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Study: Trauma centers less likely to treat women

Research also looks at pain management for patients, and depression among EMTs

Women with traumatic injuries less likely to receive trauma center care

Women are less likely than men to receive care in a trauma center after severe injury, according to a recent study. Researchers in Canada analyzed records on 33,000 women and 66,000 men with an injury severity score of greater than 15, or who died of their injuries within 24 hours of hospital arrival. About 50% of women had received care at a trauma center, compared to 63% of men. Among patients 65 or older, 37.5% of women received trauma center care, compared with 50% of men.

After adjusting for clinical, demographic and socioeconomic variables, severely injured women were 21% less likely to be treated in a trauma center. Separate analyses of women with fall-related or motor vehicle-related injuries found that they were also less likely to receive trauma center care.

The study was presented at the American Thoracic Society International Conference in Philadelphia in May.


Rates of depression, anxiety, lower among EMS thanother health care workers

Researchers from North Carolina’s Mecklenburg EMS Agency and colleagues have found that rates of depression, anxiety and high levels of stress are lower among paramedics and EMTs than other healthcare workers, including nurses, physicians and med students.

The researchers analyzed the results of a questionnaire answered by more than 34,000 paramedics and EMTs renewing their national certification in 2009. About 6.8% of EMS workers reported symptoms of depression, 6% reported signs of anxiety and 5.9% reported high levels of stress. Paramedics and those with 16 or more years of experience were more likely to be depressed and stressed-out than other groups. EMS workers who rated their overall health as poor, who did little exercise and who smoked were also more likely to be stressed, anxious or depressed.

Meanwhile, married paramedics and EMTs were less likely to be depressed or anxious than the divorced, widowed or never married; and women were less likely to be depressed than men. The study is in the July–September issue of Prehospital Emergency Care.


Pain management boots patient satisfaction ... with a caveat

Also reported in the July–September issue of Prehospital Emergency Care, EMS patients whose pain was managed effectively are 2.7 times more likely to report the overall quality of care they received was excellent—but only if responders explained the medications being used and their side effects.

Researchers from Mecklenburg EMS Agency and colleagues did a retrospective review of more than 2,700 patient satisfaction surveys collected between 2007 and 2010. Of the patients who rated their pain management as excellent, 79% rated the overall quality of care as excellent, whereas only 21% of patients rated their overall quality of care as excellent if pain management was not excellent.

A closer analysis of the data found that neither controlling pain nor explaining medications was independently associated with a statistically significant higher rating for overall care. However, when patients felt their pain was controlled and that EMTs or medics explained the medications to them, they were more likely to rate their care as excellent. Other factors that affected patient ratings included teamwork among EMS staff and the availability of needed technology.


Educating responders about death notfication improves their confidence

Training EMS personnel how to deliver news of a death improves both their confidence and their ability to communicate effectively with the bereaved, research shows.

In a study from Indiana University School of Medicine, 30 paramedics participated in a 90-minute workshop that included a lecture and role-playing in simulated death notification scenarios. Responders were taught a structured death notification method known as

GRIEV_ING:
G=Gather Gather the family and ensure that all members are present.
R=Resources Call for support resources such as ministers, family and friends.
I=Identify Identify yourself and the deceased patient by name.
E=Educate Briefly explain to the family the events that occurred.
V=Verify Verify that the family member has died. Use clear language, such as “dead” or “died.”
_=Space Give the family space and time for an emotional moment and to absorb what has happened.
I=Inquire Ask the family if they have questions; answer them.
N=Nuts and bolts Inquire about organ donation, funeral services and personal belongings. Let the family view the body.
G=Give Give them your card and contact information. Always return their calls.

After the workshop, participants said they felt more confident in their ability to discuss death with grieving families, while a post-workshop evaluation showed marked improvement in responders introducing themselves, making sure all family members were present when delivering the death notification and using clear language. The only area that didn’t show improvement was on providing organ donation information.

The study was published online June 27 in Prehospital Emergency Care.

Produced in partnership with NEMSMA, Paramedic Chief: Best Practices for the Progressive EMS Leader provides the latest research and most relevant leadership advice to EMS managers and executives. From emerging trends to analysis and insight, practical case studies to leadership development advice, Paramedic Chief is packed with useful, valuable ideas you simply can’t get anywhere else.
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