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Objective: To determine if utilizing a single paramedic crew configuration is safe for transporting low acuity patients requiring only a primary care paramedic (PCP) level of care in Air Ambulances.
Methods: We studied single-PCP transports of low acuity patients done by contract air ambulance carriers, organized by Ornge (Ontario's Air Ambulance Service) for one year. We only included interfacility transports. We excluded all scene calls, and all Code 4 (emergent) calls. Our primary outcome was clinical deterioration during transport. We then asked a panel to analyze each case of deterioration to determine if a dual-PCP configuration might have reasonably prevented the deterioration or have better treated the deterioration, compared to a single-PCP configuration.
Results: In one year, contract carriers moved 3264 patients, who met inclusion criteria. 85% were from Northern Ontario. There were 21 cases of medical deterioration (0.6%±0.26%). Paper charts were found for 20 of these cases. Most were self-limited cases of pain or nausea. A small number of cases (n=5) were cardiorespiratory decompensation. There was 100% consensus amongst the panel that all cases of clinical deterioration were not related to team size. There was also 100% consensus that a dual-PCP team would not have been better able to deal with the deterioration, compared to a single-PCP crew.
Conclusions: We found that using a single-PCP configuration for transporting low acuity patients is safe. This finding is particularly important for rural areas where air ambulance is the only means for accessibility to care and where staffing issues are magnified.
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http://dx.doi.org/10.1017/cem.2017.392 | DOI Listing |
Clin Ophthalmol
December 2024
Vitreoretinal Surgery, Acuity Eye Group, Los Angeles, CA, USA.
Purpose: Our aim is to evaluate the sensitivity and specificity of Acuity 360 telemedicine system, as compared to in-person clinic examination, in identifying clinically significant eye disease. Acuity 360 is a combination of commercially available ocular imaging devices used together to provide a comprehensive evaluation of the structures and diseases of the eye.
Methods: Observational cross-sectional study of consecutively examined patients where 19 remote examiners analyzed 80 patients using Acuity 360 images.
Heliyon
December 2024
AIMS Lab, IRIIC, United International University, Dhaka, Bangladesh.
This paper presents a comprehensive study on the development and performance evaluation of "," a mobile health (mHealth) app designed to facilitate eye screening for impaired visual acuity (VA) in Bangladesh. Recognizing the critical importance of vision and the challenges posed by visual impairments, particularly in low-resource settings, this study explores an innovative solution to enhance eye care accessibility. The app, developed for Android devices, integrates features such as VA testing using adapted Bengali letters, color blindness tests, and eye health education, aiming to make eye care more user-friendly and accessible.
View Article and Find Full Text PDFClin Ophthalmol
December 2024
Department of Ophthalmology, Mettapracharak (Wat Rai Khing) Hospital, Nakhon Pathom, Thailand.
Background: Refractive target of low simple myopic astigmatism allows increased depth-of-focus and near visual performance in monofocal intraocular lens (IOL) implants. This study investigated the effect of astigmatism and its axis on distance and near visual acuity (VA), and near visual performance for the Thai alphabet using the Thai MNREAD chart.
Design: Investigational simulation.
Int J Nurs Stud Adv
December 2024
Department of Anesthesiology, Intensive Care and Pain management, St. Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands.
Background: An early warning scoring system aims to detect clinical deterioration at an early stage and prevent failure-to-rescue in hospitalized patients. In this systematic review we studied the effect of an early warning scoring system on adverse outcome in surgical patients.
Methods: This review was conducted and reported according to PRISMA and the protocol of this review is registered at PROSPERO, under the registration number CRD42018107799.
Int J Emerg Med
December 2024
Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, USA.
Background: Over 90% of trauma deaths occur in low- and middle-income countries (LMICs). The trauma burden in Tanzania is similar to the global rate of 10% and road traffic injuries result in a 40% mortality. To understand epidemiology of trauma referrals and care we aimed to describe the patients presenting to a tertiary, referral hospital in Tanzania for trauma care, their injuries and mechanism of injury, and describe the care received.
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