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PubMed1981

Preventive medicine in practice: the state of the art.

Primary and secondary prevention, as opposed to tertiary prevention, is the logical approach to attack today's leading causes of premature death. To apply preventive medicine in their practices, physicians may use a number of tools. The traditional annual examination should be abandoned in favor of periodic screening of asymptomatic patients according to age and sex. Screening should be done on a case-finding basis, facilitated by use of a longitudinal screening flow sheet and evaluated by use of a retrospective audit. An age-sex register can help identify which patients belong to a high-risk group. Health hazard appraisal is a tool for estimating a patient's risk before and after prescribed preventive intervention, and may stimulate patient risk factor reduction-as may other behavior modification techniques. In many cases these tools can be applied by paramedical personnel. Further research is needed to gauge the effects of these techniques on risk, morbidity and mortality.

Physical Examination↗

PubMedDate not supplied

Self-reported cardiac risk factors in emergency department nurses and paramedics.

STUDY OBJECTIVE: Our objective was to assess the prevalence of cardiac risk factors in a sample of urban paramedics and emergency department (ED) nurses. METHODS: We asked 175 paramedics and ED nurses working at a busy, urban ED to complete a cardiovascular risk assessment. The survey asked subjects to report smoking history, diet, exercise habits, weight, stress levels, medication use, history of hypertension or cardiac disease, family history of cardiovascular disease (CVD), and cholesterol level (if known). RESULTS: 129 of 175 surveys were returned (74% return rate) by 85 paramedics and 44 nurses. The percentages of paramedics and nurses at high or very high risk for cardiac disease were 48% and 41%, respectively. Forty-one percent of female respondents and 46% of male respondents were at high or very high risk. Cigarette smoking was reported in 19% of the paramedics and 14% of the nurses. The percentages of paramedics and nurses who reported hypertension were 13% and 11%, respectively. High cholesterol was reported in 31% of paramedics and 16% of nurses. CONCLUSIONS: Forty-eight percent of paramedics and 41% of ED nurses at this center are at high or very high risk for cardiovascular disease, by self-report. Efforts should be made to better educate and intervene in this population of health-care providers in order to reduce their cardiac risk.

Adult↗