Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Paramediklerin Danışman Hekimden Telefonla İlaç Onayı Almaları
Paramedic's Asking for Medicine Approval Through Phone from the Consultant
Ayşegül BAYIRa, Songül DEMİRb
aAcil Tıp AD, Selçuk Üniversitesi Tıp Fakültesi, Konya, TÜRKİYE
bAnkara Acil Sağlık Hizmetleri Başkanlığı İl Ambulans Servisi Başhekimliği, Ankara, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2019;4(1):26-33
doi: 10.5336/healthsci.2018-62327
Article Language: TR
Full Text
ÖZET
 Amaç: Antalya ilinde hastane öncesinde çalışan paramediklerin danışman hekimden telefon ile ilaç onayı alma düzeylerini belirlemek ve yaşadıkları sorunlar ve bu sorunların çözümlerine yönelik bakış açılarını belirlemektir. Gereç ve Yöntemler: Araştırmacılar tarafından literatür taraması sonucunda oluşturulan 25 soruluk anket formu Antalya ilinde hastane öncesinde çalışan ve gönüllü olarak çalışmaya katılmayı kabul eden 105 paramediğe uygulanmıştır. Verilerin değerlendirilmesinde frekans, yüzdelik hesaplama ve ki-kare testi kullanılmıştır. Elde edilen sonuçlar 0,05 anlamlılık düzeyinde yorumlanmıştır. İstatistiksel hesaplamalar için IBM SPSS 22,0 paket programı kullanılmıştır. Bulgular: Çalışmaya katılan paramediklerin %48,5 (n=51)'i çalıştıkları ilin komuta kontrol merkezindeki danışman hekim sayısının yeterliliğine ilişkin olarak, danışman hekim sayısının yeterli olduğunu, ancak sadece ilaç danışmanlığı yapmadıkları için yetersiz kalındığını belirtmişlerdir. Paramediklerin %55,2'si her zaman ilaç onayı aldıklarını bildirmişlerdir. Paramediklerin %82,9'u kırsalda danışman hekime ulaşamadıkları zaman onay almadan ilaç uyguladıklarını ifade etmişlerdir. Paramediklerin %51,5'i danışman hekimden ilaç onayı istediklerinde çoğunlukla ilaç onayı verildiğini, %65,7'si video kamera sisteminin telefonla danışmadan daha faydalı olabileceğini, %66,6'sı rütbelendirme getirilmesi gerektiğini belirtmiştir. Sonuç: Çalışmamızın sonunda, paramediklerin yaklaşık yarısının ilaç onayı al(a)madıkları görülmüştür. Hastane öncesinde çalışan paramediklerin komuta kontrol merkezi ile iletişimlerinde telefonla iletişime ek olarak alternatif yolların da olması gerektiği görülmektedir.

Anahtar Kelimeler: Paramedik; telekonsültasyon; teletıp
ABSTRACT
 Objective: The purpose of this study was to determine the ratio of paramedics, who work in the city of Antalya ambulance service and who asks for approval for medication administration over the phone from a consultant physician and and to determine the problems they have experienced and their perspectives on solutions of these problems. Material and Methods: A 25-item questionnaire developed by the researchers as a result of the literature survey was applied to 105 paramedics working in the city of Antalya ambulance service and agreeing to participate voluntarily. Frequency, percentage calculation and chi square test were used in the evaluation of the data. The obtained results were interpreted at a significance level of 0.05 IBM SPSS 22.0 package program was used for statistical calculations. Results: Of all participants, 48.5% (n=51) stated the number of consulting physicians was sufficient in related to the number of consulting physicians in the command control center of the province where they were working but they were insufficient because they did not only provide drug counseling. 55.2% of paramedics stated that they always received drug approval. 82.9% of paramedics stated that they applied medication without approval when they could not reach the consultant medicine in the countryside. 51.5% of the paramedics stated that medication administration approvals were mostly given when they wanted medication administration from the consultant physician, 65.7% stated that the video camera system could be more useful over consulting the phone and 66.6% should be given a ranking. Conclusion: We found that about half of the paramedics couldn't receive medication administration approval at the end of our study. It seems that the paramedics who worked in the prehospital should have alternative ways of communication with command control center in addition to telephone communication.

Keywords: Paramedic; teleconsultant; telemedicine
REFERENCES:
  1. Roudsari BS, Nathens AB, Arreola-Risa C, Cameron P, Civil I, Grigoriou G, et al. Emergency Medical Service (EMS) systems in developed and developing countries. Injury. 2007;38(9):1001-13. [Crossref] [PubMed]
  2. Pozner CN, Zane R, Nelson SJ, Levine M. International EMS systems: The United States: past, present, and future. Resuscitation. 2004;60(3):239-44. [Crossref][PubMed]
  3. Fleischmann T, Fulde G. Emergency medicine in modern Europe. Emerg Med Australas. 2007;19(4):300-2. [Crossref]
  4. Al-Shaqsi S. Models of international emergency medical service (EMS) systems. Oman Med J. 2010;25(4):320-3. [Crossref]
  5. Czaplik M, Bergrath S, Rossaint R, Thelen S, Brodziak T, Valentin B, et al. Employment of telemedicine in emergency medicine. Clinical requirement analysis, system development and first test results. Methods Inf Med. 2014;53(2):99-107. [Crossref] [PubMed]
  6. Paksoy VM. [Comparison of International practice models in emergency health services: Anglo-American and Franko-German]. T.C. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu Dergisi. 2016;4(1):6-24.
  7. El-Masri S, Saddik B. An emergency system to improve ambulance dispatching, ambu- lance diversion and clinical handover communication-a proposed model. J Med Syst. 2012;36(6):3917-23. [Crossref][PubMed]
  8. Amadi-Obi A, Gilligan P, Owens N, O?Donnell C. Telemedicine in pre-hospital care: a review of telemedicine applications in the pre-hospital environment. Int J Emerg Med. 2014;7:29. [Crossref] [PubMed][PMC]
  9. Stevanovic A, Beckers SK, Czaplik M, Bergrath S, Coburn M, Brokmann JC, et al; TEMS Collaboration Group. Telemedical sup- port for prehospital Emergency Medical Service (TEMS trial): study protocol for a randomized controlled trial. Trials. 2017;18(1):43. [Crossref][PubMed] [PMC]
  10. Lewis ER, Thomas CA, Wilson ML, Mbarika VW. Telemedicine in acute-phase injury management: a review of practice and advancements. Telemed J E Health. 2012;18(6):434-45. [Crossref][PubMed][PMC]
  11. Adewale OS. An internet-based telemedicine system in Nigeria. Int J Inf Manage. 2004;24(3):221-34. [Crossref]
  12. Yıldırım D, Sarı E, Gündüz S, Yolcu S. [The past and present of paramedic education]. Smyrna Tıp Dergisi. 2014;(1):51-3.
  13. Özcan C. [Organization and presentation of prehospital emergency health services]. Özel G, Özel B, Özcan C, editör. Paramedik. 1. Baskı. Ankara: Güneş Tıp Kitabevleri; 2006. p.10-29.
  14. Resmi Gazete (10.04.2012, Sayı: 28260) sayılı Ambulanslar ve Acil Sağlık Araçları ile Ambulans Hizmetleri Yönetmeliği?nde Değişiklik Yapılmasına Dair Yönetmelik; 2012. p.1.
  15. Greatbatch D, Hanlon G, Goode J, O?Caithain A, Strangleman T, Luff D. Telephone triage, expert systems and clinical expertise. Sociol Health Illn. 2005;27(6):802-30. [Crossref][PubMed]
  16. Resmi Gazete (26.03.2009, Sayı: 27181) sayılı Ambulans ve Acil Bakım Teknikerleri ile Acil Tıp Teknisyenlerinin Çalışma Usul ve Esaslarına Dair Tebliğ; 2009. p.1.
  17. Akgün A. [The look of the paramedics role of the consultant in 112]. Ankara: 5. Paramedik Sempozyumu; 2010. p.72-5.
  18. Ebben RH, Vloet LC, van Grunsven PM, Breeman W, Goosselink B, Lichtveld RA, et al. Factors influencing ambulance nurses? adherence to a national protocol ambulance care: an implementation study in the Netherlands. Eur J Emerg Med. 2015;22(3):199-205. [Crossref][PubMed][PMC]
  19. Milli Eğitim Bakanlığı. [112 Command Control Center]. Acil Sağlık Hizmetlerinin Yapısı Ders Kitabı. Ankara: MEB; 2011. p.25-6.
  20. Bergrath S, Czaplik M, Rossaint R, Hirsch F, Beckers SK, Valentin B, et al. Implementation phase of a multicentre prehospital telemedicine system to support paramedics: feasibility and possible limitations. Scand J Trauma Resusc Emerg Med. 2013;21:54. [Crossref][PubMed][PMC]
  21. Soysal S, Sarıkaya S, Karcıoğlu Ö, Topaçoğlu H, Ayrık C. [Academic emergency physicians? views on prehospital care]. Akademik Acil Tıp Dergisi. 2002;44-8.
  22. Capampangan DJ, Wellik KE, Bobrow BJ, Aguilar MI, Ingall TJ, Kiernan TE, et al. Telemedicine versus telephone for remote emergency stroke consultations: a critically appraised topic. Neurologist. 2009;15(3):163- 6. [Crossref] [PubMed]
  23. Meyer BC, Raman R, Hemmen T, Obler R, Zivin JA, Rao R, et al. Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study. Lancet Neurol. 2008;7(9):787-95. [Crossref]
  24. Cho SJ, Kwon IH, Jeong J. Application of telemedicine system to prehospital medical control. Healthc Inform Res. 2015;21(3):196- 200. [Crossref][PubMed][PMC]
  25. Bergrath S, Rörtgen D, Rossaint R, Beckers SK, Fischermann H, Brokmann JC, et al. Technical and organisational feasibility of a multifunctional telemedicine system in an emergency medical service-an observational study. J Telemed Telecare. 2011;17(7):371-7.[Crossref][PubMed]

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