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The COVID-19 pandemic led to massively increased emergency medical services (EMS) activity. The need to decontaminate emergency vehicles after conveying a suspected or confirmed patient to the hospital represented a critical step, slowing the activities and impacting the number of available ambulances. This brief paper analyzes the flow of EMS processes according to the Lean Thinking management approach, which focuses on reducing waste in a production cycle. The different steps of the whole process (arrival to the Emergency Department, handover phase, decontamination, return to service, and the required transfers) and a series of strategies are discussed. The organization (centralized or delocalized), number, and location of the decontamination centers impact transfers and waiting times and, consequently, the availability of ambulances. Optimizing these processes may lead to a global performance improvement, reducing transfers and time, with greater availability of emergency vehicles. [ABSTRACT FROM AUTHOR]

The ongoing changes the system of emergency care (EC) in the Russian Federation (RF), especially its in-hospital component, require modifications of applicable laws. This paper analyzes past development and evaluates the current state of regulations pertinent to hospital-based EC in RF. We have reviewed and analyzed the regulatory statutes that governed hospital-based emergency care in Russia between 1735 and 2013. The study traces the development of past regulations (legal and normative acts) applicable to EC in RF. Main regulations currently in effect are characterized. At present, there already exists a body of laws supporting further modernization of hospital-based EC in Russia. Most recently, the legal foundation has been laid for previously novel concepts such as short-term observation, and for the creation of hospitalbased centers of EC. Work in progress involves active steps towards clinical recommendations and protocols for the envisioned new structure of EC in the RF. The paper will be of interest to professionals studying global emergency medicine development. It will help researchers and clinical practitioners in the fields of emergency medical care and healthcare management by understanding the link between regulatory deficiencies and barriers to improving emergency department operations. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic led to massively increased emergency medical services (EMS) activity. The need to decontaminate emergency vehicles after conveying a suspected or confirmed patient to the hospital represented a critical step, slowing the activities and impacting the number of available ambulances. This brief paper analyzes the flow of EMS processes according to the Lean Thinking management approach, which focuses on reducing waste in a production cycle. The different steps of the whole process (arrival to the Emergency Department, handover phase, decontamination, return to service, and the required transfers) and a series of strategies are discussed. The organization (centralized or delocalized), number, and location of the decontamination centers impact transfers and waiting times and, consequently, the availability of ambulances. Optimizing these processes may lead to a global performance improvement, reducing transfers and time, with greater availability of emergency vehicles.

It is estimated that 1.35 million people die each year as a result of road traffic injuries worldwide, with Africa having the highest annual rate. Ethiopia has the highest fatality rate in road traffic accidents, at 79%. There is no well-established emergency medical system in Ethiopia to provide pre-hospital trauma care. A crosssectional study was conducted at selected public hospitals in Addis Ababa. Purposive sampling was used to select the victims who arrived at the emergency department by ambulance. Data was gathered through structured questionnaires administered by an interviewer and a review of victims' medical records. SPSS Version 25 was used to analyze the data. In this study, 262 victims took part, with a 94% response rate. Patient positioning (50.8%) was the most commonly provided service, followed by bleeding control (43.5%). Within the first 24 hours, 8.4% of the victims died. The first 24-hours of injury-related death were significantly associated with head/neck/spine injury and total pre-hospital time. Action should be taken to increase the availability of necessary equipment in ambulances and the number of paramedic personnel. [ABSTRACT FROM AUTHOR]