Emergency Medical Technicians
Allied Health Personnel
Emergency Medical Services
Heart Arrest
Emergencies
Animal Technicians
Resuscitation from out-of-hospital cardiac arrest: is survival dependent on who is available at the scene? (1/217)
OBJECTIVE: To determine whether survival from out-of-hospital cardiac arrest is influenced by the on-scene availability of different grades of ambulance personnel and other health professionals. DESIGN: Population based, retrospective, observational study. SETTING: County of Nottinghamshire with a population of one million. SUBJECTS: All 2094 patients who had resuscitation attempted by Nottinghamshire Ambulance Service crew from 1991 to 1994; study of 1547 patients whose arrest were of cardiac aetiology. MAIN OUTCOME MEASURES: Survival to hospital admission and survival to hospital discharge. RESULTS: Overall survival from out-of-hospital cardiac arrest remains poor: 221 patients (14.3%) survived to reach hospital alive and only 94 (6.1%) survived to be discharged from hospital. Multivariate logistic regression analysis showed that the chances of those resuscitated by technician crew reaching hospital alive were poor but were greater when paramedic crew were either called to assist technicians or dealt with the arrest themselves (odds ratio 6.9 (95% confidence interval 3.92 to 26.61)). Compared to technician crew, survival to hospital discharge was only significantly improved with paramedic crew (3.55 (1.62 to 7.79)) and further improved when paramedics were assisted by either a health professional (9.91 (3.12 to 26.61)) or a medical practitioner (20.88 (6.72 to 64.94)). CONCLUSIONS: Survival from out-of-hospital cardiac arrest remains poor despite attendance at the scene of the arrest by ambulance crew and other health professionals. Patients resuscitated by a paramedic from out-of-hospital cardiac arrest caused by cardiac disease were more likely to survive to hospital discharge than when resuscitation was provided by an ambulance technician. Resuscitation by a paramedic assisted by a medical practitioner offers a patient the best chances of surviving the event. (+info)Influence of ambulance crew's length of experience on the outcome of out-of-hospital cardiac arrest. (2/217)
AIMS: To investigate whether an ambulance crew's length of experience affected the outcome of out-of-hospital cardiac arrest. METHODS AND RESULTS: This was a population-based, retrospective observational study of attempted resuscitations in 1547 consecutive arrests of cardiac aetiology by Nottinghamshire Emergency Ambulance Service crew. One thousand and seventy-one patients were managed by either a paramedic or a technician crew without assistance from other trained individuals at the scene of arrest. Overall, the chances of a patient surviving to be discharged from hospital alive did not appear to be affected by the paramedic's length of experience (among survivors, 18 months experience vs non-survivors 16 months experience, P = 0.347) but there appears to be a trend in the effect of a technician's length of experience on survival (among survivors, 60 months experience vs non-survivors 28 months experience, P = 0.075). However, when a technician had 4 years of experience or more and a paramedic 1 year's experience, survival rates did improve. Logistic regression analysis, adjusted for factors known to influence outcome, revealed that chances of survival increased once technicians had over 4 years of experience after qualification (odds ratio 2.71, 95% CI 1.17 to 6.32, P = 0.02) and paramedics after just 1 year of experience (odds ratio 2.68, 95% CI 1.05 to 6.82, P = 0.04). CONCLUSIONS: Survival from out-of-hospital cardiac arrest varies with the type of ambulance crew and length of experience after qualification. Experience in the field seems important as paramedics achieve better survival rates after just 1 year's experience, while technicians need to have more than 4 years' experience to improve survival. (+info)Comparison of naive sixth-grade children with trained professionals in the use of an automated external defibrillator. (3/217)
BACKGROUND: Survival after out-of-hospital cardiac arrest (OHCA) is strongly influenced by time to defibrillation. Wider availability of automated external defibrillators (AEDs) may decrease response times but only with increased lay use. Consequently, this study endeavored to improve our understanding of AED use in naive users by measuring times to shock and appropriateness of pad location. We chose sixth-grade students to simulate an extreme circumstance of unfamiliarity with the problem of OHCA and defibrillation. The children's AED use was then compared with that of professionals. METHODS AND RESULTS: With the use of a mock cardiac arrest scenario, AED use by 15 children was compared with that of 22 emergency medical technicians (EMTs) or paramedics. The primary end point was time from entry onto the cardiac arrest scene to delivery of the shock into simulated ventricular fibrillation. The secondary end point was appropriateness of pad placement. All subject performances were videotaped to assess safety of use and compliance with AED prompts to remain clear of the mannequin during shock delivery. Mean time to defibrillation was 90+/-14 seconds (range, 69 to 111 seconds) for the children and 67+/-10 seconds (range, 50 to 87 seconds) for the EMTs/paramedics (P<0.0001). Electrode pad placement was appropriate for all subjects. All remained clear of the "patient" during shock delivery. CONCLUSIONS: During mock cardiac arrest, the speed of AED use by untrained children is only modestly slower than that of professionals. The difference between the groups is surprisingly small, considering the naivete of the children as untutored first-time users. These findings suggest that widespread use of AEDs will require only modest training. (+info)Response of paramedics to terminally ill patients with cardiac arrest: an ethical dilemma. (4/217)
BACKGROUND: In an environment characterized by cuts to health care, hospital closures, increasing reliance on home care and an aging population, more terminally ill patients are choosing to die at home. The authors sought to determine the care received by these patients when paramedics were summoned by a 911 call and to document whether do-not-resuscitate (DNR) requests influenced the care given. METHODS: The records of a large urban emergency medical services system were reviewed to identify consecutive patients with cardiac arrest over the 10-month period November 1996 to August 1997. Data were abstracted from paramedics' ambulance call reports according to a standardized template. The proportion of these patients described as having a terminal illness was determined, as was the proportion of terminally ill patients with a DNR request. The resuscitative efforts of paramedics were compared for patients with and without a DNR request. RESULTS: Of the 1534 cardiac arrests, 144 (9.4%) involved patients described as having a terminal illness. The mean age of the patients was 72.2 (standard deviation 14.8) years. Paramedics encountered a DNR request in 90 (62.5%) of these cases. Current regulations governing paramedic practice were not followed in 34 (23.6%) of the cases. There was no difference in the likelihood that cardiopulmonary resuscitation (CPR) would be initiated between patients with and those without a DNR request (73% v. 83%; p = 0.17). In patients for whom CPR was initiated, paramedics were much more likely to withhold full advanced cardiac life support if there was a DNR request than if there was not (22% v. 68%; p < 0.001). INTERPRETATION: Paramedics are frequently called to attend terminally ill patients with cardiac arrest. Current regulations are a source of conflict between the paramedic's duty to treat and the patient's right to limit resuscitative efforts at the time of death. (+info)Prehospital care--a UK perspective. (5/217)
In the UK, emergency ambulances are responding to astonishing increases in levels of emergency calls, in the order of a 40% increase nationally in the last 5 years. Pressures in primary care service out-of-hours provision, and increasing community-based care of elderly patients, as well as increased expectation by the public are contributory causes. Services are also being pressed to improve response times, particularly to life-threatening cases. These various aspects are discussed below. (+info)Public health consequences among first responders to emergency events associated with illicit methamphetamine laboratories--selected states, 1996-1999. (6/217)
Methamphetamine, a central nervous system stimulant, is manufactured in illicit laboratories using over-the-counter ingredients. Many of these ingredients are hazardous substances that when released from active or abandoned methamphetamine laboratories can place first responders at risk for serious injuries and death. In 16 states, the Agency for Toxic Substances and Disease Registry maintains the Hazardous Substances Emergency Events Surveillance (HSEES) system to collect and analyze data about the morbidity and mortality associated with hazardous substance-release events. Based on events reported to HSEES during 1996-1999, this report describes examples of events associated with illicit methamphetamine laboratories that resulted in injuries to first responders in three states, summarizes methamphetamine-laboratory events involving injured first responders, and suggests injury prevention methods to protect first responders. (+info)Ambulance personnel and critical incidents: impact of accident and emergency work on mental health and emotional well-being. (7/217)
BACKGROUND: The association between mental health and occupational factors among ambulance personnel has not been thoroughly investigated in the UK. AIMS: To identify the prevalence of psychopathology among ambulance personnel and its relationship to personality and exposure to critical incidents. METHOD: Data were gathered from ambulance personnel by means of an anonymous questionnaire and standardised measures. RESULTS: Approximately a third of the sample reported high levels of general psychopathology, burnout and posttraumatic symptoms. Burnout was associated with less job satisfaction, longer time in service, less recovery time between incidents, and more frequent exposure to incidents. Burnout and GHQ-28 caseness were more likely in those who had experienced a particularly disturbing incident in the previous 6 months. Concerns about confidentiality and career prospects deter staff from seeking personal help. CONCLUSIONS: The mental health and emotional well-being of ambulance personnel appear to be compromised by accident and emergency work. (+info)Regional access to acute ischemic stroke intervention. (8/217)
BACKGROUND AND PURPOSE: Benefit-risk ratios from recombinant tissue plasminogen activator (rtPA) therapy for acute ischemic stroke demonstrate lack of efficacy if intravenous administration is commenced beyond 3 hours of symptom onset. We undertook to enhance therapeutic effectiveness by ensuring equitable access to rtPA for patients affected by acute ischemic stroke within a 20 000 km(2) population referral base served by a tertiary facility. METHODS: Representatives of all provider groups involved in emergency medical services developed a Regional Acute Stroke Protocol (RASP), a coordinated regional system response by dispatch personnel, paramedics, physicians, community service providers, emergency and inpatient staff in community hospitals, and the tertiary facility acute stroke team. RESULTS: As of July 26, 1999, all ambulance services in Southeastern Ontario began bypassing the closest hospital to deliver patients meeting the criteria for the RASP to the Kingston General Hospital. At 12 months, approximately 403 ischemic strokes have occurred in the region, the RASP has been activated 191 times, and 42 patients have received rtPA. CONCLUSIONS: We conclude that (1) acute stroke patients in Southeastern Ontario have improved access to interventions for stroke care; (2) geography of the region is not a barrier to access to interventions for patients with acute stroke; and (3) acute ischemic stroke patients treated with rtPA account for 5% of all acute strokes and 10% of all ischemic strokes in this region. (+info)Emergency Medical Technicians (EMTs) are healthcare professionals who provide emergency medical services to critically ill or injured individuals. They are trained to assess a patient's condition, manage respiratory, cardiac, and trauma emergencies, and administer basic life support care. EMTs may also perform emergency procedures such as spinal immobilization, automated external defibrillation, and administer medications under certain circumstances.
EMTs typically work in ambulances, fire departments, hospitals, and other emergency medical settings. They must be able to work in high-stress situations, make quick decisions, and communicate effectively with other healthcare providers. EMTs are required to obtain certification and maintain continuing education to ensure they are up-to-date on the latest practices and protocols in emergency medicine.
Allied health personnel refers to a group of healthcare professionals who are licensed or regulated to provide specific services within the healthcare system. They work in collaboration with physicians and other healthcare providers to deliver comprehensive medical care. Allied health personnel include various disciplines such as:
1. Occupational therapists
2. Physical therapists
3. Speech-language pathologists
4. Audiologists
5. Respiratory therapists
6. Dietitians and nutritionists
7. Social workers
8. Diagnostic medical sonographers
9. Radiologic technologists
10. Clinical laboratory scientists
11. Genetic counselors
12. Rehabilitation counselors
13. Therapeutic recreation specialists
These professionals play a crucial role in the prevention, diagnosis, and treatment of various medical conditions and are essential members of the healthcare team.
Emergency Medical Services (EMS) is a system that provides immediate and urgent medical care, transportation, and treatment to patients who are experiencing an acute illness or injury that poses an immediate threat to their health, safety, or life. EMS is typically composed of trained professionals, such as emergency medical technicians (EMTs), paramedics, and first responders, who work together to assess a patient's condition, administer appropriate medical interventions, and transport the patient to a hospital or other medical facility for further treatment.
The goal of EMS is to quickly and effectively stabilize patients in emergency situations, prevent further injury or illness, and ensure that they receive timely and appropriate medical care. This may involve providing basic life support (BLS) measures such as cardiopulmonary resuscitation (CPR), controlling bleeding, and managing airway obstructions, as well as more advanced interventions such as administering medications, establishing intravenous lines, and performing emergency procedures like intubation or defibrillation.
EMS systems are typically organized and managed at the local or regional level, with coordination and oversight provided by public health agencies, hospitals, and other healthcare organizations. EMS providers may work for private companies, non-profit organizations, or government agencies, and they may be dispatched to emergencies via 911 or other emergency response systems.
In summary, Emergency Medical Services (EMS) is a critical component of the healthcare system that provides urgent medical care and transportation to patients who are experiencing acute illnesses or injuries. EMS professionals work together to quickly assess, stabilize, and transport patients to appropriate medical facilities for further treatment.
Cardiac arrest, also known as heart arrest, is a medical condition where the heart suddenly stops beating or functioning properly. This results in the cessation of blood flow to the rest of the body, including the brain, leading to loss of consciousness and pulse. Cardiac arrest is often caused by electrical disturbances in the heart that disrupt its normal rhythm, known as arrhythmias. If not treated immediately with cardiopulmonary resuscitation (CPR) and defibrillation, it can lead to death or permanent brain damage due to lack of oxygen supply. It's important to note that a heart attack is different from cardiac arrest; a heart attack occurs when blood flow to a part of the heart is blocked, often by a clot, causing damage to the heart muscle, but the heart continues to beat. However, a heart attack can sometimes trigger a cardiac arrest.
A dental technician is a healthcare professional who designs, fabricates, and repairs custom-made dental devices, such as dentures, crowns, bridges, orthodontic appliances, and implant restorations. They work closely with dentists and other oral health professionals to meet the individual needs of each patient. Dental technicians typically have an associate's degree or certificate in dental technology and may be certified by a professional organization. Their work requires a strong understanding of dental materials, fabrication techniques, and the latest advances in dental technology.
An emergency is a sudden, unexpected situation that requires immediate medical attention to prevent serious harm, permanent disability, or death. Emergencies can include severe injuries, trauma, cardiac arrest, stroke, difficulty breathing, severe allergic reactions, and other life-threatening conditions. In such situations, prompt medical intervention is necessary to stabilize the patient's condition, diagnose the underlying problem, and provide appropriate treatment.
Emergency medical services (EMS) are responsible for providing emergency care to patients outside of a hospital setting, such as in the home, workplace, or public place. EMS personnel include emergency medical technicians (EMTs), paramedics, and other first responders who are trained to assess a patient's condition, provide basic life support, and transport the patient to a hospital for further treatment.
In a hospital setting, an emergency department (ED) is a specialized unit that provides immediate care to patients with acute illnesses or injuries. ED staff includes physicians, nurses, and other healthcare professionals who are trained to handle a wide range of medical emergencies. The ED is equipped with advanced medical technology and resources to provide prompt diagnosis and treatment for critically ill or injured patients.
Overall, the goal of emergency medical care is to stabilize the patient's condition, prevent further harm, and provide timely and effective treatment to improve outcomes and save lives.
An Animal Technician, also known as a Laboratory Animal Technician, is a professional who cares for and handles animals in a research or testing facility. They are responsible for ensuring the welfare and well-being of the animals, which includes providing them with proper housing, feeding, and medical care. They also assist researchers and veterinarians with procedures and experiments involving animals, and help to maintain accurate records of animal health and behavior.
Animal Technicians must have a strong understanding of animal biology, husbandry, and ethology, as well as knowledge of relevant regulations and guidelines governing the use of animals in research. They may work with a variety of species, including rodents, dogs, cats, non-human primates, and farm animals.
In addition to their technical skills, Animal Technicians must also have excellent observational and communication skills, as they are often responsible for monitoring animal behavior and reporting any changes or concerns to researchers or veterinarians. They must be able to work independently and as part of a team, and may need to work flexible hours, including evenings and weekends, to meet the needs of the animals in their care.
An emergency service in a hospital is a department that provides immediate medical or surgical care for individuals who are experiencing an acute illness, injury, or severe symptoms that require immediate attention. The goal of an emergency service is to quickly assess, stabilize, and treat patients who require urgent medical intervention, with the aim of preventing further harm or death.
Emergency services in hospitals typically operate 24 hours a day, 7 days a week, and are staffed by teams of healthcare professionals including physicians, nurses, physician assistants, nurse practitioners, and other allied health professionals. These teams are trained to provide rapid evaluation and treatment for a wide range of medical conditions, from minor injuries to life-threatening emergencies such as heart attacks, strokes, and severe infections.
In addition to providing emergency care, hospital emergency services also serve as a key point of entry for patients who require further hospitalization or specialized care. They work closely with other departments within the hospital, such as radiology, laboratory, and critical care units, to ensure that patients receive timely and appropriate treatment. Overall, the emergency service in a hospital plays a crucial role in ensuring that patients receive prompt and effective medical care during times of crisis.
National Association of Emergency Medical Technicians