Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
-
Comparative Study
The prevalence of methicillin-resistant staphylococcus aureus among out-of-hospital care providers and emergency medical technician students.
We compared the methicillin-resistant Staphylococcus aureus (MRSA) carrier rate among out-of-hospital care providers with greater than six months' experience in emergency medical services (EMS) care with that of emergency medical technician (EMT) students with two months or less of observation time as part of their clinical training. ⋯ We found that out-of-hospital care providers and EMT students had higher nasal colonization rates than the reported rate for the U.S. population (0.084% at the time the study was conducted and 1.5% currently). It is imperative that both groups adhere to infection control practices.
-
The aim of this study was to develop and critically appraise a global rating scale (GRS) for the assessment of individual paramedic clinical competence at the entry-to-practice level. ⋯ The results of this study provide evidence that the scores generated using this scale can be valid for the purpose of making decisions regarding paramedic clinical competence.
-
Swift assessment of patients presenting with chest pain results in faster treatment and improved outcomes. Allowing ambulance crews to use point-of-care (POC) devices to measure cardiac troponin I levels during transport of patients to the emergency department (ED) may result in earlier diagnosis of acute myocardial infarction, particularly in those patients without ST-segment elevation. The ability of POC devices to measure cardiac troponin I levels reliably in a moving ambulance has not previously been tested. Objective. This study was conducted to determine whether POC devices operated in a moving ambulance reliably duplicate the measurement of cardiac troponin I levels obtained by POC devices in the ED. ⋯ When used in a moving ambulance, the POC device provided results of cardiac troponin I assays that were highly correlated to the results when the device was used in the ED. The feasibility, practicality, and clinical utility of prehospital use of POC devices must still be assessed. Key words: point-of-care systems; prehospital emergency care; troponin; reliability of results; ambulances; myocardial infarction; chest pain.
-
Intravenous (IV) line placement is an important prehospital advanced life support skill, but IV success rates are variable among providers. Little is known about what factors are associated with successful IV placement, limiting the ability to develop benchmarks for skill maintenance, such as requiring a specific number of IV placements per year. ⋯ In this retrospective study, larger IV catheter size, but not the prehospital providers' previous year's experience, was associated with successful IV placement in adult patients. These data fail to support requirements for a minimum number of yearly IV placements by full-time paramedics to improve success rates.
-
To employ a battery of previously validated surveys and neuropsychological tests to compare changes in fatigue and cognitive abilities of air medical providers after 12- and 24-hour shifts. ⋯ This study identified no changes in cognitive performance following 12- and 24-hour shifts in air medical providers. This suggests that 24-hour shifts in an air medical service with low to moderate utilization do not have a detrimental effect on cognition as measured by this test battery, and are comparable to 12-hour shifts in terms of impact on cognitive function.