Articles: emergency-medical-services.
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Shock is circulatory insufficiency, inadequate oxygen delivery, and cellular hypoxia. Intravenous fluids are essential for shock management. Despite treatment, patients can face persistent shock with ongoing hypotension, contributing to higher mortality. This analysis aims to quantify hypotensive non-traumatic cases in an Australian ambulance service, determine persistent hypotension prevalence, and assess paramedic-administered intravascular fluids' impact on blood pressure changes. ⋯ This study found that three percent of non-traumatic attendances have at least one episode of hypotension, and that more than half of these have persistent hypotension. Only 44% of persistently hypotensive received fluids, and half of persistently hypotensive patients stayed hypotensive despite a reasonable volume of prehospital crystalloids.
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Bystander-applied Automated External Defibrillators (AED) improve outcomes for out-of-hospital cardiac arrest. AED placement is often driven by private enterprise or non-for-profit agencies, which may result in inequitable access. We sought to compare AED availability between four regions in British Columbia (BC). ⋯ BC's four most populous regions demonstrate substantial variability in AED accessibility. Further benefit could be derived from AEDs if placed in locations accessible all hours. Our data may encourage community planning efforts to use data-based strategies to systematically place AEDs in optimal locations with strategies to maximize accessibility.
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Observational Study
Investigating the Relationship Between Psychosocial Safety Climate and Mental Illness Stigma Among Emergency Medical Service Clinicians.
To examine the relationship between psychosocial safety climate (PSC) and mental illness stigma among emergency medical service (EMS) clinicians. Despite the presence of mental health services at many EMS agencies, workers often do not seek treatment due to mental illness stigma. To facilitate treatment receipt and maintain a healthy workforce, we must understand factors contributing to stigma. Psychosocial safety climate refers to the degree to which workers perceive that their organization fosters a work environment focused on the protection of psychological health and safety. Despite its relevance, the relationship between PSC and mental illness stigma has yet to be examined. ⋯ Psychosocial safety climate is an important and modifiable intervention target linked to mental illness stigma in EMS clinicians. Organizational policies, practices, and procedures that convey that mental health is valued and should be protected may reduce stigma and facilitate treatment receipt among this high-risk population.
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Editorial Comment
Prehospital Airway Management - the Continued Search for Evidence.