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34 records – page 1 of 4.

Ambulance nurse's experience to relieve pain in patients with addiction problems in Sweden.

https://arctichealth.org/en/permalink/ahliterature310226
Source
Int Emerg Nurs. 2019 09; 46:100779
Publication Type
Journal Article
Date
09-2019
Author
Katarina Bohm
Roger Lund
Jörgen Nordlander
Veronica Vicente
Author Affiliation
Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset in Stockholm, Sweden; The Emergency Department, Södersjukhuset in Stockholm, Sweden.
Source
Int Emerg Nurs. 2019 09; 46:100779
Date
09-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Ambulances
Emergency Medical Services - methods - standards - trends
Female
Humans
Male
Middle Aged
Nurses - psychology - statistics & numerical data
Pain Management - methods - psychology - standards
Qualitative Research
Substance-Related Disorders - drug therapy - psychology
Sweden
Abstract
Pain is a personal and subjective experience. Prehospital emergency nurses (PEN) should work on the basis that all people are equal and entitled to the same care regardless of gender, age, disability or social status. The objective of treatment in health care is that all the pain to be alleviated. People with addiction problems often seek emergency care and pain is a frequent symptom. Research shows that medical staff often under treats pain and treat patients with addiction differently.
To describe PENSs' experiences of relieving pain in patients with addiction problems, otherwise called Substance Abuse Syndrome.
The study is designed with a qualitative approach with semistructured interviews. Eight PENs were interviewed and the material was analyzed according to a manifest content analysis.
The study's main finding is that the PENs wanted to give all patients equal care but often experienced uncertainty in the care of addicts. Many of the perceived emotions created a doubt in what situations would be resolved. Lack of information and knowledge about addiction and their own feelings and values of addicts made it difficult to decide what was right or wrong treatment. The difficulty was further increased when the unclear guidelines and lack of support meant that the treatment still perceived to be different.
Pain management of patients with drug addiction can be characterized as a complex task that requires a high level of skill. PENs often encounter this population in their work. Several factors lead to their experiencing these care situations as difficult to manage. Treatment guidelines are perceived as unclear and giving weak support as to how patients with addiction and pain should be treated. To handle this, PEN sought support in their decision-making from colleagues in ambulance care and the Emergency Department. Their conclusion was that treatment would be different every time, and that patients with addiction and pain were all treated differently. Despite advances in treatment options, patients will continue to be under-treated. Unfortunately, it is not just better knowledge of pain physiology and pharmacology that is the solution. Knowledge about and attitudes to pain and addiction must be corrected before any behaviour can be changed. The results of this study will hopefully make knowledge more nuanced and raise awareness of shortcomings in order to optimize care and treatment in the prehospital environment.
PubMed ID
31345691 View in PubMed
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[Analysis of causes of pulmonary artery embolism hypodiagnostics at prehospital stage].

https://arctichealth.org/en/permalink/ahliterature122186
Source
Kardiologiia. 2012;52(6):40-7
Publication Type
Article
Date
2012
Author
A A Ermolaev
N F Plavunov
E A Spiridonova
V L Baratashvili
L L Stazhadze
Source
Kardiologiia. 2012;52(6):40-7
Date
2012
Language
Russian
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analysis of Variance
Causality
Comorbidity
Diagnostic Errors - prevention & control - statistics & numerical data
Electrocardiography - methods
Emergency Medical Services - methods - standards - statistics & numerical data
Female
Humans
Male
Middle Aged
Moscow - epidemiology
Physical Examination - methods
Propensity Score
Pulmonary Artery - pathology - physiopathology
Pulmonary Embolism - diagnosis - epidemiology - physiopathology
Risk factors
Abstract
Aim of the study was to analyze causes of pulmonary artery thromboembolism (PATE) hypodiagnostics at prehospital stage. We compared clinical and electrocardiographic picture of acute period of the disease in groups of patients with diagnosed (n=61) and undiagnosed (n=22) PATE at prehospital stage. We also assessed retrospectively probability of PATE according to Revised Geneva Score. In 49 cases we analyzed dynamics of the acute period of PATE. The analysis showed that in more than 50% of cases hypodiagnostics of PATE was caused by similarity of observed clinical and electrocardiographical picture and that of acute coronary syndrome. There were no differences between groups in Revised Geneva Score.
PubMed ID
22839669 View in PubMed
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Cardiopulmonary resuscitation: errors made by pre-hospital emergency medical personnel.

https://arctichealth.org/en/permalink/ahliterature200530
Source
Resuscitation. 1999 Sep;42(1):47-55
Publication Type
Article
Date
Sep-1999
Author
M. Liberman
A. Lavoie
D. Mulder
J. Sampalis
Author Affiliation
Montreal General Hospital Trauma Program, Department of Surgery, McGill University, Québec, Canada. liber001@med.mcgill.ca
Source
Resuscitation. 1999 Sep;42(1):47-55
Date
Sep-1999
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cardiopulmonary Resuscitation - adverse effects - education
Clinical Competence
Emergency Medical Services - methods - standards
Emergency Medical Technicians - education
Evaluation Studies as Topic
Female
Heart Arrest - therapy
Humans
Male
Manikins
Medical Errors
Middle Aged
Abstract
The purpose of the current study was to evaluate the CPR techniques of emergency healthcare professionals (emergency medical technicians, firemen, emergency first responders, CPR instructors). Skills were evaluated using a Laerdal Skillmeter Manikin, which provided a computerized printout of the quantifiable data during the CPR sequence. All of the 66 subjects in the study had completed a recertification course within the last 2 years (mean = 0.86 +/- 0.18, 95% CI). The sequence was videotaped for later viewing and for correlating the errors with the data. In addition, the participants were required to fill in a questionnaire. The most frequently occurring errors were observed in landmarking, overcompression, palpating a carotid pulse and insufficient ventilation. Although 98.5% of participants made an attempt to landmark their position for compression on the sternum, 35.9% of the total compressions performed by all subjects were incorrectly positioned on the patient's chest. Overcompression of the patient's chest accounted for 55.3% of incorrect compressions. Although 94% of participants attempted to verify a carotid pulse, only 45% were able to feel it and therefore stop performing cardiac massage. Of the total ventilations, 49% were below the American Heart Association (AHA) recommended minimum (800 ml). The results of this study showed a high rate of errors occurring in the CPR provided by emergency healthcare professionals.
PubMed ID
10524730 View in PubMed
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[Characteristics of quality and effectiveness of emergency care of patients with battle trauma to the eye].

https://arctichealth.org/en/permalink/ahliterature156798
Source
Voen Med Zh. 2008 Apr;329(4):25-9, 96
Publication Type
Article
Date
Apr-2008
Author
N M Pil'nik
E G Sukhoterina
Source
Voen Med Zh. 2008 Apr;329(4):25-9, 96
Date
Apr-2008
Language
Russian
Publication Type
Article
Keywords
Emergency Medical Services - methods - standards
Eye Injuries - diagnosis - epidemiology - etiology - surgery
Humans
Quality of Health Care
Russia
Trauma Severity Indices
Treatment Outcome
Visual acuity
War
World War II
Abstract
Deep structure and qualitative changes, descended in the Armed Forces under the influence ofscientific-technical progress, requires an active search and using in practice the most effective forms of medical maintenance of the troops, scientifically-reasonable methods of treatment of wounded and ill in new conditions. Experience of medical maintenance of armed conflicts and contingency in peaceful time during the last decade showed the necessity of future improvement of the system of delivery of different health care on stages of evacuation. The article presents the analyze of quality and of effectiveness of delivery of health care to the sufferers with eye-damages in now-day armed conflicts.
PubMed ID
18540412 View in PubMed
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Clinical decision-making described by Swedish prehospital emergency care nurse students - An exploratory study.

https://arctichealth.org/en/permalink/ahliterature284665
Source
Int Emerg Nurs. 2016 Jul;27:46-50
Publication Type
Article
Date
Jul-2016
Author
Tomas Nilsson
Veronica Lindström
Source
Int Emerg Nurs. 2016 Jul;27:46-50
Date
Jul-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Ambulances - manpower
Clinical Competence - standards
Decision Making
Emergency Medical Services - methods - standards
Female
Humans
Male
Middle Aged
Qualitative Research
Students, Nursing - psychology
Sweden
Abstract
The purpose of this study was to explore the PECN students' clinical decision-making during a seven-week clinical rotation in the ambulance services.
Developing expertise in prehospital emergency care practices requires both theoretical and empirical learning. A prehospital emergency care nurse (PECN) is a Registered Nurse (RN) with one year of additional training in emergency care. There has been little investigation of how PECN students describe their decision-making during a clinical rotation.
A qualitative study design was used, and 12 logbooks written by the Swedish PECN students were analysed using content analysis.
The students wrote about 997 patient encounters - ambulance assignments during their clinical rotation. Four themes emerged as crucial for the students' decision-making: knowing the patient, the context-situation awareness in the ambulance service, collaboration, and evaluation. Based on the themes, students made decisions on how to respond to patients' illnesses.
The PECN students used several variables in their decision-making. The decision- making was an on-going process during the whole ambulance assignment. The university has the responsibility to guide the students during their transition from an RN to a PECN. The findings of the study can support the educators and clinical supervisors in developing the programme of study for becoming a PECN.
PubMed ID
26615949 View in PubMed
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Comparison of tracheal intubation and alternative airway techniques performed in the prehospital setting by paramedics: a systematic review.

https://arctichealth.org/en/permalink/ahliterature144948
Source
CJEM. 2010 Mar;12(2):135-40
Publication Type
Article
Date
Mar-2010
Author
Jan L Jensen
Ka Wai Cheung
John M Tallon
Andrew H Travers
Author Affiliation
Division of Emergency Medical Services, Dalhousie University, Dartmouth, Nova Scotia. jljensen@dal.ca
Source
CJEM. 2010 Mar;12(2):135-40
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Allied Health Personnel
Emergency Medical Services - methods - standards
Humans
Intubation, Intratracheal - standards
Ontario
Professional Competence
Respiration, Artificial - methods - standards
Respiratory Insufficiency - therapy
Abstract
This systematic review included controlled clinical trials comparing tracheal intubation (TI) with alternative airway techniques (AAT) (bag mask ventilation and use of extraglottic devices) performed by paramedics in the prehospital setting. A priori outcomes to be assessed were survival, neurologic outcome, airway management success rates and complications. We identified trials using EMBASE, MEDLINE, CINAHL, The Cochrane Library, Web of Science, author contacts and hand searching. We included 5 trials enrolling a total of 1559 patients. No individual study showed any statistical difference in outcomes between the TI and AAT groups. Because of study heterogeneity, we did not pool the data. This is the most comprehensive review to date on paramedic trials. Owing to the heterogeneity of prehospital systems, administrators of each system must individually consider their airway management protocols.
PubMed ID
20219161 View in PubMed
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CPR-only survivors of out-of-hospital cardiac arrest: implications for out-of-hospital care and cardiac arrest research methodology.

https://arctichealth.org/en/permalink/ahliterature194482
Source
Ann Emerg Med. 2001 Jun;37(6):602-8
Publication Type
Article
Date
Jun-2001
Author
V J De Maio
I G Stiell
D W Spaite
R E Ward
M B Lyver
B J Field
D P Munkley
G A Wells
Author Affiliation
Ottawa Hospital Ontario Health Research Institute, Ottawa, Ontario, Canada. vdemaio@home.com
Source
Ann Emerg Med. 2001 Jun;37(6):602-8
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation - methods - standards
Cohort Studies
Electric Countershock
Electrocardiography
Emergency Medical Services - methods - standards
Female
Health Services Research - methods - standards
Heart Arrest - diagnosis - mortality - therapy
Humans
Male
Middle Aged
Ontario - epidemiology
Palpation
Survival Analysis
Survivors - statistics & numerical data
Time Factors
Treatment Outcome
Abstract
There is little evidence that cardiopulmonary resuscitation (CPR) alone may lead to the resuscitation of cardiac arrest victims with other than respiratory causes (eg, pediatric arrest, drowning, drug overdose). The objective of this study was to identify out-of-hospital cardiac arrest survivors resuscitated without defibrillation or advanced cardiac life support.
This observational cohort included all adult survivors of out-of-hospital cardiac arrest of a cardiac cause from phases I and II of the Ontario Prehospital Advanced Life Support Study. During the study period, the system provided a basic life support/defibrillation level of care but no advanced life support. CPR-only patients were patients determined to be without vital signs by EMS personnel who regained a palpable pulse in the field with precordial thump or CPR only and then were admitted alive to the hospital. Six members of a 7-member expert review panel had to rate the patient as either probably or definitely having an out-of-hospital cardiac arrest, and a rhythm strip consistent with a cardiac arrest rhythm had to be present to be considered a patient. Criteria considered were witness status, citizen or first responder CPR, CPR duration, arrest rhythm and rate, and performance of precordial thump.
From January 1, 1991, to June 30, 1997, 9,667 patients with out-of-hospital cardiac arrest were treated. The overall survival rate to hospital discharge was 4.6%. There were 97 apparent CPR-only patients admitted to the hospital. Application of the inclusion criteria yielded 24 CPR-only patients who had true out-of-hospital cardiac arrest and 73 patients judged not to have cardiac arrest. Of the 24 true CPR-only patients admitted to the hospital, 15 patients were discharged alive, 10 patients were witnessed by bystanders, and 7 patients were witnessed by EMS personnel. The initial arrest rhythm was pulseless electrical activity in 9 patients, asystole in 12 patients, and ventricular tachycardia in 3 patients. One patient with ventricular tachycardia converted to sinus tachycardia with a single precordial thump.
CPR-only survivors of true out-of-hospital cardiac arrest do exist; some victims of out-of-hospital cardiac arrest of primary cardiac cause can survive after provision of out-of-hospital basic life support care only. However, many patients found to be pulseless by means of out-of-hospital evaluation likely did not have a true cardiac arrest. This has implications for the survival rates of most, if not all, previous cardiac arrest reports. Survival rates from cardiac arrest may actually be lower if one excludes survivors who never had a true arrest. The absence of vital signs by out-of-hospital assessment alone is not adequate to include patients in research reports or quality evaluations for cardiac arrest.
PubMed ID
11385328 View in PubMed
Less detail

The desired competence of the Swedish ambulance nurse according to the professionals - a Delphi study.

https://arctichealth.org/en/permalink/ahliterature266558
Source
Int Emerg Nurs. 2014 Jul;22(3):127-33
Publication Type
Article
Date
Jul-2014
Author
Jonas Wihlborg
Gudrun Edgren
Anders Johansson
Bengt Sivberg
Source
Int Emerg Nurs. 2014 Jul;22(3):127-33
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Ambulances
Delphi Technique
Emergency Medical Services - methods - standards
Humans
Nursing Staff - standards
Professional Competence - standards
Questionnaires
Sweden
Abstract
Nursing is evolving into new fields of health care including ambulance care, where a branch of specialist nursing is growing. Various views exist on the desired competence for the ambulance nurse and valid guidelines are lacking in Sweden. To increase knowledge of the field, professionals were asked to describe what competences an ambulance nurse should possess. The aim of this study was therefore to elucidate the desired professional competence of the specialist ambulance nurse, according to the professionals. A modified Delphi technique was used, where a panel of professional experts expressed their views on the desired competence of the ambulance nurse. This study reports, at a high level of agreement among the panel experts, that the desired competence of the specialist ambulance nurse consist of forty-four separate competences creating ten areas of competences: execute leadership, generic abilities, interpersonal communication, institutional collaboration, pedagogic skills, possession of relevant knowledge, professional judgement, professional skills, research activities, and technical skills. The high level of agreement among the professionals as well as the large number of competences reflects the high demands placed on the ambulance nurse by the professionals themselves.
PubMed ID
24210954 View in PubMed
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34 records – page 1 of 4.