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Article ; Online: Hazard control for communicable disease transport at Ornge.

Peddle, Michael B / Smith, Justin A

CJEM

2020 Volume 22, Issue S2, Page(s) S79–S83

Abstract: Transporting patients with communicable diseases is common in critical care transport operations. At Ornge, Ontario's critical care transport provider, 13.7% of patients required contact, droplet, or airborne precautions during transport in 2019-2020. ... ...

Abstract	Transporting patients with communicable diseases is common in critical care transport operations. At Ornge, Ontario's critical care transport provider, 13.7% of patients required contact, droplet, or airborne precautions during transport in 2019-2020. Ensuring that staff are protected while transporting patients with communicable diseases must remain a prime directive for medical transport administrators and operators. Success in safety requires a robust system of hazard identification and adherence to generally accepted methods of hazard control. This commentary will discuss some of the administrative and engineering controls, as well as the personal protective equipment (PPE) strategies deployed at Ornge.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Emergency Medical Services/standards ; Humans ; Infection Control/standards ; Ontario/epidemiology ; Pandemics ; Personal Protective Equipment ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Safety Management/standards ; Transportation of Patients/standards
Keywords	covid19
Language	English
Publishing date	2020-02-03
Publishing country	England
Document type	Journal Article
ISSN	1481-8043
ISSN (online)	1481-8043
DOI	10.1017/cem.2020.399
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Hazard control for communicable disease transport at Ornge

Peddle, Michael B / Smith, Justin A

CJEM

Abstract	Transporting patients with communicable diseases is common in critical care transport operations. At Ornge, Ontario's critical care transport provider, 13.7% of patients required contact, droplet, or airborne precautions during transport in 2019-2020. Ensuring that staff are protected while transporting patients with communicable diseases must remain a prime directive for medical transport administrators and operators. Success in safety requires a robust system of hazard identification and adherence to generally accepted methods of hazard control. This commentary will discuss some of the administrative and engineering controls, as well as the personal protective equipment (PPE) strategies deployed at Ornge.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #829800
Database	COVID19

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Article ; Online: Impact of Prepatching on Paramedic In-Hospital Times for Emergent Interfacility Transfers.

Bischoff, Taylor / Sawadsky, Bruce / Peddle, Michael / Nolan, Brodie

Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors

2020 Volume 25, Issue 6, Page(s) 832–838

Abstract: ... ...

Abstract	Background
MeSH term(s)	Adult ; Allied Health Personnel ; Emergency Medical Services ; Hospitals ; Humans ; Ontario ; Patient Transfer ; Retrospective Studies
Language	English
Publishing date	2020-12-18
Publishing country	England
Document type	Journal Article
ZDB-ID	1461751-1
ISSN	1545-0066 ; 1090-3127
ISSN (online)	1545-0066
ISSN	1090-3127
DOI	10.1080/10903127.2020.1852351
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Zs.A 4762: Show issues

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Article ; Online: Prepatching Reduces Paramedic In-Hospital Time for Emergent Interfacility Transfers of Patients Requiring Mechanical Ventilation or Vasopressors: A Retrospective Cohort Study.

Glicksman, Robin / Bischoff, Taylor / Sawadsky, Bruce / Peddle, Michael / Nolan, Brodie

Air medical journal

2021 Volume 40, Issue 6, Page(s) 431–435

Abstract: Objective: Regionalization of specialty medical services may necessitate an interfacility transfer. Prepatching is a model of care adopted by critical care transport organizations to reduce the transfer time to specialty care. In this model, paramedics ... ...

Abstract	Objective: Regionalization of specialty medical services may necessitate an interfacility transfer. Prepatching is a model of care adopted by critical care transport organizations to reduce the transfer time to specialty care. In this model, paramedics communicate with a transport medical physician before arrival at the sending hospital to discuss a patient's condition and management plan, allowing paramedics to focus solely on packaging the patient when he or she arrives at the sending hospital. The objective of this study was to assess the impact of prepatching on paramedic in-hospital time for emergent interfacility transfers of patients requiring mechanical ventilation or vasopressor support. Methods: This is a retrospective cohort study of all emergent interfacility transfers by Ornge, the provincial critical care transport organization in Ontario, Canada, over a 4-year period. All patients over 18 years old who were either intubated or on vasopressor medications were included in the study population. Quantile regression was used to evaluate the impact of prepatching as well as patient and paramedic characteristics on paramedic in-hospital time. Results: A total of 4,466 emergent interfacility transports were included. Of these, 1,898 were completed with prepatching, and 2,568 were not. Vasopressor use was associated with significantly higher prepatching rates. Overall, prepatching reduced in-hospital time by 9 minutes at the 90th quantile across all patients. Increased in-hospital time was noted for patients on mechanical ventilation, on vasopressor medications, and transported by a fixed wing vehicle by 38, 29, and 49 minutes at the 90th quantile, respectively (P < .05). Conversely, patients transported by a critical care paramedic crew configuration were associated with a 27-minute decrease in in-hospital time at the 90th quantile compared with transport by an advanced care paramedic crew configuration (P < .05). Conclusion: Prepatching reduced paramedic in-hospital time for emergent interfacility transports for patients who were mechanically ventilated or require vasopressors. These results suggest that prepatching can reduce the overall time to definitive care in high-risk patients, potentially improving patient outcomes in critically ill patients.
MeSH term(s)	Adolescent ; Air Ambulances ; Allied Health Personnel ; Female ; Hospitals ; Humans ; Ontario ; Patient Transfer ; Respiration, Artificial ; Retrospective Studies
Language	English
Publishing date	2021-07-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2072853-0
ISSN	1532-6497 ; 1067-991X
ISSN (online)	1532-6497
ISSN	1067-991X
DOI	10.1016/j.amj.2021.06.006
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Zs.A 5623: Show issues

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Article ; Online: Outcomes of Patients Transported in the Prone Position to a Regional Extracorporeal Membrane Oxygenation Center: A Retrospective Cohort Study.

Zhang, Timothy / Nikouline, Anton / Riggs, Jamie / Nolan, Brodie / Pan, Andy / Peddle, Michael / Fan, Eddy / Del Sorbo, Lorenzo / Granton, John

Critical care explorations

2023 Volume 5, Issue 7, Page(s) e0948

Abstract: Prone positioning is associated with improved mortality in patients with moderate/severe acute respiratory distress syndrome (ARDS) and has been increasingly used throughout the COVID-19 pandemic. In patients with refractory hypoxemia, transfer to an ... ...

Abstract	Prone positioning is associated with improved mortality in patients with moderate/severe acute respiratory distress syndrome (ARDS) and has been increasingly used throughout the COVID-19 pandemic. In patients with refractory hypoxemia, transfer to an extracorporeal membrane oxygenation (ECMO) center may improve outcome but may be challenging due to severely compromised gas exchange. Transport of these patients in prone position may be advantageous; however, there is a paucity of data on their outcomes. Objectives: The primary objective of this retrospective cohort study was to describe the early outcomes of ARDS patients transported in prone position for evaluation at a regional ECMO center. A secondary objective was to examine the safety of their transport in the prone position. Design: Retrospective cohort study. Setting: This study used patient charts from Ornge and Toronto General Hospital in Ontario, Canada, between February 1, 2020, and November 31, 2021. Participants: Patient with ARDS transported in the prone position for ECMO evaluation to Toronto General Hospital. Main outcomes and measures: Descriptive analysis of patients transported in the prone position and their outcomes. Results: One hundred fifteen patients were included. Seventy-two received ECMO (63%) and 51 died (44%) with ARDS and sepsis as the most common listed causes of death. Patients were transported primarily for COVID-related indications (93%). Few patients required additional analgesia (8%), vasopressors (4%), or experienced clinically relevant desaturation during transport (2%). Conclusions and relevance: This cohort of patients with severe ARDS transported in prone position had outcomes ranging from similar to better compared with existing literature. Prone transport was performed safely with few complications or escalation in treatments. Prone transport to an ECMO center should be regarded as safe and potentially beneficial for patients with ARDS and refractory hypoxemia.
Language	English
Publishing date	2023-07-21
Publishing country	United States
Document type	Journal Article
ISSN	2639-8028
ISSN (online)	2639-8028
DOI	10.1097/CCE.0000000000000948
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Time to complete contemporary dental procedures - estimates from a cross-sectional survey of the dental team.

Bannister, Christian / Cope, Anwen Louise / Karki, Anup / Harper, Paul / Peddle, Sarah / Walters, Brenda / Allen, Michael / Chestnutt, Ivor Gordon

BMC oral health

2023 Volume 23, Issue 1, Page(s) 926

Abstract: Background: There are few contemporary studies on the time taken to complete dental procedures, those most heavily relied on in the United Kingdom date back to 1999.: Objectives: This work aimed to establish how long members of the dental team took ... ...

Abstract	Background: There are few contemporary studies on the time taken to complete dental procedures, those most heavily relied on in the United Kingdom date back to 1999. Objectives: This work aimed to establish how long members of the dental team took to complete specific dental procedures, relevant to their scope of practice. Methods: Data were collected via a purposive sample of 96 dentists, dental hygienists/therapists and dental nurses. Via an online survey, participants were asked to state the mean, minimum and maximum time they estimated that they took to complete individual dental procedures. Results: The mean time taken to complete procedures common to both dentists and dental hygienists/therapists ranged from 3.7 to 4 min respectively for clinical note reading prior to seeing patients to 30.1 and 28 min to undertake root surface debridement. There were no significant differences between the time taken by dentists and dental hygienists/therapists to treat adult patients. However, in all but one procedure, dental hygienists/therapists reported taking longer (p = 0.04) to treat child patients. Conclusions: The data provided here represent an up to date assessment of the time taken to complete specific tasks by different members of the dental team. These data will be of value to service planners and commissioners interested in evolving a dental care system that employs a greater degree of skill-mix and preventively oriented care.
MeSH term(s)	Adult ; Child ; Humans ; Cross-Sectional Studies ; Dental Hygienists ; Dental Care ; United Kingdom ; Surveys and Questionnaires ; Dentists
Language	English
Publishing date	2023-11-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2091511-1
ISSN	1472-6831 ; 1472-6831
ISSN (online)	1472-6831
ISSN	1472-6831
DOI	10.1186/s12903-023-03671-y
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Critical care transport in the time of COVID-19.

Tien, Homer / Sawadsky, Bruce / Lewell, Michael / Peddle, Michael / Durham, Wade

CJEM

2020 Volume 22, Issue S2, Page(s) S84–S88

MeSH term(s)	Air Ambulances ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Critical Care/standards ; Emergency Medical Services/standards ; Humans ; Infection Control/standards ; Ontario/epidemiology ; Pandemics ; Personal Protective Equipment ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Safety Management/standards ; Surge Capacity ; Transportation of Patients/standards
Keywords	covid19
Language	English
Publishing date	2020-05-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2059217-6
ISSN	1481-8035 ; 1481-8035 ; 1488-1543
ISSN (online)	1481-8035
ISSN	1481-8035 ; 1488-1543
DOI	10.1017/cem.2020.400
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Patient perspectives on the vital primary care role of community pharmacists in Nova Scotia, Canada: qualitative findings from the PUPPY Study.

Isenor, Jennifer E / Renaud, Lauren / Mathews, Maria / Morrison, Bobbi / Murphy, Andrea L / Bishop, Andrea / Bowles, Susan K / Kennie-Kaulbach, Natalie / Peddle, Sarah / Breton, Mylaine / Green, Michael E / Marshall, Emily G

The International journal of pharmacy practice

2024

Abstract: Objectives: Community pharmacists play an important role in primary care access and delivery for all patients, including patients with a family physician or nurse practitioner ("attached") and patients without a family physician or nurse practitioner (" ... ...

Abstract	Objectives: Community pharmacists play an important role in primary care access and delivery for all patients, including patients with a family physician or nurse practitioner ("attached") and patients without a family physician or nurse practitioner ("unattached"). During the COVID-19 pandemic, community pharmacists were accessible care providers for unattached patients and patients who had difficulty accessing their usual primary care providers ("semi-attached"). Before and during the pandemic, pharmacist services expanded in several Canadian provinces. The aim of this qualitative study was to explore patient experiences receiving care from community pharmacists, and their perspectives on the scope of practice of community pharmacists. Methods: Fifteen patients in Nova Scotia, Canada, were interviewed. Participant narratives pertaining to pharmacist care were analyzed thematically. Key findings: Attached, "semi-attached," and unattached patients valued community pharmacists as a cornerstone of care and sought pharmacists for a variety of health services, including triaging and system navigation. Patients spoke positively about expanding the scope of practice for community pharmacists, and better optimization of pharmacists in primary care. Conclusions: System decision-makers should consider the positive role community pharmacists can play in achieving primary care across the Quintuple Aim (population health, patient and provider experiences, reducing costs, and supporting equity in health).
Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Journal Article
ZDB-ID	1087040-4
ISSN	2042-7174 ; 0961-7671
ISSN (online)	2042-7174
ISSN	0961-7671
DOI	10.1093/ijpp/riae008
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 3320: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: The development and application of a chairside oral health risk and need stratification tool in general dental services.

Cope, Anwen Louise / Bannister, Christian / Karki, Anup / Harper, Paul / Allen, Michael / Jones, Rhiannon / Peddle, Sarah / Walters, Brenda / Chestnutt, Ivor Gordon

Journal of dentistry

2022 Volume 123, Page(s) 104206

Abstract: Objective: To describe the development and application of the Assessment of Clinical Oral Risks and Needs (ACORN) stratification tool based on a traffic light system in National Health Service (NHS) general dental services (GDS) Wales, UK.: Materials ... ...

Abstract	Objective: To describe the development and application of the Assessment of Clinical Oral Risks and Needs (ACORN) stratification tool based on a traffic light system in National Health Service (NHS) general dental services (GDS) Wales, UK. Materials and methods: This was a secondary analysis of routinely-collected dental care data. All courses of treatment provided in dental practices participating in NHS GDS Reform Programme between July 2018 and September 2019, in which an ACORN assessment and age were recorded were included in the analysis. Results: A total of 236,490 subjects contributed 339,933 courses of treatment during the study period. 'Amber' and 'red' ACORN outcomes were associated with more courses of treatment per annum than 'green' outcomes. Outcomes indicating an increased risk of decay or other dental problems were associated with a greater likelihood of several operative treatment items. Patients at greater risk of poor periodontal health were more likely to receive extractions and dentures than low-risk patients. Patients were most likely to either remain in the same ACORN outcome categories or move to a healthier state between assessments. Conclusion: More research is required to understand the utility of the ACORN tool in risk communication and behaviour change.
MeSH term(s)	Dental Care ; Dental Caries ; Humans ; Oral Health ; State Medicine ; Wales
Language	English
Publishing date	2022-06-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	186068-9
ISSN	1879-176X ; 0300-5712
ISSN (online)	1879-176X
ISSN	0300-5712
DOI	10.1016/j.jdent.2022.104206
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Zs.A 860: Show issues

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Article ; Online: Quality of abdominal ultrasound image acquisition by novice practitioners following a minimal training session on healthy volunteers.

Waterman, Bradley / Van Aarsen, Kristine / Lewell, Michael / Myslik, Frank / Peddle, Michael / Doran, Sean

CJEM

2020 Volume 22, Issue S2, Page(s) S74–S78

Abstract: Background: Point of care ultrasound (POCUS) is an essential tool for physicians to guide treatment decisions in both hospital and prehospital settings. Despite the potential patient care and system utilization benefits of prehospital ultrasound, the ... ...

Abstract	Background: Point of care ultrasound (POCUS) is an essential tool for physicians to guide treatment decisions in both hospital and prehospital settings. Despite the potential patient care and system utilization benefits of prehospital ultrasound, the financial burden of a "hands-on" training program for large numbers of paramedics remains a barrier to implementation. In this study, we conducted a prospective, observational, double-blinded study comparing paramedics to emergency physicians in their ability to generate usable abdominal ultrasound images after a 1-hour didactic training session. Methods: Canadian aeromedical critical care paramedics were compared against emergency medicine physicians in their ability to generate adequate abdominal ultrasound images on five healthy volunteers. Quality of each scan was evaluated by a trained expert in POCUS who was blinded to the identity of the participant using a 5-point Likert scale and using the standardized QUICk Focused Assessment with Sonography in Trauma (FAST) assessment tool. Results: Fourteen Critical care paramedics and four emergency department (ED) physicians were voluntarily recruited. Of paramedics, 57% had never used ultrasound before, 36% has used ultrasound without formal training, and 7% had previous training. Physicians had a higher proportion of usable scans compared with paramedics (100% v. 61.4%, Δ38.6%; 95% confidence interval, 19.3-50.28). Conclusions: Paramedics were not able to produce images of interpretable quality at the same frequency when compared with emergency medicine physicians. However, a 61.4% usable image rate for paramedics following a short 1-hour didactic training session is promising for future studies, which could incorporate a short hands-on tutorial while remaining cost-effective.
MeSH term(s)	Abdomen/diagnostic imaging ; Canada ; Emergency Medical Services ; Healthy Volunteers ; Humans ; Prospective Studies ; Ultrasonography
Language	English
Publishing date	2020-10-20
Publishing country	England
Document type	Journal Article ; Observational Study
ISSN	1481-8043
ISSN (online)	1481-8043
DOI	10.1017/cem.2020.29
Database	MEDical Literature Analysis and Retrieval System OnLINE

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