Journal articles on the topic 'Ambulance service Victoria'
To see the other types of publications on this topic, follow the link: Ambulance service Victoria.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Ambulance service Victoria.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Eastwood, Kathryn, Amee Morgans, Karen Smith, Angela Hodgkinson, Gareth Becker, and Johannes Stoelwinder. "A novel approach for managing the growing demand for ambulance services by low-acuity patients." Australian Health Review 40, no. 4 (2016): 378. http://dx.doi.org/10.1071/ah15134.
Full textAbstract:
Objective The aim of the present study was to describe the Ambulance Victoria (AV) secondary telephone triage service, called the Referral Service (RS), for low-priority patients calling triple zero. This service provides alternatives to ambulance dispatch, such as doctor or nurse home visits. Methods A descriptive epidemiological review of all the cases managed between 2009 and 2012 was conducted, using data from AV case records, the Victorian Admitted Episodes Dataset and the Australian Bureau of Statistics. Cases were reviewed for patient demographics, condition, final disposition and RS outcome. Results In all, 107148 cases were included in the study, accounting for 10.3% of the total calls for ambulance attendance. Median patient age was 54 years and 55% were female. Geographically based socioeconomic status was associated with the rate of calls to the RS (r = –0.72; 95% confidence interval CI –0.104, –0.049; P < 0.001). Abdominal pain and back symptoms were the most common patient problems. Although 68% of patients were referred to the emergency department, only 27.6% of the total cases were by emergency ambulance; the remainder were diverted to non-emergency ambulance or the patient’s own private transport. The remaining 32% of cases were referred to alternative service providers or given home care advice. Conclusions This paper describes the use of an ongoing secondary triage service, providing an effective strategy for managing emergency ambulance demand. What is known about the topic? Some calls to emergency services telephone numbers for ambulance assistance consist of cases deemed to be low-acuity that could potentially be better managed in the primary care setting. The demand on ambulance resources is increasing each year. Secondary telephone triage systems have been trialled in ambulance services in the US and UK with minimal success in terms of overall impact on ambulance resourcing. What does this paper add? This study describes a model of secondary telephone triage in the ambulance setting that has provided an effective way to divert patients to more suitable forms of health care to meet their needs. What are the implications for practitioners? The implications for practitioners are vast. Some of the issues that currently face paramedics include: fatigue because of high workloads; skills decay because of a lack of exposure to patients requiring intervention with skills the paramedics have, as well as a lack of time for paramedics to practice these skills during their downtime; and decreasing job satisfaction linked to both these factors. Implications for patients include quicker response times because more ambulances will be available to respond and increased patient safety because of decreased fatigue and higher skill levels in paramedics.
2
Joyce, Catherine M., Jo Wainer, Frank Archer, Andrea Wyatt, and Leon Pitermann. "Trends in the paramedic workforce: a profession in transition." Australian Health Review 33, no. 4 (2009): 533. http://dx.doi.org/10.1071/ah090533.
Full textAbstract:
Ambulance services play a key role in the Australian health system, as the primary providers of pre-hospital clinical care, emergency care and specialised transport.1 Although at present there is a strong focus on broad health system reform, and health workforce reform specifically, little attention has been paid to the place of pre-hospital clinical care and the paramedic workforce that provides these services. Despite their significant role in the health system, there is no strategic national approach by government to the development of ambulance services or the paramedic workforce. In this paper, we review current and emerging trends impacting on the paramedic workforce. We examine changes in patterns of ambulance service provision and the nature of clinical work undertaken by paramedics, as well as developments in education, training and career pathways. We focus on the current situation in Victoria to illustrate and identify a number of important implications of current changes, for the profession, service and training providers, and policy makers.
3
Eastwood, Kathryn, Dhanya Nambiar, Rosamond Dwyer, Judy A. Lowthian, Peter Cameron, and Karen Smith. "Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study." BMJ Open 10, no. 11 (November 2020): e042351. http://dx.doi.org/10.1136/bmjopen-2020-042351.
Full textAbstract:
BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.
4
Smith, Erin C., Frederick M. Burkle, Paul F. Holman, Justin M. Dunlop, and Frank L. Archer. "Lessons from the Front Lines: The Prehospital Experience of the 2009 Novel H1N1 Outbreak in Victoria, Australia." Disaster Medicine and Public Health Preparedness 3, S2 (December 2009): S154—S159. http://dx.doi.org/10.1097/dmp.0b013e3181be8250.
Full textAbstract:
ABSTRACTThe H1N1 (swine influenza) 2009 outbreak in Victoria, Australia, provided a unique opportunity to review the prehospital response to a public health emergency. As part of Ambulance Victoria’s response to the outbreak, relevant emergency response plans and pandemic plans were instigated, focused efforts were aimed at encouraging the use of personal protective equipment (PPE), and additional questions were included in the call-taking script for telephone triage of emergency calls to identify potential cases of H1N1 from the point of call. As a result, paramedics were alerted to all potential cases of H1N1 influenza or any patient who met the current case definition before their arrival on the scene and were advised to use appropriate PPE. During the period of May 1 to July 2, Ambulance Victoria telephone triaged 1598 calls relating to H1N1 (1228 in metropolitan areas and 243 in rural areas) and managed 127 calls via a referral service that provides specific telephone triage for potential H1N1 influenza cases based on the national call-taking script. The referral service determines whether a patient requires an emergency ambulance or can be diverted to other resources such as flu clinics. Key lessons learned during the H1N1 outbreak include a focused need for continued education and communication regarding infection control and the appropriate use of PPE. Current guidelines regarding PPE use are adequate for use during an outbreak of infectious disease. Compliance with PPE needs to be addressed through the use of intra-agency communications and regular information updates early in the progress of the outbreak. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S154–S159)
5
Xu, B. "Delivery of ambulance service by volunteers in Victoria, Australia: an ethical dilemma?" Journal of Medical Ethics 34, no. 10 (October 1, 2008): 704–5. http://dx.doi.org/10.1136/jme.2007.022376.
Full text
6
Boyle, Malcolm J., M. ClinEpi, Erin C. Smith, and Frank L. Archer. "Trauma Incidents Attended by Emergency Medical Services in Victoria, Australia." Prehospital and Disaster Medicine 23, no. 1 (February 2008): 20–28. http://dx.doi.org/10.1017/s1049023x00005501.
Full textAbstract:
AbstractIntroduction:International literature describing the profile of trauma patients attended by a statewide emergency medical services (EMS) system is lacking. Most literature is limited to descriptions of trauma responses for a single emergency medical service, or to patients transported to a specific Level-1 trauma hospital. There is no Victorian or Australian literature describing the type of trauma patients transported by a state emergency medical service.Purpose:The purpose of this study was to define a profile of all trauma incidents attended by statewide EMS.Methods:A retrospective cohort study of all patient care records (PCR) for trauma responses attended by Victorian Ambulance Services for 2002 was conducted. Criteria for trauma categories were defined previously, and data were extracted from the PCRs and entered into a secure data repository for descriptive analysis to determine the trauma profile. Ethics committee approval was obtained.Results:There were 53,039 trauma incidents attended by emergency ambulances during the 12-month period. Of these, 1,566 patients were in physiological distress, 11,086 had a significant pattern of injury, and a further 8,931 had an identifiable mechanism of injury. The profile includes minor trauma (n = 9,342), standing falls (n = 20,511), no patient transported (n = 3,687), and deceased patients (n = 459).Conclusions:This is a unique analysis of prehospital trauma. It provides a baseline dataset that may be utilized in future studies of prehospital trauma care. Additionally, this dataset identifies a ten-fold difference in major trauma between the prehospital and the hospital assessments.
7
Cantwell, Kate, Amee Morgans, Karen Smith, Michael Livingston, and Paul Dietze. "Improving the coding and classification of ambulance data through the application of International Classification of Disease 10th revision." Australian Health Review 38, no. 1 (2014): 70. http://dx.doi.org/10.1071/ah13163.
Full textAbstract:
Objectives This paper aims to examine whether an adaptation of the International Classification of Disease (ICD) coding system can be applied retrospectively to final paramedic assessment data in an ambulance dataset with a view to developing more fine-grained, clinically relevant case definitions than are available through point-of-call data. Methods Over 1.2 million case records were extracted from the Ambulance Victoria data warehouse. Data fields included dispatch code, cause (CN) and final primary assessment (FPA). Each FPA was converted to an ICD-10-AM code using word matching or best fit. ICD-10-AM codes were then converted into Major Diagnostic Categories (MDC). CN was aligned with the ICD-10-AM codes for external cause of morbidity and mortality. Results The most accurate results were obtained when ICD-10-AM codes were assigned using information from both FPA and CN. Comparison of cases coded as unconscious at point-of-call with the associated paramedic assessment highlighted the extra clinical detail obtained when paramedic assessment data are used. Conclusions Ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Coding of ambulance data using ICD-10-AM allows for comparison of not only ambulance service users but also with other population groups. What is known about the topic? There is no reliable and standard coding and categorising system for paramedic assessment data contained in ambulance service databases. What does this paper add? This study demonstrates that ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Representation of ambulance case types using ICD-10-AM-coded information obtained after paramedic assessment is more fine grained and clinically relevant than point-of-call data, which uses caller information before ambulance attendance. What are the implications for practitioners? This paper describes a model of coding using an internationally recognised standard coding and categorising system to support analysis of paramedic assessment. Ambulance data coded using ICD-10-AM allows for reliable reporting and comparison within the prehospital setting and across the healthcare industry.
8
Zhao, Henry, Lauren Pesavento, Edrich Rodrigues, Patrick Salvaris, Karen Smith, Stephen Bernard, Michael Stephenson, et al. "009 The ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithmic pre-hospital triage tool for endovascular thrombectomy: ongoing paramedic validation." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 6 (May 24, 2018): A5.1—A5. http://dx.doi.org/10.1136/jnnp-2018-anzan.9.
Full textAbstract:
IntroductionThe ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithm is a severity based 3-step paramedic triage tool for pre-hospital recognition of large vessel occlusion (LVO), designed to improve specificity and paramedic assessment reliability compared to existing triage scales. ACT-FAST sequentially assesses 1. Unilateral arm fall to stretcher <10 s; 2a. Severe language disturbance (right arm weak), or 2b. Severe gaze deviation/hemi-neglect assessed by shoulder tap (left arm weak); 3. Clinical eligibility questions. We present the results of the ongoing Ambulance Victoria paramedic validation study.MethodsAmbulance Victoria paramedics assessed ACT-FAST in all suspected stroke patients pre-hospital in metropolitan Melbourne, Australia, and in the Royal Melbourne Hospital Emergency Department since July 2017. Algorithm results were validated against a comparator of ICA/M1 occlusion on CT-angiography with NIHSS ≥6 (Class 1 indications for endovascular thrombectomy).ResultsData were available from n=119 assessments (ED n=68, pre-hospital n=51). Patient diagnoses were LVO n=20 (15.6%), non-LVO infarcts n=45 (38.5%), ICH n=10 (8.3%) and no stroke on imaging n=44 (37.6%). ACT-FAST showed 85% sensitivity, 88.9% specificity, 60.7% (72% excluding ICH) positive predictive value and 96.7% negative predictive value for LVO. Of 10 false-positives, 4 received thrombectomy for non-Class 1 indications (basilar/M2 occlusions/cervical dissection), 3 were ICH, and 1 was tumour. Three false-negatives were LVO with milder syndromes.DiscussionThe ongoing ACT-FAST algorithm validation study shows high accuracy for clinical recognition of LVO. The streamlined algorithmic approach with just two examination items provides a more practical option for implementation in large emergency service networks. Accurate pre-hospital recognition of LVO will allow bypass to endovascular centres and early activation of neuro-intervention services to expedite endovascular thrombectomy.
9
Mercier, Eric, Peter A. Cameron, Karen Smith, and Ben Beck. "Prehospital trauma death review in the State of Victoria, Australia: a study protocol." BMJ Open 8, no. 7 (July 2018): e022070. http://dx.doi.org/10.1136/bmjopen-2018-022070.
Full textAbstract:
IntroductionRegionalised trauma systems have been shown to improve outcomes for trauma patients. However, the evaluation of these trauma systems has been oriented towards in-hospital care. Therefore, the epidemiology and care delivered to the injured patients who died in the prehospital setting remain poorly studied. This study aims to provide an overview of a methodological approach to reviewing trauma deaths in order to assess the preventability, identify areas for improvements in the system of care provided to these patients and evaluate the potential for novel interventions to improve outcomes for seriously injured trauma patients.Methods and analysisThe planned study is a retrospective review of prehospital and early in-hospital (<24 hours) deaths following traumatic out-of-hospital cardiac arrest that were attended by Ambulance Victoria between 2008 and 2014. Eligible patients will be identified from the Victorian Ambulance Cardiac Arrest Registry and linked with the National Coronial Information System. For patients who were transported to hospital, data will be linked the Victoria State Trauma Registry. The project will be undertaken in four phases: (1) survivability assessment; (2) preventability assessment; (3) identification of potential areas for improvement; and (4) identification of potentially useful novel technologies. Survivability assessment will be based on predetermined anatomical injuries considered unsurvivable. For patients with potentially survivable injuries, multidisciplinary expert panel reviews will be conducted to assess the preventability as well as the identification of potential areas for improvement and the utility of novel technologies.Ethics and disseminationThe present study was approved by the Victorian Department of Justice and Regulation HREC (CF/16/272) and the Monash University HREC (CF16/532 – 2016000259). Results of the study will be published in peer-reviewed journals and reports provided to Ambulance Victoria, the Victorian State Trauma Committee and the Victorian State Government Department of Health and Human Services.
10
Eastwood, Kathryn, Stuart Howell, Ziad Nehme, Judith Finn, Karen Smith, Peter Cameron, Dion Stub, and Janet E. Bray. "Impact of a mass media campaign on presentations and ambulance use for acute coronary syndrome." Open Heart 8, no. 2 (October 2021): e001792. http://dx.doi.org/10.1136/openhrt-2021-001792.
Full textAbstract:
ObjectiveBetween 2009 and 2013, the National Heart Foundation of Australia ran mass media campaigns to improve Australian’s awareness of acute coronary syndrome (ACS) symptoms and the need to call emergency medical services (EMS). This study examined the impact of this campaign on emergency department (ED) presentations and EMS use in Victoria, Australia.MethodsThe Victorian Department of Health and Human Services provided data for adult Victorian patients presenting to public hospitals with an ED diagnosis of ACS or unspecified chest pain (U-CP). We modelled changes in the incidence of ED presentations, and the association between the campaign period and (1) EMS arrival and (2) referred to ED by a general practitioner (GP). Models were adjusted for increasing population size, ACS subtype and demographics.ResultsBetween 2003 and 2015, there were 124 632 eligible ED presentations with ACS and 536 148 with U-CP. In patients with ACS, the campaign period was associated with an increase in ED presentations (incidence rate ratio: 1.11; 95% CI 1.07 to 1.15), a decrease in presentations via a GP (adjusted OR (AOR): 0.77; 95% CI 0.70 to 0.86) and an increase in EMS use (AOR: 1.10; 95% CI 1.05 to 1.17). Similar, but smaller associations were seen in U-CP.ConclusionsThe Warning Signs Campaign was associated with improvements in treatment seeking in patients with ACS—including increased EMS use. The increase in ACS ED presentations corresponds with a decrease in out-of-hospital cardiac arrest over this time. Future education needs to focus on improving EMS use in ACS patient groups where use remains low.
11
Cox, Shelley, Rohan Martin, Piyali Somaia, and Karen Smith. "The development of a data-matching algorithm to define the ‘case patient’." Australian Health Review 37, no. 1 (2013): 54. http://dx.doi.org/10.1071/ah11161.
Full textAbstract:
Objectives. To describe a model that matches electronic patient care records within a given case to one or more patients within that case. Method. This retrospective study included data from all metropolitan Ambulance Victoria electronic patient care records (n = 445 576) for the time period 1 January 2009–31 May 2010. Data were captured via VACIS (Ambulance Victoria, Melbourne, Vic., Australia), an in-field electronic data capture system linked to an integrated data warehouse database. The case patient algorithm included ‘Jaro–Winkler’, ‘Soundex’ and ‘weight matching’ conditions. Results. The case patient matching algorithm has a sensitivity of 99.98%, a specificity of 99.91% and an overall accuracy of 99.98%. Conclusions. The case patient algorithm provides Ambulance Victoria with a sophisticated, efficient and highly accurate method of matching patient records within a given case. This method has applicability to other emergency services where unique identifiers are case based rather than patient based. What is known about the topic? Accurate pre-hospital data that can be linked to patient outcomes is widely accepted as critical to support pre-hospital patient care and system performance. What does this paper add? There is a paucity of literature describing electronic matching of patient care records at the patient level rather than the case level. Ambulance Victoria has developed a complex yet efficient and highly accurate method for electronically matching patient records, in the absence of a patient-specific unique identifier. Linkage of patient information from multiple patient care records to determine if the records are for the same individual defines the ‘case patient’. What are the implications for practitioners? This paper describes a model of record linkage where patients are matched within a given case at the patient level as opposed to the case level. This methodology is applicable to other emergency services where unique identifiers are case based.
12
Eastwood, Kathryn, Karen Smith, Amee Morgans, and Johannes Stoelwinder. "Appropriateness of cases presenting in the emergency department following ambulance service secondary telephone triage: a retrospective cohort study." BMJ Open 7, no. 10 (October 2017): e016845. http://dx.doi.org/10.1136/bmjopen-2017-016845.
Full textAbstract:
ObjectiveTo investigate the appropriateness of cases presenting to the emergency department (ED) following ambulance-based secondary telephone triage.DesignA pragmatic retrospective cohort analysis of all the planned and unplanned ED presentations within 48 hours of a secondary telephone triage.SettingThe secondary telephone triage service, called the Referral Service, and the hospitals were located in metropolitan Melbourne, Australia and operated 24 hours a day, servicing 4.25 million people. The Referral Service provides an in-depth secondary triage of cases classified as low acuity when calling the Australian emergency telephone number.PopulationCases triaged by the Referral Service between September 2009 and June 2012 were linked to ED and hospital admission records (N=44,523). Planned ED presentations were cases referred to the ED following the secondary triage, unplanned ED presentations were cases that presented despite being referred to alternative care pathways.Main outcome measuresAppropriateness was measured using an ED suitability definition and hospital admission rates. These were compared with mean population data which consisted of all of the ED presentations for the state (termed the ‘average Victorian ED presentation’).ResultsPlanned ED presentations were more likely to be ED suitable than unplanned ED presentations (OR 1.62; 95% CI 1.5 to 1.7; p<0.001) and the average Victorian ED presentation (OR 1.85; 95% CI 1.01 to 3.4; p=0.046). They were also more likely to be admitted to the hospital than the unplanned ED presentation (OR 1.5; 95% CI 1.4 to 1.6; p<0.001) and the average Victorian ED presentation (OR 2.3, 95% CI 2.24 to 2.33; p<0.001). Just under 15% of cases diverted away from the emergency care pathways presented in the ED (unplanned ED attendances), and 9.5% of all the alternative care pathway cases were classified as ED suitable and 6.5% were admitted to hospital.ConclusionsSecondary telephone triage was able to appropriately identify many ED suitable cases, and while most cases referred to alternative care pathways did not present in the ED. Further research is required to establish that these were not inappropriately triaged away from the emergency care pathways.
13
Peeters, Anna, Karen Smith, Peter Cameron, and John McNeil. "Predicted impact on Victoria's ambulance services of a new major trauma system." ANZ Journal of Surgery 71, no. 12 (December 2001): 747–52. http://dx.doi.org/10.1046/j.1445-1433.2001.02274.x.
Full text
14
Morgans, Amee, Frank Archer, Tony Walker, and Evelyn Thuma. "Barriers to accessing ambulance services in rural Victoria for acute asthma: Patients' and medical professionals' perspectives." Australian Journal of Rural Health 13, no. 2 (April 2005): 116–20. http://dx.doi.org/10.1111/j.1440-1854.2005.00665.x.
Full text
15
Flynn, Julie, Frank Archer, and Amee Morgans. "Sensitivity and Specificity of the Medical Priority Dispatch System in Detecting Cardiac Arrest Emergency Calls in Melbourne." Prehospital and Disaster Medicine 21, no. 2 (April 2006): 72–76. http://dx.doi.org/10.1017/s1049023x00003381.
Full textAbstract:
AbstractIntroduction:In Australia, cardiac arrest kills 142 out of every 100,000 people each year; with only 3–4% of out-of-hospital patients with cardiac arrest in Melbourne surviving to hospital discharge. Prompt initiation of cardiopulmonary resuscitation (CPR), defibrillation, and advanced cardiac care greatly improves the chances of survival from cardiac arrest. A critical step in survival is identifying by the emergency ambulance dispatcher potential of the probability that the person is in cardiac arrest. The Melbourne Metropolitan Ambulance Service (MAS) uses the computerized call-taking system, Medical Priority Dispatch System (MPDS), to triage incoming, emergency, requests for ambulance responses. The MPDS is used in many emergency medical systems around the world, however, there is little published evidence of the system's efficacy.Objective:This study attempts to undertake a sensitivity/specificity analysis to determine the ability of MPDS to detect cardiac arrest.Methods:Emergency ambulance dispatch records of all cases identified as suspected cardiac arrest by MPDS were matched with ambulance, patient-care records and records from the Victorian Ambulance Cardiac Arrest Registry to determine the number of correctly identified cardiac arrests. Additionally, cases that had cardiac arrests, but were not identified correctly at the point of call-taking, were examined. All data were collected retrospectively for a three-month period (01 January through 31 March 2003).Results:The sensitivity of MPDS in detecting cardiac arrest was 76.7% (95% confidence interval (CI): 73.6%–79.8%) and specificity was 99.2% (95% CI: 99.1–99.3%). These results indicate that cardiac arrests are correctly identified in 76.7% of cases.Conclusion:Although the system correctly identified 76.7% of cardiac arrest cases, the number of false negatives suggests that there is room for improvement in recognition by MPDS to maximize chances for survival in out-of-hospital cardiac arrest. This study provides an objective and comprehensive measurement of the accuracy of MPDS cardiac-arrest detection in Melbourne, as well as providing a baseline for comparison with subsequent changes to the MPDS.
16
Gao, Crystal, Zheng Jie Lim, Sabrina Yeh, Scott Santinon, Scott De Haas, and Kristy Austin. "Assessing the Efficacy of a One-day Structured Induction Program in Orienting Clinical Staff to a Novel Prehospital Medical Deployment Model." Prehospital and Disaster Medicine 34, s1 (May 2019): s102—s103. http://dx.doi.org/10.1017/s1049023x19002127.
Full textAbstract:
Introduction:St. John Ambulance Victoria provides first aid and medical services at a variety of mass gathering events (MGEs) throughout Victoria. Volunteer healthcare professionals and students (termed “volunteers”) form Medical Assistance Teams (MAT) at these MGEs. MAT deployments manage a variety of patient presentations which include critically ill patients. This reduces high acuity patient transfers to the hospital and, where possible, avoid ambulance and hospital utilization.Aim:To determine the effectiveness of interdisciplinary prehospital simulation workshops in preparing volunteers for MAT deployment at MGEs.Methods:A one-day, simulation-based training session within the MAT environment was implemented to introduce volunteers to the management of various scenarios faced at MGEs. All volunteers were provided an orientation to the equipment and setting up MAT deployments at MGEs. Volunteers then participated in interdisciplinary group-based scenarios such as cardiac arrest management, drug intoxication, spinal injuries, agitated patients, and airway management. To determine the effectiveness of this training session, volunteers were invited to participate in a post-training survey, comprising of Likert scores and open-ended responses.Results:Seventeen volunteers attended the training session with 10 (58.8%) completing the post-training survey. Volunteers were satisfied with environment familiarization in the MAT (Average 4.47/5.00) and found the simulation-based training helpful (Average 3.67/4.00). The induction overall was well-received (4.60/5.00) with volunteers feeling more confident in being deployed at MGEs (4.20/5.00).Discussion:The results of the simulation-based training session were positive with volunteers receptive to the need for a training day prior to MAT deployment at MGEs. The simulation session enables volunteers to be comfortable with working in MAT and managing a diverse range of patients at MGEs. This session is likely to improve interdisciplinary communication and teamwork in the MAT. Future research is aimed at following these volunteers after several MAT deployments to improve the training session for future participants.
17
Knott, Jonathan C., Alex Pleban, David Taylor, and David Castle. "Management of Mental Health Patients Attending Victorian Emergency Departments." Australian & New Zealand Journal of Psychiatry 41, no. 9 (September 2007): 759–67. http://dx.doi.org/10.1080/00048670701517934.
Full textAbstract:
Objective: To evaluate the management of mental health presentations to Victorian emergency departments. Method: An observational study in five Victorian emergency departments (four metropolitan and one regional). All patients with an ICD-10 discharge diagnosis for a predetermined mental health disorder were included. Data were collected on patient demographics, presentation, clinical management (emergency and mental health) and disposition. Results: There were 3702 patients enrolled (96.0% of all mental health presentations). At presentation 39.1% were intoxicated and 39.9% arrived by ambulance, 17.6% with the police. There was a significant variation (p <0.001) between sites for: the median time to be seen by a clinician (14 vs 43 min), the time between referral to and review by mental health services (15 vs 50 min), the median time in the emergency department (208 min vs 380 min), the proportion who spent >24 h in the emergency department (0.0% vs 11.6%) and disposition (proportion discharged home from ED 49.8% vs 63.5%). Conclusion: Important variations were identified in the management of patients with mental health presentations to Victorian emergency departments. This variation is most likely due to differing access to resources. All levels of administration must work with carers and patients to ensure that optimal patient care is provided at every site.
18
Gao, Crystal, Zheng Jie Lim, Brendan Freestone, Kristy Austin, and Rob McManus. "Use of a Novel Electronic Patient Care Record System at Mass Gathering Events by St. John Ambulance Victoria." Prehospital and Disaster Medicine 34, s1 (May 2019): s88. http://dx.doi.org/10.1017/s1049023x19001845.
Full textAbstract:
Introduction:The growing number of mass gathering events (MGEs) in Victoria has seen an increase in demand for event health services and the need for real-time reporting of medical incidents at these events.Aim:Since 2016, St. John Ambulance Victoria has introduced an electronic patient care record (ePCR) system with the aim of improving patient care and satisfaction. It appears that this ePCR system is the first of its kind to be trialed at MGEs by a volunteer organization.Methods:A qualitative study was conducted to determine strengths and limitations of the ePCR system by compiling results of surveys and interviews and through anonymous feedback from volunteers and patrons (event organizers, patients). This study is ongoing.Results:It was found that the use of ePCR: 1.Allowed for collection of relevant data to assist in future planning of MGEs2.Aids the overall coordination of first aid delivery at MGEs -faster relaying of patient information to event commanders-reduction of paperwork-improved ability to locate first aid crews using GPS tracking3.Received positive feedback from first aiders, event organizers, and patrons4.Was deemed easy-to-use (4/5), acceptable (4.3/5), and helpful (4.1/5) by our membersDiscussion:These experiences demonstrate that ePCR is well-received, easy to use, and leads to improved patient satisfaction and treatment outcomes at MGEs. Furthermore, the ability to collect and analyze real-time data such as GPS location tracking, incidence heat maps, and patient demographics facilitate future event planning and resource allocation at MGEs. It is acknowledged that this study is preliminary, and the trialed use of an ePCR system has been limited to metropolitan areas and MGEs with <1 million patrons. The intent is to continue this study and explore the use of ePCRs at larger MGEs and events in rural or regional areas.
19
McGuinness, Sarah L., Josphin Johnson, Owen Eades, Peter A. Cameron, Andrew Forbes, Jane Fisher, Kelsey Grantham, et al. "Mental Health Outcomes in Australian Healthcare and Aged-Care Workers during the Second Year of the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 19, no. 9 (April 19, 2022): 4951. http://dx.doi.org/10.3390/ijerph19094951.
Full textAbstract:
Objective: the COVID-19 pandemic has incurred psychological risks for healthcare workers (HCWs). We established a Victorian HCW cohort (the Coronavirus in Victorian Healthcare and Aged-Care Workers (COVIC-HA) cohort study) to examine COVID-19 impacts on HCWs and assess organisational responses over time. Methods: mixed-methods cohort study, with baseline data collected via an online survey (7 May–18 July 2021) across four healthcare settings: ambulance, hospitals, primary care, and residential aged-care. Outcomes included self-reported symptoms of depression, anxiety, post-traumatic stress (PTS), wellbeing, burnout, and resilience, measured using validated tools. Work and home-related COVID-19 impacts and perceptions of workplace responses were also captured. Results: among 984 HCWs, symptoms of clinically significant depression, anxiety, and PTS were reported by 22.5%, 14.0%, and 20.4%, respectively, highest among paramedics and nurses. Emotional exhaustion reflecting moderate–severe burnout was reported by 65.1%. Concerns about contracting COVID-19 at work and transmitting COVID-19 were common, but 91.2% felt well-informed on workplace changes and 78.3% reported that support services were available. Conclusions: Australian HCWs employed during 2021 experienced adverse mental health outcomes, with prevalence differences observed according to occupation. Longitudinal evidence is needed to inform workplace strategies that support the physical and mental wellbeing of HCWs at organisational and state policy levels.
20
Kinsella, Rita, Tom Collins, Bridget Shaw, James Sayer, Belinda Cary, Andrew Walby, and Sallie Cowan. "Management of patients brought in by ambulance to the emergency department: role of the Advanced Musculoskeletal Physiotherapist." Australian Health Review 42, no. 3 (2018): 309. http://dx.doi.org/10.1071/ah16094.
Full textAbstract:
Objective The aim of the present study was to evaluate the role of the Advanced Musculoskeletal Physiotherapist (AMP) in managing patients brought in by ambulance to the emergency department (ED). Methods This study was a dual-centre observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12-month period and seen by an AMP were compared with a matched group seen by other ED staff. Primary outcome measures were wait time and length of stay (LOS) in the ED. Results Data from 1441 patients within the Australasian Triage Scale (ATS) Categories 3–5 with musculoskeletal complaints were included in the analysis. Subgroup analysis of 825 patients aged ≤65 years demonstrated that for Category 4 (semi-urgent) patients, the median wait time to see the AMP was 9.5 min (interquartile range (IQR) 3.25–18.00 min) compared with 25 min (IQR 10.00–56.00 min) to see other ED staff (P ≤ 0.05). LOS analysis was undertaken on patients discharged home and demonstrated that there was a 1.20 greater probability (95% confidence interval 1.07–1.35) that ATS Category 4 patients managed by the AMP were discharged within the 4-hour public hospital target compared with patients managed by other ED staff: 87.04% (94/108) of patients managed by the AMPs met this standard compared with 72.35% (123/170) of patients managed by other ED staff (P = 0.002). Conclusions Patients aged ≤65 years with musculoskeletal complaints brought in by ambulance to the ED and triaged to ATS Category 4 are likely to wait less time to be seen and are discharged home more quickly when managed by an AMP. This study has added to the evidence that AMPs improve patient flow in the ED, freeing up time for other ED staff to see higher-acuity, more complex patients. What is known about the topic? There is a growing body of evidence establishing that AMPs improve the flow of patients presenting with musculoskeletal conditions to the ED through reduced wait times and LOS and, at the same time, providing good-quality care and enhanced patient satisfaction. What does this paper add? Within their primary contact capacity, AMPs also manage patients who are brought in by ambulance presenting with musculoskeletal conditions. To the authors’ knowledge, there is currently no available literature documenting the performance of AMPs in the management of this cohort of patients. What are the implications for practitioners? This study has added to the body of evidence that AMPs improve patient flow in the ED and illustrates that AMPs, by seeing patients brought in by ambulance, are able to have a positive impact on the pressures increasingly facing the Victorian Ambulance Service and emergency hospital care.
21
Smith, Gavin, David McD Taylor, Amee Morgans, and Peter Cameron. "Prehospital Synchronized Electrical Cardioversion of a Poorly Perfused SVT Patient by Paramedics." Prehospital and Disaster Medicine 28, no. 3 (March 14, 2013): 301–4. http://dx.doi.org/10.1017/s1049023x13000174.
Full textAbstract:
AbstractSynchronized Direct Current Cardioversion (SDC) is an established therapy for the termination of supraventricular tachycardia (SVT – either atrio-ventricular nodal reentry tachycardia (AVNRT) or atrio-ventricular reentrant tachycardia (AVRT)) with poor perfusion. The evidence is extremely limited with regard to the safety and effectiveness of this therapy. In Australia, half of the eight ambulance services include SDC within their clinical practice guidelines for the management of poorly perfused SVT; however the degree of variation in the application of SDC across these guidelines suggests a need to quantify the practice. This case provides a previously unreported example of the safety and effectiveness of prehospital SDC for SVT (with poor perfusion precipitated by a Valsalva Maneuver) by Victorian paramedics, and discusses the available literature regarding the effectiveness and safety of this practice.SmithG, TaylorD, MorgansA, CameronP. Prehospital synchronized electrical cardioversion of a poorly perfused SVT patient by paramedics. Prehosp Disaster Med. 2013;28(3):1-4.
22
McMillan, Alison. "Epidemic Thunderstorm Asthma." Prehospital and Disaster Medicine 34, s1 (May 2019): s7. http://dx.doi.org/10.1017/s1049023x19000335.
Full textAbstract:
Introduction:On November 21 and 22 of 2016, Victoria witnessed an unprecedented epidemic thunderstorm asthma emergency event in size acuity and impact. This scenario was never exercised nor contemplated. The event resulted in a 73% increase in calls to the Emergency Services Telecommunications Authority and 814 ambulance cases in the six hours from 6 pm on November 21, 2016. A 58% increase in people presented to public hospital emergency departments in Melbourne and Geelong on November 21 and 22, 2016 (based on the three-year average). 313 calls were made to the nurse on call from people with breathing, respiratory, and allergy problems (compared to an average of 63 calls for the previous month). Tragically, ten deaths are linked to this event.Methods:A substantial amount of work has been completed, much of which goes towards addressing the Inspector-General for Emergency Management recommendations following a review of the event, including: Release of an epidemic thunderstorm asthma campaign and education programs which were rolled out across Victoria for the community and health professionals from September through November 2017;Development of a new epidemic thunderstorm asthma forecasting system on 1 October 2017 and updated warning protocols during the 2017 grass pollen season;Implementation of a Real-time Health Emergency Monitoring System to alert the department of demands on public hospital emergency departments on the system; andIntroduction of a new State Health Emergency Response Plan in October 2017 to improve coordination and communications before and during a health emergency.Discussion:The presentation will concentrate on the lessons learned more than two years down the track from the event in November 2016.
23
Mercier, E., E. Andrew, Z. Nehme, M. Lijovic, S. Bernard, and K. Smith. "LO73: Long-term functional outcome and health-related quality of life of elderly out-of-hospital cardiac arrest survivors." CJEM 19, S1 (May 2017): S53. http://dx.doi.org/10.1017/cem.2017.135.
Full textAbstract:
Introduction: This study aims to describe the long-term functional outcome and health-related quality of life of elderly (≥65 years old) out-of-hospital cardiac arrest (OHCA) survivors in Victoria, Australia. Methods: Elderly OHCA patients who arrested between January 1st, 2010 and December 31st, 2014 were identified from the Victorian Ambulance Cardiac Arrest Registry (VACAR). Living status, Glasgow Outcome Scale-Extended (GOS-E), Euro-QoL (EQ-5D) and Twelve-item Short Form (SF-12) Health Survey were collected by telephone 12 months following the OHCA. Results: Emergency medical services attended on 14,678 elderly OHCA during the study period, 6,851 (46.7%) of which received a resuscitation attempt. Of these, 668 patients (9.8%) survived to hospital discharge. The mean age of the survivors was 75 (standard deviation (SD) 7.4) years and 504 (75.4%) were male. Eighty-five patients subsequently died within 12 months of their OHCA. A total of 483 patients were interviewed (response rate 82.9%). At 12 months, 313 responders (64.9%) were living at home without care. Most responders (n=324 (67.2%)) had a good long-term functional recovery with a GOS-E ≥7. The proportion of patients with a GOS-E≥7 progressively decreased with increasing age (65-74 years: 66.1%, 75-84 years: 53.0%,≥85 years: 27.3%). On the EQ-5D, the majority of survivors reported no problem with mobility (n=266 (55.1%)), self-care (n=403 (83.4%)), activity (n=293 (60.6%)), pain (n=335 (69.3%)) and anxiety (n=358 (74.1%)). On the SF-12, the mean mental component summary was 56.3 (SD 6.6) while the mean physical component summary was 44.7 (SD 11.4) (both measures range from 0-100). Among the 1,951 patients who arrested in a supported accommodation, 849 (43.5%) had a resuscitation attempt, and of these, 21 survived to hospital discharge (2.5%). Only eight (1.0%) of these patients were still alive 12 months after the OHCA and one survivor (0.12%) had a good functional outcome (GOS-E≥7). Conclusion: Most elderly OHCA survivors have an adequate long-term functional status and health-related quality of life. However, the likelihood of having a good functional recovery decreases with increasing age, and is rare for patients arresting in a supported accommodation.
24
Witt, Katrina, Dan Lubman, Belinda Lloyd, and Karen Smith. "Co-consumption of alcohol and psychotropic medications in episodes of non-fatal self-poisoning attended by ambulance services in Victoria, Australia: Evidence of potential modification by medical severity." British Journal of Psychiatry 211, no. 1 (July 2017): 53. http://dx.doi.org/10.1192/bjp.211.1.53.
Full text
25
Nehme, Z., E. Andrew, J. E. Bray, P. Cameron, S. Bernard, I. T. Meredith, and K. Smith. "The significance of pre-arrest factors in out-of-hospital cardiac arrests witnessed by emergency medical services: A report from the Victorian Ambulance Cardiac Arrest Registry." Resuscitation 88 (March 2015): 35–42. http://dx.doi.org/10.1016/j.resuscitation.2014.12.009.
Full text
26
Lord, Bill, Emily Andrew, Amanda Henderson, David J. Anderson, Karen Smith, and Stephen Bernard. "Palliative care in paramedic practice: A retrospective cohort study." Palliative Medicine 33, no. 4 (February 5, 2019): 445–51. http://dx.doi.org/10.1177/0269216319828278.
Full textAbstract:
Background: Paramedics may be involved in the care of patients experiencing a health crisis associated with palliative care. However, little is known about the paramedic’s role in the care of these patients. Aim: To describe the incidence and nature of cases attended by paramedics and the care provided where the reason for attendance was associated with a history of palliative care. Design: This is a retrospective cohort study. Setting/participants: Adult patients (aged >17 years) attended by paramedics in the Australian state of Victoria between 1 July 2015 and 30 June 2016 where terms associated with palliative care or end of life were recorded in the patient care record. Secondary transfers including inter-hospital transport cases were excluded. Results: A total of 4348 cases met inclusion criteria. Median age was 74 years (interquartile range 64–83). The most common paramedic assessments were ‘respiratory’ (20.1%), ‘pain’ (15.8%) and ‘deceased’ (7.9%); 74.4% ( n = 3237) were transported, with the most common destination being a hospital (99.5%, n = 3221). Of those with pain as the primary impression, 359 (53.9%) received an analgesic, morphine, fentanyl or methoxyflurane, and 356 (99.2%) were transported following analgesic administration. Resuscitation was attempted in 98 (29.1%) of the 337 cases coded as cardiac arrest. Among non-transported cases, there were 105 (9.6%) cases where paramedics re-attended the patient within 24 h of the previous attendance. Conclusion: Paramedics have a significant role in caring for patients receiving palliative care. These results should inform the design of integrated systems of care that involve ambulance services in the planning and delivery of community-based palliative care.
27
Popovic-Filipovic, Slavica. "Serbs on Corsica in the Great War. Part 1." Srpski arhiv za celokupno lekarstvo 146, no. 7-8 (2018): 470–76. http://dx.doi.org/10.2298/sarh170704169p.
Full textAbstract:
Historians and historical research of the role of the Serbian nation in the Great War give ample respect and recognition of the great battles and great victories. However, the exodus of the Serbian people and its armies out of Serbia is also not forgotten. Neither are the Salonika Front, nor other battlefronts. Less well known and researched is the fate of 35,000 young Serbian recruits, the young people dispersed to distant lands. This research is concentrated on the fate of the Serbian refugees in Corsica, on those who helped them, looked after them, and treated them to recovery, and who themselves came there from other parts of the world. Those Serbian refugees in Corsica were looked after by the representatives of diplomatic, humanitarian, and medical missions from Serbia, France, and Great Britain. The life of the Serbian refugee colony in Corsica was organized, financed, and supported by the Royal Serbian Government in exile in France, the French Relief Committee for the wounded, sick, and refugees, the Serbian Relief Fund, the Scottish Women?s Hospitals for Foreign Service, the local authorities, and numerous individuals in Corsica. We have paid particular attention to the Scottish Women?s Hospital in Corsica that provided a special hospital unit called ?Corsica Unit,? situated in Ajaccio, with the isolation ward in Lazaret, and ambulances and dispensaries located in various villages, where the Serbian refugees were billeted. At the time of centennial commemorations of the Great War, we want to express our profound gratitude to the humanitarian and medical assistance from all quarters, and in particular to the Scottish Women?s Hospitals, and Dr. Elsie Inglis, the founder and the leader of this medical mission.
28
Popovic-Filipovic, Slavica. "Srbi na Korzici u Velikom ratu - 2. deo." Srpski arhiv za celokupno lekarstvo 146, no. 9-10 (2018): 599–606. http://dx.doi.org/10.2298/sarh170704170p.
Full textAbstract:
Historians and historical research of the role of the Serbian nation in the Great War give ample respect and recognition of the great battles and great victories. However, the exodus of the Serbian people and its armies out of Serbia is also not forgotten. Neither are the Salonika Front, nor other battlefronts. Less well known and researched is the fate of 35,000 young Serbian recruits, the young people dispersed to distant lands. This research is concentrated on the fate of the Serbian refugees in Corsica, on those who helped them, looked after them, and treated them to recovery, and who themselves came there from other parts of the world. Those Serbian refugees in Corsica were looked after by the representatives of diplomatic, humanitarian, and medical missions from Serbia, France, and Great Britain. The life of the Serbian refugee colony in Corsica was organized, financed, and supported by the Royal Serbian Government in exile in France, the French Relief Committee for the wounded, sick, and refugees, the Serbian Relief Fund, the Scottish Women?s Hospitals for Foreign Service, the local authorities, and numerous individuals in Corsica. We have paid particular attention to the Scottish Women?s Hospital in Corsica that provided a special hospital unit called ?Corsica Unit,? situated in Ajaccio, with the isolation ward in Lazaret, and ambulances and dispensaries located in various villages, where the Serbian refugees were billeted. At the time of centennial commemorations of the Great War, we want to express our profound gratitude to the humanitarian and medical assistance from all quarters, and in particular to the Scottish Women?s Hospitals, and Dr. Elsie Inglis, the founder and the leader of this medical mission.
29
Lord, Bill, Emily Andrew, Karen Smith, Amanda Henderson, David J. Anderson, and Stephen Bernard. "OP7 Palliative care in paramedic practice: a retrospective cohort study." Emergency Medicine Journal 36, no. 10 (September 24, 2019): e4.3-e5. http://dx.doi.org/10.1136/emermed-2019-999abs.7.
Full textAbstract:
IntroductionParamedics may be involved in the care of patients experiencing a health crisis associated with palliative care. However, little is known about the paramedic’s role in the care of these patients. This study therefore aimed to describe the incidence and nature of cases attended by paramedics, the treatment provided, and the transport destination if transported, where the reason for attendance was associated with a history of palliative care.MethodsThis retrospective cohort study included all adult patients (aged > 17 years) attended by paramedics in the Australian state of Victoria between 1 July 2015 and 30 June 2016 where terms associated with palliative care, dying or end of life were recorded in the patient care record. Secondary transfers were excluded. Descriptive statistics were used to analyse the sample. Categorical data are presented as frequencies and proportions, with comparisons made using the χ2 test.Results4,348 cases met inclusion criteria. Most patients were aged between 61–80 years (47.9%). The most common assessments recorded by paramedics were ‘respiratory’ (20.1%), ‘pain’ (15.8%), and ‘deceased’ (7.9%). 54.0% (n=2,346) received treatment from the paramedics, and 74.4% (n=3,237) were transported, with the most common destination a hospital (99.5%, n=3,221). Of those with pain as the primary impression, 359 (53.9%) received an analgesic. Nausea and/or vomiting was documented in 15.6% (n=680) of cases attended. Antiemetics administered in these cases included metoclopramide (n=71, 10.4%), prochlorperazine (n=21, 3.1%), and ondansetron (n=9, 1.3%). Resuscitation was attempted in 98 (29.1%) of the 337 cases coded as cardiac arrest. Among non-transported cases, there were 105 (9.6%) cases where paramedics re-attended the patient within 24 hours of the previous attendance.Discussion and conclusionParamedics may become involved in the care of patients receiving palliative care due to exacerbation of symptoms or a new health emergency. As such, the paramedic has a key role in managing symptoms or liaising with other members of the patient’s palliative care team to provide appropriate care. The results should inform integrated systems of care that involve ambulance services in the planning and delivery of community-based palliative care.
30
Moore, Kirsten J., Colleen J. Doyle, Trisha L. Dunning, Ann T. Hague, Lucas A. Lloyd, Jo Bourke, and Stephen D. Gill. "Public sector residential aged care: identifying novel associations between quality indicators and other demographic and health-related factors." Australian Health Review 38, no. 3 (2014): 325. http://dx.doi.org/10.1071/ah13184.
Full textAbstract:
Objective To explore associations among quality indicators (QI; e.g. pressure ulcers, falls and/or fractures, physical restraint, use of multiple medications, unplanned weight loss) of the Victorian Public Sector Residential Aged Care Services (VPSRACS) with other demographic and health-related factors. Methods Data for 380 residents over a 3-month period were extracted retrospectively from client databases at four VPSRAC facilities. Results Four significant logistic regression models were developed. The strongest models related to falls and polypharmacy. Significant associations for these models included the following: (1) residents with a higher body mass index were 6% less likely (95% confidence interval (CI) 1%–11%) to fall, whereas high levels of cognitive impairment increased the risk of falling by 8% (95% CI 2%–14%); (2) being ambulant with a gait aid more than doubled the risk of falling compared with non-ambulant residents (95% CI 19%–546%); and (3) higher cognitive impairment was associated with a 6% (95% CI 1%–11%) reduction in the likelihood of polypharmacy. Conclusions Identification of significant relationships between the VPSRACS QI and other demographic and health-related factors is a preliminary step towards a more in-depth understanding of the factors that influence the QI and predict adverse events. What is known about the topic? Currently, the VPSRACS report on five QI. Previous research has shown associations between several of these indicators, but not all. What does this paper add? This paper examines associations between the five VPSRAC QI as well as other key demographic and health-related factors. Novel findings from regression analyses included an increased risk of falls associated with recommended body mass index and using gait aids, but no association between pressure ulcers and the Norton score. Regression models for other QI were limited by the small occurrences of the QI. However, significant associations were identified indicating that residents using a gait aid had a lower level of unplanned weight loss and residents with polypharmacy had higher unplanned weight loss. What are the implications for practitioners? This paper reinforces the value of collecting VPSRAC QI data to enable facilities to consider how these variables could impact on care quality and to proactively plan to reduce the risk of adverse events. Although QI data can be used to benchmark with other settings, this paper shows how QI data can be used to inform practice within a facility and help identify patient-related factors that may warrant further investigation.
31
Moore, Kirsten J., Colleen J. Doyle, Trisha L. Dunning, Ann T. Hague, Lucas A. Lloyd, Jo Bourke, and Stephen D. Gill. "Corrigendum to: Public sector residential aged care: identifying novel associations between quality indicators and other demographic and health-related factors." Australian Health Review 39, no. 1 (2015): 120. http://dx.doi.org/10.1071/ah13184_co.
Full textAbstract:
Objective To explore associations among quality indicators (QI; e.g. pressure ulcers, falls and/or fractures, physical restraint, use of multiple medications, unplanned weight loss) of the Victorian Public Sector Residential Aged Care Services (VPSRACS) with other demographic and health-related factors. Methods Data for 380 residents over a 3-month period were extracted retrospectively from client databases at four VPSRAC facilities. Results Four significant logistic regression models were developed. The strongest models related to falls and polypharmacy. Significant associations for these models included the following: (1) residents with a higher body mass index were 6% less likely (95% confidence interval (CI) 1%–11%) to fall, whereas high levels of cognitive impairment increased the risk of falling by 8% (95% CI 2%–14%); (2) being ambulant with a gait aid more than doubled the risk of falling compared with non-ambulant residents (95% CI 19%–546%); and (3) higher cognitive impairment was associated with a 6% (95% CI 1%–11%) reduction in the likelihood of polypharmacy. Conclusions Identification of significant relationships between the VPSRACS QI and other demographic and health-related factors is a preliminary step towards a more in-depth understanding of the factors that influence the QI and predict adverse events. What is known about the topic? Currently, the VPSRACS report on five QI. Previous research has shown associations between several of these indicators, but not all. What does this paper add? This paper examines associations between the five VPSRAC QI as well as other key demographic and health-related factors. Novel findings from regression analyses included an increased risk of falls associated with recommended body mass index and using gait aids, but no association between pressure ulcers and the Norton score. Regression models for other QI were limited by the small occurrences of the QI. However, significant associations were identified indicating that residents using a gait aid had a lower level of unplanned weight loss and residents with polypharmacy had higher unplanned weight loss. What are the implications for practitioners? This paper reinforces the value of collecting VPSRAC QI data to enable facilities to consider how these variables could impact on care quality and to proactively plan to reduce the risk of adverse events. Although QI data can be used to benchmark with other settings, this paper shows how QI data can be used to inform practice within a facility and help identify patient-related factors that may warrant further investigation.
32
Williams, Brett. "Removal of Invasive Devices from Deceased Persons: Forensic implications for Paramedics – a Victorian perspective." Australasian Journal of Paramedicine 3, no. 4 (July 14, 2015). http://dx.doi.org/10.33151/ajp.3.4.339.
Full textAbstract:
Professor Cordner is Professor of forensic medicine at Monash University Institutes of Health and Director of the Victorian Institute of Forensic Medicine His work in the area of forensic medicine and human rights has seen him take tours of duty in East Timor and Kosovo, as well as a year-long stint consulting to the International Committee of the Red Cross in Geneva. The following interview was conducted to invite Professor Cordner’s professional opinion in relation to practices and implications with respect to the removal of invasive clinical devices from deceased persons, as they currently apply to paramedics of Metropolitan Ambulance Service in Melbourne, and Rural Ambulance Victoria.
33
O’Meara, Peter. "Ambulance satisfaction surveys: Their utility in policy development, system change and professional practice." Australasian Journal of Paramedicine 1, no. 3 (October 6, 2003). http://dx.doi.org/10.33151/ajp.1.3.212.
Full textAbstract:
This study surveyed general practitioners, registered nurses, ambulance officers and members of the public to determine satisfaction levels in rural ambulance services in the Australian State of Victoria. It was part of a larger study developing rural models of ambulance service delivery. Respondents were asked to complete a survey about their satisfaction with their local ambulance services and their confidence in local emergency medical systems. Satisfaction levels were very high and associated with direct experience as patients or as immediate family members of patients. Focusing on specific elements of the ambulance system in future satisfaction surveys may improve the capacity of managers and policy makers to develop appropriate policies and implement changes in system design and professional practice.
34
Smith, Jeremy, Emily Andrew, and Karen Smith. "Prehospital early warning scores are associated with requirement for medical retrieval services." Australasian Journal of Paramedicine 19 (April 10, 2022). http://dx.doi.org/10.33151/ajp.19.956.
Full textAbstract:
Objective: Prehospital early warning scores (EWSs) can accurately identify patients at risk of clinical deterioration. We hypothesised that EWSs can identify patients during the prehospital phase who will subsequently require clinical escalation via medical retrieval.
Methods: A retrospective observational study of adult patients attended in 2018 by Ambulance Victoria in rural regions was conducted. We calculated EWSs using National Early Warning Score 2 (NEWS2) and Rapid Emergency Medicine Score (REMS) methods. Primary outcome was activation of Adult Retrieval Victoria (ARV) within 24h of ambulance attendance. We evaluated sensitivity and specificity for each score, and used multivariable logistic regression analysis to assess the independent association between EWSs and ARV activation.
Results: 71 401 patients were included, of which 607 (0.9%) required ARV activation within 24h. Sensitivity and specificity of NEWS2 were 0.484 (95% CI 0.444–0.525) and 0.806 (95% CI 0.803–0.809) respectively, compared with 0.552 (95% CI 0.511–0.592) and 0.508 (95% CI 0.504–0.512) respectively for REMS. After adjustment for remoteness, distance to hospital, sex, age and hospital service level, a medium/high risk score according to the NEWS2 (OR 4.12; 95% CI 3.50–4.85, p<0.001) and REMS (OR 2.92, 95% CI 2.26–3.77) was associated with ARV activation. Odds of ARV activation increased with remoteness and decreasing service level of the receiving hospital.
Conclusions: Prehospital NEWS2 and REMS were associated with medical retrieval within 24h of ambulance attendance. EWSs may allow early identification of ambulance patients requiring medical retrieval, thus facilitating earlier activation and reduced time to definitive care.
35
Dyson, Kylie, Janet Bray, Karen Smith, Stephen Bernard, Lahn Straney, and Finn Judith. "Abstract 12334: How Much Exposure to Resuscitation Do Emergency Medical Service Personnel Get?" Circulation 130, suppl_2 (November 25, 2014). http://dx.doi.org/10.1161/circ.130.suppl_2.12334.
Full textAbstract:
Objectives: The exposure of emergency medical service personnel (paramedics) to out-of-hospital cardiac arrest (OHCA) and resuscitation procedures could be an important factor in skill maintenance and quality of care. This study aims to describe paramedic exposure to OHCA resuscitation in the state of Victoria, Australia (population 5.8 million). Methods: We extracted and linked data from the Victorian Ambulance Cardiac Arrest Registry (VACAR) and Ambulance Victoria’s employment dataset for the period 2003-2012. Paramedics were considered to have ‘exposure’ to OHCA if they attended a case where resuscitation was attempted. Individual rates were calculated for annual exposure (number of OHCA exposures for each paramedic/years employed in study period) and days between exposures (total paramedic days/total number of exposures). Results: Over the 10-year period, there were 49,107 OHCAs and 5,673 paramedics employed. Resuscitation was attempted in 44% of patients. An average of 3.2 (SD±1.1) paramedics attended each case. The median average exposure of paramedics was 2.2 (IQR=1.2-3.5) OHCAs/year. The proportion with no exposures in a year increased from 39% in 2003 to 43% in 2012 ( p =0.036). OHCA exposure was significantly less in those employed part-time or casual ( p <0.001), in a rural area ( p <0.001) or with a lower qualification ( p <0.001) (Table). Annual exposure to pediatric and traumatic OHCAs was particularly low (Table). Paramedics were exposed to an average of 0.006 OHCAs/day, meaning it would take an average of 163 days be exposed to OHCA and up to 12.5 years for rare cases, such as pediatric OHCAs. Conclusion: Our study identified paramedic exposure to resuscitation is low and has decreased over time. This highlights the importance of supplementing paramedic exposure with other methods, such as simulation, to maintain resuscitation skills. This may be particularly important to paramedics with low exposure and for rare case types, such as pediatric OHCA.
36
Boyle, Malcolm, and Peter O’Meara. "From roadside to hospital: A pilot study to investigate the factors influencing the time taken to deliver trauma patients to a regional hospital." Australasian Journal of Paramedicine 6, no. 3 (July 16, 2015). http://dx.doi.org/10.33151/ajp.6.3.463.
Full textAbstract:
IntroductionOne of the trauma system objectives for the ambulance service is to get the right patient to the right hospital in a timely manner. The Review of Trauma and Emergency Services in Victoria, Australia, identified prolonged prehospital scene times of greater than 20 minutes for non trapped patients as a deficiency that may have adverse outcomes for severely injured trauma patients. The objective of this pilot study was to identify the factors that impact on the timely transfer of trauma patients from the scene of an incident to a regional hospital emergency department and justification for the delays, as the basis for a further detailed study.MethodsA retrospective pilot cohort study of trauma patients transported by ambulance to the emergency department of the Latrobe Regional Hospital over a six-month period who had an emergency department triage category of 1, 2 or 3 was undertaken. Data relating to the prehospital care of trauma patients with scene times > 20 minutes and transport times > 30 minutes were extracted from Rural Ambulance Victoria patient care records and hospital patient records. Ethics approval was granted.ResultsThere were 70 trauma patients transported to the hospital during the collection period. Of these 49 patients were available for analysis, 21 cases were excluded due to incomplete time or ED triage details. There were 12 cases where scene times were > 20 minutes. Only one paramedic crew spent an unjustifiably long time at the scene and only one patient had a transport time to hospital > 30 minutes.ConclusionThis pilot study confirms that there are prolonged prehospital scene times involving paramedics, however, the study suggests that most of the extended times are explained by factors outside the control of the attending paramedics. There was only one case where the scene time was not justified. One patient had a transport time > 30 minutes which was due to the patient being taken to a higher level of care. Experiences from this pilot study have led to changes in subsequent prehospital trauma studies.
37
Pfeiffer, Christina K., Karen Smith, Stephen Bernard, Stuart R. Dalziel, Stephen Hearps, Tobias Geis, Michael Kabesch, and Franz E. Babl. "Prehospital benzodiazepine use and need for respiratory support in paediatric seizures." Emergency Medicine Journal, January 25, 2022, emermed-2021-211735. http://dx.doi.org/10.1136/emermed-2021-211735.
Full textAbstract:
BackgroundParamedics are frequently called to attend seizures in children. High-quality evidence on second-line treatment of benzodiazepine (BZD)-refractory convulsions with parenteral long-acting antiepileptic drugs in children has become available from the ED. In order to address the potential need for an alternative agent, we set out to determine the association of BZD use prehospital and the need for respiratory support.MethodsWe conducted a retrospective observational study of state-wide ambulance service data (Ambulance Victoria in Victoria, Australia, population: 6.5 million). Children aged 0–17 years assessed for seizures by paramedics were analysed for demographics, process factors, treatment and airway management. We calculated adjusted ORs (AOR) of the requirement for respiratory support in relation to the number of BZD doses administered.ResultsParamedics attended 5112 children with suspected seizures over 1 year (1 July 2018 to 30 June 2019). Overall, need for respiratory support was low (n=166; 3.2%). Before ambulance arrival, 509 (10.0%) had already received a BZD and 420 (8.2%) were treated with midazolam by paramedics. Of the 846 (16.5%) patients treated with BZD, 597 (70.6%) received 1 BZD dose, 156 (18.4%) 2 doses and 93 (11.0%) >2 doses of BZD. Patients who were administered 1, 2 and >2 doses of BZD received respiratory support in 8.9%, 32.1% (AOR 4.6 vs 1 dose, 95% CI 2.9 to 7.4) and 49.5% (AOR 10.3 vs 1 dose, 95% CI 6.0 to 17.9), respectively.ConclusionsIncreasing administration of BZD doses was associated with higher use of respiratory support. Alternative prehospital antiepileptic drugs to minimise respiratory depression should be investigated in future research.
38
Dyson, Kylie, Janet Bray, Karen Smith, Stephen Bernard, Lahn Straney, and Judith Finn. "Abstract 269: How Much Exposure to Resuscitation Do Emergency Medical Services Personnel Get?" Circulation 130, suppl_2 (November 25, 2014). http://dx.doi.org/10.1161/circ.130.suppl_2.269.
Full textAbstract:
Objectives: The exposure of emergency medical service personnel (paramedics) to out-of-hospital cardiac arrest (OHCA) and resuscitation procedures could be an important factor in skill maintenance and quality of care. This study aims to describe paramedic exposure to OHCA resuscitation in the state of Victoria, Australia (population 5.8 million). Methods: We extracted and linked data from the Victorian Ambulance Cardiac Arrest Registry (VACAR) and Ambulance Victoria’s employment dataset for the period 2003-2012. Paramedics were considered to have ‘exposure’ to OHCA if they attended a case where resuscitation was attempted. Individual rates were calculated for annual exposure (number of OHCA exposures for each paramedic/years employed in study period) and days between exposures (total paramedic days/total number of exposures). Results: Over the 10-year period, there were 49,107 OHCAs and 5,673 paramedics employed. Resuscitation was attempted in 44% of patients. An average of 3.2 (SD±1.1) paramedics attended each case. The median average exposure of paramedics was 2.2 (IQR=1.2-3.5) OHCAs/year. The proportion with no exposures in a year increased from 39% in 2003 to 43% in 2012 (p=0.036). OHCA exposure was significantly less in those employed part-time or casual (p<0.001), in a rural area (p<0.001) or with a lower qualification (p<0.001) (Table). Annual exposure to pediatric and traumatic OHCAs was particularly low (Table). Paramedics were exposed to an average of 0.006 OHCAs/day, meaning it would take an average of 163 days be exposed to OHCA and up to 12.5 years for rare cases, such as pediatric OHCAs. Conclusion: Our study identified paramedic exposure to resuscitation is low and has decreased over time. This highlights the importance of supplementing paramedic exposure with other methods, such as simulation, to maintain resuscitation skills. This may be particularly important to paramedics with low exposure and for rare case types, such as pediatric OHCA.
39
O'Meara, Peter, Helen Hickson, and Chris Huggins. "Starting the conversation: What are the issues for paramedic student clinical education?" Australasian Journal of Paramedicine 11, no. 4 (July 24, 2014). http://dx.doi.org/10.33151/ajp.11.4.4.
Full textAbstract:
ObjectivesThis paper examines the issues that affect the quality of paramedic student clinical placements. Participants included paramedics, paramedic educators, paramedic students and ambulance service managers who had gathered for an Australian conference in Bendigo in central Victoria. The aim of this paper is to highlight issues identified by the participants and to start a conversation about the importance of clinical placement for paramedic students.MethodsThis was a qualitative study utilising ‘Community conversations’ as a research methodology. ‘Community conversations’ is an action research approach. This study had 53 participants, who spent around 5 hours in conversation throughout a 3-day conference. The conversation initiated was to discuss and raise issues that related to paramedic student clinical placements, and identify creative and innovative solutions.ResultsIn this paper, we focus on three themes that emerged from the conversations: planning and preparation of the placement; continuity of placement experience; and diversity of placements. We argue that better communication is required between the university, the ambulance service, the paramedic educator/clinical instructor and the student.ConclusionsClinical education is an essential element of student learning and skill development, yet in Australia there are no mandatory requirements in relation to duration, content or measurement of quality in student clinical placements. We strongly recommend that continuity is an essential element of a quality clinical placement and argue that students should be allocated to work in one location for 1–2 week blocks.
40
Nehme, Emily, Nicole Magnuson, Lindsay Mackay, Gareth Becker, Mark Wilson, and Karen Smith. "Sstudy of prehospital video telehealth for callers with mental health-related complaints." Emergency Medicine Journal, December 1, 2022, emermed-2022-212456. http://dx.doi.org/10.1136/emermed-2022-212456.
Full textAbstract:
BackgroundPatients with mental health-related complaints are a key driver of increasing emergency medical service (EMS) demand; however, they require minimal intervention by EMS personnel. We describe the outcomes of a video telehealth study by mental health nurses (MHNs) in an EMS call-taking centre.MethodsThis was a prospective study of adult (≥18 years) EMS callers with non-urgent mental health concerns in Victoria, Australia who underwent secondary triage between 1 March 2020 and 31 May 2021. Multivariable logistic regression models were used to compare the influence of video telehealth with voice-only triage by an MHN or secondary triage practitioner on the need for ambulance dispatch. One-week follow-up was conducted with video telehealth patients. Interviews were conducted with MHNs and a cost analysis was performed.ResultsA total of 9588 patients were included of which 738 (7.7%) completed video consultation. The median age of video telehealth patients was 34 years (Q1: 24, Q3: 47), 62% were female and the most common complaint was suicidal or self-harm ideation (50.0%). After multivariable adjustment, video telehealth was associated with reduced odds of emergency ambulance dispatch (OR=0.173, 95% CI 0.144 to 0.209) when compared with voice-only triage by a secondary triage practitioner, but not voice-only triage by an MHN (OR=1.009, 95% CI 0.827 to 1.232). Video triage was associated with increased referrals to alternative services (excluding EDs) when compared with voice-only triage by an MHN (OR=1.321, 95% CI 1.087 to 1.606). Among those responding to 1-week follow-up, 92.8% were satisfied with the telehealth service and MHNs viewed it favourably. The average cost per video telehealth case was half that of a traditional secondary triage.ConclusionThe use of video telehealth by MHNs was associated with fewer emergency ambulance dispatches when compared with voice-only triage by secondary triage practitioners, and increased referrals to alternative services. This cost-effective technology was viewed favourably by patients and MHNs. Expansion of video technology in EMS call taking warrants exploration.
41
Scott, Debbie, Rowan P. Ogeil, Foruhar Maoyeri, Cherie Heilbronn, Kerri Coomber, Karen Smith, Peter G. Miller, and Dan I. Lubman. "Alcohol Accessibility and Family Violence-related Ambulance Attendances." Journal of Interpersonal Violence, January 18, 2021, 088626052098626. http://dx.doi.org/10.1177/0886260520986262.
Full textAbstract:
There is substantial evidence supporting the association between alcohol license density and violent crime. However, the impact of different types of alcohol licenses on intimate partner and family violence is sparse. We explored the associations between access to alcohol outlets, and family and intimate partner violence using paramedic clinical records, given this service is often the first to respond to acute crises. Coded ambulance attendance data from 694 postcodes in Victoria, Australia, from July 1, 2016 to June 30, 2018 where alcohol or another drug, mental health or self-harm associated with family or intimate partner violence was indicated were examined. A hybrid model of spatial autoregressive and negative binomial zero-inflated Poisson-based count regression models was used to examine associations with alcohol outlet density and socioeconomic factors. We found that access to a liquor license outlet was significantly associated with family violence-related attendances across all types of outlets, including on-premise (late night) licenses ( β = 1.73, SE: 0.18), restaurant licenses ( β = 0.83, SE: 0.28), and packaged liquor licenses ( β = 0.62, SE: 0.06). Our results demonstrate a significant relationship between alcohol-related harms in the context of family violence and provides evidence of the relationship between alcohol-related family violence in both victims and perpetrators. The findings of this study highlight the need for public health interventions such as licensing policy and town planning changes to reduce these harms by restricting alcohol availability.
42
Coory, M., K. Grant, and H. Kelly. "Influenza-like illness surveillance using a deputising medical service corresponds to surveillance from sentinel general practices." Eurosurveillance 14, no. 44 (November 5, 2009). http://dx.doi.org/10.2807/ese.14.44.19387-en.
Full textAbstract:
Standard sources of data for influenza surveillance include notifications of laboratory-confirmed cases and notifications from sentinel general practices. These data are not always available in a timely fashion, leading to proposals to use more immediate data sources such as over-the-counter drug sales, ambulance call-outs and web searches to monitor influenza-like illness (ILI). We aimed to assess data from a deputising medical service as another source of data for timely syndromic influenza surveillance. We measured the extent of agreement between the weekly percentage of patients with ILI reported from sentinel general practices and the corresponding weekly percentage reported from a deputising medical service in Victoria, Australia over ten years, from 1999 to 2008. There was good agreement between the two data sources, with suitably narrow limits of agreement. The deputising medical service did not use a standardised definition of ILI and is not supplemented by laboratory confirmation of suspected cases. Nevertheless, the results of this study show that such data can provide low cost and timely ILI surveillance.
43
Delardes, Belinda, Samantha Chakraborty, Karen Smith, and Kelly-Ann Bowles. "Development of an electronic referral proforma from paramedics to general practitioners: A Delphi study." Australasian Journal of Paramedicine 19 (June 1, 2022). http://dx.doi.org/10.33151/ajp.19.918.
Full textAbstract:
Introduction Currently, non-transported patients who are attended to by a state-funded ambulance service in Victoria and are advised to visit their general practitioner (GP) do not have informational continuity of care, as there is no communication between the referring paramedic and GP. This research aimed to develop a functional electronic referral (e-referral) proforma from paramedics to GPs that can be used to support handover of patients’ clinical information for non-transported patients. Methods Paramedics, GPs and digital health experts were invited to participate in the study. The study design utilised an online Delphi technique, where participants responded to three rounds of surveys relating to the pertinence, feasibility, content and presentation of an e-referral tool. Questions were open-ended or requested responses on a 5-point Likert scale. Results A total of 21 clinicians participated in the study and developed an e-referral proforma. After three rounds, participants agreed the proforma should contain the following information: the patients’ identifying information, presenting complaint, social concerns, vital sign survey, management or advice given to the patient and reason for referral. Stakeholders stressed that the mode and timing of delivery must be flexible enough so that implementing the e-referral proforma does not become burdensome for clinicians. Conclusion A structured e-referral system between paramedics and GPs is feasible and offers a method to improve informational continuity of care and in turn, patient safety.
44
O’Brien, Kylie, Amber Moore, Peter Hartley, and David Dawson. "Lessons about work readiness from final year paramedic students in an Australian university." Australasian Journal of Paramedicine 10, no. 4 (November 4, 2013). http://dx.doi.org/10.33151/ajp.10.4.52.
Full textAbstract:
Introduction Paramedic education is changing in Australia from a post-employment model in which in-house training is provided by state-based service providers to pre-employment Bachelor degree education in universities. Little is known about how well prepared final year paramedic students nearing the end of their university course perceive themselves to be to enter the workforce. The objective of the study was to investigate perceptions of preparedness for the workforce of final year paramedic students at Victoria University, Melbourne, Australia. Methods A survey was conducted with final year paramedic students in their last semester at Victoria University, Melbourne, Australia. The survey focussed on eight dimensions relating to paramedic practice: theoretical skills, clinical skills; practical skills; interpersonal skills; communication with colleagues and other professionals; coping skills; lifelong learning; and ethics and legal responsibilities. Part 1 of the survey required participants to choose from six possible responses on how well they believe their paramedic course has prepared them in relation to 64 statements. Part 2 consisted of 5 open- ended questions. Data from part 1 was analysed to find the mean ‘preparedness scores’ on the 8 dimensions of paramedic practice. Responses from part 2 of survey were transcribed and imported into NVivo8, where each part of the questions were analysed and grouped into themes. Results Response rate was 14% (n=23). Respondents felt ‘somewhat adequately’ to ‘adequately’ prepared for the workforce. Responses to Part 2 indicated a range of perceptions in relation to preparedness to enter the paramedic workforce, ranging from feeling unprepared to put knowledge into practice, prepared in some aspects but not in others, through to feeling prepared but with a realisation that there would be much to learn on the job. Respondents comments provide paramedic educators with some clear ideas about what final year students value in terms of preparing them for practice: whilst respondents valued the clinical practice opportunities they had had, they wanted more clinical placements with more variety, for example placements in different areas of healthcare. Conclusion This small survey provides paramedic educators with some clear ideas about what final year students value in terms of preparing them for practice. As Australian paramedic education moves from a post-employment training model to a pre-employment model, further consideration is needed of how courses will best address the development of clinical and practical skills of students and meet the requirements of ambulance service employers. Collegiate dialogue between employers, educators and students will assist in addressing this.
45
McGuinness, Sarah L., Johnson Josphin, Owen Eades, Sharon Clifford, Jane Fisher, Maggie Kirkman, Grant Russell, et al. "Organizational responses to the COVID-19 pandemic in Victoria, Australia: A qualitative study across four healthcare settings." Frontiers in Public Health 10 (September 29, 2022). http://dx.doi.org/10.3389/fpubh.2022.965664.
Full textAbstract:
ObjectiveOrganizational responses that support healthcare workers (HCWs) and mitigate health risks are necessary to offset the impact of the COVID-19 pandemic. We aimed to understand how HCWs and key personnel working in healthcare settings in Melbourne, Australia perceived their employing organizations' responses to the COVID-19 pandemic.MethodIn this qualitative study, conducted May-July 2021 as part of the longitudinal Coronavirus in Victorian Healthcare and Aged Care Workers (COVIC-HA) study, we purposively sampled and interviewed HCWs and key personnel from healthcare organizations across hospital, ambulance, aged care and primary care (general practice) settings. We also examined HCWs' free-text responses to a question about organizational resources and/or supports from the COVIC-HA Study's baseline survey. We thematically analyzed data using an iterative process.ResultsWe analyzed data from interviews with 28 HCWs and 21 key personnel and free-text responses from 365 HCWs, yielding three major themes: navigating a changing and uncertain environment, maintaining service delivery during a pandemic, and meeting the safety and psychological needs of staff . HCWs valued organizational efforts to engage openly and honesty with staff, and proactive responses such as strategies to enhance workplace safety (e.g., personal protective equipment spotters). Suggestions for improvement identified in the themes included streamlined information processes, greater involvement of HCWs in decision-making, increased investment in staff wellbeing initiatives and sustainable approaches to strengthen the healthcare workforce.ConclusionsThis study provides in-depth insights into the challenges and successes of organizational responses across four healthcare settings in the uncertain environment of a pandemic. Future efforts to mitigate the impact of acute stressors on HCWs should include a strong focus on bidirectional communication, effective and realistic strategies to strengthen and sustain the healthcare workforce, and greater investment in flexible and meaningful psychological support and wellbeing initiatives for HCWs.
46
Boyle, Malcolm, Stephen Burgess, Mark Chilton, Brian Fallows, Bill Lord, David Shugg, Brett Williams, and Andrea Wyatt. "Monash University Centre for Ambulance and Paramedic Studies (MUCAPS) Submission to the Department of Human Services (DHS), in response to the DHS Discussion Paper examining the regulation of the Health Professions in Victoria." Australasian Journal of Paramedicine 1, no. 3 (October 6, 2003). http://dx.doi.org/10.33151/ajp.1.3.208.
Full textAbstract:
This submission will primarily address the regulation of the health professions from the perspective of an education institution, and is made in response to the Discussion paper examining regulation of the health professions in Victoria, dated October 2003 which was issued by the Policy and Strategic Projects Division of the Victorian Department of Human Services, Melbourne, Victoria.
47
Shugg, David, and Les Hotchin. "Response - The origins and history of the Institute of Ambulance Officers’ (Australia) official magazine." Australasian Journal of Paramedicine 1, no. 1 (August 28, 2014). http://dx.doi.org/10.33151/ajp.1.1.69.
Full text
48
Yi, Alice. "Cover art." University of Western Ontario Medical Journal 86, no. 1 (August 29, 2017). http://dx.doi.org/10.5206/uwomj.v86i1.2120.
Full textAbstract:
Cover art by Alice Yi.
Description: An air ambulance sits on a helipad a short distance away from a hospital. At first glance, these buildings look like they can be from anywhere, but upon closer inspection, the unmistakable countours of Victoria Hospital reveal themselves. Victoria Hospital is the only hospital in the London Health Sciences network that services trauma patients, and is the designated Lead Trauma Hospital for all of Southwestern Ontario. Due to the large population that LHSC serves—and large distances between populations—air ambulances are often essential for timely patient transport. These helicopters have become a sign of how far technology and infrastructure have come in trauma and disaster medicine, and how we can bring further advancements to the field.
49
Murcott,, Pauline. "Second Annual JEPHC Symposium." Australasian Journal of Paramedicine 8, no. 2 (May 3, 2010). http://dx.doi.org/10.33151/ajp.8.2.99.
Full textAbstract:
Over 140 delegates attended this year’s 2nd Annual Journal of Emergency Primary Health Care (JEPHC) Symposium which was held at the Alfred Hospital’s Monash Clinical Schoolon 8th April 2010. The Symposium was once again co-hosted by JEPHC, Monash University Department of Community Emergency Health and Paramedic Practice (DCEHPP), the Australian College of Ambulance Professionals (ACAP) and Ambulance Victoria (AV).
50
Burns, Brian. "Re: Helicopter EMS in Cork: a paramedicine perspective." Irish Journal of Paramedicine 3, no. 2 (October 9, 2018). http://dx.doi.org/10.32378/ijp.v3i2.151.
Full textAbstract:
<p>Response to Knox, S. (2018). Helicopter EMS in Cork: a paramedicine perspective. Irish Journal of Paramedicine, 3(2). doi:http://dx.doi.org/10.32378/ijp.v3i2.113</p><p> </p><p>Dear Editor,</p><p>I read Dr. Shane Knox’s commentary “Helicopter EMS in Cork” (1) in the current edition of the Journal with interest.<br /> Firstly, to be clear, I have the utmost respect for paramedics. The commencement of an EMS helicopter in Cork is a landmark step forward in prehospital care. The ‘Toyota’ reference made in the Knox article is in relation to a misquote published in the Irish Times from a recent RTE Radio interview I gave around the staffing model of a Helicopter EMS (HEMS). The reference I made to Toyota was in fact with respect to the physician-paramedic HEMS model that is the norm in Australia, Northern Ireland, Scotland, England, Wales and mainland Europe. I don’t view a physician-paramedic team as a Rolls-Royce, platinum or gold standard model, but rather more like a Toyota; attainable and highly durable. In August 2015, the College of Paramedics (UK) stated “The College of Paramedics support proposals for a HEMS service in Northern Ireland, with a view that this service should be integrated within a trauma network in Northern Ireland and consist of a specialist pre-hospital Doctor and Paramedic team.” (2) The HEMS in Northern Ireland is now staffed with this model by the Northern Ireland Ambulance Service (NIAS). <br /> The Irish government recently endorsed the development of a Trauma System for Ireland. Inherent to any trauma system is enhanced prehospital trauma care capability. Albeit the air ambulance will certainly bring speed, it will not bring enhanced skills without a doctor-paramedic team that will save additional lives, nor will it meet the PHECC dispatch standards for emergency calls by road (dual paramedic). The doctor-paramedic model can provide advanced prehospital critical interventions such as balanced emergency anaesthesia, mechanical ventilation, finger thoracostomy, blood transfusion and eye, life and limb-saving procedures (e.g. lateral canthotomy, resuscitative thoracotomy) as well as enhanced system activation such as prehospital massive transfusion activation and bringing a patient direct to theatre from helipad (code crimson).<br /> Recently, Mark Winter, an operations manager of Wales Air Ambulance (doctor-paramedic EMRTS team) said: “One of the things we talk about in our world is ‘unexpected survivors’-those patients who have had emergency front line treatment at the roadside or at the home who otherwise would have to be taken to the hospital, where it might have been too late.” (3) The similar EMRS in Scotland is increasing coverage as I write this to meet the demands of the newly developed Scottish Trauma Network. I’m sure the patient needs are the same in Ireland as they are in Northern Ireland or Great Britain. <br /> A doctor-paramedic team extends critical care to life-threatening prehospital and medical emergencies such as STEMI with cardiogenic shock requiring safe intubation and ventilation, central inotropic support or controlled mechanical ventilation and targeted BP control in neurological emergencies (e.g. subarachnoid haemorrhage, stroke with coma). This team responds rapidly to prehospital or hospital tasking and can provide intensive care level stabilisation and support anywhere. <br /> Certainly as Knox points out many of the interventions/skills that can be brought to the scene can also be performed by critical care paramedics (e.g. MICA in Victoria). This expertise does not occur overnight and takes years to develop. In my opinion, in Ireland a critical care paramedic model can only develop in the environment of a physician-paramedic team in terms of training, curriculum development and governance. There are excellent Irish advanced paramedics and prehospital specialist doctors in Ireland and abroad who together would make an excellent team that would serve the community and patient needs to the highest level. Now is the time. </p>