Emergency Ambulance Personnel Research Articles

Postmortem Identification of a Foreign Body in the Heart: A Case Report.

The presence of a foreign body in the heart have been reported, mostly in adults. Deaths and injuries can result from the breakage or rupture of angiography catheters. We present a case in which an angiocath tip was identified in the right ventricle of a pediatric patient, and the patient died as a result thereof. As no similar cases have been reported, we would like to draw attention to this subject. A 4.5-month-old female patient who was hospitalized 3 times during her life had a history of peripheral venous access establishment in the extremities with angiocatheters. During these hospital admissions, a central catheter was not inserted, and no additional problems were identified. Emergency personnel responded and found the patient at home, experiencing bradycardia and arrhythmia. She was resuscitated and taken to the hospital, where she died. The autopsy revealed, the tip of a 1.5cm long, 1mm wide lumen catheter had penetrated the right ventricular wall (Fig.1) (Fig.2), thus her death was attributed to complications that developed as a result of the peripheral vascular access catheter tip breaking and migrating to the right ventricle. Although the patient did not have an ECG, physical examination by the emergency ambulance personnel revealed an irregular and bradycardic heartbeat, suggesting that the child may have developed arrhythmia and atrioventricular conduction block. Health care professionals must check upon removal of peripheral intravenous access, and record whether the integrity of the peripheral catheter tip was compromised to prevent similar events in future. Fig.1 Angiocath tip piercing the right ventricular wall and exiting the heart Fig.2 a A 1.5cm long, b 1mm wide lumen catheter tip penetrating the right ventricular wall.

The Construction of the Sequential Medical System for Trauma Care

The connection between pre-hospital and in-hospital emergency care is paramount in determining the survival rate of trauma patients. Sequential Medical System (SMS) puts an accent on the continuous and efficient entire process of trauma treatment, which promotes the connection of pre-hospital and in-hospital medical activities from “seamless” to “deep convergence” by information sharing platforms, joint teaching rounds, and cooperative medical science popularization. SMS upholds a “people’s health-centered” approach under the guidance of Healthy China Strategy, and its application enables emergency ambulance personnel to participate in the teaching rounds at hospitals, and follow up with their patients. SMS contributes to enhancing patients’ experience, especially to improve the efficiency of the emergency green channel for severe trauma patients. The system embodies the human-oriented discipline in trauma treatment, and facilitates the innovation research on medical and health system reform.

Family & bystander experiences of emergency ambulance services care: a scoping review

BackgroundEmergency ambulance personnel respond to a variety of incidents in the community, including medical, trauma and obstetric emergencies. Family and bystanders present on scene may provide first aid, reassurance, background information or even act as proxy decision-makers. For most people, involvement in any event requiring an emergency ambulance response is a stressful and salient experience. The aim of this scoping review is to identify and synthesise all published, peer-reviewed research describing family and bystanders’ experiences of emergency ambulance care.MethodsThis scoping review included peer-reviewed studies that reported on family or bystander experiences where emergency ambulance services responded. Five databases were searched in May 2022: Medline, CINAHL, Scopus, ProQuest Dissertation & Theses and PsycINFO. After de-duplication and title and abstract screening, 72 articles were reviewed in full by two authors for inclusion. Data analysis was completed using thematic synthesis.ResultsThirty-five articles reporting heterogeneous research designs were included in this review (Qualitative = 21, Quantitative = 2, Mixed methods = 10, Evidence synthesis = 2). Thematic synthesis developed five key themes characterising family member and bystander experiences. In an emergency event, family members and bystanders described chaotic and unreal scenes and emotional extremes of hope and hopelessness. Communication with emergency ambulance personnel played a key role in family member and bystander experience both during and after an emergency event. It is particularly important to family members that they are present during emergencies not just as witnesses but as partners in decision-making. In the event of a death, family and bystanders want access to psychological post-event support.ConclusionBy incorporating patient and family-centred care into practice emergency ambulance personnel can influence the experience of family members and bystanders during emergency ambulance responses. More research is needed to explore the needs of diverse populations, particularly regarding differences in cultural and family paradigms as current research reports the experiences of westernised nuclear family experiences.

The effect of social interaction on decision making in emergency ambulance teams: a statistical discourse analysis

IntroductionThis study examined the effects of social interaction, cognitive flexibility, and seniority on the correct response among emergency ambulance teams during case intervention.MethodsThe research, structured with the sequential exploratory mixed method, was conducted with 18 emergency ambulance personnel. The approach process of the teams working on the scenario was video recorded. The records were transcribed by the researchers, including gestures and facial expressions. Discourses were coded and modeled with regression.ResultsThe number of discourses was higher in groups with high correct intervention scores. As the level of cognitive flexibility or seniority increased, the correct intervention score tended to decrease too. Informing has been identified as the only variable that positively affects the correct response to the emergency case, especially in the first period, which is directed toward case intervention preparation.ConclusionWithin the findings of the research, it is recommended that activities and scenario-based training practices that will increase the intra-team communication of the emergency ambulance personnel should be included in the medical education and in-service training.

‘Mum, I think we might ring the ambulance, okay?’ A qualitative exploration of bereaved family members’ experiences of emergency ambulance care at the end of life

Background: In the context of a sudden or unexpected event, people with a life-limiting illness and their family caregivers may be dependent on emergency ambulance services Aim: To explore bereaved family members’ experiences of emergency ambulance care at the end of life. Design: A qualitative study using reflexive thematic analysis of data collected from semi-structured phone interviews. Setting/Participants: A purposive sample of 38 family caregivers identified from a database of deaths in Aotearoa, New Zealand. Results: Emergency ambulance personnel assist, inform and reassure patients and family caregivers managing distressing symptoms, falls, infections, unexpected events and death itself. Family members and patients are aware of the pressure on emergency services and sometimes hesitate to call an ambulance. Associating ambulances with unwanted transport to hospital is also a source of reluctance. Conclusions: The generalist palliative care provided by emergency ambulance personnel is a vital service for patients in the last year of life, and their caregivers. This must be acknowledged in palliative care policy and supported with training, specialist consultation and adequate resources.

112 ACİL YARDIM İSTASYONLARININ MEMNUNİYET, VERİMLİLİK, GÜVENLİK VE PERFORMANS AÇISINDAN DEĞERLENDİRME ÖLÇEĞİNİN GELİŞTİRİLMESİ VE UYGULAMA ÖRNEĞİ

Amaç: Çalışmanın amacı, çalışan personel görüşleri ile 112 acil yardım istasyonlarının memnuniyet, verimlilik, güvenlik ve performans açısından değerlendirilmesi için geçerli ve güvenilir bir ölçme aracının geliştirilmesidir.Gereç ve Yöntem: Betimsel tarzda yapılandırılan çalışmada aday ölçek maddelerinin elde edilmesi için 112 acil yardım istasyonlarında görevli 50 personelden açık uçlu soru uygulaması ile 44 maddeden oluşan soru havuzu elde edilmiştir. İlk uygulamada 112 acil yardım istasyonunda görev yapan 414 çalışandan elde edilen verilerle açıklayıcı faktör analizi ve güvenirlik analizi, ikinci uygulamada 230 çalışandan elde edilen verilerle doğrulayıcı faktör analizi gerçekleştirilmiştir. Araştırma kapsamında geliştirilen bağımsız dört ölçek ile yapılan örnek uygulamadan elde edilen skorlarla katılımcıların demografik özellikleri karşılaştırma testleri ile analiz edilmiştir. Verilerin analizinde SPSS 26,0 ve AMOS istatistik yazılımı kullanılmıştır. Araştırmada 59 faklı ilde görev yapan toplam 644 katılımcıdan veri toplanmıştır.Bulgular: Araştırmanın ilk aşamasında oluşturulan anket formu içerisinden bağımsız dört ölçek geliştirilmiştir. Ölçek alt boyutları açısından bakıldığında güvenilirlik değerleri memnuniyet alt boyutu için 0,878; verimlilik alt boyutu için 0,856; performans alt boyutu için 0,825 ve güvenlik alt boyutu için 0,935 olduğu belirlenmiştir. Araştırma kapsamında geliştirilen dört bağımsız ölçeğin 112 acil yardım istasyonlarını memnuniyet, verimlilik, performans ve güvenlik açısından geçerli ve güvenilir biçimde ölçtüğü sonucuna ulaşılmıştır. 112 acil yardı istasyonunda görev yapan personelin cinsiyetleri, unvanları ve görev süreleri ile 112 acil yardım istasyonlarının sağladığı performans, memnuniyet, verimlilik ve güvenlik boyutları ölçek puanları ile anlamlı bir fark tespit edilmemiştir (p>0,05).Sonuç: Geliştirilen ölçek, bu konudaki literatüre ve 112 acil yardım istasyonlarının güvenlik, performans, verimlilik ve memnuniyet açısından geliştirilmesine yönelik çalışmalara katkı sağlayacaktır.

Paramedic care of the dying, deceased and bereaved in Aotearoa, New Zealand

Paramedics play an essential and distinct role as providers of care to the dying, deceased and bereaved in Aotearoa, New Zealand and around the world. In this paper, we highlight what is known about the features, barriers and facilitators of quality end-of-life care by emergency ambulance personnel. We also identify priorities for future policy and practice, education and research in this area. Paramedics provide urgent and after-hours support to those with known life-limiting illness and their caregivers, but also attend sudden deaths, from unexpected or unknown causes. Paramedic care at the end of life may involve attempted resuscitation; challenging decision-making and communication; symptom relief; recognition of irreversible dying; provision of compassionate, culturally responsive support for co-responders, bystanders and the bereaved. There is an insufficient acknowledgement of the critical and unique role of paramedics, as providers of urgent care to the dying deceased and bereaved. Ambulance personnel around the world want better preparation and support for end-of-life care. Future research should aim to evaluate and improve this vital care, explore the needs and experiences of those who call an ambulance in the context of death, dying or bereavement and address equity and cultural responsiveness.

Emergency ambulance service involvement with residential care homes in the support of older people with dementia: an observational study.

BackgroundOlder people resident in care homes have a limited life expectancy and approximately two-thirds have limited mental capacity. Despite initiatives to reduce unplanned hospital admissions for this population, little is known about the involvement of emergency services in supporting residents in these settings.MethodsThis paper reports on a longitudinal study that tracked the involvement of emergency ambulance personnel in the support of older people with dementia, resident in care homes with no on-site nursing providing personal care only. 133 residents with dementia across 6 care homes in the East of England were tracked for a year. The paper examines the frequency and reasons for emergency ambulance call-outs, outcomes and factors associated with emergency ambulance service use.Results56% of residents used ambulance services. Less than half (43%) of all call-outs resulted in an unscheduled admission to hospital. In addition to trauma following a following a fall in the home, results suggest that at least a reasonable proportion of ambulance contacts are for ambulatory care sensitive conditions. An emergency ambulance is not likely to be called for older rather than younger residents or for women more than men. Length of residence does not influence use of emergency ambulance services among older people with dementia. Contact with primary care services and admission route into the care home were both significantly associated with emergency ambulance service use. The odds of using emergency ambulance services for residents admitted from a relative’s home were 90% lower than the odds of using emergency ambulance services for residents admitted from their own home.ConclusionsEmergency service involvement with this vulnerable population merits further examination. Future research on emergency ambulance service use by older people with dementia in care homes, should account for important contextual factors, namely, presence or absence of on-site nursing, GP involvement, and access to residents’ family, alongside resident health characteristics.

Posttraumatic stress disorder among emergency ambulance personnel in Baghdad, Iraq

Posttraumatic stress disorder among emergency ambulance personnel in Baghdad, Iraq

Personality, Coping and Posttraumatic Growth in Emergency Ambulance Personnel

Inherent in emergency service work is a relatively high level of exposure to potentially traumatic experiences. Traditionally, research has examined the negative or pathological effects that trauma may have on individuals, as well as variables that are proposed to influence post-trauma outcomes, for example, personality, coping, organisational and demographic factors. In recent years, empirical post-trauma research has broadened its scope to investigate positive changes that may also occur following the experience of a traumatic event. This study examines personality and coping variables in relation to levels of posttraumatic growth (PTG) in emergency ambulance personnel (N = 526). Correlations revealed that extraversion, openness, agreeableness, conscientiousness, and coping levels significantly relate to perceptions of PTG. Multiple regression analysis demonstrated that the relationship between personality and PTG is largely mediated by levels of coping. Implications of the research include the tailorin...

Personality, Coping and Posttraumatic Growth in Emergency Ambulance Personnel.

Inherent in emergency service work is a relatively high level of exposure to potentially traumatic experiences. Traditionally, research has examined the negative or pathological effects that trauma may have on individuals, as well as variables that are proposed to influence post-trauma outcomes, for example, personality, coping, organisational and demographic factors. In recent years, empirical post-trauma research has broadened its scope to investigate positive changes that may also occur following the experience of a traumatic event. This study examines personality and coping variables in relation to levels of posttraumatic growth (PTG) in emergency ambulance personnel (N = 526). Correlations revealed that extraversion, openness, agreeableness, conscientiousness, and coping levels significantly relate to perceptions of PTG. Multiple regression analysis demonstrated that the relationship between personality and PTG is largely mediated by levels of coping. Implications of the research include the tailorin...

Associations between organizational and incident factors and emotional distress in emergency ambulance personnel

This study examined the prevalence and correlates of post-traumatic stress disorder (PTSD), anxiety and depression among emergency ambulance personnel. A questionnaire and reminder were sent anonymously to 1029 emergency ambulance personnel in a large ambulance service. Among the 617 respondents, levels of PTSD symptoms did not differ according to grade, but men had a higher prevalence rate than women. Key predictors of the severity of symptoms were organizational stress, the frequency of experiencing potentially traumatic incidents, length of service, and dissociation in response to an index incident. The degree of organizational, but not incident-related, stress discriminated between 'cases' and 'non-cases'. Nine and 23% of recorded scores indicated clinical levels of depression and anxiety respectively. Several work factors were associated with these emotions, explaining 38% of anxiety and 31% of depression scores. Both organizational and individually based interventions may be necessary to minimize PTSD and other emotional disorders among ambulance personnel.

The Prevalence of Post-Traumatic Growth in Emergency Ambulance Personnel

Departing from a deprivation approach to the study of trauma, a small body of literature has recently emerged that examines positive, rather than negative, post-trauma changes. Studies to date have focused on individuals’ positive reactions to a personally endured traumatic event for example, as bereaved parents, living with HIV/AIDS, or surviving cancer. Negative symptoms following a traumatic event that is experienced during the course of fulfilling professional obligations (e.g., in ambulance, fire and police services), are reported to be akin to the negative post-trauma symptoms found in direct survivors of a traumatic event. In this study, we investigated the prevalence of self-reported positive changes (posttraumatic growth) in emergency ambulance personnel, a population that are readily exposed to potentially traumatic incidents. Results indicated that a large proportion of both seasoned ambulance personnel and new recruits to the service, perceived positive changes in themselves that they attributed to having experienced a traumatic event at work. A significant mean difference was also detected between personnel who had endured a personal trauma in addition to a work-related trauma (n = 281) and personnel who had endured trauma only in the course of their employment responsibilities (n = 217). The study supports theoretical and clinical expectations that the experience of occupational trauma can act as a catalyst for significant positive post-trauma changes.

The prevalence of post-traumatic growth in emergency ambulance personnel.

Departing from a deprivation approach to the study of trauma, a small body of literature has recently emerged that examines positive, rather than negative, post-trauma changes. Studies to date have...