Clinical competencies of emergency medical services paramedics in responding to emergency conditions using Objective Structured Clinical Examination (OSCE) in Guilan

2021 ◽  
Vol 7 (2) ◽  
pp. 101-105
Author(s):  
Arash Amirrafiei ◽  
Seyyed Mahdi Zia Ziabari ◽  
Fatemeh Haghshenas-Bakerdar ◽  
Ehsan Kazemnejad-Leili ◽  
Payman Asadi
Keyword(s):  
Emergency Medical Services ◽  
Clinical Examination ◽  
Content Validity ◽  
Work Experience ◽  
Clinical Skills ◽  
Statistical Tests ◽  
Objective Structured Clinical Examination ◽  
Medical Services ◽  
Clinical Competencies ◽  
Emergency Medical

Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE). Methods: In this descriptive study, 70 EMS staff from selected Emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0.7 and 0.8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0.89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests. Results: Findings showed that 56.3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P=0.02) and work experience (P=0.03) as well as clinical skills in confronting trauma. Conclusion: Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.

Abstract 203: Characteristics of Emergency Medical Service Responses for Adults With Cardiovascular Disease-related Chief Complaints in The United States, 2016

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Isaac A Nwaise ◽  
Erika C Odom
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Emergency Medical Services ◽  
Statistical Tests ◽  
The United States ◽  
Medical Services ◽  
National Database ◽  
Patient Disposition ◽  
Emergency Medical ◽  
Chief Complaints

Background: Gaps exist in understanding the commonality of cardiovascular disease (CVD)-related responses by emergency medical services responders in the United States (US) community setting. Objective: We examined characteristics of CVD-related responses among US adults with 9-1-1 emergency medical services (EMS) responses in a national database. Methods: The 2016 National Emergency Medical Services Information System (NEMSIS) database (Version 2.2.1) from 49 states was used. CVD-related chief complaints were defined by data element E09_12 in the NEMSIS code book. Exclusions were EMS cancellations, persons not found, those with unknown sex, and patients aged <18 years. Rates (per 1,000 EMS responses) were calculated for total population and by patient demographics. Chi-square statistical tests were used to assess associations. Percentages of CVD-related chief complaints were calculated for EMS responses (incident patient disposition, type of destination, and reasons for destination), and clinical characteristics (provider’s primary impression, provider’s secondary impression, primary symptom, and EMS condition code). Results: We identified over 19.8 million EMS responses among adults aged ≥18 years old in 2016, including 1,336,684 (67.4 per 1,000 EMS responses) with CVD-related chief complaints. Rates of CVD-related chief complaints per 1,000 EMS responses for females (68.5), patients aged 65-74 years old (87.7), Hawaiian Pacific Islanders (83.6), whites (73.4), and those living in the South census region (72.8) were significantly higher than their respective counterparts. Among EMS responses, most CVD-related chief complaints were treated and transported by EMS (83.1%), and of those transported by EMS, 83.5% were transported to a hospital. Reasons for hospital destinations among adults with CVD-related chief complaints were patient’s preferred hospital (34%) and closest facility (32.9%). Most CVD-related chief complaints were chest pain or discomfort according to provider’s primary impression (48%) and provider’s secondary impressions (6.1%). Finally, pain (46.2%) was the most frequently reported condition as primary symptom among EMS patient with CVD-related chief complaints. Conclusion: Approximately 1-in-15 EMS (9-1-1) responses among adults involved a CVD-related chief complaint. Future research could focus on trends for CVD-related EMS responses overtime. Keyword: 9-1-1 emergency system, prehospital cardiovascular disease, CVD-related events.

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

Vaccination Against Seasonal or Pandemic Influenza in Emergency Medical Services

2016 ◽  
Vol 31 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Alexandre Moser ◽  
Cédric Mabire ◽  
Olivier Hugli ◽  
Victor Dorribo ◽  
Giorgio Zanetti ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Pandemic Influenza ◽  
Work Experience ◽  
Good Health ◽  
Vaccination Rate ◽  
Vaccination Status ◽  
Medical Services ◽  
Publication Type ◽  
Vaccination Rates ◽  
Emergency Medical

AbstractIntroductionInfluenza is a major concern for Emergency Medical Services (EMS); EMS workers’ (EMS-Ws) vaccination rates remain low despite promotion. Determinants of vaccination for seasonal influenza (SI) or pandemic influenza (PI) are unknown in this setting.HypothesisThe influence of the H1N1 pandemic on EMS-W vaccination rates, differences between SI and PI vaccination rates, and the vaccination determinants were investigated.MethodsA survey was conducted in 2011 involving 65 Swiss EMS-Ws. Socio-professional data, self-declared SI/PI vaccination status, and motives for vaccine refusal or acceptation were collected.ResultsResponse rate was 95%. The EMS-Ws were predominantly male (n=45; 73%), in good health (87%), with a mean age of 36 (SD=7.7) years. Seventy-four percent had more than six years of work experience. Self-declared vaccination rates were 40% for both SI and PI (PI+/SI+), 19% for PI only (PI+/SI-), 1.6% for SI only (PI-/SI+), and 39% were not vaccinated against either (PI-/SI-). Women’s vaccination rates specifically were lower in all categories but the difference was not statistically significant. During the previous three years, 92% of PI+/SI+ EMS-Ws received at least one SI vaccination; it was 8.3% in the case of PI-/SI- (P=.001) and 25% for PI+/SI- (P=.001). During the pandemic, SI vaccination rate increased from 26% during the preceding year to 42% (P=.001). Thirty percent of the PI+/SI+ EMS-Ws declared that they would not get vaccination next year, while this proportion was null for the PI-/SI- and PI+/SI- groups. Altruism and discomfort induced by the surgical mask required were the main motivations to get vaccinated against PI. Factors limiting PI or SI vaccination included the option to wear a mask, avoidance of medication, fear of adverse effects, and concerns about safety and effectiveness.ConclusionAverage vaccination rate in this study’s EMS-Ws was below recommended values, particularly for women. Previous vaccination status was a significant determinant of PI and future vaccinations. The new mask policy seemed to play a dual role, and its net impact is probably limited. This population could be divided in three groups: favorable to all vaccinations; against all, even in a pandemic context; and ambivalent with a “pandemic effect.” These results suggest a consistent vaccination pattern, only altered by exceptional circumstances.MoserA, MabireC, HugliO, DorriboV, ZanettiG, Lazor-BlanchetC, CarronPN. Vaccination against seasonal or pandemic influenza in Emergency Medical Services. Prehosp Disaster Med. 2016;31(2):155–162.

Assessing Nursing Students’ Clinical Competencies Using a Problem-Focused Objective Structured Clinical Examination

2016 ◽  
Vol 39 (3) ◽  
pp. 388-399 ◽  
Author(s):  
Xuemei Zhu ◽  
Li Yang ◽  
Ping Lin ◽  
Guizhi Lu ◽  
Ningning Xiao ◽  
...  
Keyword(s):  
Nursing Students ◽  
Undergraduate Students ◽  
Clinical Examination ◽  
Clinical Skills ◽  
Standardized Patients ◽  
Objective Structured Clinical Examination ◽  
Clinical Competencies ◽  
Graduation Examination ◽  
The Difference ◽  
Technical Operation

The objectives of this study were to develop, implement, and evaluate an innovative modified Objective Structured Clinical Examination (OSCE) model, and to compare students’ performance of different clinical skills as assessed by standardized patients and OSCE examiners. Data were obtained from final year undergraduate students undergoing the modified OSCE as a graduation examination. Seventy-seven students rotated through four stations (nine substations). Standardized patients scored students higher than examiners in history taking (9.14 ± 0.92 vs. 8.42 ± 0.85), response to emergency event (8.88 ± 1.12 vs. 7.62 ± 1.54), executive medical orders (8.77 ± 0.96 vs. 8.25 ± 1.43), technical operation (18.21 ± 1.26 vs. 16.91 ± 1.35), nursing evaluation (4.53 ± 0.28 vs. 4.29 ± 0.52), and health education stations (13.79 ± 1.31 vs. 11.93 ± 2.25; p < .01). In addition, the results indicated that the difference between standardized patient and examiner scores for physical examination skills was nonsignificant (8.70 ± 1.18 vs. 8.80 ± 1.27; p > .05). The modified, problem-focused, and nursing process–driven OSCE model effectively assessed nursing students’ clinical competencies, and clinical and critical thinking.

scholarly journals Measuring Adverse Events in Helicopter Emergency Medical Services: Establishing Content Validity

2013 ◽  
Vol 18 (1) ◽  
pp. 35-45 ◽  
Author(s):  
P. Daniel Patterson ◽  
Judith R. Lave ◽  
Christian Martin-Gill ◽  
Matthew D. Weaver ◽  
Richard J. Wadas ◽  
...  
Keyword(s):  
Adverse Events ◽  
Emergency Medical Services ◽  
Content Validity ◽  
Medical Services ◽  
Helicopter Emergency Medical Services ◽  
Emergency Medical

scholarly journals Evaluation of emergency medical services staff knowledge in breaking bad news to patients

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091869
Author(s):  
Paweł Rasmus ◽  
Elżbieta Kozłowska ◽  
Katarzyna Robaczyńska ◽  
Krzysztof Pękala ◽  
Dariusz Timler ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Work Experience ◽  
Medical Personnel ◽  
Bad News ◽  
Medical Services ◽  
Breaking Bad News ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Breaking Bad ◽  
Emergency Medical

Objective The aim of the study was to investigate knowledge of breaking bad news (BBN) among medical personnel in the emergency medical services (EMS). Methods A cross-sectional survey was conducted of 148 individuals employed in EMS. An interview was conducted using a structured questionnaire. Results Of study participants, 89.2% were not aware of any formal BBN procedure and 58.1% had not participated in any form of training. Compared with males, females were more likely to report that dealing with the emotional state of the family or the patient was the most difficult aspect of BBN. Only a few participants were aware of the SPIKES protocol for BBN, and none knew what the acronym meant. Sex, educational level, occupation, work experience and workplace were not associated with knowledge of BBN procedures. Conclusions Knowledge of BBN in both male and female EMS staff was insufficient. EMS personnel held different opinions about the method of BBN. Even staff who have participated in specific BBN training or have extensive professional experience were pessimistic about BBN skills in self-assessments.

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