Emergency Health Care Providers Research Articles

HRVEST: a novel data solution for using wearable smart technology to measure physiologic stress variables during a randomized clinical trial

The purpose of this study was to address the logistical and data challenges of using wearable technologies in the context of a clinical trial to measure heart rate variability (HRV) as a marker of physiologic stress in emergency healthcare providers during the COVID-19 pandemic. When using these wearable smart garments, the dilemma is two-fold: (1) the volume of raw physiological data produced is enormous and is recorded in formats not easily portable in standard analytic software, and (2) the commensurate data analysis often requires proprietary software. Our team iteratively developed a novel algorithm called HRVEST that can successfully process enormous volumes of physiologic raw data generated by wearable smart garments and meet the specific needs of HRV analyses. HRVEST is a noise-filtering and data-processing algorithm that allows the precise measurements of heart rate variability (HRV) of clinicians working in an Emergency Department (ED). HRVEST automatically processed the biometric data derived from 413 electrocardiogram (ECG) recordings in just over 15 min. Furthermore, throughout this study, we identified unique challenges of working with these technologies and proposed solutions that may facilitate future use in broader contexts. With HRVEST, using wearable smart garments to monitor HRV over long periods of time becomes logistically and feasibly viable for future studies. We also see the potential for real-time feedback to prophylactically reduce emergency physician stress, like informing optimal break-taking or short meditation sessions to lower heart rate. This could improve emotional wellbeing and, subsequently, clinical decision-making and patient outcomes.

Use of Information Technology Systems for Regional Health Care Information-Sharing and Coordination During Large-Scale Medical Surge Events.

Medical surge events require effective coordination between multiple partners. Unfortunately, the information technology (IT) systems currently used for information-sharing by emergency responders and managers in the United States are insufficient to coordinate with health care providers, particularly during large-scale regional incidents. The numerous innovations adopted for the COVID-19 response and continuing advances in IT systems for emergency management and health care information-sharing suggest a more promising future. This article describes: (1) several IT systems and data platforms currently used for information-sharing, operational coordination, patient tracking, and resource-sharing between emergency management and health care providers at the regional level in the US; and (2) barriers and opportunities for using these systems and platforms to improve regional health care information-sharing and coordination during a large-scale medical surge event. The article concludes with a statement about the need for a comprehensive landscape analysis of the component systems in this IT ecosystem.

Palliative care needs and barriers in an urban Ugandan Emergency Department: A mixed-methods survey of emergency healthcare workers and patients

BackgroundPalliative Care offers patient-centered, symptom-focused relief for patients with incurable disease, and early integration of palliative care ensures quality of life and death while reducing medical impoverishment. The Emergency Department is an ideal yet understudied, under-utilized location to initiate palliative care. ObjectiveTo evaluate the palliative care needs of patients with incurable disease and perceived barriers amongst healthcare providers in the Emergency Department of Kiruddu National Referral Hospital, Kampala, Uganda. MethodsA mixed methods survey of Emergency Department healthcare workers and patients was conducted. A crosse sectional survey of ninety-nine patients was conducted using the integrated Palliative Care Outcome Scale (IPOS). Eleven interviews were conducted with healthcare workers at Kiruddu Hospital, identified by purposive sampling. Descriptive and inferential statistics were used to analyze quantitative data.. Grounded theory approach was used to construct the in depth interview questions, code and analyze qualitative results and collapse these results into final themes. ResultsThe most common diagnoses were HIV/HIV-TB (32 %), heart disease (18 %), and sickle cell disease (14 %). The prevalence of unmet palliative care needs was substantial: more that 70 % of patients reported untreated symptoms e.g., pain, fatigue, difficulty breathing. Seventy-seven percent of the population reported severe or overwhelming pain. The main barriers to provision of palliative care in the Emergency Department as identified by healthcare workers were: (1) lack of adequate training in palliative care; (2) Challenges due to patient volume and understaffing; (3) the misconception that palliative care is associated with pain management alone; (4) Financial constraints as the greatest challenge faced by patients with incurable disease. ConclusionsWe report a high prevalence of unmet palliative care needs among patients in this urban Ugandan Emergency Department, and important barriers reported by emergency healthcare providers. Identification of these barriers offers opportunities to overcome them including harnessing novel mHealth interventions such as clinical support apps or telehealth palliative care consultants. Integration of palliative care in this setting would improve the care of vulnerable patients, provide healthcare workers with an additional care modality while likely adding value to the health system.

Sudden death in the southern region of Saudi Arabia: A retrospective study.

Sudden death is unanticipated, non-violent death taking place within the first 24 h after the onset of symptoms. It is a major public health problem worldwide. Moreover, the effects of living at moderate altitude on mortality are poorly understood. To retrospectively report the frequency and the main causes of sudden deaths in relation to total deaths at Asir Central Hospital, 2255 m above sea level, in the southern region of Saudi Arabia over a period of 4 years from 2013 to 2016. The medical records of 1821 deaths were examined and showed 353 cases (19.4%) of sudden death. The highest incidence of sudden death was among the elderly (51%), whereas, the lowest was among children and adolescents (6.5%). With regard to gender, the incidence of sudden death was higher in males (54.4%) compared to 45.6% in females. In this study, we found that the most common direct causes of sudden death were cardiovascular diseases (29.2%), respiratory disease (22.7%), infectious disease (12.2%), cancer (9.4%) and hematological diseases (6.2%). With respect to seasonal variation, the highest incidence was during winter (31.32%) followed by summer (25.8%). The results of this study will help emergency physicians and health care providers to exercise due care to reduce the incidence of sudden death and raise public awareness about the impact of sudden death.

Integration of information and communication technology in emergency medical services: The Chungbuk Smart Emergency Service Project

Background: The lack of healthcare providers and financial resources in medically vulnerable areas results in reduced access to timely emergency care, leading to higher mortality rates. Utilizing information and communication technology (ICT) in the emergency medical services (EMS) system can potentially reduce health disparities and supplement the shortage of medical personnel. This study introduces the Chungbuk Smart Emergency Medical Service Project to improve EMS in Chungbuk province using ICT.Current Concepts: To improve regional EMS, the Chungbuk EMS Collaboration Committee initiated an ICT-EMS project that incorporates an algorithm-based patient triage system and real-time hospital selection for patient transfers. This initiative is funded by the Smart City Challenge project, which fosters a more comprehensive EMS system by promoting collaboration among local government agencies, local hospitals, and fire headquarters. The system allows the sharing of patients’ information from the notification stage through hospital transfer, thus ensuring efficient treatment and seamless communication between paramedics and health care providers.Discussion and Conclusion: Effective use of ICT for information sharing and coordination during EMS, from ambulance dispatch to hospital treatment, is essential for improving regional EMS. Clear communication, cooperation, and well-defined roles are necessary for the efficient use of ICT by emergency healthcare providers. Making healthcare providers understand the purpose of ICT equipment is crucial for its successful implementation. Verification of the effectiveness of ICT-based EMS improvement projects will lead to their global expansion, besides benefitting domestic EMS.

Knowledge, Attitude, and Associated Factors towards Prehospital Care among Emergency Health Care Providers Working in Selected Prehospital Care Centers in Addis Ababa, Ethiopia: A Cross-Sectional Study.

Patients' health outcomes can suffer as a result of poor knowledge and unfavorable attitude towards prehospital emergency care. The purpose of this study was to assess emergency health care providers' (EHCPs') knowledge, attitude, and associated factors towards prehospital care in selected prehospital Emergency Medical Service institutions in Addis Abeba, Ethiopia. An institutional-based cross-sectional study design was conducted among EHCPs working in the three selected prehospital emergency medical care centers in Addis Ababa. Data were collected using a standard self-administered questionnaire, cleaned, coded, and entered into EPI Data Version 6, and then exported to SPSS Version 26 for further analysis. The generated data were compiled using frequency tables, charts, and percentages. Logistic regression analysis was used to see the association between independent and dependent variables. One hundred thirty-five (135) study participants were included in this study, with a response rate of 95.7%. The mean age of the respondents was 29.2 years (SD = 4.86). Almost three-quarters of the respondents (71.1%) were aged between 26 and 35 years. Of the total participants, 58.5% and 62.2% of EHCPs had good knowledge and a favorable attitude towards prehospital care, respectively. The study revealed that profession (AOR = 3.2; 95% CI, 1.03 - 7.65), educational status (AOR = 1.17; 95% CI, 1.08 - 4.93), and having training (AOR = 2.25; 95% CI, 1.33 - 4.52) were significantly associated with the knowledge of EHCPs. This finding also revealed that the respondent's knowledge (AOR = 1.36; 95% CI, 1.05 - 2.32) and having training (AOR = 3.2; 95% CI, 1.24 - 7.83) were significantly associated with EHCPs' attitudes towards prehospital care. The knowledge and attitude of EHCPs regarding prehospital care were found to be good and favorable as compared to previous studies. In-service training regarding emergency health conditions and the time needed to care for the patient is important for quality prehospital emergency medical care.

The Right to Refuse: Understanding Healthcare Providers' Perspectives on Patient Autonomy in Emergency Care.

Healthcare providers in prehospital care and emergency departments are often at the frontline of medical crises, facing a range of ethical dilemmas, particularly when it comes to patients refusing treatment. This study aimed to delve into the attitudes of these providers toward treatment refusal, unearthing the strategies they employ in navigating such challenging situations while actively working in prehospital emergency health services. Our findings showed that, as the participants' age and experience increased, so did their inclination to respect patient autonomy and avoid persuading them to change their decision about treatment. It was noted that doctors, paramedics, and emergency medical technicians demonstrated a deeper understanding of patients' rights than other medical specialists. However, even with this understanding, the prioritization of patients' rights tended to diminish in life-threatening situations, giving rise to ethical dilemmas. This underlines the complexity of balancing the healthcare professionals' responsibilities and the patients' autonomy, which can generate ethically challenging scenarios for those working in emergency healthcare. By investigating these attitudes and experiences, this study seeks to foster a more profound understanding of the ethical quandaries faced by emergency healthcare providers. Our ultimate aim is to contribute to the development of effective strategies that support both patients and professionals in managing these tough circumstances.

Hacking Acute Care: A Qualitative Study on the Health Care Impacts of Ransomware Attacks Against Hospitals

Cyberattacks are an increasing threat to health care institutions which potentially impair patient outcomes. Current research is limited and focuses mainly on the technical consequences, whereas little is known about health care staff experiences and the effect on emergency care. This study aimed to explore the acute care effect of several large ransomware attacks against hospitals that occurred in Europe and the United States between 2017 and2022. This interview-based qualitative study assessed the experiences of emergency health care professionals and information technology (IT) staff and investigated the challenges during the acute and recovery phase of hospital ransomware attacks. The semistructured interview guideline was based on relevant literature and cybersecurity expert consultation. Transcripts were anonymized, and traceable information regarding participants and/or their organizations was removed for privacy purposes. Nine participants were interviewed, including emergency health care providers and IT-focused staff. Five themes were constructed from the data: effects and challenges regarding patient care continuity, challenges during the recovery process, personal effect on health care staff, preparedness and lessons identified, and future recommendations. According to the participants of this qualitative study, ransomware attacks have a significant effect on emergency department workflow, acute care delivery, and the personal well-being of health care providers. Preparedness for such incidents is limited, and many challenges are encountered during the acute and recovery phase of attacks. Although there was profound hesitancy among hospitals to participate in this study, the limited number of participants provided valuable information that can be used to develop response strategies for hospital ransomware attacks.

Emergency Healthcare Providers’ Perceptions of Preparedness and Willingness to Work during Disasters and Public Health Emergencies

Introduction:This study evaluates the perceptions of preparedness and willingness to work during disasters and public health emergencies among 213 healthcare workers from 10 ministries of health hospitals in the southern region of Saudi Arabia, which is exposed to the risk of disasters such as flash floods in wadis, fires, sandstorms, armed conflicts at the border and ongoing waves of COVID-19 pandemic.Method:This study employed a quantitative research design by using a survey (Fight or Flight).Results:The results showed that participants' willingness to work unconditionally during disasters and emergencies varied based on the type of condition: natural disasters (61.97%), seasonal influenza pandemic (52.58%), smallpox pandemic (47.89%), SARS/COVID-19 pandemic (43.56%), special flu pandemic (36.15%), mass shooting (37.56%), chemical incident and bombing threats (31.92%), biological events (28.17%), Ebola outbreaks (27.7%), and nuclear incident (24.88%).Conclusion:Among several factors that determine healthcare workers’ willingness to work during disasters and public health emergencies, appropriate knowledge and skills to confidently manage an incident and the assurance of their families’ safety are two decisive factors. Although we could only find a significant correlation between education and willingness to work during emergencies, previous reports have confirmed a significant correlation between education, age, and years of experience and the perception of hazards and fear and consequently willingness to work under threatening circumstances. While unsuccessful management of disasters and emergencies may be the result of organizational shortcomings and resource scarcity, healthcare workers’ lack of knowledge, skills, and confidence and emotional distractions due to uncertainty about their own safety and that of their families may also play a significant role. Besides educational initiatives, which increase staff members’ confidence through knowledge acquisition and skill improvement, other measures, which guarantee their families’ safety and well-being during an emergency, should be established and implemented.

The consequences of emotionally evocative patient behaviors on emergency nurses' patient assessments and handoffs: An experimental study using simulated patient cases

BackgroundEngaging with human emotions is an integral but poorly understood part of the work of emergency healthcare providers. Patient factors (e.g., irritable behavior; mental illness) can evoke strong emotions, and evidence suggests that these emotions can impact care quality and patient safety. Given that nurses play a critical role in providing high quality care, efforts to identify and remedy factors that may compromise care are needed. Yet to date, few experiments have been conducted. ObjectiveTo examine the effects of emotionally evocative patient behavior as well as the presence of mental illness on emergency nurses' emotions, patient assessments, testing advocacy, and written handoffs. DesignExperimental vignette research. SettingOnline experiment distributed via email between October and December 2020. ParticipantsConvenience sample of 130 emergency nurses from seven hospitals in the Northeastern United States and one hospital in the mid-Atlantic region in the United States. MethodsNurses completed four multimedia computer-simulated patient encounters in which patient behavior (irritable vs. calm) and mental illness (present vs. absent) were experimentally varied. Nurses reported their emotions and clinical assessments, recommended diagnostic tests, and provided written handoffs. Tests were coded for whether the test would result in a correct diagnosis, and handoffs were coded for negative and positive patient descriptions and the presence of specific clinical information. ResultsNurses experienced more negative emotions (anger, unease) and reported less engagement when assessing patients exhibiting irritable (vs. calm) behavior. Nurses also judged patients with irritable (vs. calm) behavior as more likely to exaggerate their pain and as poorer historians, and as less likely to cooperate, return to work, and recover. Nurses' handoffs were more likely to communicate negative descriptions of patients with irritable (vs. calm) behavior and omit specific clinical information (e.g., whether tests were ordered, personal information). The presence of mental illness increased unease and sadness and resulted in nurses being less likely to recommend a necessary test for a correct diagnosis. ConclusionsEmergency nurses' assessments and handoffs were impacted by patient factors, particularly irritable patient behavior. As nurses are central to the clinical team and experience regular, close contact with patients, the effects of irritable patient behavior on nursing assessments and care practices have important implications. We discuss potential approaches to address these ill effects, including reflexive practice, teamwork, and standardization of handoffs. Tweetable abstractSimulated experimental study found that despite having received identical clinical information, emergency nurses believed that patients displaying irritable behaviours were less likely to return to work soon and were less likely to recover than patients who displayed calm behaviour.

Emergency Department Virtual Happy Hour: A Novel Approach to Peer Group Support During a Pandemic.

Introduction Communities responded to the coronavirus disease 2019 (COVID-19) pandemic with mandatory social-distancing regulations. Pandemic and disaster research shows that social isolation can often cause negative emotions and medical provider burnout. The primary objective of this study was to create and evaluate a novel wellness program, the Happy Hour Wellness Initiative (HHWI), based on peer support group concepts to foster resilience for emergency healthcare providers in response to a novel disaster. Methods The study was performed at a large emergency department with physicians, advanced practice providers, and staff invited to attend weekly "virtual happy hour" sessions. Participants individually opted into each of the six weekly sessions, with no obligation to attend. The program was designed based on the tenets of a peer support group and implemented by video conferencing. Participants completed a demographic questionnaire and answered open-ended questions after the six-session HHWI ended. Results Of the 40 survey respondents, 30% reported feeling stressed and 40% felt isolated at the early declaration of the pandemic. Regarding the HHWI, 90% of participants had no expectations from the HHWI, but 90% reported that their favorite part of the initiative was the feeling of togetherness. Most participants (95%) requested a continuation of the HHWI, even if not by a video-conferencing platform, and 90% reported feeling sad after the HHWI ended. Conclusion The emergency department HHWI was a welcome opportunity for employees to combat stress and anxiety brought on by the COVID-19 pandemic and social distancing. The initiative fostered team building, comradery, group advocacy, stress relief, and cheerfulness. The initiative was so greatly welcomed as a tool for wellness that almost all participants recommended that the HHWI should be available, not just in times of hardship, but year-round. The HHWI has provided a new approach to promote wellness in emergency care providers using a peer support group.

New medications to mitigate attacks of hereditary angioedema: does one size fit all?

Hereditary angioedema has received renewed attention in the past two decades, with the elucidation of the biochemical pathways resulting in bradykinin overproduction in patients with congenital C1esterase inhibitor (C1INH) deficiency, leading to recurrent attacks of tissue swelling due to uncontrolled vascular permeability. 1 Busse PJ Christiansen SC Hereditary angioedema. N Engl J Med. 2020; 382: 1136-1148 Crossref PubMed Scopus (132) Google Scholar Oedema attacks affecting the lingual or laryngeal area can become lethal as a result of asphyxiation. 2 Minafra FG Gonçalves TR Alves TM Pinto JA The mortality from hereditary angioedema worldwide: a review of the real-world data literature. Clin Rev Allergy Immunol. 2022; 62: 232-239 Crossref PubMed Scopus (4) Google Scholar Several new treatments have emerged, 143 years after Quincke's first description of hereditary angioedema and 15 years after the introduction of the first specific bradykinin B2 receptor inhibitor (icatibant). These drugs specifically target crucial steps in the kallikrein–kinin (contact) cascade downstream of bradykinin production. 3 Fijen LM Bork K Cohn DM Current and prospective targets of pharmacologic treatment of hereditary angioedema types 1 and 2. Clin Rev Allergy Immunol. 2021; 61: 66-76 Crossref PubMed Scopus (0) Google Scholar Many of these agents have shown their efficacy and safety in acute (on-demand) treatment and prophylaxis of hereditary angioedema attacks, saving lives and revolutionising patients’ quality of life. 4 Lumry WR Settipane RA Hereditary angioedema: epidemiology and burden of disease. Allergy Asthma Proc. 2020; 41: S08-S Crossref Google Scholar These modalities fit well into the modern paradigm in hereditary angioedema treatment, supporting patients’ autonomy, recommending self-administration, and reducing reliance on hospital emergency rooms, health-care providers, and medical points of care. 5 Maurer M Magerl M Betschel S et al. The international WAO/EAACI guideline for the management of hereditary angioedema—the 2021 revision and update. Allergy. 2022; 77: 1961-1990 Crossref PubMed Scopus (32) Google Scholar An investigational oral plasma kallikrein inhibitor for on-demand treatment of hereditary angioedema: a two-part, randomised, double-blind, placebo-controlled, crossover phase 2 trialOral administration of sebetralstat was well tolerated and led to rapid suppression of plasma kallikrein activity, resulting in increased time to use of conventional attack treatment and faster symptom relief versus placebo. Based on these results, a phase 3 trial to evaluate the efficacy and safety of two dose levels of sebetralstat in adolescent and adult participants with hereditary angioedema has been initiated ( NCT05259917 ). Full-Text PDF

Improvement in the diagnosis and practices of emergency healthcare providers for heat emergencies after HEAT (heat emergency awareness & treatment) an educational intervention: a multicenter quasi-experimental study

BackgroundThe incidence of heat emergencies, including heat stroke and heat exhaustion, have increased recently due to climate change. This has affected global health and has become an issue of consideration for human health and well-being. Due to overlapping clinical manifestations with other diseases, and most of these emergencies occurring in an elderly patient, patients with a comorbid condition, or patients on poly medicine, diagnosing and managing them in the emergency department can be challenging. This study assessed whether an educational training on heat emergencies, defined as heat intervention in our study, could improve the diagnosis and management practices of ED healthcare providers in the ED setting.MethodsA quasi-experimental study was conducted in the EDs of four hospitals in Karachi, Pakistan. Eight thousand two hundred three (8203) patients were enrolled at the ED triage based on symptoms of heat emergencies. The pre-intervention data were collected from May to July 2017, while the post-intervention data were collected from May to July 2018. The HEAT intervention, consisting of educational activities targeted toward ED healthcare providers, was implemented in April 2018. The outcomes assessed were improved recognition—measured by increased frequency of diagnosing heat emergencies and improved management—measured by increased temperature monitoring, external cooling measures, and intravenous fluids in the post-intervention period compared to pre-intervention.ResultsFour thousand one hundred eighty-two patients were enrolled in the pre-intervention period and 4022 in the post-intervention period, with at least one symptom falling under the criteria for diagnosis of a heat emergency. The diagnosis rate improved from 3% (n = 125/4181) to 7.5% (n = 7.5/4022) (p-value < 0.001), temperature monitoring improved from 0.9% (n = 41/4181) to 13% (n = 496/4022) (p-value < 0.001) and external cooling measure (water sponging) improved from 1.3% (n = 89/4181) to 3.4% (n = 210/4022) (p-value < 0.001) after the administration of the HEAT intervention.ConclusionThe HEAT intervention in our study improved ED healthcare providers' approach towards diagnosis and management practices of patients presenting with health emergencies (heat stroke or heat exhaustion) in the ED setting. The findings support the case of training ED healthcare providers to address emerging health issues due to rising temperatures/ climate change using standardized treatment algorithms.

Access and Emergency Medical Care for Massive or Multiple Injuries

Access and emergency medical care for massive or multiple injuries is an comprehensive interdisciplinary challenge. Taking care of the growing causes of emergency care levels as well as cross-sectoral collaboration in the management of multiple incidents, reducing disease, disability, and mortality in the population with multiple disorders. In a disaster or extraordinary situation with mass casualties is a state in which the health care system is overloaded and the ability to provide emergency health care is considerably hindered. The aim of this review is to present the current state of knowledge on what we, the authors, say are the central aspects of trauma management of mass casualty incidents. Emergency planning and methodology are related to accidental states, elementary medical staff disasters, medical equipment, drilling material, concretizing assessment tools, monitoring, mass incident prevention. In terms of implementing a good action plan, effective collaboration between state agencies such as fire departament and law enforcement is necessary in identifying and directing critically ill patients to designated trauma centres. The integration of emergency systems for incident management, through providing resources like, medical equipment, drugs, autoambulances, ongoing education and training. This has the impact of increasing knowledge of medical emergency procedures that would help reduce the risk of consequences of mass incidents. When applied to MCI responses, damage-control principles reduce resource utilization and optimze surge capacity, consequently reducing the rate of mortality.

Measuring the Readiness of Primary Care Nurses to Provide Emergency Health Care in Primary Health Centers at Al-Qaseem, KSA

Measuring the Readiness of Primary Care Nurses to Provide Emergency Health Care in Primary Health Centers at Al-Qaseem, KSA

Recognition of Stroke in the Emergency Room (ROSIER) Scale in Identifying Strokes and Transient Ischemic Attacks (TIAs); a Systematic Review and Meta-Analysis.

A range of screening tools has been developed to assist emergency healthcare providers in rapidly and accurately diagnosing strokes. In this study, we investigated the diagnostic value of the Recognition of Stroke in the Emergency Room (ROSIER) scale in identifying individuals with stroke and transient ischemic attack (TIA). We conducted a systematic search across online databases of PubMed, Embase, Scopus, and Web of Science until June 12th, 2023, aiming to identify studies that assessed the diagnostic performance of the ROSIER scale in detecting strokes and TIAs among individuals with suspected stroke symptoms. Data extracted from 34 studies were analyzed, demonstrating that the ROSIER score, with a cut-off value of ≥ 1, has sensitivity of 0.89 (95% confidence interval (CI): 0.86-0.92), specificity of 0.76 (95% CI: 0.69-0.81), diagnostic odds ratio (DOR) of 25.41 (95% CI: 17.2-37.54), and area under the curve (AUC) of 0.91 (95% CI: 0.85-0.90) in detection of strokes and TIAs. Meta-regression subgroup analysis revealed variations in sensitivity and specificity based on different settings and assessors. Sensitivity was higher in pre-hospital settings when the test was administered by emergency medical services (EMS) and emergency department (ED) paramedic staff, whereas specificity was higher in emergency department settings and when physicians and neurologists conducted the test. A moderate level of evidence shows that the ROSIER scale is considered an excellent tool for identifying strokes and TIAs. As a valid method for identifying strokes, it holds applicability across diverse settings and can be effectively used by assessors with different specialties.

Development and Feasibility of the Emergency Medical Services Hub for Northern Thai Older Adults: An Action Research Study

Most older adults have unique needs and are suffering from chronic diseases. It is important to have quick and easy access to emergency medical services. Three-phase action research aimed to develop and assess the feasibility of implementing the Emergency Medical Service Hub for Older Adults Model in Upper Northern Thailand was conducted. In phase I and phase II, 27 emergency healthcare providers and 10 older adults were purposively recruited, and in phase III 16 emergency healthcare providers evaluated the feasibility of the model. The framework guided the study was based on action research methodologyand six emergency medical services system functions. Data were collected via in-depth interviews, observation, and self-report of the implementation feasibility questionnaire. All research instruments were validated by three experts, yielded a content validity index of 0.80-1, and the reliability test of the implementation feasibility questionnaire revealed a Cronbach’s alpha coefficient of 0.81. Data were analyzed using descriptive statistics and content analysis.The final model consisted of six components: effective communication, registry and database, geographic information system, effective emergency medical service team, one-stop service emergency department for older adults, and continuum of care. Overall, the possibility of the model implementation was rated as high. The benefit and safety aspect of implementing the model was at the highest level, followed by its applicability. The use of the model is likely to benefit older adults. Effective implementation requires proper resource support and future study to examine the effectiveness of the model in a full-scale clinical trial is recommended.

An Overview of Job Satisfaction of Emergency Healthcare Providers In Northern Cyprus

Introduction: Emergency calls are a challenging triangle that requires quick assessment, immediate action, and correct decision-making. The appropriate work environment and conditions of emergency healthcare workers result in this triangle's flawless functioning. This study aims to evaluate and overview the job satisfaction of the personnel working in emergency healthcare in Northern Cyprus. Methods: This descriptive study was conducted to evaluate the job satisfaction of the personnel working in emergency healthcare in Northern Cyprus. This research involved nurses, paramedics, and EMTs, who intervene in an emergency call. The participants' job satisfaction was evaluated by the scale developed by Güneri (2011). The scale score range was 47-235. A high score was considered as increased job satisfaction. Results: 132 personnel who work in emergency healthcare in Northern Cyprus participated in this study. 31.82% were aged between 36 and 49 years, 81.6 % were women, and 42.42% were undergraduates. 31.6% had worked for more than ten years. 39.39% (52) declared that they had occupational disease/accidents. 43.18% said they had received training more than two years ago. The participants' mean job satisfaction score was moderate (143.59 ± 26.86). Job satisfaction was higher in emergency call center personnel, high school graduates, and head nurses, working 40-50 hours a week, with seniority 1-4 years, and had integration training (p&lt;0.05). Conclusion: Emergency healthcare personnel in Northern Cyprus are primarily nurses. Most of them have not received updated training recently. Studies in which most participants are paramedics will reflect the current situation more objectively. Therefore, structuring emergency health services as a separate unit within the Ministry of Health and the necessary regulations can increase job satisfaction even more.

Exploring the Psychological Experiences of Frontline Healthcare Providers Dealing with Covid Patients

People's physical and mental health have been severely affected by the COVID-19 pandemic. Medical and psychological preparedness of the emergency healthcare workers (HCWs) is critical during a continuing outbreak of Ebola virus disease. An investigation of the psychological impact of the COVID-19 pandemic on emergency health care providers (EHCPs), as well as their stress coping mechanisms or protective factors, and obstacles they face while caring for COVID-19 patients will be conducted. From April 2, 2020 to April 25, 2020, 15 frontline emergency healthcare workers (HCWs) dealt with COVID-19 patients. In person or via phone, semi-structured interviews were done. Analysis was conducted utilising a thematic approach to data collection. A number of key findings focused on coping strategies for dealing with stressful situations, including: limiting media exposure; sharing duty details on a limited basis; religious coping; altruism as a fallback strategy; and, dealing with challenges, including: psychological responses and noncompliance with the public/denial by religious scholars. The COVID-19 pandemic-related stress and anxiety were discussed and various coping mechanisms were practiced and advised. Stress and worry in the population are often attributed to the media. Coping mechanisms included religious faith and a desire to serve humanity and their country.

HASTANE ÖNCESİ SEREBROVASKÜLER HASTALIKLARA YAKLAŞIM ORGANİZASYONU

Serebrovasküler hastalıklar dünyada ölüm nedenleri arasında kardiyovasküler hastalıklar sonrası ikinci sırada bulunan hayatı tehdit eden hastalıklar arasında olup, sıklıkla hastane öncesi acil sağlık hizmetlerinin konusu olmaktadır. Hastane öncesi acil sağlık hizmetlerinde tanı, tedavi ve transportta oluşan gecikmeler yüksek mortalite ve morbiditeye neden olan sonuçlar doğurabilmektedir. Serebrovasküler hastalıklar en çok iskemik daha az ise hemorajik kaynaklı karşımıza çıkmaktadır. Hastane öncesi acil sağlık hizmetleri sağlık çalışanlarının serebrovasküler hastalıkları erken tanıma ve doğru müdahale donanımına sahip olmaları hastalar için son derece önemlidir. Bu derlemenin amacı literatür bilgileri ışığında serebrovasküler hastalıkların hastane öncesi tanı ve tedavisi ile ilgili güncel bilgileri gözden geçirmektir.