Air ambulance services in the Arctic 1999-2009 : a Norwegian study.

Air ambulance services in the Arctic have to deal with remote locations, long distances, rough weather conditions and seasonable darkness. Despite these challenges, the people living in the area expect a high quality of specialist health care. The objective of this study was to analyse the air ambulance operations performed in the Norwegian Arctic and study variations in diagnoses and flight patterns around the year. A retrospective analysis. All air ambulance operations performed during the time 1999 – 2009 period were analysed. The subjects were patients transported and flights performed. The primary outcome measures were patients’ diagnoses and task patterns around the year. A total of 345 patients were transported and 321 flights performed. Coronary heart and vascular disease, bone fractures and infections were the most common diagnoses. Most patients (85%) had NACA score 3 or 4. Half of all fractures occurred in April and August. Most patients were males (66%), and one fourth was not Norwegian. The median flying time (one way) was 3 h 33 m. Ten percent of the flights were delayed, and only 14% were performed between midnight and 8.00 AM. The period April to August was the busiest one (58% of operations). Norway has run a safe air ambulance service in the Arctic for the last 11 years. In the future more shipping and polar adventure operations may influence the need for air ambulances, especially during summer and autumn

Health status in the ambulance services: a systematic review

BACKGROUND: Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. This article systematically explores the literature on health problems and work-related and individual health predictors in the ambulance services. METHODS: We identified the relevant empirical literature by searching several electronic databases including Medline, EMBASE, PsychINFO, CINAHL, and ISI Web of Science. Other relevant sources were identified through reference lists and other relevant studies known by the research group. RESULTS: Forty-nine studies are included in this review. Our analysis shows that ambulance workers have a higher standardized mortality rate, higher level of fatal accidents, higher level of accident injuries and a higher standardized early retirement on medical grounds than the general working population and workers in other health occupations. Ambulance workers also seem to have more musculoskeletal problems than the general population. These conclusions are preliminary at present because each is based on a single study. More studies have addressed mental health problems. The prevalence of post-traumatic stress symptom caseness was > 20% in five of seven studies, and similarly high prevalence rates were reported for anxiety and general psychopathology in four of five studies. However, it is unclear whether ambulance personnel suffer from more mental health problems than the general working population. CONCLUSION: Several indicators suggest that workers in the ambulance services experience more health problems than the general working population and workers in other health occupations. Several methodological challenges, such as small sample sizes, non-representative samples, and lack of comparisons with normative data limit the interpretation of many studies. More coordinated research and replication are needed to compare data across studies. We discuss some strategies for future research

Management of chest pain in the French emergency healthcare system: the prospective observational EPIDOULTHO study

International audienc

An automated CPR device compared with standard chest compressions for out-of-hospital resuscitation

Background: Effective cardiopulmonary resuscitation and increased coronary perfusion pressures have been linked to improved survival from cardiac arrest. This study aimed to compare the rates of survival between conventional cardiopulmonary resuscitation (C-CPR) and automated CPR (A-CPR) using AutoPulse™ in adults following out-of-hospital cardiac arrest (OHCA).Methods: This was a retrospective study using a matched case-control design across three regional study sites in Victoria, Australia. Each case was matched to at least two (maximum four) controls using age, gender, response time, presenting cardiac rhythm and bystander CPR, and analysed using conditional fixed-effects logistic regression.Results: During the period 1 October 2006 to 30 April 2010 there were 66 OHCA cases using A-CPR. These were matched to 220 cases of OHCA involving the administration of C-CPR only (controls). Survival to hospital was achieved in 26% (17/66) of cases receiving A-CPR compared with 20% (43/220) of controls receiving C-CPR and the propensity score adjusted odds ratio [AOR (95% CI)] was 1.69 (0.79, 3.63). Results were similar using only bystander witnessed OHCA cases with presumed cardiac aetiology. Survival to hospital was achieved for 29% (14/48) of cases receiving A-CPR compared with 18% (21/116) of those receiving C-CPR [AOR = 1.80 (0.78, 4.11)].Conclusions: The use of A-CPR resulted in a higher rate of survival to hospital compared with C-CPR, yet a tendency for a lower rate of survival to hospital discharge, however these associations did not reach statistical significance. Further research is warranted which is prospective in nature, involves randomisation and larger number of cases to investigate potential sub-group benefits of A-CPR including survival to hospital discharge

Violence against healthcare workers.

EditorialSCOPUS: ed.jinfo:eu-repo/semantics/publishe