Abstract:
INTRODUCTION:Out-of-hospital cardiac arrest (OHCA) is a lethal health problem that affects between 236,000 and 325,000 people in the United States each year. As resuscitation attempts are unsuccessful in 70-98% of OHCA cases, Emergency Medical Services (EMS) personnel often face the needs of bereaved family members. PROBLEM:Decisions to continue or terminate resuscitation at OHCA are influenced by factors other than patient clinical characteristics, such as EMS personnel's knowledge, attitudes, and beliefs regarding family emotional preparedness. However, there is little research exploring how EMS personnel care for bereaved family members, or how they are affected by family dynamics and the emotional contexts. The aim of this study is to analyze EMS personnel's experiences of caring for families when patients suffer cardiac arrest and sudden death. METHODS:The study is based on a hermeneutic lifeworld approach. Qualitative interviews were conducted with 10 EMS personnel from an EMS agency in southern Sweden. RESULTS:The EMS personnel interviewed felt responsible for both patient care and family care, and sometimes failed to prioritize these responsibilities as a result of their own perceptions, feelings and reactions. Moving from patient care to family care implied a movement from well-structured guidance to a situational response, where the personnel were forced to balance between interpretive reasoning and a more direct emotional response, at their own discretion. With such affective responses in decision-making, the personnel risked erroneous conclusions and care relationships with elements of dishonesty, misguided benevolence and false hopes. The ability to recognize and respond to people's existential questions and needs was essential. It was dependent on the EMS personnel's balance between closeness and distance, and on their courage in facing the emotional expressions of the families, as well as the personnel's own vulnerability. The presence of family members placed great demands on mobility (moving from patient care to family care) in the decision-making process, invoking a need for ethical competence. CONCLUSION:Ethical caring competence is needed in the care of bereaved family members to avoid additional suffering. Opportunities to reflect on these situations within a framework of care ethics, continuous moral education, and clinical ethics training are needed. Support in dealing with personal discomfort and clear guidelines on family support could benefit EMS personnel.
journal_name
Prehosp Disaster Medjournal_title
Prehospital and disaster medicineauthors
Bremer A,Dahlberg K,Sandman Ldoi
10.1017/S1049023X12000167subject
Has Abstractpub_date
2012-02-01 00:00:00pages
42-52issue
1eissn
1049-023Xissn
1945-1938pii
S1049023X12000167journal_volume
27pub_type
杂志文章abstract:BACKGROUND:The current Fire/Emergency Medical Services (EMS) model throughout the United States involves emergency vehicles which respond from a primary location (ie, firehouse or municipal facility) to emergency calls. Quick response vehicles (QRVs) have been used in various Fire/EMS systems; however, their effectiven...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X15004732
更新日期:2015-08-01 00:00:00
abstract::The 12 January 2010 earthquake that struck Port-au-Prince, Haiti caused >200,000 deaths, thousands of injuries requiring immediate surgical interventions, and 1.5 million internally displaced survivors. The earthquake destroyed or disabled most medical facilities in the city, seriously hampering the ability to deliver...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00008645
更新日期:2010-11-01 00:00:00
abstract:INTRODUCTION:Telecommunication systems are important for sharing information among health institutions to successfully provide medical response following disasters. HYPOTHESIS/PROBLEM:The aim of this study was to clarify the problems associated with telecommunication systems in the acute phase of the Great East Japan ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X14000119
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Training students has been proven to be the optimal way to deliver cardiopulmonary resuscitation (CPR) skills. However, it is somehow unknown whether or not the current recommendations appropriate for Caucasian students are also suitable for East Asian students. The purpose of this study is to explore the be...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X1800047X
更新日期:2018-08-01 00:00:00
abstract::Indonesia has had its share of natural and manmade disasters. From 1997 to 2002, Indonesia has experienced 90 incidents of terrorist bomb attacks. In 13 (14.4%) of the terrorist attacks, the bombs did not explode. A total of 224 persons have been killed, and 340 persons have been injured. Most of those killed or injur...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00000832
更新日期:2003-04-01 00:00:00
abstract:INTRODUCTION:Traditionally, post disaster response activities have focused on immediate trauma and communicable diseases. In developed countries such as Australia, the post disaster risk for communicable disease is low. However, a "disease transition" is now recognized at the population level where noncommunicable dise...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/S1049023X1400137X
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Violence against humanitarian health care workers and facilities in situations of armed conflict is a serious humanitarian problem. Targeting health care workers and destroying or looting medical facilities directly or indirectly impacts the delivery of emergency and life-saving medical assistance, often a...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X14000934
更新日期:2014-10-01 00:00:00
abstract::The purpose of this discussion is to review the use of destinations other than the hospital emergency department, to transport patients injured as a result of a mass-casualty incident (MCI). A MCI has the ability to overwhelm traditional hospital resources normally thought of as appropriate destinations for the transp...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00007949
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Although emergency medical services (EMS) liability litigation is a concern of many prehospital health care providers, there have been no studies of these legal cases nationwide and no local case studies since 1987. METHODS:A retrospective case series was obtained from a computerized database of trial cou...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x0004142x
更新日期:1994-10-01 00:00:00
abstract::This article describes the basic principles around establishing a Disaster Medicine Camp and the organization of the Ukrainian Disaster Medicine Mobile Hospital, which provided medical aid to victims of the 2001 earthquake in India. All of the information was obtained through direct observation and estimates based on ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x0000039x
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVES:To assess the performance of two pediatric length-based tapes (Broselow and Handtevy) in predicting actual weights of US children. METHODS:In this descriptive study, weights and lengths of children (newborn through 13 years of age) were extracted from the 2009-2010 National Health and Nutrition Examination ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16000455
更新日期:2016-08-01 00:00:00
abstract::Introduction Previous studies have found that older adults are more likely to use Emergency Medical Services (EMS) than younger adults, but the reasons for this remain understudied. Hypothesis/Problem This study aimed to determine if older age is associated with using EMS for transportation to an emergency department ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X17000036
更新日期:2017-06-01 00:00:00
abstract:INTRODUCTION:Mildly injured and "worried well" patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00004623
更新日期:2007-05-01 00:00:00
abstract::Mass gatherings have a higher patient presentation rate than is found within the general population. Despite this fact, many mass gatherings are occurring without suitable medical coverage. South Africa has had no standard approach or model to determine the number of medical personnel needed to deploy to an event. The...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00008748
更新日期:2010-11-01 00:00:00
abstract:INTRODUCTION:Serotonin and sympathomimetic toxicity (SST) after ingestion of amphetamine-based drugs can lead to severe morbidity and death. There have been evaluations of the safety and efficacy of on-site treatment protocols for SST at music festivals. PROBLEM:The study aimed to examine the safety and efficacy of tr...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X19005089
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:In November 2013, the Haiyan typhoon hit parts of the Philippines. The typhoon caused severe damage to the medical facilities and many injuries and deaths. Health professionals have a crucial role in the immediate disaster response system, but knowledge of their experiences of working during and in the immed...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16001412
更新日期:2017-04-01 00:00:00
abstract:INTRODUCTION:Millions of vulnerable, elderly individuals live in coastal areas susceptible to hurricanes and are at risk for adverse health outcomes. The purpose of this study was to determine the status of preparedness for and possible health consequences of a hurricane on a vulnerable, but experienced, elderly popula...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:This study was aimed to analyze post-disaster birth outcomes in coastal and inland regions of Miyagi Prefecture, Japan. METHODS:Primary data sets were compiled from birth records of obstetric facilities and 12,808 patients were analyzed for baseline birth outcomes by region. Regional risk analysis of the lo...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X18000183
更新日期:2018-04-01 00:00:00
abstract:INTRODUCTION:Quantitative benchmarking of trauma-related prehospital response for Multiple Casualty Events (MCE) is complicated by major difficulties due to the simultaneous occurrences of multiple prehospital activities. HYPOTHESIS/PROBLEM:Attempts to quantify the various components of prehospital medical response in...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12000416
更新日期:2012-04-01 00:00:00
abstract::Study Objectives Traction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) ana...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X17006859
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:The need to manage psychological symptoms after disasters can result in an increase in the prescription of psychotropic drugs, including antidepressants and anxiolytics. Therefore, an increase in the prescription of antidepressants and anxiolytics could be an indicator of general psychological distress in ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12001392
更新日期:2012-12-01 00:00:00
abstract:INTRODUCTION:Professional behavior is one of the cornerstones of effective emergency medical services (EMS) practice and is a required part of the National Standard Curricula for advanced levels of EMS education. However, peer rating of emergency medical technicians with respect to the 11 categories of professional beh...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00002284
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To identify risk factors for adverse events that occur during interfacility transfers by advanced life support (ALS). DESIGN:A four-year, retrospective, case series. SETTING:Three ALS units in a rural/suburban emergency medical services (EMS) system. PARTICIPANTS:351 transports to or from twelve acute care...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x0004084x
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:End tidal CO2 (ETCO2) has been established as a standard for confirmation of an airway, but its role is expanding. In certain settings ETCO2 closely approximates the partial pressure of arterial CO2 (PaCO2) and has been described as a tool to optimize a patient's ventilatory status. ETCO2 monitors are incr...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12001768
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:Predicting injury patterns of patients based only on mechanism of injury is difficult and is well described in the literature. Characteristics of patients on-scene immediately following injury(ies) may lead to predicting injury patterns. Although reported frequently, the significance of victim ambulation aft...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12001501
更新日期:2013-02-01 00:00:00
abstract:INTRODUCTION:The importance of accessing care within the first hour after injury has been a fundamental tenet of trauma system planning for 30 years. However, the scientific basis for this belief either has been missing or largely derived from case series from trauma centers. This study sought to determine the correlat...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00004143
更新日期:2006-11-01 00:00:00
abstract:UNLABELLED:Introduction To aid in preparation of military medic trainers for a possible new curriculum in teaching junctional tourniquet use, the investigators studied the time to control hemorrhage and blood volume lost in order to provide evidence for ease of use. Hypothesis Models of junctional tourniquet could perf...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16000443
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:The objective was to test, in this trauma system, the North American hypothesis that exceeding the 60-minute limit for the entire prehospital time ("golden hour of shock") increases mortality of blunt polytrauma patients. METHODS:In a prospective, observational, cohort study conducted between 1990 and 1996,...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00000212
更新日期:2002-04-01 00:00:00
abstract::In catastrophic disasters such as major earthquakes in densely populated regions, effective Life-Supporting First-Aid (LSFA) and basic rescue can be administered to the injured by previously trained, uninjured survivors (co-victims). Administration of LSFA immediately after disaster strikes can add to the overall medi...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00040231
更新日期:1993-04-01 00:00:00
abstract:INTRODUCTION:The ever-present risk of mass casualties and disaster situations may result in airway management situations that overwhelm local emergency medical services (EMS) resources. Endotracheal intubation requires significant user education/training and carries the risk of malposition. Furthermore, personal protec...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00007743
更新日期:2010-01-01 00:00:00