Biomedical subjects

F Gagnon

Publications and source records attributed to F Gagnon.

40 records · Page 3Linked to original sources

PubMedDate not supplied

Critical incident stress intervention after loss of an air ambulance: two-year follow up.

OBJECTIVE: Following an air ambulance crash with five fatalities, critical incident stress debriefing (CISD) was provided for involved paramedics, physicians, and nurses. A study was conducted to evaluate the long-term effects of a critical incident with critical incident stress debriefing according to the Mitchell model. METHODS: Six months following the incident, empirically designed questionnaires were mailed to all transport paramedics and directly involved medical staff, and a random sample of both nurses from the dispatch/receiving institution and paramedics from around the province. Twenty-four months post-incident, all members of the transport paramedics completed the Impact of Events Scale and the General Health Questionnaires. RESULTS: There were no differences between groups on any scores, except for disturbed sleep patterns, bad dreams, and the need for personal counseling being greater among transport paramedics at one day. There was no correlation between how well the deceased individuals were known, amount of debriefing, and symptom severity. A trend was seen for those with pre-existing stress management routines to have less severe symptoms at six months (p = 0.07). At two years, 16% of transport paramedics still had significant abnormal behavior. CONCLUSIONS: CISD did not appear to affect the severity of stress symptoms, whereas having pre-existing stress management strategies may. These findings give justification for proceeding to a randomized, controlled trial of different levels of critical incident stress intervention.

Accidents, Aviation↗

PubMedDate not supplied

The cost of family-oriented communication before air medical interfacility transport.

INTRODUCTION: Family-oriented communication with parents by transport teams eases the stress associated with transferring children to tertiary care. This study was conducted to determine the duration of family-oriented visits and whether the visit contributed significant cost to the mission. METHOD: Data collection was prospective and double-blind; questions were incorporated into another study. Subjects were infants or children requiring assisted ventilation and air transport to tertiary care. Time from completion of stabilization to departure and reasons for any delay were recorded. Cost of contact time longer than 20 minutes (total acceptable time for family visit and transfer to vehicle) was calculated at paramedic overtime at $0.82/minute and aircraft wait time at $200/hour if incurred. RESULTS: Forty-six patients were enrolled. In 16 cases (35%), time between completing stabilization and hospital departure exceeded 20 minutes, with "family visit" listed as the explanation. Nine of these visits incurred overtime, and two incurred aircraft wait costs. Total costs for providing communication visits more than 10 minutes long were $607 or approximately $13 per patient. CONCLUSION: The costs for visit time longer than 10 minutes are small compared with the documented benefits of family-oriented communication. However, transport personnel must be mindful of the potential to incur additional cost through overtime, aircraft wait time, or pilot replacement.

Air Ambulances↗

PubMedDate not supplied

Impact of systolic and diastolic blood pressure on ischemic vascular diseases in French-Canadian men from 1974 to 1990.

The relationships of systolic and diastolic blood pressure (BP) to ischemic heart disease (IHD), intermittent claudication (IC) and stroke were evaluated in 4385 men (aged 35 to 64 years in 1973) clinically free from these vascular diseases at entry and followed for 16 years. The mean of two readings measured in 1973-74 was used as the baseline BP. The cut-of for quintile 5 was systolic BP greater than 152 mmHg and diastolic BP greater than 92 mmHg. Relative risks (RR) were adjusted for main risk factors and calculated separately for systolic and diastolic BP. From 1974-90, 1120 first ischemic vascular events were documented: 792 IHD, 216 IC and 112 strokes. The incidences of each ischemic vascular disease increased, starting at quintile 4, for either systolic or diastolic BP. For systolic BP, the adjusted RR of quintile 5 compared with quintile 1 were 1.8 for IHD (95% confidence interval 1.4 to 2.2), 2.7 for IC (1.8 to 4.2) and 3.8 for stroke (2.1 to 7.0); for diastolic BP, the RR were 1.8 for IHD (1.5 to 2.3), 1.5 for IC (1.0 to 2.1) and 3.5 for stroke (2.0 to 6.4). For IHD, the RR of BP were similar for angina and myocardial infarction, and more pronounced for coronary death. In this population, elevated BP constitutes an important risk factor not only for stroke, but also for the main manifestations of IHD and IC. The impact of systolic BP was at least as significant as that of diastolic BP on these ischemic vascular events.

Adult↗

PubMedDate not supplied

[The Beck Anxiety Inventory. Psychometric properties of a French translation].

The Beck Anxiety Inventory (Beck, Epstein, Brown, & Steer, 1988) is a 21-item checklist developed with large clinical samples to measure anxiety symptoms associated with DSM III-R (APA, 1987) anxiety disorders. Administration and scoring are rapid; the patient rates symptom intensity during the last seven days on a 0 to 3 scale. The BAI adequately covers the major cognitive, affective, and physiological symptoms of anxiety. Care was taken during scale construction to eliminate items that would be confounded with depression items. The authors demonstrate excellent reliability and appropriate convergent and discriminant validity with other measures of anxiety and depression as well as criterion-related validity with in patient samples (Beck et al., 1988). The properties of the BAI have been further studied by Beck and collaborators as well as by other groups of researchers. Since its appearance in 1988 the BAI has quickly been adopted by clinical researchers in the United States, Canada, and the United Kingdom. Five studies present psychometric data on a French translation of the BAI. The translation process involved alternative versions by three translators, a panel of experts, and pilot testing on a group of 20 volunteers. The first study with university students (N = 72) indicated good internal consistence (Cronbach's alpha = .85) and stability (r = .63) at four weeks. The second study (N = 91) demonstrated convergent and discriminant validity significant positive: correlations with measures of obsessive-compulsive symptoms, irrational beliefs, and depression; significant negative correlations with assertiveness and self-esteem, and non-significant correlations with two measures of social desirability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗