As cases of COVID-19 decline globally, Aidan Baron takes a closer look at the long-term gaps in healthcare systems exposed by the current pandemic which urgently need addressing
Research indicates that students of lower socioeconomic status are educationally disadvantaged. This study sought to examine differences in paramedic students' academic performance from counties with varied socioeconomic status in the United States of America. Student performance data and socioeconomic status data were combined for counties within the states of California, Mississippi, Louisiana, Texas and Virginia. Linear multiple regression modelling was performed to determine the relationship between income, high school graduation rate, poverty and food insecurity, with first-attempt scores on the Fisdap Paramedic Readiness Exam versions 3 and 4. Linear regression models indicated that there was a significant relationship between county-level income, poverty, graduation rate, food insecurity, and paramedic student academic performance. It remains unclear what type of relationship exists between individual socioeconomic status and individual academic performance of paramedic students. These findings support the future collection of individual student socioeconomic data to identify issues and mitigate impact on academic performance.
Literature throughout the years has identified that wellbeing includes a variety of concepts that primarily have social, physical, and mental components. Research still needs to identify how the key aspects of these themes link together to create a holistic wellbeing approach, especially in frontline emergency healthcare, like paramedics. Linking together physiological indicators and psychological mediators is currently being investigated through a feasibility study at Anglia Ruskin University. We describe these components as an individual's state in relation to their heart rate variability and cortisol levels (physiological), and individual, social, and organisational mediators (psychological). We present a narrative review of selected literature to introduce and describe these components to the paramedic profession. This review is not exhaustive or representative of all literature on the topic and thus our description should be interpreted as an introduction to concepts of paramedic wellbeing that has not previously been combined or discussed in such a manner.
Severe haemorrhage may lead to pathologic release of fibrinolytic enzymes, which break down blood clots. Tranexamic acid (TXA) is a drug that inhibits the fibrinolysis of blood clots.
The purpose of this review is to explore current literature regarding prehospital TXA administration for patients suffering severe haemorrhage following trauma, and to discuss whether this drug should be more widely used across modern international ambulance services.
Literature searches of EBSCO Host, ProQuest and PubMed databases were conducted in August, 2019.
TXA administration within 3 hours following injury is associated with improved outcomes for severe haemorrhage patients. However, there are reservations that the success of TXA in developing countries and military settings may not be directly transferrable to the modern civilian healthcare systems.
The benefits of prehospital TXA administration appear compelling. Further studies will help guide wider international implementation of this drug in paramedic practice.
The authors present the case of an Irukandji-like syndrome resulting from cnidarian envenomation, following multiple stings from the lion's mane jellyfish (Cyanea capillata) encountered by a sea swimmer in the coastal waters of the UK. This case presents the initial features of Irukandji-like syndrome in this 45-year-old female, her management in the emergency department and subsequent discharge. Envenomation from the lion's mane species and the Irukandji syndrome are briefly discussed.