Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Case Reports
Pericardiocentesis by an Air Medical Service for Cardiac Tamponade Caused by Purulent Pericarditis.
This case presentation describes the clinical management and course of an adult patient found to be in cardiac tamponade secondary to purulent pericarditis. This etiology represents an uncommon cause of pericardial tamponade and highlights the importance of recognizing clinical signs of this physiological state despite the uncommon presentation. This also reinforces that critical care transport teams must be trained and facile with high acuity-low occurrence skills such as pericardiocentesis as such time-sensitive measures may be necessary to stabilize patients for transport. The patient in this case had clinical improvement after pericardiocentesis was performed and this allowed for the safe transport of the patient to a tertiary care center.
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Infant or child death is reported as being the most distressing type of case paramedics attend. Student paramedics also identify supporting bereaved families as an area associated with low confidence. This study evaluated the CARES skills framework (Connect to emotion, Attention training, Reflective listening, Empathy, Support help seeking) as a peer support model to encourage student paramedics to talk about grief and death related to infants and children. ⋯ Findings contribute to evidence that suggests the CARES model is a useful mechanism to enhance peer social support in paramedic students.
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Like other public safety professions, paramedicine has historically been a male-dominated occupation. Although women are increasingly choosing paramedicine as a career, participation in leadership roles remains limited. Drawing on data from a comprehensive mental health survey, we describe the proportion of women in leadership in a single, large, urban paramedic service in Ontario, Canada. ⋯ Although paramedicine is witnessing an encouraging shift in the demography of its workforce, our results point to a potential under-representation of women in leadership roles. Future research should focus on identifying and ameliorating barriers to career advancement among women and other historically underrepresented people.
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Asthma represents one of the most common medical conditions among children encountered by emergency medical services (EMS). While care disparities for children with asthma have been observed in other healthcare settings, limited data exist characterizing disparities in prehospital care. We sought to characterize differences in prehospital treatment and transport of children with suspected asthma exacerbations by race and ethnicity, within the context of community socioeconomic status. ⋯ Black non-Hispanic children comprised a larger proportion of EMS encounters for asthma and were more likely to receive a bronchodilator in adjusted analyses accounting for community socioeconomic status. However, these children were less likely to be transported by EMS. These findings may reflect disease severity not manifested by abnormal vital signs, management, and other social factors that warrant further investigation.