Disease relevance of Allied Health Personnel

• PATIENTS--All adults in nontraumatic cardiac arrest, treated by paramedics, who would receive epinephrine according to American Heart Association advanced cardiac life support guidelines [1].
• Trained paramedical personnel recorded the presence or absence of selected ophthalmological signs and symptoms associated with vitamin A deficiency in 13,450 children [2].
• Drug management of out-of-hospital countershock refractory ventricular fibrillation was evaluated by including 100 mg lidocaine bolus intravenously as the only anti-arrhythmic option in a protocol for use by paramedics [3].
• DESIGN AND SETTING: This was a randomized, prospective study using prophylactic lidocaine in patients complaining of chest pain who presented to our paramedic system between January 1984 and January 1988 [4].
• BACKGROUND: This study aimed to determine whether field end-tidal carbon dioxide CO2 (ETCO2) monitoring decreases inadvertent severe hyperventilation after paramedic rapid sequence intubation [5].

High impact information on Allied Health Personnel

• Data from a survey of training programs demonstrate that paramedic and EMT education in pediatric emergencies may be inadequate [6].
• Preliminary results of 400 mg lidocaine administered by paramedics using an automatic injector are encouraging [7].
• Paramedic 2 performed TENS in patients randomly assigned to G1 with actual TENS or to G2 with sham TENS [8].
• DISCUSSION: A simple intervention, such as providing paramedics with 28% Venturi masks, can reduce the number of COPD patients exposed to HCO [9].
• Results were shared with paramedics, and guidelines agreed for the initial provision of lower concentrations of oxygen (LCO, FiO(2) < or = 0.28) [9].

Chemical compound and disease context of Allied Health Personnel

• A randomized comparison study of bretylium tosylate and lidocaine in resuscitation of patients from out-of-hospital ventricular fibrillation in a paramedic system [10].
• Forty-six patients with moderate to severe pain caused by orthopedic injuries, burns, multiple trauma, or intraabdominal conditions were treated with intravenous (IV) nalbuphine hydrochloride (Nubain; DuPont Pharmaceuticals, Wilmington, DE) by paramedics before arrival at the hospital [11].
• From a starting point of asystole paramedics were required to perform ECG analysis, intubation, i.v. access, adrenalin and atropine injection, flushing of the drug bolus before conversion to ventricular fibrillation followed by defibrillation in addition to ventilation and chest compression [12].
• Because of their demonstrated ability to rapidly slow ventricular rate, the calcium channel blocker, diltiazem, or the beta-adrenergic blocker, esmolol, should be the preferred agents for treating rapid atrial fibrillation in the emergency department or the paramedic ambulance [13].
• METHODS: Records of an urban emergency medical services system from September 1, 2002, through September 1, 2003, were queried for patients who had a paramedic impression of shortness of breath or respiratory distress and had received nitroglycerin and/or furosemide [14].

Biological context of Allied Health Personnel

• All paramedic calls to the LAC/USC base station are reviewed by an emergency medicine resident using a special tape review form which focuses on communication skills, initial paramedic field assessment, sense of urgency of the case, and the completeness of the filed report [15].
• In conclusion, volunteers being carried by paramedics through a staircase had a significant discharge of both epinephrine and norepinephrine resulting in increased heart rate, but only elevated epinephrine plasma levels during EMS transport [16].

Associations of Allied Health Personnel with chemical compounds

• Paramedics administered HDE (> 0.1 mg/kg), SDE (< 0.1 mg/kg), or no epinephrine (NE), based on base hospital physician order and availability of access for drug delivery [17].
• Midazolam and succinylcholine were administered, and paramedics were allowed a maximum of 3 attempts at orotracheal intubation [18].
• Demographic information, past medical history, medications, number of adenosine doses given, and complications were recorded by the paramedic on a case-report form [19].
• RESULTS: During the verapamil period, paramedics identified 102 cases of SVT and administered verapamil to 17 patients [20].
• We conducted a prospective, randomized, blinded study comparing the effectiveness of calcium chloride with saline in the prehospital paramedic setting [21].

Gene context of Allied Health Personnel

• Should paramedics intubate patients with SARS-like symptoms [22]?
• Of these 80 programs that use flight paramedics, 76 programs (95%) require certification in ACLS, 65 (81%) in PALS, and 50 (63%) in BCLS [23].
• The VSPA interval was added to the 9-1-1 call-to-dispatch and vehicle dispatch-to-scene intervals to determine the total time interval from call received until paramedic access to the patient (9-1-1 call-to-patient access) [24].
• A trained paramedic completed a 90-minute screening interview, including the Symptom Checklist-90, Mini-Mental State Exam, and Auditory-Verbal Learning Test. Persons failing the screens were interviewed by a psychiatrist and a neurologist [25].
• Call-to-shock time for all patients was less in the police group than in the paramedic group (5.6 versus 6.3 minutes, P = .038) [26].

Analytical, diagnostic and therapeutic context of Allied Health Personnel

• Succinylcholine-assisted endotracheal intubation by paramedics [27].
• Fifteen paramedic volunteers ventilated the model utilizing mouth-to-mouth, mouth-to-mask, bag-valve-mask, or portable field ventilator (Impact or HARV) [28].
• METHODS: Data were collected prospectively as part of the San Diego Paramedic Rapid Sequence Intubation Trial, which enrolled adults with severe head injuries (Glasgow Coma Score, 3-8) that could not be intubated without neuromuscular blockade [5].
• Standing orders for administration of analgesia were available and permitted paramedics to give either morphine sulfate or nitrous oxide per protocol [29].
• This paper compares the effects of administration of metaproterenol when administered by paramedics using either a metered-dose inhaler (MDI) or a hand-held nebulizer (HHN) [30].

References