ORCID Profile
0000-0002-3882-9864
Current Organisations
Monash University
,
BC Emergency Health Services
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Publisher: Australian Tactical Medical Association
Date: 24-01-2019
Abstract: Background: A recent publication in the Journal of Trauma and Acute Care Surgery reported that patients who received a tourniquet (TQ) for severe extremity bleeding had a fourfold decrease in overall shock related mortality (Scerbo et al., 2017). A systematic review conducted in the United States (US) by Beaucreux, Vivian, Miles, Sylvain, and Pasquier (2018) showed that tourniquets are an effective tool for haemorrhage control in civilian populations with low levels of associated complications. Not a lot is known about the attitudes of Australian paramedics toward TQ’s or their use thereof, but anecdotal evidence suggests that their use is contentious. Case: We present a case of severe extremity haemorrhage involving a 90-year-old male who sustained a partial utation to the lower aspect of the left leg proximal to the ankle whilst cutting a tree branch with a 5-inch toothed garden saw. Conclusion: In this case, the paramedics who attended to this patient believed that the use of a TQ was extreme. Standard trauma management and haemorrhage control measures that included a pressure bandage, vacuum splint and warming blanket served as confounding factors in obscuring an ongoing insidious bleed. Based on the injury profile, the patients advanced age, medications for comorbidities and associated decrease in physiological reserves this patient was a candidate for early TQ application. Failure to apply a TQ may have contributed to coagulopathy and the need for postoperative transfusions.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Australian Tactical Medical Association
Date: 20-01-2019
Abstract: This year sees the launch of the official journal of the Australian Tactical Medical Association (ATMA), the Journal of High Threat and Austere Medicine (JHTAM). This initiative is a significant achievement in the progression of high threat medicine in Australia and builds upon the success of the past 18 months. Whilst ‘Tactical Medicine’ conjures in the minds of the uninformed ideas of black-clad specialists in body armour, JHTAM and ATMA actually encompass and represent a wide range of applications of first aid and medicine. The crossover between all these applications is significant, and collaboration will only allow for a larger evidence base to draw from, as well as opening communication channels and starting conversations that enable greater and more cohesive response capacity in wilderness, expedition, prehospital, tactical, military and austere applications.
Publisher: Mark Allen Group
Date: 05-09-2011
Abstract: The Australian Defence Force (ADF) has long battled in hot and arduous environments. From the trenches of Tobruk during World War II and the thick jungle of Vietnam through to current theatres of war such as the rugged mountains of Afghanistan. Australian soldiers are exposed to the constant threat of heat illness, and while avoidable in training settings, it cannot be prevented in some combat situations. Prevention however, is a key factor in the exclusion of heat illness cases, a matter that the ADF has worked hard to highlight through mandatory annual training. It is for this reason that military heat casualty rates remain low in the ADF. This article provides some useful assessment tools which help to differentiate between the different levels of heat illness and furthermore, underlines the critical stages of heat illness and includes literature on the aetiology, pathophysiology, clinical manifestations and prehospital care management of heat illness.
Publisher: SAGE Publications
Date: 2021
DOI: 10.33151/AJP.18.950
Abstract: The field of paramedicine has undergone significant change and modernisation over the past 50 years. Presently there are no consistent terms or lexicon used across the profession to describe different levels of advanced practice. This inconsistency risks creating confusion as the professionalisation of paramedic practice continues. As well, many empirical studies support the claim that communication and the importance of managing language actively plays a crucial role in supporting change and in shaping the new paradigm. Therefore, the way one uses communication, and the deliberate choice of words to describe advance practice, will support change in the desired direction. This article explores these terms and their attendant influences on perceptions of practice to argue for change towards the standardised use of the term ‘advanced care paramedic’ across the Anglo-American paramedic system.
Publisher: Emerald
Date: 20-12-2022
DOI: 10.1108/IJES-05-2021-0025
Abstract: This study aims to map and examine the existing evidence to provide an overview of what is known about the structure and characteristics of the Anglo-American paramedic system in developed countries. The review includes results examining the structure and characteristics of the Anglo-American paramedic system in English-speaking developed countries. Databases, including Embase, MEDLINE, Web of Science, EBSCOhost, CINAHL, Google Scholar and Epistemonikos, were searched from the inception of the databases. A grey literature search strategy was conducted to identify non-indexed relevant literature along with forward and backward searching of citations and references of included studies. Two reviewers undertook title and abstract screening, followed by full-text screening. Finally, data extraction was performed using a customised instrument. Included studies were summarised using narrative synthesis structured around broad themes exploring the structure and characteristics of the Anglo-American paramedic system. The synthesis of information shows that varying models (or subsystems) exist within the Anglo-American paramedic system. The use of metaphorical models based on philosophical underpinnings are used to describe two novel subsystems within the Anglo-American paramedic system. These are the professionally autonomous and directive paramedic systems, with the directive model being further categorised into the rescue and hospital-managed submodels. This study is the first of its kind to explore the modern subcategorisation of the Anglo-American paramedic system using a realist lens as the basis for its approach.
Publisher: SAGE Publications
Date: 2020
DOI: 10.33151/AJP.17.787
Abstract: Paramedicine has undergone significant change in the past two decades. While the Anglo-American paramedic system continues to grow there appears to be a dearth of published literature regarding modern categorisation of this evolving paramedic system. The objective of this scoping review is to examine and map the existing evidence to provide an overview of the characteristics and structural similarities and differences of Anglo-American paramedic systems in English-speaking developed countries. Databases, including Embase, MEDLINE, Web of Science, EBSCOhost, CINAHL, Google Scholar and Epistemonikos, will be searched from inception. A grey literature search strategy has also been developed to identify non-indexed relevant literature. Citations and references of included studies will also be searched. Two reviewers will undertake title and abstract screening, followed by full text screening. Data extraction will be conducted using a customised instrument. Inclusion criteria: results examining management, leadership or governance in paramedicine related to the Anglo-American paramedic model in English-speaking developed countries will be included in the review. Included studies will be summarised using narrative synthesis structured around themes of management, leadership and governance in paramedicine.
No related grants have been discovered for Timothy Makrides.