947 resultados para Emergency Medical Technicians
Resumo:
Vehicle crashes rank among the leading causes of death in the United States. In 2006, the AAA Foundation for Traffic Safety made a long- term commitment to address the safety culture of the United States, as it relates to traffic safety, by launching a sustained research and educational outreach initiative. An initiative to produce a culture of safety in Iowa includes the Iowa Comprehensive Highway Safety Plan (CHSP). The Iowa CHSP engages diverse safety stakeholders and charts the course for the state, bringing to bear sound science and the power of shared community values to change the culture and achieve a standard of safer travel for our citizens. Despite the states ongoing efforts toward highway safety, an average of 445 deaths and thousands of injuries occur on Iowas public roads each year. As such, a need exists to revisit the concept of safety culture from a diverse, multi-disciplinary perspective in an effort to improve traffic safety. This study summarizes the best practices and effective laws in improving safety culture in the United States and abroad. Additionally, this study solicited the opinions of experts in public health, education, law enforcement, public policy, social psychology, safety advocacy, and traffic safety engineering in a bid to assess the traffic safety culture initiatives in Iowa. Recommendations for improving traffic safety culture are offered in line with the top five Iowa CHSP safety policy strategies, which are young drivers, occupant protection, motorcycle safety, traffic safety enforcement and traffic safety improvement program, as well as the eight safety program strategies outlined in the CHSP. As a result of this study, eleven high-level goals were developed, each with specific actions to support its success. The goals are: improve emergency medical services response, toughen law enforcement and prosecution, increase safety belt use, reduce speeding-related crashes, reduce alcohol-related crashes, improve commercial vehicle safety, improve motorcycle safety, improve young driver education, improve older driver safety, strengthen teenage licensing process, and reduce distracted driving.
Resumo:
This report synthesizes the safety corridor programs of 13 states that currently have some type of program: Alaska, California, Florida, Kentucky, Minnesota, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Virginia, and Washington. This synthesis can help Midwestern states implement their own safety corridor programs and select pilot corridors or enhance existing corridors. Survey and interview information about the states programs was gathered from members of each state department of transportation (DOT) and Federal Highway Administration (FHWA) division office. Topics discussed included definitions of a safety corridor; length and number of corridors in the program; criteria for selection of a corridor; measures of effectiveness of an implemented safety corridor; organizational structure of the program; funding and legislation issues; and engineering, education, enforcement, and emergency medical service strategies. Safety corridor programs with successful results were then examined in more detail, and field visits were made to Kansas, Oregon, Pennsylvania, and Washington for first-hand observations. With the survey and field visit information, several characteristics of successful safety corridor programs were identified, including multidisciplinary (3E and 4E) efforts; selection, evaluation, and decommissioning strategies; organization structure, champions, and funding; task forces and Corridor Safety Action Plans; road safety audits; and legislation and other safety issues. Based on the synthesis, the report makes recommendations for establishing and maintaining a successful safety corridor program.
Resumo:
The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccinepreventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowas population, work must continue with public and private health care providers to promote the programs vision of healthy Iowans living in communities free of vaccinepreventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among undervaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.
Resumo:
The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccinepreventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowas population, work must continue with public and private health care providers to promote the programs vision of healthy Iowans living in communities free of vaccinepreventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among undervaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.
Resumo:
The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccinepreventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowas population, work must continue with public and private health care providers to promote the programs vision of healthy Iowans living in communities free of vaccinepreventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among undervaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.
Resumo:
The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccinepreventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowas population, work must continue with public and private health care providers to promote the programs vision of healthy Iowans living in communities free of vaccinepreventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among undervaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.
Resumo:
Introduccin: Analizar la eficiencia de aadir la determinacin NT-proBNP al examen clnico convencional (ECC) para el diagnstico de insuficiencia cardaca (IC) en pacientes con disnea que acuden a servicios de urgencias (SU) espaoles. Material y mtodos: Se desarroll un rbol de decisin para evaluar los resultados clnicos y econmicos de ambas alternativas durante 60 das de seguimiento desde la visita al SU en pacientes hospitalizados y no hospitalizados. Los parmetros clnicos fueron principalmente obtenidos del estudio PRIDE y validados por mdicos de SU y cardilogos. El punto de corte de la determinacin NT-proBNP fue de 900 pg/mL (sensibilidad del 90% y especificidad del 85%). En base a datos espa noles publicados, se asumi que el 65% de pacientes con disnea sufran IC. El uso de recursos fue identificado mediante opinin de expertos y evaluado desde la perspectiva del Sistema Nacional de Salud (SNS). El anlisis compar el diagnstico final del paciente con el diagnstico realizado en el SU. Se realizaron diversos anlisis de sensibilidad para evaluar la incertidumbre del modelo. Resultados: El diagnstico incorporando la determinacin NT-proBNP fue correcto en el 91,96% de los pacientes (59,09% verdaderos positivos y 32,87% verdaderos negativos) frente al 85,53% mediante ECC (50,79% verdaderos positivos y 34,74% verdaderos negativos). La incorporacin de la determinacin NT-proBNP result tener un coste menor (3.720 versus 5.188 ). Los anlisis de sensibilidad realizados confirmaron los resultados.
Resumo:
Problmatique : Le rle des paramdics se transforme partout dans le monde. Les besoins des ans et des malades chroniques entranent une forte proportion dinterventions prhospitalires non urgentes. La confrontation entre la perception et lexprience du rle peut entraner un conflit correspondant un stress organisationnel modr et chronique chez ces travailleurs. Pour y faire face, diffrentes stratgies dadaptation peuvent tre adoptes. Objectifs : Cette tude vise dpeindre la ralit des interventions prhospitalires non urgentes des paramdics qubcois et explorer son influence sur leur perception du rle et les manifestations de cynisme et de dsengagement. Mthode : Les donnes qualitatives obtenues en entrevues semi-structures ont t codifies et analyses partir dun modle adapt des thories en psychosociologie du travail et dadministration de la sant (n=13, 3 rgions, intervenants de - de 3 + de 20 ans de carrire). Rsultats : Les paramdics reconnaissent vivre un conflit de rle alors que la formation et la dfinition de leur pratique se rapportent exclusivement lurgence, au contraire de leur exprience. Ils manifestent des attitudes de cynisme et de dsengagement affectant la qualit des services, prcisant quil sagit dune ralit inhrente leur exprience professionnelle intimement relie lpuisement professionnel, plus qu un manque fondamental de professionnalisme. Conclusion : Les paramdics dcrivent diffrents mcanismes instaurer qui visent reconnatre la dualit conflictuelle de leur pratique dont, la mise en valeur de leur aptitude clinique intervenir en premire ligne dans un cadre prhospitalier non urgent ainsi que lajustement et le rehaussement des programmes de formation.
Resumo:
Se desconoce en la actualidad en Colombia la calidad de la interpretacin de los gases arteriales por parte de los residentes de medicina de emergencias. Los gases arteriales es una de las ayudas diagnsticas de ms rpida consecucin en el servicio de urgencias y ms utilizadas por ser indispensable en la valoracin de patologas de alta prevalencia como son las enfermedades respiratorias y la sepsis. Su mala interpretacin puede llevar a mal direccionamiento del manejo de pacientes en estado crtico por lo que es indefectible que los residentes logren un buen entrenamiento en la interpretacin de los mismos. Por esta razn se realiza este estudio analtico de concordancia con recoleccin prospectiva, de corte transversal que busca determinar el grado de concordancia en la interpretacin de gases arteriales de los residentes del programa de Medicina de Emergencias de la Universidad del Rosario y especialista en cuidado crtico, as como la interpretacin entre ellos segn su nivel de entrenamiento y describir cules son los hallazgos que encuentran en la interpretacin de los mismos. Se recolectaron 60 gases arteriales realizados a paciente hospitalizados en la unidad de cuidados intensivos de la Fundacin Santa Fe de Bogot y se hall la concordancia entre la lectura de los residentes del programa de Medicina de Emergencias y un intensivista. Encontrando una concordancia moderada (r 0.445 y 0.442, ) en las respuestas identificadas en los residentes de segundo y tercer ao de residencia(p:0,000y0,01).(MESH: Blood Gas Anlisis, Emergency Medical Services, Education, Medical, Graduate)
Resumo:
El traumatismo craneoenceflico, es la epidemia silenciosa de nuestra poca, que genera gastos en salud, en pases como Estados Unidos, cercanos a los 60 billones de dlares anuales, y cerca de 400 billones en rehabilitacin de los discapacitados. El pilar del manejo mdico del trauma craneoenceflico moderado o severo, es la osmoterapia, principalmente con sustancias como el manitol y las soluciones hipertnicas. Se realiz la revisin de 14 bases de datos, encontrando 4657754 artculos, quedando al final 40 artculos despus de un anlisis exhaustivo, que se relacionaban con el manejo de la hipertensin endocraneana y terapia osmtica. Resultados: Se compararon diferentes estudios, encontrando gran variabilidad estos, sin homogenizacin en los anlisis estadsticos, y la poca rigurosidad no permitieron, la recoleccin de datos y la comparacin entre los diferentes estudios, no permiti realizar el meta-anlisis y por esto se decidi la realizacin de una revisin sistemtica de la literatura. Se evidenci principalmente tres cosas: la primera es la poca rigurosidad con la que se realizan los estudios clnicos; la segunda, es que an falta mucha ms investigacin principalmente, la presencia de estudios clnicos aleatorizados multicntricos, que logren dar una slida evidencia y que genere validez cientfica que se requiere, a pesar de la evidencia clara en la prctica clnica; la tercera es la seguridad para su uso, con poca presencia de complicaciones para las soluciones salinas hipertnicas.
Resumo:
Se realiz un estudio transversal, se incluyeron 3 residentes no cardilogos y se les dio formacin bsica en ecocardiografa (horas tericas 22, horas prcticas 65), con recomendaciones de la Sociedad Americana de Ecocardiografia y aportes del aprendizaje basado en problemas, con el desarrollo de competencia tcnicas y diagnsticas necesarias, se realiz el anlisis de concordancia entre residentes y ecocardiografistas expertos, se recolectaron 122 pacientes hospitalizados que cumplieran con los criterios de inclusin y exclusin, se les realizo un ecocardiograma convencional por el experto y una valoracin ecocardiogrfica por el residente, se evalu la ventana acstica, contractilidad, funcin del ventrculo izquierdo y derrame pericrdico. La hiptesis planteada fue obtener una concordancia moderada. Resultados: Se analiz la concordancia entre observadores para la contractilidad miocrdica (Kappa: 0,57 p=0,000), funcin sistlica del ventrculo izquierdo (Kappa 0,54 p=0.000) siendo esta moderada por estar entre 0,40 0,60 y con una alta significancia estadstica, para la calidad de la ventana acstica (Kappa: 0,22 p= 0.000) y presencia de derrame pericrdico (Kappa: 0,26 p= 0.000) se encontr una escasa concordancia ubicndose entre 0,20 0,40. Se estableci una sensibilidad de 90%, especificidad de 67%, un valor predictivo positivo de 80% y un valor predictivo negativo de 85% para el diagnstico de disfuncin sistlica del ventrculo izquierdo realizado por los residentes.
Resumo:
Introduccin: La escala de severidad en emergencias es una herramienta que ofrece seguridad a pacientes en servicios de urgencias. Este trabajo evala la aplicacin de la escala ESI 4.0 en trminos de oportunidad de atencin y consumo de recursos en la Fundacin Santa F de Bogot, para comparar los resultados con parmetros estndar. Metodologa Estudio observacional analtico de corte transversal. Se incluyeron 385 pacientes aleatorizados por nivel de atencin. Se tomaron datos demogrficos y variables como consumo de recursos y destino del paciente para su descripcin y anlisis. Resultados: El promedio de edad fue 44.9 aos IC95%42.946.9, el 54.5% fueron mujeres. Se encontr un tiempo promedio de espera para nivel 1 de 1.39 min, para el nivel 2 de 22.9 min 2, para el nivel 3 de 41.9 min, para el nivel 4 de 56.9 min y para el nivel 5 de 52.1 min. El tiempo promedio de estancia en urgencias fue 5.9 horas y el 78.9% consumi recursos. Al comparar los tiempos con estndares mundiales en el nivel 1, 2 y 3 son significativamente mayores (P<0,05), en el nivel 4 es similar (p0,51) y en el nivel 5 es significativamente menor (p=0,00) Discusin: La escala ESI 4.0 es una herramienta segura, con un comportamiento similar en oportunidad de atencin y consumo de recursos con respecto a los estndares de cuidado en los servicios de urgencias.
Resumo:
Introduccin: Se ha determinado que las jornadas laborales, generan un deterioro cognoscitivo y funcional en las personas, con la consecuente afectacin en los servicios de salud, al ser una de las disciplinas que ms se encuentran en riesgo de cometer errores durante sus procesos de atencin. Es por esto que en el presente estudio se pretendi evaluar el impacto de la jornada laboral en la capacidad de atencin de los mdicos de urgencias. Metodologa: Se realiz un estudio transversal aplicando el Psychomotor Vigilance Test, el cual evala la capacidad de atencin de las personas despus de realizar diferentes actividades segn el tiempo de respuesta en milisegundos. Se tom una muestra de la poblacin del personal mdico de urgencias de la Fundacin Santa F de Bogot, estableciendo una comparacin del mismo paciente en los diferentes turnos. Resultados: En el presente estudio se document un tiempo de respuesta promedio al inicio de la jornada diurna de 436,6 ms (IC95% 401-477) y al final de 443,1 ms (IC95% 388-484). Con respecto a la jornada nocturna se document un tiempo de respuesta promedio inicial de 422,8 ms (IC95% 403-457) y al final de 467,44 ms (IC95% 423-501). Discusin: Encontramos diferencias estadsticamente significativas en cuanto al tiempo de respuesta entre la jornada diurna y nocturna. Por lo tanto es recomendable crear polticas de Estado que gestionen el horario laboral del personal de salud para que prime la seguridad y la calidad de atencin en el paciente, evitando al mximo cualquier posibilidad de error mdico
