In Sweden, as in many other countries, paramedics or nurses constitute the majority of prehospital personnel. if tasks usually performed by doctors are to be performed by these personnel, there is a need for guideline...
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In Sweden, as in many other countries, paramedics or nurses constitute the majority of prehospital personnel. if tasks usually performed by doctors are to be performed by these personnel, there is a need for guidelines and triage in the handling of medical emergencies. We describe an information management system used in ambulances for data communication, documentation, triaging and presentation of checklists. In most cases, data are input while the patient is being cared for. The information is collected and stored together with data automatically received from the dispatch centre. The latter data are transferred by a mobile radio network to the ambulance. Medical data (e.g. electrocardiograms) are transferred from the ambulance over the data network to the receiving medical facility. All transferred data are finally collected in a database for statistical analysis and follow-up.
Study objective: Stress is an emergent occupational problem in modern societies. Among workers, medical practitioners are particularly exposed. However, data objectifying stress levels during work time are scarce. The...
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Study objective: Stress is an emergent occupational problem in modern societies. Among workers, medical practitioners are particularly exposed. However, data objectifying stress levels during work time are scarce. The aim of this study was to establish diurnal salivary cortisol levels in a highly stressful work environment, the medical dispatch center of an emergency care unit. Methods: Eight emergency medical dispatchers agreed to be sampled every 2 hours from 9 AM to 7 PM during a usual day of work. Eight matched control subjects sampled during their leisure time were used as a control group. Results: Whatever the time of the day, emergency medical dispatchers showed significantly increased cortisol levels during their work time compared with levels found in the control group. There was a significant difference in the amount of daytime cortisol secretion between control subjects and emergency medical dispatchers (0.345 nmol/L;95% confidence interval [CI] 0.04 to 0.93 nmol/L), with a mean daytime augmentation of 22.8% in emergency medical dispatchers compared with that in control subjects. In addition, among emergency medical dispatchers, the subjective perception of emotional stress was positively correlated with total cortisol concentrations per day (r=0.78;95% Cl 0.39 to 1). Conclusion: Our data show that work tasks of emergency medical dispatchers led to a hypersecretion of cortisol. Because the damaging effects of persistent cortisol increases on health and cognitive functions are well recognized in human beings, it seems necessary to rapidly identify stressful work situations and targets for organizational improvements to minimize stress in these situations.
Although some minor modifications were forged, the general consensus was tomaintain most of the current guidelines for phone first/phone fast, no-assisted-ventilation CPR, theA-B-C (vs C-A-B) sequence of CPR, and the ...
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Although some minor modifications were forged, the general consensus was tomaintain most of the current guidelines for phone first/phone fast, no-assisted-ventilation CPR, theA-B-C (vs C-A-B) sequence of CPR, and the recovery position. The decisions to leave theseguidelines as they are were based on a lack of evidence to justify the proposed changes, coupledwith a reluctance to make revisions that would require major changes in worldwide educationalpractices without such ***, some major changes were made. The time-honoredprocedure ol pulse check by lay rescuers was eliminated altogether and replaced with an assessmentfor other signs of circulation. Likewise, it was recommended that even the professional rescuer nowcheck for these other signs of circulation. Although professional rescuers may simultaneously checkfor a pulse, they should do so only for a short period of time (within 10 seconds).There was alsoenthusiasm for deleting the ventilation aspect of EMS dispatcher-assisted CPR instructions that areprovided to rescuers at the scene who are inexperienced in CPR. lt was made clear, though, that thedata are applicable only to adult patients who are receiving CPR and that the data are appropriatemost for EMS systems with rapid response times.
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