Prehospital and disaster medicine
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Paramedics rely on establishing a health provider-patient relationship with patients that promotes two-way communication, patient satisfaction, and facilitates appropriate patient assessment and treatment. Paramedics also must have an ability to empathize with patients and their family members in order to develop a successful health provider-patient relationship. The objective of this study was to assess paramedics' empathy and attitudes toward patients with specific conditions. ⋯ The results of this study provide the discipline of paramedic health care with useful data, and provide students, academics, and other educators with important information regarding the improvement of the health provider-patient relationship and paramedic education curriculum development.
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Prehosp Disaster Med · Apr 2013
Multicenter StudyPrehospital Sepsis Project (PSP): knowledge and attitudes of United States advanced out-of-hospital care providers.
Severe sepsis and septic shock are common and often fatal medical problems. The Prehospital Sepsis Project is a multifaceted study that aims to improve the out-of-hospital care of patients with sepsis by means of education and enhancement of skills. The objective of this Project was to assess the knowledge and attitudes in the principles of diagnosis and management of sepsis in a cohort of United States out-of-hospital care providers. ⋯ Poor understanding of the principles of diagnosis and management of sepsis was observed in this cohort, suggesting the need for enhancement of education. Survey items will be used to develop a focused, interactive Web-based learning program. Limitations include potential for self-selection and data accuracy.
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Prehosp Disaster Med · Apr 2013
Level of disaster preparedness in patients visiting the emergency department: results of the civilian assessment of readiness for disaster (CARD) survey.
Patients seeking care in public hospitals are often resource-limited populations who have in past disasters become the most vulnerable. The objective of this study was to determine the personal disaster preparedness of emergency department (ED) patients and to identify predictors of low levels of preparedness. It was hypothesized that vulnerable populations would be better prepared for disasters. ⋯ This study and others have found that only the minority of any group is actually prepared for disaster. Future research should focus on ways to implement disaster preparedness education, specifically targeting vulnerable populations, then measuring the effects of educational programs to demonstrate that preparedness has increased as a result.
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Prehosp Disaster Med · Apr 2013
Amount of usage and involvement in explosions not associated with increased contamination of prehospital vehicles with multi-drug-resistant organisms.
The role of explosions and patient transport vehicles as sources and vectors of Gram-negative, multidrug-resistant organisms (MDROs) that predominate infections following lengthy evacuations after disasters due to natural hazards and in current war-trauma patients is unknown. ⋯ Given the implications that this knowledge gap has on military and civilian prehospital reservoirs of infection, further study is warranted to confirm these findings and identify targets for preventive intervention throughout civilian disaster and military casualty evacuation chains.
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End tidal CO2 (ETCO2) has been established as a standard for confirmation of an airway, but its role is expanding. In certain settings ETCO2 closely approximates the partial pressure of arterial CO2 (PaCO2) and has been described as a tool to optimize a patient's ventilatory status. ETCO2 monitors are increasingly being used by EMS personnel to guide ventilation in the prehospital setting. Severely traumatized and burn patients represent a unique population to which this practice has not been validated. ⋯ ETCO2 is an inadequate tool for predicting PaCO2 or optimizing ventilation in severely injured patients. Adherence to current ETCO2 guidelines in the prehospital setting may contribute to acidosis and increased mortality. Consideration should be given to developing alternate protocols to guide ventilation of the severely injured in the prehospital setting.