975 results
Search Results
2. Home Or Hospital Care For Coronary Thrombosis? Working Paper [With Discussion]
- Author
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Colling, Aubrey, Carson, Peter, and Hampton, John
- Published
- 1978
3. Prehospital Emergency Medical Services: Paper Versus Technology.
- Author
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Piani, Tommaso, Boccolato, Lorenzo, Ruzza, Gianpaolo, Pausler, Daniele, Trillò, Giulio, Macor, Cristiana, Pascolo, Piero, and De Monte, Amato
- Subjects
- *
AMBULANCES , *DIFFUSION of innovations , *DOCUMENTATION , *EMERGENCY medical services , *EMERGENCY medicine , *EXPERIENTIAL learning , *INTENSIVE care nursing , *PORTABLE computers , *QUALITY assurance , *MEDICAL triage , *WORK , *DIGITAL technology - Abstract
Digital technology has an essential role in the development and application of innovations within the health care system. Its application is not limited to the hospital environment but extends to the emergency medical services system. The experimental phase of the shift to electronic emergency medical services documentation was performed within the Azienda Sanitaria Universitaria Friuli Centrale of Udine (Italy), a local health authority covering about 533 000 inhabitants. Considering the results of this study, we believe it is important to continue to update the methods of data collection and analysis in correlation with the management and outcomes of the patients. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
4. A systematic review of post-traumatic growth in ambulance personnel: facilitators and prevalence rates.
- Author
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Abdo, Molly and Schlösser, Annette
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POST-traumatic stress disorder ,PSYCHOLOGICAL resilience ,WOUNDS & injuries ,CINAHL database ,SEX distribution ,POSTTRAUMATIC growth ,PSYCHOLOGICAL adaptation ,SYSTEMATIC reviews ,MEDLINE ,ALTERNATIVE medicine specialists ,PERSONALITY ,AMBULANCES ,DATA analysis software ,PSYCHOLOGY information storage & retrieval systems ,ERIC (Information retrieval system) ,INTER-observer reliability - Abstract
Introduction: Ambulance personnel are exposed to traumatic and stressful situations, which can increase the risk of mental health conditions, such as post-traumatic stress disorder (PTSD). High rates of PTSD have been found in ambulance personnel (Petrie et al., 2018), but no review is available to examine post-traumatic growth (PTG - positive psychological change following a trauma) in this population. This literature review provides an overview of the prevalence rates and facilitators that may contribute to PTG in ambulance personnel. Methods: A systematic search was conducted on EBSCOhost in January 2024 across the following six databases: Academic Search Ultimate, PsycINFO, PsycARTICLES, MEDLINE, ERIC and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ultimate. Results: Eleven papers were identified for this review. Pooled prevalence of PTG was moderate (52%), and facilitators for PTG were grouped into five categories: coping style/strategies, resilience, personality traits, gender and incident characteristics. Conclusions: Numerous facilitators contributed to the development of PTG, although these did not arise in all papers. The quality of research ranged from satisfactory to excellent. Evidence suggested that adaptive coping style, high levels of resilience, the absence of a personality trait (neuroticism) and being female may facilitate PTG. Further research is needed to support the reliability of findings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. V2X-assisted emergency vehicle transit in VANETs.
- Author
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Kaja, Hasita, Stoehr, Jacob M, and Beard, Cory
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AMBULANCES ,EMERGENCY vehicles ,VEHICULAR ad hoc networks ,TRAFFIC patterns ,AD hoc computer networks - Abstract
Vehicular ad hoc networks (VANETs) can support safety-critical applications such as the safe and fast movement of emergency vehicles while preventing crashes, delays, and congestion involving emergency vehicles. A simulation approach to evaluate ambulance transit using VANET capabilities is presented in this paper for a real-life road network taken in and around the University of Missouri–Kansas City, USA. Three different VANET functional scenarios are compared with a base scenario (SC-1) which depicts the present-day traffic pattern and vehicle behaviors. In the three scenarios, the second one (SC-2) adds vehicle-to-vehicle (V2V) and vehicle-to-infrastructure (V2I) communications along with the present-day traffic pattern; ambulances use VANETs simply to announce their arrival. The third scenario (SC-3) provides functionalities for ambulances to rerouting when they learn about a current or an anticipated road congestion. And the fourth scenario (SC-4) adds vehicle rerouting capabilities, so ambulance routes can be sent to vehicles, and they can avoid the ambulance path. Performance results are presented and evaluated for metrics such as delay, packet drop ratio, the average speed of the ambulance, average vehicle density, and ambulance message interval time. From the simulation results, it was observed that the ambulance transit time reduces by 12.52%, 14.65%, and 18.75% for SC-2, SC-3, and SC-4, respectively, as compared with SC-1, while the average ambulance speed increases by 14.49%, 15.57%, and 20.90% for SC-2, SC-3, and SC-4, respectively, when compared with SC-1. This paper provides substantial evidence that VANET capabilities for emergency vehicles can enhance crash protection and reduce the commute time for emergency response. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
6. Prevalence and Characteristics of Ambulance Collisions, a Systematic Literature Review.
- Author
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Delavary, Milad, Ghayeninezhad, Zahra, and Lavallière, Martin
- Subjects
AMBULANCES ,MEDICAL emergencies ,CITIES & towns - Abstract
The risk of dying or being injured as a result of traffic collisions is higher for medical emergency responders than for other professional drivers. This systematic review synthesizes the literature regarding the collisions of ambulances, focusing on the prevalence and characteristics surrounding such events. Keywords including paramedics and traffic collisions were searched in papers available in PubMed from January 1990 to July 2021. Two independent reviewers screened the abstracts of 2494 papers and ended up with 93 full-text articles to assess for eligibility, of which 26 papers were finally kept for this review. There was a total of 18 studies conducted in the United States, followed by 3 in Turkey, 2 in Taiwan, 1 in both the United States and Canada, 1 in France, and 1 in Poland. There is a high record of injury and fatal collisions for ambulances compared to other commercial or similarly sized vehicles. Drivers less than 35 years old with low experience and a history of citations are more likely to be involved in such collisions. Ambulance collisions are more likely to happen in urban areas and intersections are the riskiest locations. Most collisions occur when the ambulance is responding to an emergency call (i.e., going to the patient or the hospital) and using lights and sirens. Tailored preventive policies and programs for improving paramedics' safety should be sought to reduce the burden of these occupational collisions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
7. A systematic review: what factors predict Post-Traumatic Stress Symptoms in ambulance personnel?
- Author
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Brooks, Damian and Brooks, Rachel
- Subjects
POST-traumatic stress ,AMBULANCES ,PSYCHOLOGICAL adaptation ,PERSONALITY ,STRAINS & stresses (Mechanics) - Abstract
Background: Ambulance personnel are frequently exposed to traumatic accidents, which makes them a high risk for poor mental health. High rates of Post-Traumatic Stress Symptoms (PTSS) have been found within ambulance personnel samples but no review has been completed to examine the factors that may be implicated in the development of these symptoms. This literature review provides an overview of the factors that predict PTSS in ambulance personnel. Methods: A systematic search strategy was conducted in April 2020 across the following four databases: PsycINFO, PsycARTICLES, MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Results: Eighteen papers were included in this review, and the predictive factors examined were grouped into four categories: coping style, personal factors, environmental factors and organisational factors. Conclusions: An array of factors across the four categories were implicated in the development of PTSS, but these tended to be indicated in only one or two papers. Evidence was found to suggest that dysfunctional coping styles, reduced levels of some personality traits, proximity and nature of the critical incident and high levels of organisation stress can all lead to PTSS. Further research is needed to support the reliability of findings. [ABSTRACT FROM AUTHOR] - Published
- 2021
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- View/download PDF
8. 'We're just an ambulance at the bottom of the cliff': Strategies and (a)politics of change in Berlin's community food spaces.
- Author
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Véron, Ophélie
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COMMUNITY gardens ,KITCHEN gardens ,AMBULANCES ,SOCIAL injustice ,PRACTICAL politics - Abstract
The benefits of community-based, grassroots food practices, such as community gardens or kitchens, are widely acknowledged. However, they have also been shown to support neoliberal and exclusionary dynamics. This paper examines this contradiction on the ground by unpacking the processes and mechanisms through which these initiatives reproduce, reinforce or challenge social inequities and injustices in the city. It suggests the concept of community food space to look at the articulation of practices and intentions within these groups, and highlight emancipatory practices situated around food rather than simply about food. The paper draws upon an ongoing militant ethnography into community food spaces in Berlin, Germany. Exploring the complex and diverse landscape of Berlin food activism, it illuminates the ways in which food may be used to perpetuate unjust social configurations or, on the contrary, to advance social justice at both local and structural levels. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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9. A Context-Aware Framework to Manage the Priority of Injured Persons Arriving at Emergencies.
- Author
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Ouakasse, Fathia, Stitini, Oumaima, and Rakrak, Said
- Subjects
AMBULANCES ,TRAFFIC accidents ,HOSPITAL emergency services - Abstract
Integrating the Internet of Medical Things (IoMT) in the Hospital system has modified the traditional medical service from a reactive system based on hospitalization and diseases to a preventive and interoperable system based mainly on the interactive data flow between patients and health professionals. Medical data is collected and processed using medically connected objects (MCOs). According to gathered data, the new medical system should be able to sort patient states based on urgent and critical vital signs, and consequently, priorities are defined. In this paper, we focus on managing priority in hospital emergencies to adapt dynamic operations and interactions with different stakeholders according to the changes in their execution context. Indeed, based on data sensed from MCOs implemented in ambulances, emergency rooms might be prepared to receive injured persons like victims of road accidents or other incidents. Therefore, we design a context-aware monitoring framework for injured people based on gathered medical data to manage priorities. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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10. The Effects of Budget Constraints in the Ministry of Internal Affairs in Romania.
- Author
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Corman, Narcis-Alexandru
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BUDGET ,FIRST aid in illness & injury ,PUBLIC policy (Law) ,PUBLIC finance ,AMBULANCES - Abstract
The main purpose of this paper is to demonstrate how important it is for the Ministry of Internal Affairs to have a sufficient budget to carry out the missions entrusted by law. The Ministry of Internal Affairs has very important responsibilities in terms of maintaining public order and intervention in emergency situations. The Romanian Police, the Romanian Gendarmerie, the Romanian Border Police, which are in charge of maintaining public order, as well as the General Inspectorate for Emergency Situations, which is in charge of extinguishing fires and providing first aid through SMURD ambulances, are active within the Ministry of Internal Affairs. In this paper, the possible negative impacts of the application of the Government's Emergency Ordinances regarding some fiscal-budgetary measures, adopted in 2023, will be presented. [ABSTRACT FROM AUTHOR]
- Published
- 2023
11. Lessons of the COVID-19 Pandemic for Ambulance Service in Kazakhstan.
- Author
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Messova, Assylzhan, Pivina, Lyudmila, Ygiyeva, Diana, Batenova, Gulnara, Dyussupov, Almas, Jamedinova, Ulzhan, Syzdykbayev, Marat, Adilgozhina, Saltanat, and Bayanbaev, Arman
- Subjects
CROSS-sectional method ,HELPLINES ,DATA analysis ,RESEARCH funding ,EMERGENCY medical services ,RETROSPECTIVE studies ,AMBULANCES ,RESEARCH methodology ,ANALYSIS of variance ,FRIEDMAN test (Statistics) ,STATISTICS ,DATA analysis software ,COVID-19 pandemic - Abstract
Background: Emergency medical services (EMS) are intended to provide people with immediate, effective, and safe access to the healthcare system. The effects of pandemics on emergency medical services (EMS) have not been studied sufficiently. The aim of this paper is to assess the frequency and structure of calls at an ambulance station in Kazakhstan during the period of 2019–2023. Methods: A retrospective analysis was conducted to estimate the incidence of emergency assistance cases from 2019 to 2023. Results: An analysis of the structure and number of ambulance calls before the pandemic, during the pandemic, and post-pandemic period did not reveal significant changes, except for calls in urgency category IV. Patients of urgency category IV handled by an ambulance decreased by 2 and 1.7 times in 2020 and 2021, respectively, which appears to be related to quarantine measures. In 2022 and 2023, category IV calls were 4.7 and 4.5 times higher than in 2019. Conclusions: This study's findings suggest no changes in the dynamics of ambulance calls, except urgency category IV calls. The number of category IV urgent calls decreased significantly during the COVID-19 pandemic and increased in the post-pandemic period. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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12. Successful Intraosseous (IO) Adenosine Administration for the Termination of Supraventricular Tachycardia (SVT) in a 3.5-Year-Old Child—Case Report and Literature Review.
- Author
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Zachaj, Jakub, Kręglicki, Łukasz, Sikora, Tomasz, Moorthi, Katarzyna, Jaśkiewicz, Filip, Nadolny, Klaudiusz, and Gałązkowski, Robert
- Subjects
HALOTHERAPY ,AIRPLANES ,ADENOSINES ,BLOOD vessels ,HOSPITAL admission & discharge ,SUPRAVENTRICULAR tachycardia ,TREATMENT effectiveness ,HOSPITAL emergency services ,INTRAOSSEOUS infusions ,HEART beat ,AMBULANCES ,MEDICAL equipment ,PAIN management ,BLOOD pressure ,CYANOSIS ,LIDOCAINE ,TRANSPORTATION of patients - Abstract
Paediatric supraventricular tachycardia (SVT) is a common arrhythmia of great clinical significance. If not treated promptly, it can cause heart failure and cardiogenic shock. Depending on the patient's condition, SVT treatment involves vagal manoeuvres, pharmacological, or direct current cardioversion. The goal of acute SVT management is to immediately convert SVT to a normal sinus rhythm (NSR) and prevent its recurrence. Adenosine is recommended as the first-line treatment for stable SVT by the European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines, when vagal manoeuvres have proven ineffective. The ERC and AHA guidelines recommend the intravenous route of administration. The intraosseous (IO) administration technique is also possible, but still relatively unknown. The aim of this paper is to describe a 3.5-year-old child with SVT that was converted to NSR following IO administration of adenosine. Successful conversion was achieved after the second attempt with the adenosine dose. In the described case, there was no recurrence of SVT. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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13. NUMERICAL STRENGTH STUDY OF ULTRA-LIGHT COMPOSITE SEAT FRAME DESTINED TO PASSENGERS TRANSPORT.
- Author
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CZECHOWSKI, LESZEK, KOTEŁKO, MARIA, and JANKOWSKI, MARCIN
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AMBULANCES ,CARBON fibers ,ALUMINUM ,DEAD loads (Mechanics) ,COMPOSITE materials - Abstract
The paper concerns numerical study of the ultra-light seat frame serving transported patients in ambulance. The structure of seat was designed to be built of the carbon fibers, aluminium and steel. The present prototype distinguishes itself with low mass and high strength. During modelling, the stress state and displacement state were verified based on requirements according to regulation ECE14. In simulation, solid, beam and connection elements were employed to consider all the parts of structures. The analysis of the stress state verification based on the assumptions of boundary conditions close to regulation ECE14. The isotropic materials were considered to be in elastic range. In case of composite materials, TSAI-WU (TSW) criterion for assessment of strength was taken into account. Five different variants of seat were taken into consideration to indicate the differences between them. The paper includes the results of analysis of composite structure under static loads which were shown and discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
14. Delivery of public health interventions by the ambulance sector: a scoping review.
- Author
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Ablard, Suzanne, Miller, Elisha, Poulton, Steven, Cantrell, Anna, Booth, Andrew, Lee, Andrew, Mason, Suzanne, and Bell, Fiona
- Subjects
AMBULANCES ,PUBLIC health education ,PUBLIC health ,BIBLIOGRAPHIC databases ,MEDICAL screening ,GREY literature - Abstract
Background: With millions of unscheduled patient contacts every year and increasing call outs clustered around the most deprived communities, it is clear the ambulance sector could have a role to play in improving population health. However, the application and value of a public health approach within the ambulance sector has not been comprehensively explored. A scoping review was undertaken to explore the role of the ambulance sector in the delivery of public health interventions and what impact this has on population health and ambulance sector outcomes. Methods: A search strategy was developed on MEDLINE and translated to other major medical and health related bibliographic databases (Embase; CINAHL; HMIC; Science and Social Sciences Citation Index; Cochrane Library) to identify literature published since 2000 in OECD countries. Targeted grey literature, reference list, and citation searching was also carried out. Search results were downloaded to Microsoft Excel and screened by three reviewers according to pre-determined inclusion / exclusion criteria. Data from included studies, such as the type of activity noted within the paper, the population involved and the public health approach that was utilised, was extracted from within the paper using a data extraction form and narratively synthesised. Results: Fifty-two references were included in the final review (37 database searching; 9 reference list searching; 6 grey literature). Included articles were categorised according to the relevant public health domains and subdomains as articulated by the UK Faculty of Public Health: Health improvement domain: Public health education and advice (Health promotion sub-domain) (n=13) Emergency Services personnel providing vaccines (Disease prevention sub-domain) (n=1) Health care public health domain Paramedicine (Service delivery sub-domain) (n=30) Screening tools and referral pathways used by the ambulance sector (Service delivery sub-domain) (n=28) Health intelligence using ambulance sector data (population health management sub-domain) (n=26) Of note, some domains (e.g. health protection) returned nil results. Discussion: The scoping review demonstrates the breadth of public health related activities in which the ambulance sector is involved. However, an overemphasis on demand management outcomes precludes definitive conclusions on the impact of ambulance sector-led public health initiatives on public health outcomes. Future evaluations of public health initiatives should incorporate wider health system perspectives beyond the immediately apparent remit of the ambulance sector. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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- View/download PDF
15. Impact of low-intensity heat events on mortality and morbidity in regions with hot, humid summers: a scoping literature review.
- Author
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Strathearn, Melanie, Osborne, Nicholas J., and Selvey, Linda A.
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AMBULANCES ,LITERATURE reviews ,HEAT waves (Meteorology) ,HIGH-income countries ,SUMMER ,MORTALITY - Abstract
The objective of this study is to determine the impacts of low-intensity heat on human health in regions with hot, humid summers. Current literature has highlighted an increase in mortality and morbidity rates during significant heat events. While the impacts on high-intensity events are established, the impacts on low-intensity events, particularly in regions with hot, humid summers, are less clear. A scoping review was conducted searching three databases (PubMed, EMBASE, Web of Science) using key terms based on the inclusion criteria. We included papers that investigated the direct human health impacts of low-intensity heat events (single day or heatwaves) in regions with hot, humid summers in middle- and high-income countries. We excluded papers written in languages other than English. Of the 600 publications identified, 33 met the inclusion criteria. Findings suggest that low-intensity heatwaves can increase all-cause non-accidental, cardiovascular-, respiratory- and diabetes-related mortality, in regions experiencing hot, humid summers. Impacts of low-intensity heatwaves on morbidity are less clear, with research predominantly focusing on hospitalisation rates with a range of outcomes. Few studies investigating the impact of low-intensity heat events on emergency department presentations and ambulance dispatches were found. However, the data from a limited number of studies suggest that both of these outcome measures increase during low-intensity heat events. Low-intensity heat events may increase mortality. There is insufficient evidence of a causal effect of low-intensity heat events on increasing morbidity for a firm conclusion. Further research on the impact of low-intensity heat on morbidity and mortality using consistent parameters is warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
16. Blockchain based reputation management, data storage and distributed revocation in vehicular energy networks in smart health care systems.
- Author
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Jamal, Abid, Javed, Muhammad Umar, Alrajeh, Nabil, Bouk, Safdar Hussain, and Javaid, Nadeem
- Subjects
REPUTATION ,HEALTH care networks ,AMBULANCES ,BLOCKCHAINS ,CLOUD storage ,DIGITAL signatures ,REVOCATION ,DATA warehousing - Abstract
In vehicular energy networks (VENs) operating in smart health care systems (SHaCarS), reputation of vehicles, i.e., ambulances, plays an important role as all functions depend upon it including message sharing, energy trading, etc. Keeping this in view, this paper presents a reputation management scheme. To ensure that the proposed scheme is secure and transparent, Blockchain (BC) technology is used. In the proposed model, the registration of ambulances is performed through a certificate authority (CA). Later, a pseudo mechanism is designed using Elliptic Curve Digital Signature Algorithm, which ensures conditional anonymity and traceability. The ambulances are provided with the pseudo identities, which are mapped with the real identities to prevent disputes. Besides, the proposed scheme uses a Shamir secret sharing (SSS) algorithm to enable distributed revocation in BC based VENs operating in SHaCarS. In addition, the ambulances' reputation information is stored in interplanetary file system (IPFS) in an efficient manner. The hashes are generated by IPFS upon data storage, which are then stored in BC. The performance evaluation of the proposed system is done via extensive simulations. The results show 18–20% reduction in computational overhead and 35–40% reduction in storage overhead. The proposed system's robustness is tested by inducing the 51% attack and the replay attack. In addition, the security analysis of the smart contract is performed using Oyente. The results show that the system proposed for reputation management in the underlying work is robust and computationally efficient. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
17. Respect for patients' rights in health facilities: experiences of patients during the early period of the COVID-19 pandemic in Ghana.
- Author
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Golo, Harrison Kwame
- Subjects
PATIENT abuse ,HEALTH facilities ,HEALTH services accessibility ,RESEARCH methodology ,AMBULANCES ,POPULATION geography ,INTERVIEWING ,PATIENTS' attitudes ,PATIENTS' rights ,HEALTH ,INFORMATION resources ,ACCESS to information ,SOUND recordings ,JUDGMENT sampling ,DATA analysis software ,COVID-19 pandemic ,MEDICAL record access control ,LEGAL status of patients - Abstract
Purpose: This paper aims to identify human rights violations of patients during the early periods of the COVID-19 pandemic in Ghana by investigating the experiences of people on how health-care professionals discharged their responsibilities during the time in question. Design/methodology/approach: Explanatory design of the mixed methods approach was adopted, with the intention of collecting both quantitative and qualitative data sequentially, and then integrating the results at the interpretation stage. The approach enriched the quality of data collected as it offered the advantage of shedding light on the primary motivations and reasons for attitudes and behaviours and helped to provide an in-depth understanding of how individuals interpret the happenings around them and their experiences. Thus, although some amount of quantitative method was used in the data collection, the core of this paper is based on the qualitative interpretations. Findings: The study reveals that health-care professionals, especially those in the Tema Metropolis, undermined certain fundamental human rights of patients during the early period of the COVID-19 pandemic. This includes failure to provide information to patients about treatment options and potential risks of medications; failure to seek the informed consent of patients before performing medical procedures; denial of access to medical files of patients for transfer; and inability or failure to provide medical ambulances services to patients on time. Originality/value: Although many publications on human rights dimensions and health protective issues on COVID-19 pandemic are available on a global scale, still little information pertaining to experiences of individuals with health-care professionals during the early days of the COVID-19 pandemic, especially in Ghana through the lens of patient's rights exists. This paper, therefore, fills an important gap in health-care management information, critical for policy decision-making processes regarding patient's rights in times of pandemic control. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
18. Exploring the effectiveness of a regional nurse practitioner led, long‐acting injectable buprenorphine‐based model of care for opioid use disorder.
- Author
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Strike, Teresa, D'Angelo‐Kemp, Dante, and Searby, Adam
- Subjects
DRUG addiction ,NARCOTICS ,NEEDLE exchange programs ,PSYCHIATRIC nursing ,AUDITING ,STATISTICS ,INJECTIONS ,EVALUATION of human services programs ,NURSE administrators ,BUPRENORPHINE ,RURAL conditions ,AMBULANCES ,DRUG overdose ,RETROSPECTIVE studies ,REGRESSION analysis ,OUTPATIENT medical care management ,PEARSON correlation (Statistics) ,CONTROLLED release preparations ,COMMUNITY mental health personnel ,STATISTICAL models ,DATA analysis ,DATA analysis software ,PAIN management ,OPIOID abuse ,HEROIN - Abstract
The introduction of long‐acting injectable buprenorphine preparations for opioid use disorder has been widely heralded as a breakthrough treatment, with several studies indicating positive results when using these medications. In many locations, nurse practitioners prescribe, administer, and monitor long‐acting injectable preparations. The objective of this paper is to explore whether a reduction in dispensed needles and syringes is attributable to increased nurse practitioner prescribing of LAIB. We used a retrospective audit of needles dispensed through the health service needle and syringe program vending machine, and individuals treated with long‐acting injectable buprenorphine by the nurse practitioner led model. In addition, we examined potential factors that may influence changes in the number of needles dispensed. Linear regression found that each individual with opioid dependence treated with long‐acting injectable buprenorphine was associated with 90 fewer needles dispensed each month (p < 0.001). The nurse practitioner led model of care for individuals with opioid dependence appears to have influenced the number of needles dispensed at the needle and syringe program. Although all confounding factors could not be discounted entirely, such as substance availability, affordability, and individuals obtaining injecting equipment elsewhere, our research indicates that a nurse practitioner led model of treating individuals with opioid use disorder influenced needle and syringe dispensing in the study setting. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
19. Predicting Urgent Dialysis at Ambulance Transport to the Emergency Department Using Machine Learning Methods.
- Author
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MAJOUNI, Sheida, TENNANKORE, Karthik, and ABIDI, Syed Sibte Raza
- Subjects
HOSPITALS ,SUPPORT vector machines ,HOSPITAL emergency services ,AMBULANCES ,MACHINE learning ,TRANSPORTATION of patients ,EMERGENCY medical technicians ,CONFERENCES & conventions ,COMPARATIVE studies ,PEARSON correlation (Statistics) ,HEMODIALYSIS ,PREDICTION models ,SENSITIVITY & specificity (Statistics) ,RECEIVER operating characteristic curves ,LOGISTIC regression analysis ,ARTIFICIAL neural networks ,LONGITUDINAL method - Abstract
Hemodialysis patients frequently require ambulance transport to the hospital for dialysis. Some patients require urgent dialysis (UD) within 24 hours of transport to hospital to avoid morbidity and mortality. UD is not available in all hospitals; therefore, predicting patients who need UD prior to hospital transport can help paramedics with destination planning. In this paper, we developed machine learning models for paramedics to predict whether a patient needs UD based on patient characteristics available at the time of ambulance transport. This paper presented a study based on ambulance data collected in Halifax, Canada. Given that relatively few patients need UD, a class imbalance problem is addressed by up-sampling methods and prediction models are developed using multiple machine learning methods. The achieved prediction scores are F1-score=0.76, sensitivity=0.76, and specificity=0.97, confirming that models can predict UD with limited patient characteristics. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
20. A Cloud-Based Ambulance Detection System Using YOLOv8 for Minimizing Ambulance Response Time.
- Author
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Noor, Ayman, Algrafi, Ziad, Alharbi, Basil, Noor, Talal H., Alsaeedi, Abdullah, Alluhaibi, Reyadh, and Alwateer, Majed
- Subjects
AMBULANCES ,TRAFFIC cameras ,DATA acquisition systems ,TRAFFIC signs & signals ,TRAFFIC flow - Abstract
Ambulance vehicles face a challenging issue in minimizing the response time for an emergency call due to the high volume of traffic and traffic signal delays. Several research works have proposed ambulance vehicle detection approaches and techniques to prioritize ambulance vehicles by turning the traffic light to green for saving patients' lives. However, the detection of ambulance vehicles is a challenging issue due to the similarities between ambulance vehicles and other commercial trucks. In this paper, we chose a machine learning (ML) technique, namely, YOLOv8 (You Only Look Once), for ambulance vehicle detection by synchronizing it with the traffic camera and sending an open signal to the traffic system for clearing the way on the road. This will reduce the amount of time it takes the ambulance to arrive at the traffic light. In particular, we managed to gather our own dataset from 10 different countries. Each country has 300 images of its own ambulance vehicles (i.e., 3000 images in total). Then, we trained our YOLOv8 model on these datasets with various techniques, including pre-trained vs. non-pre-trained, and compared them. Moreover, we introduced a layered system consisting of a data acquisition layer, an ambulance detection layer, a monitoring layer, and a cloud layer to support our cloud-based ambulance detection system. Last but not least, we conducted several experiments to validate our proposed system. Furthermore, we compared the performance of our YOLOv8 model with other models presented in the literature including YOLOv5 and YOLOv7. The results of the experiments are quite promising where the universal model of YOLOv8 scored an average of 0.982, 0.976, 0.958, and 0.967 for the accuracy, precision, recall, and F1-score, respectively. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
21. Collecting behavioral evidence from a highly mobile and seasonal population: A protocol for a survey on quad bike injuries.
- Author
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Menon, Preetha, El-Sadig, Mohamed, Albastaki, Marwan F., Alzaabi, Humaid, Alhammadi, Saleh, Almehrzi, Mansour, Aljanaahi, Hamed, Al-Rifai, Rami H., Masuadi, Emad M., and Grivna, Michal
- Subjects
DEMOGRAPHIC surveys ,AMBULANCES ,CYCLING ,CYCLISTS ,BICYCLES ,SEASONS ,TRAFFIC accidents - Abstract
Background: Quad bikes are popular recreational, four-wheeled bikes in the Middle East. Injury prevention programs targeting quad bike crashes in the United Arab Emirates (UAE) need evidence about the risk factors and behaviours associated with these crashes in the target population. This is a protocol for a study aiming to investigate quad bike rider behaviours and to assess the risk factors associated with related injuries in the UAE. Methods: This is a cross-sectional observational study aiming to describe a seasonal sport in a desert environment. With an estimated sample size of 451, the survey will follow a three-stage, location-based sampling strategy using the line-transect method. A sampling frame of desert locations with high injury incidences was developed, using Dubai ambulance injury records. Further expansion of the sampling frame was participatory, involving police, enthusiasts, emergency responders and gas station employees. The data collection will be limited to the winter months in fifteen high-injury desert locations across three major Emirates in the UAE. Trained researchers will observe the riders directly in the desert to note their riding habits, followed by a researcher-administered interview on riding and injury history. The interviews will be administered in Arabic and English using Qualtrics software on handheld tablets with offline and online entry mode. In addition, paper-based entry with the same format will be used as a contingency in busy quad bike locations. Conclusion: The objective of this study protocol is to develop a comprehensive survey that will furnish substantial evidence for the formulation of effective injury prevention strategies. To enhance the credibility of the recorded riding behaviors, field observations will be employed. The uniqueness of this study lies in its innovative sampling strategy, custom-tailored to accommodate the highly mobile and transient population of desert bikers in the UAE. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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22. Exploring the wellbeing of ambulance staff using the 'public value' perspective: opportunities and challenges for research.
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Heath, Geoffrey, Wankhade, Paresh, and Murphy, Peter
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PUBLIC value ,WELL-being ,COVID-19 pandemic ,AMBULANCES ,PUBLIC administration ,BUDGET cuts - Abstract
This paper investigates the problematic nature of ambulance paramedics' wellbeing and applies the conceptualizations and theoretical perspective of public value (PV) to understand and potentially improve their experience. It synthesizes previous discourse from public accounting and public management and applies it to NHS ambulance services which have been prominent in the response to the Covid-19 pandemic but are currently under-researched in public management literature. The authors suggest a future interdisciplinary research agenda. This paper explores how a public service policy and delivery system based on the notions of public value could be developed and implemented for emergency services staff. The authors focus on the wellbeing of NHS ambulance personnel; demonstrating that the wellbeing of the provider, as well as the public service recipient, should be considered in the evaluation of public services. During the Covid-19 pandemic, there was a surge of support for frontline healthcare staff, including ambulance workers. For example, in the UK, there were regular public 'claps for carers', celebrating healthcare 'heroes'. However, this may shift attention from more pressing issues, such as budget cuts and working conditions. It also puts more stress on staff to perform 'heroically': risking their own health and wellbeing. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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- View/download PDF
23. Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users.
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Evans, Bridie A., Khanom, Ashra, Edwards, Adrian, Edwards, Bethan, Farr, Angela, Foster, Theresa, Fothergill, Rachael, Gripper, Penny, Gunson, Imogen, Porter, Alison, Rees, Nigel, Scott, Jason, Snooks, Helen, and Watkins, Alan
- Subjects
AMBULANCES ,INTERVIEWING ,PATIENTS' attitudes ,EXPERIENCE ,QUALITATIVE research ,SOUND recordings ,THEMATIC analysis ,DATA analysis software ,MEDICAL case management ,PATIENT-professional relations ,EMERGENCY medicine ,POLICE - Abstract
Introduction: People who call emergency ambulances frequently are often vulnerable because of health and social circumstances, have unresolved problems or cannot access appropriate care. They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency services and is available in some UK regions. We report results of interviews with people who use emergency ambulance services frequently to understand their experiences of calling and receiving treatment. Methods: We used a two‐stage recruitment process. A UK ambulance service identified six people who were known to them as frequently calling emergency services. Through third‐sector organisations, we also recruited nine individuals with healthcare experiences reflecting the characteristics of people who call frequently. We gained informed consent to record and transcribe all telephone interviews. We used thematic analysis to explore the results. Results: People said they make frequent calls to emergency ambulance services as a last resort when they perceive their care needs are urgent and other routes to help have failed. Those with the most complex health needs generally felt their immediate requirements were not resolved and underlying mental and physical problems led them to call again. A third of respondents were also attended to by police and were arrested for behaviour associated with their health needs. Those callers receiving case management did not know they were selected for this. Some respondents were concerned that case management could label frequent callers as troublemakers. Conclusion: People who make frequent calls to emergency ambulance services feel their health and care needs are urgent and ongoing. They cannot see alternative ways to receive help and resolve problems. Communication between health professionals and service users appears inadequate. More research is needed to understand service users' motivations and requirements to inform design and delivery of accessible and effective services. Patient or Public Contribution: People with relevant experience were involved in developing, undertaking and disseminating this research. Two public contributors helped design and deliver the study, including developing and analysing service user interviews and drafting this paper. Eight public members of a Lived Experience Advisory Panel contributed at key stages of study design, interpretation and dissemination. Two more public contributors were members of an independent Study Steering Committee. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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24. Development of prehospital emergency care in Singapore.
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Nadarajan, Gayathri Devi, Jalil, Nurul Asyikin Binte Mohamed, White, Alexander Elgin, Hock, Marcus Ong Eng, and Venkataraman, Anantharaman
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HEALTH services accessibility ,AMBULANCES ,PUBLIC administration ,EMERGENCY medical services ,EMERGENCY medicine - Abstract
This review paper describes the development of the pre-hospital system in Singapore from the pre-war days. Every country's prehospital community needs a deep understanding of how they developed over the years, factors that played a part, and the aspirations their community and government have set for this. This can guide future evolution of the services to ensure that care provided is relevant, applicable and in keeping with the community's needs. Countries with similar contextual circumstances, but at a different stage of development of their PECs, may learn from these. [ABSTRACT FROM AUTHOR]
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- 2024
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25. The Antietam Staff Walk at the Uniformed Services University: A Program Evaluation.
- Author
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Cole, Rebekah, Van Shufflin, Matthew W, Smith, Dale C, and Woodard, Scott C
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- *
COURSE evaluation (Education) , *MEDICAL students , *AMBULANCES , *MILITARY medicine , *PREVENTIVE medicine , *BATTLE casualties , *MILITARY officers - Abstract
Introduction: The battle along Antietam Creek in September 1862 was pivotal in shaping future combat medical readiness practices. With the full confidence of his commander, Major (Dr) Jonathan Letterman implemented an innovative ambulance corps system, which contributed immensely to modern-day battlefield medicine. Each year, the Uniformed Services University (USU) holds the Antietam Staff Walk, during which military medical students are engaged by faculty at various "stops" along the 6-mile walk. The four learning objectives for the Antietam Staff Walk are to (1) introduce the role of the "staff ride," (2) orient learners to reading terrain, (3) reinforce the six principles of health service support, and (4) recall the heritage of the military medical officer. The Department of Military and Emergency Medicine at USU commissioned a program evaluation to determine if these course objectives were being met, evaluate the effectiveness of the Antietam Staff Walk as a teaching tool, and make recommendations for improving its educational impact. Materials and Methods: We engaged in qualitative program evaluation to evaluate the Antietam Staff Walk course objectives. Our research team analyzed 156 reflection papers written by second-year military medical students attending Antietam in August 2021. We coded each of the papers, noting important words and phrases that were salient to the students' learning experiences at Antietam. Our research team then compiled each of these codes into a master list and then determined how to divide this list into major categories. We collectively defined each of these categories, which served as the resulting themes of this program evaluation. Results: Three themes emerged: (1) creation of an ambulance corps allows for proximal battlefield medicine, (2) a lack of buddy aid inspires Tactical Casualty Combat Care, and (3) disease/nonbattle injury necessitates preventative medicine. The students foremost gained an appreciation for the impact of the ambulance corps and recognized that the ambulance corps not only impacted medical care, but also the mission as a whole. However, may not have completely understood the long, slow evolution of battlefield care and may have overestimated the knowledge of physicians practicing mid-19th century medicine. We provided recommendations for addressing these learning opportunities during future Antietam Staff Walks at USU. Conclusions: Our review of the Antietam Staff Ride resulted in several curricular recommendations for enhancing its learning impact. Our program evaluation serves as a model for line units and other military organizations to optimize the impact of the historical staff ride as a teaching tool. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Optimized Ambulance Allocation Using Hybrid PSOGA for Improving the Ambulance Service.
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Gupta, Hina and Zaheeruddin
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- *
AMBULANCES , *AMBULANCE service , *PARTICLE swarm optimization , *EMERGENCY medical services , *TRAVEL time (Traffic engineering) , *GENETIC algorithms , *CROP allocation - Abstract
Emergency Medical Service (EMS) is an integral part of the healthcare system that works dedicatedly to save the lives of people. The prime responsibility of any EMS provider is to offer a timely response to the person in need. The timely assistance increases the chances of survivability of a person. In India, escalating count of road accidents has increased the demand for ambulance services to provide pre-hospital treatment or transportation of victims to the hospital. This paper presents a new optimization strategy of Hybrid Particle Swarm Optimization and Genetic Algorithm (HPSOGA) for ambulance allocation to reduce the ambulance response time. Considering a set of assumptions, the authors have applied the new strategy for allocating 50 ambulances to 11 base stations in Southern Delhi. The working environment of EMS which includes stochastic requests, travel time, and dynamic traffic conditions have been taken into account to attain accurate results. The new optimization strategy of HPSOGA has been implemented in a MATLAB environment to find an optimized allocation plan with minimum response time. With the proposed algorithm the authors have been able to reduce the average response time by 11.61%. The paper also presents the comparison of HPSOGA, Genetic Algorithm (GA), and Particle Swarm Optimization (PSO) for the stated problem. The algorithms are compared in terms of objective value (response time), convergence rate, and constancy repeatability to conclude that HPSOGA performs better than the other two algorithms. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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27. The impact on ambulance mobilisations of an increasing age profile of telecare service users receiving advanced proactive, personalised telecare in Spain - a longitudinal study 2014-2018.
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Contreras, Wendy Hugoosgift, Sarquella, Ester, Binefa, Eva, Entrambasaguas, Mar, Stjerne, Anette, and Booth, Peter
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AMBULANCES ,PATIENT-centered care ,CONFERENCES & conventions ,TELEMEDICINE - Abstract
Introduction: Spain is one of the leading countries in the application of proactive and personalised telecare to help support frail and vulnerable service users to live independently in their own homes for longer*. Concern was however noted regarding potential impacts on ambulance mobilisations as time in the service, and mean age at cessation, increased by 1.3 years. Aims, Objectives, Theory and Methods: The purpose of this study was to investigate these impacts. A longitudinal study of a telecare service user population in Spain (n=202.1k to 247.9k) was undertaken using anonymised operational data collected in the delivery of proactive and personalised telecare services by Televida Servicios Sociosanitarios over the period 2014-18. The population was subject to change over time as new service users became eligible to register for the service, and others ceased the service. Each of these factors were also studied to assess potential confounding or covariate factors in the population also influencing the mobilisation of ambulances. Key Findings: For the studied population, ambulance mobilisation on a per-person/per-annum (pp/pa) basis reduced over the period despite the increasing age profile at cessation and with the characteristics of the population at registration remaining otherwise similar over the period. Overall mobilisations reduced by 27.9% (0.665 to 0.479 pp/pa) over the period whilst for ambulances there was a reduction of 33.3% (0.461 to 0.307 pp/pa). There were also smaller reductions in the number for family and state security mobilisations. The study identified the positive correlation coefficient between ambulance mobilisations and service user's dependency levels, and marginal negative correlation in older age bands. We are aware of no other studies which have investigated the impact on ambulance mobilisations of advanced proactive telecare and the increasing age of the services users supported to continue living independently. We believe this paper, therefore, contributes new insight which extends the existing research literature. Conclusions: The increasing age at cessation has not correlated with an increased proportion of higher dependency service users. The share of those over 85 years in the high dependency level decreased. This indicates that the changes in the telecare service contributing to increased time living independently may also have helped service users remain in lower risk bands. Limitations: There is a risk that use of mean annual measures may obscure important variations within the data. Changes in levels of proactivity, personalisation and increased use of sophisticated monitoring sensors of the telecare services are not the subject of this paper, but addressed in part in allied research. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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28. Driving the ambulance: an essential component of emergency medical services: an integrative review.
- Author
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Becker, Julia and Hugelius, Karin
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EMERGENCY medical services ,MEDICAL care ,AMBULANCES ,TRANSPORTATION of patients ,PATIENTS' attitudes - Abstract
Background: The transport of patients from one location to another is a fundamental part of emergency medical services. However, little interest has been shown in the actual driving of the ambulance. Therefore, this review aimed to investigate how the driving of the ambulance affects the patient and the medical care provided in an emergency medical situation.Methods: A systematic integrative review using both quantitative and qualitative designs based on 17 scientific papers published between 2011 and 2020 was conducted.Results: Ambulance driving, both the actual speed, driving pattern, navigation, and communication between the driver and the patient, influenced both the patient's medical condition and the possibility of providing adequate care during the transport. The driving itself had an impact on prehospital time spent on the road, safety, comfort, and medical issues. The driver's health and ability to manage stress caused by traffic, time pressure, sirens, and disturbing moments also significantly influenced ambulance transport safety.Conclusions: The driving of the ambulance had a potential effect on patient health, wellbeing, and safety. Therefore, driving should be considered an essential part of the medical care offered within emergency medical services, requiring specific skills and competence in both medicine, stress management, and risk approaches in addition to the technical skills of driving a vehicle. Further studies on the driving, environmental, and safety aspects of being transported in an ambulance are needed from a patient's perspective. [ABSTRACT FROM AUTHOR]- Published
- 2021
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- View/download PDF
29. The Effect of Heat Events on Prehospital and Retrieval Service Utilization in Rural and Remote Areas: A Scoping Review.
- Author
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O'Donnell, Elen, Honan, Bridget, Quilty, Simon, and Schultz, Rebecca
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HEAT ,AMBULANCES ,SYSTEMATIC reviews ,LITERATURE reviews ,RURAL population - Abstract
Introduction: It is well-established that heatwaves increase demand for emergency transport in metropolitan areas; however, little is known about the impact of heat events on demand for prehospital retrieval services in rural and remote areas, or how heatwaves are defined in this context.Inclusion Criteria: Papers were eligible for inclusion if they reported on the impact of a heat event on the activity of a prehospital and retrieval service in a rural or remote area.Methods: A search of PubMed, Cochrane, Science Direct, CINAHL, and Google Scholar databases was undertaken on August 18, 2020 using search terms related to emergency medical transport, extreme heat, and rural or remote. Data relevant to the impact of heat on retrieval service activity were extracted, as well as definitions of extreme heat.Results: Two papers were identified, both from Australia. Both found that heat events increased the number of road ambulance call-outs. Both studies used the Excess Heat Factor (EHF) to define heatwave periods of interest.Conclusions: This review found almost no primary literature on demand for prehospital retrieval services in rural and remote areas, and no data specifically related to aeromedical transport. The research did recognize the disproportionate impact of heat-related increase in service demand on Australian rural and regional health services. With the effects of climate change already being felt, there is an urgent need for more research and action in this area. [ABSTRACT FROM AUTHOR]- Published
- 2021
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- View/download PDF
30. Simulation-based education as a provider of fieldwork insights – experiences of ambulance nurse specialist students.
- Author
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Andersson, Ulf, Boysen, Gabriella Norberg, and Sterner, Anders
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RESEARCH ,AMBULANCES ,SIMULATED patients ,SIMULATION methods in education ,TRANSPORTATION of patients ,HUMAN anatomical models ,FIELDWORK (Educational method) ,EXPERIENCE ,QUALITATIVE research ,SURVEYS ,STUDENTS ,DESCRIPTIVE statistics ,GRADUATE students ,NURSING students ,CONTENT analysis ,THEMATIC analysis ,EMERGENCY nursing ,EDUCATIONAL outcomes - Abstract
Background: Medicine is facing a global shortage of nurses, including those with postgraduate education. One suggested educational method for undergraduate and postgraduate education, such as specialist ambulance nurse education, is simulation-based education (SBE). The implementation of SBE is motivated, in part, by the desire to attract and retain students, but also to contribute to student learning. Consequently, the use of SBE is increasing in specialist ambulance nurse education. The aim of this study was to explore how specialist ambulance nursing students experience SBE. Methods: This qualitative survey study involved the collection of study data using a purposefully designed, paper-based survey comprising five open-ended questions that required participant free-text answers. The answers were analysed using inductive content analysis and searching for descriptions of the participants' experiences. The survey was presented to 35 specialist ambulance nursing students. Results: The results are presented in two themes: SBE as learning and SBE as an educational method. Participating in SBE during the programme provides students with a realistic understanding of their future profession and its expected demands. The learning experience disregards prior work experience in ambulance services. Conclusions: Based on the findings, conclusions are that SBE is an appreciated educational method among nursing students, regardless of their prior experience in the field of prehospital care. To some extent, this differs from previous research findings related to this subject. Furthermore, SBE contributes to the provision of field work insights, preparing the ambulance nurse specialist students. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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- View/download PDF
31. Regularised Semi-parametric Composite Likelihood Intensity Modelling of a Swedish Spatial Ambulance Call Point Pattern.
- Author
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Bayisa, Fekadu L., Ådahl, Markus, Rydén, Patrik, and Cronie, Ottmar
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POISSON processes ,AMBULANCES ,SOCIOECONOMIC status ,POPULATION density ,BANDWIDTHS ,POINT processes - Abstract
Motivated by the development of optimal dispatching strategies for prehospital resources, we model the spatial distribution of ambulance call events in the Swedish municipality Skellefteå during 2014–2018 in order to identify important spatial covariates and discern hotspot regions. Our large-scale multivariate data point pattern of call events consists of spatial locations and marks containing the associated priority levels and sex labels. The covariates used are related to road network coverage, population density, and socio-economic status. For each marginal point pattern, we model the associated intensity function by means of a log-linear function of the covariates and their interaction terms, in combination with lasso-like elastic-net regularized composite/Poisson process likelihood estimation. This enables variable selection and collinearity adjustment as well as reduction of variance inflation from overfitting and bias from underfitting. To incorporate mobility adjustment, reflecting people's movement patterns, we also include a nonparametric (kernel) intensity estimate as an additional covariate. The kernel intensity estimation performed here exploits a new heuristic bandwidth selection algorithm. We discover that hotspot regions occur along dense parts of the road network. A mean absolute error evaluation of the fitted model indicates that it is suitable for designing prehospital resource dispatching strategies. Supplementary materials accompanying this paper appear online. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
32. Developing a prehospital care service in a low‐resource setting: Barriers and solutions.
- Author
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Takoutsing, Berjo D. and Zolo, Yvan
- Subjects
RESOURCE-limited settings ,EMERGENCY medical services ,MEDICAL care ,COMMUNICABLE diseases ,EPIDEMIOLOGICAL transition ,NON-communicable diseases - Abstract
Prehospital care (PHC) is critical to the comprehensive and effective functioning of a healthcare system. Given the disproportionate burden of both communicable and non‐communicable diseases in low‐income nations, its significance cannot be understated. In spite of this, many of these nations lack a comprehensive PHC system. Setting up a cost‐effective PHC system in this environment can be difficult and necessitate a variety of stakeholders at various healthcare delivery system levels. Therefore, it is necessary to consider these anticipated barriers and identify feasible solutions for its execution. This will assist in creating a PHC system that is suited to the local needs and achieve sustainable and global health goals. This paper describes the challenges and solutions to establishing a prehospital care service in a low‐resource setting. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
33. A mixed-integer programming model for identifying intuitive ambulance dispatching policies.
- Author
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Albert, Laura A.
- Subjects
AMBULANCES ,INTEGER programming ,MARKOV processes ,PRODUCTION planning ,CONSUMERS - Abstract
Markov decision process models and algorithms can be used to identify optimal policies for dispatching ambulances to spatially distributed customers, where the optimal policies indicate the ambulance to dispatch to each customer type in each state. Since the optimal solutions are dependent on Markov state variables, they may not always correspond to a simple set of rules when implementing the policies in practice. Restricted policies that conform to a priority list for each type of customer may be desirable for use in practice, since such policies are transparent, explainable, and easy to implement. A priority list policy is an ordered list of ambulances that indicates the preferred order to dispatch the ambulances to a customer type subject to ambulance availability. This paper proposes a constrained Markov decision process model for identifying optimal priority list policies that is formulated as a mixed integer programming model, does not extend the Markov state space, and can be solved using standard algorithms. A series of computational examples illustrate the benefit of intuitive policies. The optimal mixed integer programming solutions to the computational examples have objective function values that are close to those of the unrestricted model and are superior to those of heuristics. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
34. Driving Assistance System for Ambulances to Minimise the Vibrations in Patient Cabin.
- Author
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Aldegheishem, Abdulaziz, Alrajeh, Nabil, Parra, Lorena, Romero, Oscar, and Lloret, Jaime
- Subjects
AMBULANCES ,AMBULANCE service ,TEST systems ,OVERALL survival ,TASK performance - Abstract
The ambulance service is the main transport for diseased or injured people which suffers the same acceleration forces as regular vehicles. These accelerations, caused by the movement of the vehicle, impact the performance of tasks executed by sanitary personnel, which can affect patient survival or recovery time. In this paper, we have trained, validated, and tested a system to assess driving in ambulance services. The proposed system is composed of a sensor node which measures the vehicle vibrations using an accelerometer. It also includes a GPS sensor, a battery, a display, and a speaker. When two possible routes reach the same destination point, the system compares the two routes based on previously classified data and calculates an index and a score. Thus, the index balances the possible routes in terms of time to reach the destination and the vibrations suffered in the patient cabin to recommend the route that minimises those vibrations. Three datasets are used to train, validate, and test the system. Based on an Artificial Neural network (ANN), the classification model is trained with tagged data classified as low, medium, and high vibrations, and 97% accuracy is achieved. Then, the obtained model is validated using data from three routes of another region. Finally, the system is tested in two new scenarios with two possible routes to reach the destination. The results indicate that the route with less vibration is preferred when there are low time differences (less than 6%) between the two possible routes. Nonetheless, with the current weighting factors, the shortest route is preferred when time differences between routes are higher than 20%, regardless of the higher vibrations in the shortest route. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
35. Modifiable factors to prevent severe hypoglycaemic and diabetic ketoacidosis presentations in people with type 1 diabetes.
- Author
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Tamsett, Zacchary, James, Steven, Brown, Fran, O'Neal, David N., and Ekinci, Elif I.
- Subjects
- *
INSULIN therapy , *TYPE 1 diabetes , *PATIENT education , *GLYCEMIC control , *CINAHL database , *DIABETIC acidosis , *SEVERITY of illness index , *DESCRIPTIVE statistics , *HOSPITAL emergency services , *SYSTEMATIC reviews , *MEDLINE , *MEDICAL emergencies , *MEDICAL databases , *CONTINUOUS glucose monitoring , *AMBULANCES , *PUBLIC health , *HYPOGLYCEMIA , *DIABETES , *MEDICAL care costs , *DISEASE complications - Abstract
Aims: In tackling rising diabetes‐related emergencies, the need to understand and address emergency service usage by people with type 1 diabetes is vital. This review aimed to quantify current trends in presentations for type 1 diabetes‐related emergencies and identify public health strategies that reduce the frequency of diabetes‐related emergencies and improve glycaemic management. Methods: Medline (OVID), Cochrane and CINAHL were searched for studies published between 2000 and 2023, focusing on people with type 1 diabetes, severe hypoglycaemia and/or diabetic ketoacidosis, and ambulance and/or emergency department usage. There were 1313 papers identified, with 37 publications meeting review criteria. Results: The incidence of type 1 diabetes‐related emergencies varied from 2.4 to 14.6% over one year for hypoglycaemic episodes, and between 0.07 and 11.8 events per 100 person‐years for hyperglycaemic episodes. Notably, our findings revealed that ongoing diabetes education and the integration of diabetes technology, such as continuous glucose monitoring and insulin pump therapy, significantly reduced the incidence of these emergencies. However, socio‐economic disparities posed barriers to accessing these technologies, subsequently shifting the cost to emergency healthcare and highlighting the need for governments to consider subsidising these technologies as part of preventative measures. Conclusions: Improving access to continuous glucose monitoring and insulin pump therapy, in combination with ongoing diabetes education focusing on symptom recognition and early management, will reduce the incidence of diabetes‐related emergencies. Concurrent research assessing emergency healthcare usage patterns during the implementation of such measures is essential to ensure these are cost‐effective. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
36. Effects of the COVID-19 Pandemic on Prehospital Emergency Care for Adults with Stroke and Transient Ischaemic Attack: A Systematic Review and Meta-Analysis.
- Author
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Burton, Edel, Aladkhen, Johnny, O'Donnell, Cathal, Masterson, Siobhán, Merwick, Áine, McCarthy, Vera JC, Kearney, Patricia M., and Buckley, Claire M.
- Subjects
MEDICAL information storage & retrieval systems ,RESEARCH funding ,EMERGENCY medicine ,EMERGENCY medical services ,QUANTITATIVE research ,META-analysis ,MEDLINE ,SYSTEMATIC reviews ,AMBULANCES ,STROKE ,ONLINE information services ,COVID-19 pandemic ,TRANSIENT ischemic attack - Abstract
COVID-19 has challenged global health care systems and resulted in prehospital delays for time-sensitive emergencies, like stroke and transient ischemic attacks (TIA). However, there are conflicting international reports on the level of effect of the pandemic on ambulance response intervals and emergency call volumes for these conditions. The purpose of this study was to synthesize the international evidence on the effect of COVID-19 on ambulance response intervals and emergency call volume for suspected stroke and TIA. Following a published protocol, we conducted a systematic search of six databases through May 31, 2022. We re-ran this search on April 14, 2023, to check for any new papers. We considered for inclusion peer-reviewed quantitative studies comparing prehospital emergency care for adults with suspected stroke/TIA before and during the COVID-19 pandemic. Two authors screened title/abstract and full text articles. One author carried out data extraction, with a random selection of articles being checked by another author. We calculated overall pooled estimates of ambulance intervals (activation, response, patient care, and total prehospital intervals) and stroke/TIA emergency call volume. Subgroup and sensitivity analyses included location and stroke/TIA diagnosis. Two authors assessed study quality using the appropriate Joanna Briggs Institute tool. We worked with patient and public involvement contributors and clinical and policy stakeholders throughout the review. Of 4,083 studies identified, 52 unique articles met the inclusion criteria. Mean response interval (-1.29 min [-2.19 to -0.38]) and mean total prehospital interval (-6.42 min [-10.60 to -2.25]) were shorter in the pre-COVID-19 period, compared to the COVID-19 period. Furthermore, there was a higher incidence rate of emergency call volume for suspected stroke/TIA per day pre-COVID-19 compared with the COVID-19 period (log IRR = 0.17 [0.02 to 0.33]). Ambulance response interval definitions and terminology varied between regions and countries. Our review indicates that prehospital delays for suspected stroke/TIA increased during the COVID-19 pandemic. Furthermore, emergency call volume for suspected stroke/TIA decreased during this period. In order to minimize delays in future pandemics or other health care emergencies future research may involve understanding the potential reasons for these delays. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
37. The role of lifestyle on NHS ambulance workers' wellbeing.
- Author
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Hutchinson, Lucy C., Forshaw, Mark J., McIlroy, David, and Poole, Helen
- Subjects
MENTAL health personnel ,AMBULANCES ,JOB stress ,ALCOHOL drinking ,MENTAL health ,PHYSICAL activity - Abstract
The role of lifestyle on mental health in the ambulance worker population is unclear. The aim of this paper is to explore the role and impact of lifestyle on the mental health of ambulance workers within the United Kingdom (UK). Participants (N = 160) were recruited from 4 NHS ambulance trusts in England. Data were collected on lifestyle factors (sleep, physical activity and alcohol use) and mental health outcomes (trauma, anxiety, depression and stress); these were assessed by use of various questionnaires including validated measures. Sleep was shown to be the single biggest unique and significant predictor to all mental health outcomes. Suggestions for future research and intervention are considered. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
38. THE CRIMEAN WAR AND THE FORMATION OF THE MEDICAL STAFF CORPS
- Author
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Sweetman, John
- Published
- 1975
39. Risk-averse flexible policy on ambulance allocation in humanitarian operations under uncertainty.
- Author
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Yu, Guodong, Liu, Aijun, and Sun, Huiping
- Subjects
AMBULANCES ,MARKOV processes ,STOCHASTIC dominance ,EMERGENCY medical services ,CONCAVE functions - Abstract
Proactive ambulance management is constructive to improve the response efficiency for emergency medical service (EMS) systems under uncertainty. In this paper, we present a dynamic optimisation model concerning the ambulance dispatching and relocation. We develop a flexible operation policy driven by the interval rolling to match vehicles with calls in batch. We formulate the problem in Markov Decision Process and incorporate M / G / c queues to minimise the average response and delay time. Considering the curse-of-dimensionality, we provide a simulation-based empirical dynamic programming with the state aggregation and post-decision state to solve the model. To further accelerate the computational efficiency, a greedy heuristic method is introduced to improve the quality of sampling operations. Then, a risk-averse model is developed based on the stochastic dominance strategy to improve operational reliability. We develop an equivalent linear programming to evaluate concave dominating functions. We test the performance by a numerical case and extract managerial insights for practitioners. Our results show that the proposed flexible and risk-averse solution outperforms the classic model on reducing the delay under uncertain calls. And the improvement is more active during peak hours, when real-time needs exceed available ambulances. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
40. Artificial Intelligence-Powered Contactless Face Recognition Technique for Internet of Things Access for Smart Mobility.
- Author
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Hiremani, Nirmala, Hasan, Mohammad Kamrul, Basavaraju, T. G., Islam, Shayla, Alboaneen, Dabiah, Alkayal, Entisar, Alharbi, Nesreen M., Mansor, Zulkefli, and Amanlou, Sanaz
- Subjects
FACE perception ,HUMAN facial recognition software ,INTERNET of things ,AMBULANCES ,INTERNET access ,ARTIFICIAL intelligence ,INTELLIGENT transportation systems ,SMART devices - Abstract
A contactless system became necessary for smart mobility during the COVID-19 pandemic. There are many touchpoints in private and public areas where contact is essential, such as intelligent transportation systems for vaccine carriers, patient ambulances, elevators, metros, buses, hospitals, and banks. A secured contactless device reduces the chances of COVID-19 infection spread. Several devices use smart cards, fingerprint identification, or code-based access. Most of these devices require some form of touch. The cost of such devices varies, depending on their capability and intended use. Sensors developed by using artificial intelligence (AI) to provide secured access are an emerging area. This paper presents an AI-powered contactless face recognition system. The solution has the Internet of Things (IoT) enabled access system. To identify a person, it uses AI assistance for face recognition with the help of Python Dlib's facial recognition network. Dlib offers a wide range of functionality across several machine learning sectors and is open-source. The Arduino Uno (ATmega328P) and STK500 protocol has been used for communication to testify and validate the performance of the proposed technique. The objective is to detect and recognize faces by the proposed contactless approach. The obtained result shows 92% accuracy, 94% sensitivity, 96% precision and FRR 6% for face detection. There is a significant improvement in FRR in our work compared to the published 27.27%. The implemented solution in this paper provides accurate and secure contactless access to conventional, readily available techniques in public health safety. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
41. Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review.
- Author
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Armstrong, Stephanie, Langlois, Adele, Laparidou, Despina, Dixon, Mark, Appleton, Jason P., Bath, Philip M., Snooks, Helen, and Siriwardena, A. Niroshan
- Subjects
RANDOMIZED controlled trials ,AMBULANCE service ,INFORMED consent (Medical law) ,EMERGENCY medical technicians ,AIRWAY (Anatomy) ,AMBULANCES ,EMERGENCY medical services ,EMERGENCY medicine ,RESEARCH funding ,SYSTEMATIC reviews - Abstract
Background: We sought to understand the main ethical considerations when conducting clinical trials in the prehospital ambulance based setting.Methods: A systematic review of the literature on randomised controlled trials in ambulance settings was undertaken. A search of eight databases identified published studies involving recruitment of ambulance service users. Four independent authors undertook abstract and full-text reviews to determine eligibility and extract relevant data. The data extraction concentrated on ethical considerations, with any discussion of ethics being included for further analysis. The resultant data were combined to form a narrative synthesis.Results: In all, 56 papers were identified as meeting the inclusion criteria. Issues relating to consent were the most significant theme identified. Type of consent differed depending on the condition or intervention being studied. The country in which the research took place did not appear to influence the type of consent, apart from the USA where exception from consent appeared to be most commonly used. A wide range of terms were used to describe consent.Conclusions: Consent was the main ethical consideration in published ambulance based research. A range of consent models were used ranging from informed consent to exception from consent (waiver of consent). Many studies cited international guidelines as informing their choice of consent model but diverse and sometimes confused terms were used to describe these models. This suggests that standardisation of consent models and the terminology used to describe them is warranted. [ABSTRACT FROM AUTHOR]- Published
- 2017
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42. A participatory ergonomics intervention to re-design work and improve the musculoskeletal health of paramedics: protocol for a cluster randomised controlled trial.
- Author
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Davies, Karen, Weale, Victoria, and Oakman, Jodi
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EMERGENCY medical technicians ,AMBULANCES ,AMBULANCE service ,ERGONOMICS ,MUSCULOSKELETAL pain ,EMPLOYEE participation in management ,MUSCULOSKELETAL system diseases - Abstract
Background: In this paper, we present the protocol for a cluster randomised controlled trial to evaluate the effectiveness and implementation of a participative risk management intervention to address work-related musculoskeletal disorders (WMSDs). The aims of the study include to evaluate the implementation process and the impact of the intervention on work related musculoskeletal pain and discomfort and exposure to physical and psychosocial hazards in paramedics over a 12-month period. Methods: The intervention in this study is to implement A Participative Hazard Identification and Risk Management (APHIRM) toolkit in an ambulance service. Eighteen work groups containing eligible participants (registered paramedics) will be randomised into the intervention or wait-list control arm in one of three rolling recruitment periods. The APHIRM toolkit survey will be offered at baseline and 12 months later, to all current eligible participants in each work group allocated to the trial. The intervention work groups will receive the remainder of the APHIRM toolkit procedures. Identifying data about individual participants will not be collected in the survey, to protect participant privacy and encourage participation. Changes in primary (musculoskeletal pain and discomfort) and secondary (exposure to physical and psychosocial hazards at work) outcomes measured in the survey will be analysed comparing the baseline and follow up response of the cluster. A process evaluation is included to analyse the implementation and associated barriers or facilitators. Discussion: This study is important in providing a comprehensive approach which focusses on both physical and psychosocial hazards using worker participation, to address WMSDs, a well-known and significant problem for ambulance services. The effectiveness of the intervention in work groups will be rigorously evaluated. If significant positive results are observed, the intervention may be adopted in ambulance services, both nationally and internationally. Trial registration: ISRCTN77150219. Registered 21 November 2021. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
43. Displaced risk. Keeping mothers and babies safe: a UK ambulance service lens.
- Author
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Heys, Stephanie, Main, Camella, Humphreys, Aimee, and Torrance, Rachael
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MATERNAL-child health services ,HEALTH services accessibility ,AMBULANCES ,EMERGENCY medical technicians ,NATIONAL health services ,INTERPROFESSIONAL relations ,INTEGRATED health care delivery ,EMERGENCY medicine ,PATIENT safety - Abstract
Aim: The aim of this professional practice paper is to provide a critical commentary on displaced risk among perinatal and neonatal patients attended to by the ambulance service. Background: NHS services across the United Kingdom are currently facing unprecedented demand and increased scrutiny in their ability to provide safe and personalised care to patients. While current focus in the system centres around addressing social care demand, hospital bed capacity, planned care waiting times, staffing and ambulance handover delays, a less explored cohort of patients impacted by the current healthcare crisis is perinatal and neonatal populations attended to by the ambulance service. Little focus has been paid within national agendas to the care provided to women and babies outside of planned maternity and obstetric care. A case is presented to highlight the importance of considering urgent and emergency maternity care provision provided by the ambulance service, and the impact of 'displaced risk' due to the current pressures within healthcare systems. Conclusion: Placed in a national context, drawing upon current independent reviews into maternity services, national transformation agendas and the most recent MBRRACE-UK confidential enquiry into maternal deaths and morbidity, a case is made to commissioners and Integrated Care Systems to focus on and invest in the unplanned pre-hospital care of maternity and neonatal patients. Recognition of the ambulance service as a key provider of care to this cohort of patients is paramount, calling on services and systems to work together on realising and addressing displaced risk for perinatal populations across the United Kingdom. A system approach that acknowledges the need for high-quality care at every point of contact and equitability in access to services for pregnant, postpartum and neonatal patients is vital. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
44. 'An accident waiting to happen' ‐ experiences of police officers, paramedics, and mental health clinicians involved in 911‐mental health crises: a cross‐sectional survey.
- Author
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Kuehl, Silke, Kim, Alice Hyun Min, and Every‐Palmer, Susanna
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MENTAL health personnel ,ACCIDENTS ,SUICIDE ,WORK ,ATTITUDES of medical personnel ,AMBULANCES ,CROSS-sectional method ,RESEARCH methodology ,EMERGENCY medical technicians ,QUANTITATIVE research ,FISHER exact test ,SURVEYS ,SUICIDAL ideation ,COMPARATIVE studies ,PSYCHOSOCIAL factors ,EXPERIENTIAL learning ,DESCRIPTIVE statistics ,HEALTH care teams ,RESEARCH funding ,CHI-squared test ,POLICE psychology ,EMERGENCY medical personnel ,CONTENT analysis ,MISINFORMATION ,DATA analysis software ,TRUST ,CRISIS intervention (Mental health services) ,PSYCHIATRIC emergencies - Abstract
Accessible Summary: What is known on the subject: Police and ambulance staff are increasingly asked to help people experiencing mental health crises, but they often feel under‐prepared.The single frontline service approach is time‐intensive and risks a coercive pathway to care.The emergency department is the default location for transfers by police or ambulance involving a person involved in a mental health crisis, despite being viewed as suboptimal. What the paper adds to existing knowledge: Police and ambulance staff struggled keeping up with the mental health demand, reporting inadequate mental health training, little enjoyment and negative experiences when trying to access help from other services.Most mental health staff had adequate mental health training and enjoyed their work, but many experienced difficulties getting help from other services.Police and ambulance staff found it hard to work with mental health services. What are the implications for practice: The combination of limited training, poor interagency referral processes, and difficulties accessing support from mental health services means that when police and ambulance services attend mental health crises alone, distress may be heightened and prolonged. Enhanced mental health training for first responders and more streamlined referral processes may improve process and outcomes.Mental health nurses have key skills that could be utilized in assisting police and ambulance staff who attend 911 emergency mental health calls.New models such as co‐response teams, whereby police, mental health clinicians and ambulance staff respond conjointly should be trialled and evaluated. Introduction: First responders are increasingly called to assist people experiencing mental health crises but little research exists canvassing multi‐agency perspectives of such work. Aim/Question: To understand the views of police officers, ambulance and mental health staff attending mental health or suicide‐related crises in Aotearoa New Zealand and to discover how they experience current models of cross‐agency collaboration. Methods: A descriptive cross‐sectional survey involving mixed methods. Quantitative data were analysed using descriptive statistics and free text by content analysis. Results: Participants included 57 police officers, 29 paramedics and 33 mental health professionals. Mental health staff felt adequately trained, but only 36% described good processes for accessing inter‐agency support. Police and ambulance staff felt undertrained and unprepared. Accessing mental health expertise was considered difficult by 89% of police and 62% of ambulance staff. Discussion: Frontline services struggle managing mental health‐related 911 emergencies. Current models are not working well. Miscommunication, dissatisfaction and distrust exist between police, ambulance and mental health services. Conclusion: The single‐agency frontline response may be detrimental to service users in crisis and under‐utilizes the skills of mental health staff. New ways of inter‐agency cooperation are required, such as co‐located police, ambulance and mental health nurses responding in partnership. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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45. Simulating emergency patient flow during the COVID-19 pandemic.
- Author
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Bovim, Thomas Reiten, Gullhav, Anders N., Andersson, Henrik, Dale, Jostien, and Karlsen, Kjetil
- Abstract
The work presented in this paper is based on two projects that were conducted at St. Olavs Hospital (Norway) when preparing for the COVID-19 pandemic. Three discrete event simulation models are provided to evaluate the resource requirements during the peak of the pandemic. First, we estimate the number of beds needed in the emergency department (ED). In the second model, we estimate the number of ambulances required to maintain prepandemic response times for emergency patients. The third model is a coupling of the two former models, and it is used to study the effects of ED boarding time for COVID-19 patients. The resource needs are analysed under different COVID-19 testing policies. A strict testing policy increases the bed requirements in the ED, while it has the opposite effect for ambulances. Two distinct mechanisms causing boarding time are found. The effects from boarding time are most prominent during night and weekends. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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- View/download PDF
46. IoT-Based Smart Patient Health Monitoring with Ambulance Tracking System for Pakistan.
- Author
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Ali, T., Haq, I. U., Mehmood, K., Imran, M., and Iftikhar, U.
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AMBULANCES ,PATIENT monitoring ,INTERNET of things ,MEDICAL equipment ,TREATMENT delay (Medicine) ,PHYSICIANS - Abstract
Healthcare is one of the most important applications of the Internet of Things (IoT), which can be used to investigate the health status of a remote patient. In this paper, an IoT-based health monitoring and ambulance tracking system is proposed. In the IoT-based health monitoring system, various parameters related to a patient's health such as heartbeat, electrocardiography, temperature are measured by certain medical devices (sensors) and transmitted through IoT devices; while in an ambulance they are sent to an internet cloud where they are stored and analyzed for pre-treatment purposes. The main premise of the research is that when an emergency occurs, the ambulance should reach the hospital as quickly as possible and send the information about the patient's condition to the hospital in question to prepare for treatment. Meanwhile, pre-treatment can also be initiated in the ambulance if the doctor recommends it after checking the patient's condition via the IoT platform. The results of this study show that the proposed strategy is very effective in saving the precious lives of patients due to delays in treatment. In addition, it is recommended that the Internet of Things (IoT) provides reliable solutions for effective patient health monitoring and treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2023
47. A Multi-Objective Facility Coverage Location Problem for Emergency Medical Service Decisions in Hajj.
- Author
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Naji, Huda Zaki, Al-Behadili, Mohanad, and Kadim, Mohammad Sari
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EMERGENCY medical services ,SEARCH algorithms ,HEALTH facilities ,PILGRIMAGE to Mecca ,AMBULANCES ,PILGRIMS & pilgrimages - Abstract
Copyright of Baghdad Science Journal is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2024
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48. Bayesian spatio-temporal modelling and prediction of areal demands for ambulance services.
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Nicoletta, Vittorio, Guglielmi, Alessandra, Ruiz, Angel, Bélanger, Valérie, and Lanzarone, Ettore
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AMBULANCE service ,AMBULANCES ,MARKOV chain Monte Carlo ,DEMAND forecasting ,MONTE Carlo method ,PREDICTION models - Abstract
Careful planning of an ambulance service is critical to reduce response times to emergency calls and make assistance more effective. However, the demand for emergency services is highly variable, and good prediction of the number of future emergency calls, and their spatial and temporal distribution, is challenging. In this work, we propose a Bayesian approach to predict the number of emergency calls in future time periods for each zone of the served territory. The number of calls is described by a generalized linear mixed effects model, and inference, in terms of posterior predictive distributions, is obtained through Markov chain Monte Carlo simulation. Our approach is applied in a large city in Canada. The paper demonstrates that using a model for areal data provides good results in terms of predictive accuracy and allows flexibility in accounting for the main features of the dataset. Moreover, it shows the computational efficiency of the approach despite the huge dataset. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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49. SmartEUS: An Integrated Dynamic Platform For The Innovation Of Healthcare Emergency-Urgency Services.
- Author
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Trapani, Natalia, Catania, Felice, Aragno, Cesare, Cucè, Giuseppe, and Di Dio, Giuseppe
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DIGITAL technology ,AMBULANCES ,EMERGENCY medical services ,HOSPITAL emergency services ,DECISION support systems ,MEDICAL emergencies ,MEDICAL care - Abstract
The SmartEUS project aims to design, develop, and test a highly innovative model for the provision of Emergency Urgency Services (EUS) based on the concept of clinical pathway (i.e., the entire emergency care chain). The project is innovative both from an organizational and technological point of view. It is based on an e-Health approach, capable of exploiting new digital technologies in a coordinated way to support the evolution of emergency health systems towards dynamic and safer processes. The paper presents the SmartEUS platform which can integrate the information from all the key players in medical emergency response (emergency operation center, emergency medical service, hospital emergency department) improving their coordination. The most relevant innovations of the proposed solution are data integration and interoperability, advanced communication and collaboration, knowledge-based resource allocation, telemedicine integration to support decision making in dispatching and resource assignment. In fact, a Decision Support System is integrated into SmartEUS cloud platform to suggest to the emergency operation center which emergency medical service and hospital emergency department. In fact, information on the patient status can include results from ambulance's on board telediagnosis equipment, alerting the hospital emergency department even before the arrive of the patient, thus guaranteeing the appropriateness of care according to patient needs (e.g., patient pre-triage index, potential pre-hospital diagnosis) and reducing emergency department overcrowding and resources saturation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
50. Knowledge of telemedicine and its associated factors among health professional in Ethiopia: A systematic review and meta-analysis.
- Author
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Shibabaw, Adamu Ambachew, Chereka, Alex Ayenew, Walle, Agmasie Damtew, Demsash, Addisalem Workie, Dube, Geleta Nenko, dubale, Abiy Tasew, Kassie, Sisay Yitayh, Kitil, Gemeda Wakgari, Jember, Mesafint zewold, Gebeyehu, Chernet Desalegn, Ariger, Aster Temesgen, and Dires, Eshetie Andargie
- Subjects
AMBULANCES ,MEDICAL personnel ,COMPUTER literacy ,ONLINE databases ,INTERNET access ,SEARCH engines - Abstract
Introduction: Telemedicine is a useful tool for decreasing hospital stress, patient suffering, ambulance needs, hospital anxiety, and costs while improving the standard of care. Nonetheless, the lack of awareness regarding telemedicine poses a barrier to its application, presenting several difficulties in underdeveloped nations like Ethiopia. This review evaluates Ethiopian-specific telemedicine knowledge and associated factors. Methods: This systematic review was conducted using a search of several online databases in addition to the main databases, like Medline, PubMed, Scopus, and Science Direct. The writers have looked for, reviewed, and summarized information about telemedicine knowledge in the healthcare system. This study contained seven studies that examined telemedicine knowledge in the Ethiopian healthcare sector. Studies that followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) were found using search engines. The investigation was carried out using STATA version 11. The indicator of heterogeneity (I
2 ) was used to assess the level of heterogeneity among the included studies. The funnel plot was visually inspected, and Egger's regression test was run to check for publication bias. The pooled effect size of every study is estimated using a random-effect model meta-analysis. Results: Examination of 2160 studies, seven studies involving 2775 health professionals, and seven out of the 2160 publications assessed satisfied the inclusion criteria and were added to the systematic review and meta-analysis. The pooled prevalence of Telemedicine knowledge was 45.20 (95% CI: 34.87–55.53). Whereas the pooled factor was computer training was 2.24 times (AOR = 2.24 (95%; CI: 1.64–3.08)), computer access was 2.07 times (AOR = 2.07 (95% CI: 1.50–2.87)), internet access was 3.09 times (AOR = 3.09 (95% CI: 1.34–7.13)), social media access were 3.09 times (AOR = 3.09(95%; CI: 1.34–7.13)), educational status degree and above were 2.73 times (AOR = 2.73; 95% CI: 0.85–8.82), Awareness were 3.18 times (AOR = 3.18 (95%; CI: 1.02–9.91)), Management support was 1.85 (AOR = 1.85 (95% CI: 01.25–2.75)), computer literacy were 2.90 times (AOR = 2.90 (95% CI: 1.81–4.64)), computer owner were 1.70 times (AOR = 1.70 (95% CI: 1.05–2.76)), male gender were 1.95 times (AOR = 1.95 (95% CI: 1.32–2.87)). Conclusion: The overall pooled prevalence of telemedicine knowledge was low. Gender, education, management support, computer access, social media access, internet access, telemedicine awareness, and telemedicine training associated with telemedicine knowledge. [ABSTRACT FROM AUTHOR]- Published
- 2024
- Full Text
- View/download PDF
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