Articles: emergency-medical-services.
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Scand J Prim Health Care · Sep 2024
Self-injurious thoughts and behaviours as the reason for contact to Norwegian emergency primary care centres: an observational study.
To describe and compare contacts regarding self-injurious thoughts and behaviours to other contacts to emergency primary care. ⋯ The infrequency and severity of these encounters might necessitate training, decision support and procedures to compensate for the health care personnel's limited exposure.
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Scand J Trauma Resus · Sep 2024
Editorial Comment LetterChallenges and considerations in prehospital triage for traumatic brain injury patients.
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Scand J Trauma Resus · Sep 2024
Is time to first CT scan in patients with isolated severe traumatic brain injury prolonged when prehospital arterial cannulation is performed? A retrospective non-inferiority study.
Invasive blood pressure measurement is the in-hospital gold standard to guide hemodynamic management and consecutively cerebral perfusion pressure in patients with traumatic brain injury (TBI). Its prehospital use is controversial since it may delay further care. The primary aim of this study was to test the hypothesis that patients with severe traumatic brain injury who receive prehospital arterial cannulation, compared to those with in-hospital cannulation, do not have a prolonged time between on-scene arrival and first computed tomography (CT) of the head by more than ten minutes. ⋯ Time-interval between on-scene arrival and first head CT in patients with isolated severe traumatic brain injury who received prehospital arterial cannulation was not prolonged compared to those with in-hospital cannulation. This supports early out-of-hospital arterial cannulation performed by experienced providers.
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Prehospital blood gas analysis (BGA) is an evolving field that offers the potential for early identification and management of critically ill patients. However, the utility and accuracy of prehospital BGA are subjects of ongoing debate. ⋯ Prehospital BGA holds significant potential for enhancing patient care in the prehospital setting, though technical challenges need to be considered. However, further research is required to establish optimal indications and demonstrate the benefits for prehospital BGA in specific clinical contexts.
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Palliative medicine · Sep 2024
Development of a palliative paramedicine framework to standardise best practice: A Delphi study.
Growing global demand for palliative care services has prompted generalist clinicians to provide adjunct support to specialist teams. Paramedics are uniquely placed to respond to these patients in the community. However, embedding palliative care principles into their core business will require multifactorial interventions at structural, healthcare service and individual clinician and consumer levels. ⋯ This study has developed a comprehensive national framework addressing the macro-, meso- and micro-level interventions required to standardise palliative paramedicine across Australia. Future research ought to engage a multidisciplinary team to create an implementation strategy, addressing any perceived barriers, facilitators and challenges for applying the framework into policy and practice.