Volume 2 Issue 2

Pre-hospital management of cystic fibrosis patients presenting with haemoptysis

This paper discusses the pre-hospital clinical management of cystic fibrosis (CF) patients suffering with haemoptysis. While clear guidelines and procedures exist within hospitals in regard to the management of such patients, the same cannot be said for the pre-hospital setting, with very limited clinical practice guidance. Massive haemoptysis is a serious threat to life, though for some patients such as the CF population, even a minor bleed can have devastating effect on quality of life. This paper proposes a pre-hospital clinical guideline based on a retrospective case series from a large Australian tertiary hospital. It is hoped this paper will provide important clinical information regarding CF patients suffering with haemoptysis as it is imperative the management of these patients is undertaken promptly and is well-informed.

Evaluating the impact on 911 calls by an in-home programme with a multidisciplinary team

Introduction Collaboration of emergency medical services and community organisations such as primary health care providers, social service agencies, and public safety groups can enable innovative initiatives that have the potential to improve the level of health care within a community and reduce health care system pressures. The purpose of this research is to evaluate the impact of an ‘aging at home’ program that uses an integrated health care team involving community paramedics on 911 calls. Methods This study involved a retrospective case series involving a chart review of clients participating in the ‘Aging at Home’ program located in a rural community in Ontario between January 1 2010 and April 30 2011. Each record was evaluated for the presenting problem and whether transport to a local hospital emergency department was initiated by using 911. Results Of the 129 client interactions by community paramedics and personal support workers, 13 chief complaint categories were determined and 15 incidents resulted in emergency department visits by using 911. Conclusion The use of community paramedics in an integrated health care team aimed at supporting clients living at home demonstrates a negative correlation in the use of 911 calls.

Disaster training: lessons learnt from the 2008 Sichuan China earthquake

Gaps in training have been identified from reviews of the experiences of prehospital medical personnel faced with previous disasters like the Sichuan earthquake in 2008. It would be useful to identify and develop standardised training and educational core competencies in pre-hospital disaster training adapted to the local situation and health system in China. This paper identified six areas of training needs for responders to enhance their effectiveness in disaster settings. Two levels of training for frontline first responders and disaster response managers may be the best approach to encompass the wide range of competencies expected to deal with disaster situations. Healthcare professionals globally have much to learn from the experiences and lessons of natural disasters in China.

Risk factors for musculo-skeletal injuries in Australian paramedics

This cross-sectional study aimed to determine the individual, physical and psychosocial risk factors associated with back, neck and shoulder musculoskeletal pain, injuries and claims in paramedics.An internet-based survey of an Australian ambulance service was conducted between May and June 2011. The questionnaire included individual (demographic and psychological) items, and questions on the physical and psychosocial aspects of the job. The outcome measures included pain, injuries sustained and claims in the previous 12 months.Variables associated with pain included perceived heavy manual handling, not being consulted about work changes and the high physical and psychological consequences of the job including feeling worn out, while increased alcohol consumption was also found to be associated with pain. Variables associated with injuries included heavy manual handling, being consulted about work changes, work organisation factors, lack of psychological support from the line manager and feeling worn out. Variables associated with claims were older age, being female, having a busy last shift rotation, repetitive and heavy manual handling, worry about patient violence and increased alcohol consumption.Perceived injury risk mitigation strategies included reducing the physical job demands, including reducing the weight of kit and equipment.