428 results
Search Results
2. Can ambulance dispatch categories discriminate traffic incidents that do/do not require a lights and sirens response?
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Ceklic, Ellen, Tohira, Hideo, Finn, Judith, Brink, Deon, Bailey, Paul, Whiteside, Austin, Brown, Elizabeth, Brits, Rudolph, and Ball, Stephen
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- 2022
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3. Burnout in emergency medical technicians and paramedics in the USA
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Sporer, Celia
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- 2021
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4. Effect of COVID-19 on management of patients with low back pain in the emergency department
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Caitlin Jones, Sweekriti Sharma, Gustavo C Machado, Adrian C Traeger, Christina Abdel Shaheed, and Christopher G. Maher
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Opioid ,Emergency Nursing ,Ambulance ,Retrospective analysis ,Humans ,Medicine ,Low back pain ,Pandemics ,Retrospective Studies ,Emergency department ,business.industry ,Electronic medical record ,COVID-19 ,Analgesics, Opioid ,Coronavirus ,Relative risk ,Emergency medicine ,Diagnostic imaging ,medicine.symptom ,Emergency Service, Hospital ,business ,Research Paper ,Healthcare system - Abstract
Background Patients presenting to Emergency Department (ED) with non-specific low back pain can receive more unnecessary, intensive and costly care than is recommended. The COVID-19 pandemic has provided an unprecedented opportunity to examine how health systems prioritise necessary care that provides clear benefits to patients. The purpose of this study was to examine the impact of COVID-19 on care of low back pain in the ED. Methods We performed a retrospective analysis of electronic medical record data on care for low back pain from three public hospitals in Sydney. We included patients diagnosed with spinal conditions who presented between March and May in 2019 and in 2020. Outcomes were the total number of patients presenting with spinal conditions to ED, the proportion diagnosed with non-specific low back pain, and the proportion receiving potentially unnecessary aspects of care (ambulance use, imaging, opioids, hospital admissions). We calculated relative risk with 95% CIs and examined plots with locally weighted smoothed curves. Results Presentations for spinal conditions over a three-month period to three EDs reduced from 694 in 2019 to 475 in 2020 (31% reduction, 95% CI = 26%–37%). The proportion of patients diagnosed with non-specific low back pain (83% in 2019 vs 86% in 2020), or receiving potentially unnecessary care were similar in 2019 and 2020 (Imaging = 25% vs 25%; Opioids = 54% vs 56%; Admitted = 18% vs 20%; pathology test = 24% vs 23%). The proportion of patients arriving by ambulance was higher during the pandemic; 29% in 2019 vs 41% in 2020 (RR = 1.39, 95% CI = 1.19–1.63). Conclusions ED presentations for low back pain associated with spinal conditions decreased substantially during the COVID-19 pandemic. Use of potentially unnecessary aspects of care did not change or increased during the pandemic.
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- 2022
5. A Context-Aware Framework to Manage the Priority of Injured Persons Arriving at Emergencies.
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Ouakasse, Fathia, Stitini, Oumaima, and Rakrak, Said
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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]
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- 2023
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6. Patients' experiences of the caring encounter with the psychiatric emergency response team in the emergency medical service—A qualitative interview study
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Veronica Lindström, Andreas Carlborg, and Lars Sturesson
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Emergency Medical Services ,medicine.medical_specialty ,Population ,emergency medical service ,Suicide prevention ,03 medical and health sciences ,0302 clinical medicine ,Patient experience ,medicine ,Emergency medical services ,Humans ,ambulance ,030212 general & internal medicine ,Psychiatry ,education ,Qualitative Research ,Service (business) ,education.field_of_study ,lcsh:R5-920 ,business.industry ,patient experience ,Mental Disorders ,030503 health policy & services ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,psychiatric emergency response team ,Mental illness ,medicine.disease ,mental illness ,Original Research Paper ,Content analysis ,Emergencies ,Emergency Service, Hospital ,0305 other medical science ,business ,Psychology ,lcsh:Medicine (General) ,Original Research Papers ,suicide prevention ,Qualitative research - Abstract
Background Mental illnesses are increasing in the population; consequently, the number of psychiatric emergencies handled by the emergency medical services (EMS) has also increased. Alternative response systems have been developed and evaluated, but there is still a lack of knowledge concerning the patients' experiences of being cared for in the EMS by a psychiatric emergency response unit (In Swedish: Psykiatrisk Akut Mobilitet [PAM]). Objective The aim of this study was to explore patients' experiences of the caring encounter with the PAM team. Design A qualitative study design with 14 patients' interviews and content analysis was used. Results The patients expressed that the PAM team created a safe environment and actively involved the patient in their care by creating an open and safe place for dialogue. In this safe environment, the patients described how they participated in the decision making and received care without fear of being dismissed, ignored or judged. Discussion and Conclusion The patients' experiences of being cared for by the PAM team show that person‐centred care was achieved by involving the patients in their own care. This participation was possible because mutual trust and confidence existed, and the patients acknowledged the specialist response unit to be a valuable part of the EMS. However, further studies are needed to explore whether the PAM as a response unit in the EMS decreases the risk of suicide and to examine different health economic aspects of using PAM in the EMS.
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- 2020
7. Effect of Ambulance Stretcher Bed Height Adjustment on CPR Quality and Rescuer Fatigue in a Laboratory Environment
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Chin-Shan Ho, Cheng-Pang Yang, Chun-Hao Chang, Chi Chang Huang, Fang Li, Chun-Sheng Ho, Chien-Ching Tang, and Yi-Ju Hsu
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Resuscitator ,Adult ,Male ,medicine.medical_treatment ,Ambulances ,Manikins ,Continuous chest compression ,stretcher bed ,Stretchers ,rescuer fatigue ,Medicine ,Humans ,ambulance ,Cardiopulmonary resuscitation ,chest compression ,CPR quality ,Simulation Training ,Fatigue ,Rating of perceived exertion ,Cross-Over Studies ,business.industry ,Upper body ,Significant difference ,General Medicine ,Crossover study ,Cardiopulmonary Resuscitation ,Emergency Medical Technicians ,Treatment Outcome ,Anesthesia ,Cpr quality ,Ergonomics ,business ,Out-of-Hospital Cardiac Arrest ,Research Paper - Abstract
Background: The quality of cardiopulmonary resuscitation (CPR) is closely related to the survival rate of a patient, and it is crucial to maintain the quality of CPR during the ambulance journey to the receiving hospital. The purpose of this study was to investigate the effects of different stretcher bed heights on operator CPR quality. Methods: In this randomized crossover trial, 16 male emergency medical technicians-paramedics (EMT-Ps) performed continuous chest compressions on a hemimorphic mannequin for 5 minutes, alternating between the current height of the stretcher bed on the ambulance (38 ± 1 cm) (S-38) and the height of the participant's midpoint of the patella (S-knee), where the stretcher bed surface is. Results: According to the analysis of the quality of CPR exercises with two different stretcher bed heights at 5 minutes of continuous chest compression, the mean chest compression depth (CCD) of the S-38 position (53.81 ± 1.91 cm) was significantly lower than that of the S-knee (55.12 ± 2.03 cm; p < 0.001). The mean chest compression rate (CCR) of the S-38 position (111.44 ± 3.44 beats/min) was significantly higher than that of the S-knee (109.63 ± 4.46 beats/min; p = 0.027). The mean of total chest compressions (TCC) of the S-38 position (557.44 ± 16.81 times) was significantly higher than that of the S-knee (548.24 ± 19.40 times; p = 0.029). The rating of perceived exertion (RPE) of the S-38 position was significantly higher than that of the S-knee (12.75 ± 1.91 %; p = 0.015). Only the chest compression rebound rate (CCRR) (S-38: 97.56 ± 4.63 % vs. S-knee: 98.31 ± 1.89 %, p = 0.401) and the chest compression fraction (CCF) (S-38: 98.44 ± 0.81 % vs. S-knee: 98.44 ± 0.96 %, p = 1.000) did not reach a significant difference. Conclusion: When a resuscitator is performing chest compressions in a standing position in an ambulance, the excessive downward leaning of the resuscitator's upper body affects CPR quality and increases fatigue. This study has verified that setting the stretcher bed of the ambulance at the knee height of the EMTs provides better CPR quality and lower fatigue.
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- 2021
8. A paramedic's role in reducing number of falls and fall-related emergency service use by over 65s: a systematic review.
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Bonner, Mhairi, Capsey, Matt, and Batey, Jo
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EMERGENCY medical technicians ,EMERGENCY medical services ,ADULTS ,OLDER patients ,QUALITY of life ,AMBULANCE service - Abstract
Background: Around 10–25% of emergency calls for adults aged over 65 are attributed to falls. Regardless of whether injuries are caused, quality of life is often affected by fear of falling, leading to reduced confidence and activity, negatively impacting mobility and risking depression and isolation. Ambulance service staff are well placed to identify falls risk factors so patients can be directed to falls prevention services. This article aims to determine how the referral by paramedics of uninjured falls patients to community falls services may reduce future falls and emergency services use. Methods: The CINAHL, MEDLINE and AMED electronic databases, grey literature sources and reference lists of relevant papers were systematically searched to identify primary research of an experimental design. Studies were eligible if they included elderly patients, aged over 65, who had received a paramedic response following a fall, were found to be uninjured and who were referred to local falls services rather than being transported to hospital. The study outcomes were required to include the rate of subsequent falls and emergency service use. Results: Four papers from three studies were included in the review following quality assessment. Results were not always statistically significant but showed a reduction in subsequent falls, particularly in the high-risk population, and in emergency service call-outs. A consistent positive effect was seen on the patients' well-being and independence related to activities of daily living across the studies. Conclusions: The relationship between paramedics and local falls services has changed the pre-hospital management of these patients. Generally, access to a falls-specific care package has proved beneficial in supporting independence and reducing unnecessary transport to hospital. Further research into the uptake of this care pathway by paramedics now it is more established may be useful, as would research into barriers to adherence of the elderly to such an intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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9. Weather Fluctuations May Have an Impact on Stroke Occurrence in a Society: A Population-Based Cohort Study
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Katsura Tsukamoto, Sho Nachi, Shinji Ogura, Naoki Matsumaru, Hideshi Okada, Kodai Suzuki, and Takahiro Yoshida
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lcsh:Diseases of the circulatory (Cardiovascular) system ,Time Factors ,Ambulances ,030204 cardiovascular system & hematology ,Lower risk ,Risk Assessment ,03 medical and health sciences ,Population based cohort ,0302 clinical medicine ,Japan ,Risk Factors ,medicine ,Humans ,ambulance ,Significant risk ,Stroke ,Original Paper ,stroke risk factors ,business.industry ,Incidence (epidemiology) ,Incidence ,Significant difference ,humidity ,temperature ,Odds ratio ,medicine.disease ,Prognosis ,Blood pressure ,Neurology ,lcsh:RC666-701 ,weather ,Neurology (clinical) ,Seasons ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Demography - Abstract
Background: Stroke has been found to have a seasonally varying incidence; blood pressure, one of its risk factors, is influenced by humidity and temperature. The relationship between the incidence of stroke and meteorological parameters remains controversial. Objective: We investigated whether meteorological conditions are significant risk factors for stroke, focusing on the fluctuation of weather elements that triggers the onset of stroke. Methods: We collected ambulance transportation data recorded by emergency personnel from Gifu Prefecture. We included cases where the cause of the transportation was stroke and excluded cases of trauma. We combined these data with meteorological data as well as data on average temperature, average air pressure, and humidity provided publicly by the Japan Meteorological Agency. Our target period was from January 2012 to December 2016. Results: In the 5-year target period, there were 5,501 occurrences of ambulance transportation due to stroke. A seasonal tendency was confirmed, since ambulance transportation for stroke occurred more frequently at low temperatures (p < 0.001). Temperature (odds ratio: 0.91; p < 0.001) and humidity change (odds ratio: 1.50; p = 0.016) were identified as risk factors for ambulance transportation due to stroke. An increase in temperature incurs a lower risk than a decrease (odds ratio: 0.58; p = 0.09), although there is no statistically significant difference. Conclusions: Meteorological effects on the frequency of ambulance transportation due to stroke were studied. A lower temperature and radical humidity change were identified as risk factors for ambulance transportation due to stroke, and a decrease in temperature was also associated. We speculate on the possibilities of using meteorological data to optimize the assignment of limited medical resources in medical economics.
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- 2020
10. Circumstances surrounding non‐fatal opioid overdoses attended by ambulance services
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Madah‐Amiri, Desiree, Clausen, Thomas, Myrmel, Lars, Brattebø, Guttorm, and Lobmaier, Philipp
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Adult ,Male ,Original Paper ,Emergency Medical Services ,Adolescent ,Naloxone ,Norway ,Narcotic Antagonists ,EMS ,Ambulances ,Middle Aged ,Original Papers ,Analgesics, Opioid ,Young Adult ,opioid ,Humans ,ambulance ,Female ,pre‐hospital ,non‐fatal overdose ,Drug Overdose ,Retrospective Studies - Abstract
Introduction and Aims Opioid overdose fatalities are a significant concern globally. Non‐fatal overdoses have been described as a strong predictor for future overdoses, and are often attended by the ambulance services. This paper explores characteristics associated with non‐fatal overdoses and aims to identify possible trends among these events in an urban area in Norway. Design and Methods This is a retrospective analysis of non‐fatal overdoses from Bergen ambulance services from 2012 to 2013. Demographic, temporal and geographic data were explored. Results During the two years, 463 non‐fatal opioid overdoses were attended by ambulance services. Ambulance call‐outs occurred primarily during the late afternoon and evening hours of weekdays. Summer months had more overdoses than other seasons, with a peak in August. Overdoses were nearly twice as likely to occur in a public location in August (risk ratio 1.92, P = 0.042). Ambulance response times were more likely to be longer to private locations, and these victims were more likely to be treated and left at the scene. There was no difference in arrival time for drug‐related and non‐drug related dispatch. Discussion and Conclusions The temporal patterns suggest that non‐fatal overdoses occur during non‐recreational time periods. The longer ambulance response time and disposition for private addresses indicate potential opportunities for peer interventions. Our analysis describes circumstances surrounding non‐fatal overdoses and can be useful in guiding relevant, targeted prevention interventions. [Madah‐Amiri D, Clausen T, Myrmel L, Brattebø G, Lobmaier P. Circumstances surrounding non‐fatal opioid overdoses attended by ambulance services. Drug Alcohol Rev 2017;36:288‐294]
- Published
- 2016
11. Predicting Urgent Dialysis at Ambulance Transport to the Emergency Department Using Machine Learning Methods.
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MAJOUNI, Sheida, TENNANKORE, Karthik, and Raza ABIDI, Syed Sibte
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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]
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- 2023
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12. An analysis of the exposure to violence and burnout levels of ambulance staff
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Sibel Coskun Cenk
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Health worker ,Workplace violence ,Subscale score ,education ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,030204 cardiovascular system & hematology ,Verbal abuse ,Burnout ,Ambulance ,Original Research Paper ,03 medical and health sciences ,0302 clinical medicine ,Sample size determination ,Depersonalization ,medicine ,medicine.symptom ,Psychology ,Emotional exhaustion ,Web survey ,Clinical psychology - Abstract
Objective: Ambulance workers experiences some of the highest risks of job-related violence. This descriptive study was conducted to analyze the exposure to violence and burnout levels of ambulance workers in Turkey. Method: The research was conducted via web survey with the ambulance staff. The sampling size was 143 ambulance workers who participate in this study. A 30-item questionnaire and the Maslach Burnout Inventory (MBI) were used to collect data. Results: In study, 58.7% of respondents were female; 57.3% were paramedics. 86.5% of respondents were exposed to verbal abuse, and 35% of them were exposed to physical violence. Swearing and yelling were the most common forms of verbal abuse whereas pushing and throwing objects were the most common forms of physical violence. 47.3% of the physical violence cases were reported. In the sampling, MBI scores indicated that the mean Depersonalization subscale score was X = 7.97 ± 3.82; Emotional Exhaustion subscale score was X = 12.07 ± 6.57; and Personal Accomplishment subscale score was X = 9.16 ± 5.14. Significant differences were determined in MBI scores (p
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- 2019
13. Enhancing mental health awareness in emergency services (the ENHANcE I project)
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Mark Hayward, Yasin Koc, Sorcha O’Brien, Cassie M. Hazell, Sarah F. Fielding-Smith, and Social Psychology
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medicine.medical_specialty ,Cross-sectional study ,media_common.quotation_subject ,Population ,Psychological intervention ,Stigma (botany) ,accident and emergency ,03 medical and health sciences ,0302 clinical medicine ,medicine ,ambulance ,030212 general & internal medicine ,education ,Psychiatry ,media_common ,Service (business) ,education.field_of_study ,police ,Mental health ,030227 psychiatry ,Psychiatry and Mental health ,polic ,stigma ,Sympathy ,Papers ,Other ,mental health awareness ,Psychology ,Reputation - Abstract
Background The number of mental health-related 999 calls to emergency services has increased in recent years. However, emergency services staff have an unfavourable reputation when it comes to supporting people experiencing mental health problems. Aims To assess the levels of explicit and implicit mental health stigma among accident and emergency, ambulance and police staff, and draw comparisons with the general population. Additional analyses sought to identify which variables predict mental health stigma among emergency services staff. Method A cross-sectional survey of 1837 participants, comprising four independent groups (accident and emergency, ambulance and police staff, and the general population). Results Levels of mental health stigma across all four groups were lower than those reported in recent surveys of the general population by the ‘Time to Change’ campaign. Within this study, explicit levels of mental health stigma were lower among the general population compared with emergency services staff. There was no difference between emergency service professions, nor were there any between-group differences in terms of implicit mental health stigma. The only consistent predictors of mental health stigma were attitudes and future behavioural intentions, whereby increased stigma was predicted by increased fear, reduced sympathy and greater intended discrimination. Conclusions Our findings suggest that levels of mental health stigma have improved over time, but there is room for improvement in emergency services staff. Interventions to improve mental health stigma may be most effective if, in line with the cognitive–behavioural model of stigma, they target attitudes and behavioural intentions.
- Published
- 2021
14. Prioritizing novel and existing ambulance performance measures through expert and lay consensus: A three-stage multimethod consensus study
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Andy Irving, Viet-Hai Phung, Joanne Coster, Aloysius Niroshan Siriwardena, and Janette Turner
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Emergency Medical Services ,Consensus ,A300 Clinical Medicine ,Delphi Technique ,media_common.quotation_subject ,Ambulances ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,consensus methods ,Surveys and Questionnaires ,Outcome Assessment, Health Care ,Patient experience ,Hospital discharge ,Humans ,Medicine ,ambulance ,Quality (business) ,030212 general & internal medicine ,computer.programming_language ,media_common ,quality and performance ,Three stage ,Health Priorities ,business.industry ,Community Participation ,Public Health, Environmental and Occupational Health ,patient and public involvement ,030208 emergency & critical care medicine ,Service provider ,Public involvement ,medicine.disease ,Original Research Paper ,delphi ,B780 Paramedical Nursing ,Medical emergency ,outcome measurement ,business ,Original Research Papers ,computer ,Delphi - Abstract
Background Current ambulance quality and performance measures, such as response times, do not reflect the wider scope of care that services now provide. Using a three‐stage consensus process, we aimed to identify new ways of measuring ambulance service quality and performance that represent service provider and public perspectives. Design A multistakeholder consensus event, modified Delphi study, and patient and public consensus workshop. Setting and participants Representatives from ambulance services, patient and public involvement (PPI) groups, emergency care clinical academics, commissioners and policymakers. Results Nine measures/principles were highly prioritized by >75% of consensus event participants, including measures relating to pain, patient experience, accuracy of dispatch decisions and patient safety. Twenty experts participated in two Delphi rounds to further refine and prioritize measures; 20 measures in three domains scored ≥8/9, indicating good consensus, including proportion of calls correctly prioritized, time to definitive care and measures related to pain. Eighteen patient/public representatives attended a consensus workshop, and six measures were identified as important. These include time to definitive care, response time, reduction in pain scores, calls correctly prioritized to appropriate levels of response and survival to hospital discharge for treatable emergency conditions. Conclusions Using consensus methods, we identified a shortlist of ambulance outcome and performance measures that are important to ambulance clinicians and service providers, service users, commissioners, and clinical academics, reflecting current pre‐hospital ambulance care and services. The measures can potentially be used to assess pre‐hospital quality or performance over time, with most calculated using routinely available data.
- Published
- 2017
15. Simulation-based education as a provider of fieldwork insights – experiences of ambulance nurse specialist students.
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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]
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- 2023
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16. Changes in alcohol intoxication-related ambulance attendances during COVID-19: How have government announcements and policies affected ambulance call outs?
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Agatha Faulkner, Debbie Scott, Dan I. Lubman, Karen Smith, James Wilson, Rowan P. Ogeil, Naomi Beard, and Victoria Manning
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paramedicine ,government policy ,Odds ,Alcohol intoxication ,intoxication ,Pandemic ,Internal Medicine ,Medicine ,ambulance ,Government ,business.industry ,Health Policy ,Stressor ,Public Health, Environmental and Occupational Health ,COVID-19 ,Obstetrics and Gynecology ,Paramedicine ,Odds ratio ,medicine.disease ,Metropolitan area ,Psychiatry and Mental health ,Infectious Diseases ,alcohol harms ,Pediatrics, Perinatology and Child Health ,Public aspects of medicine ,RA1-1270 ,Geriatrics and Gerontology ,Alcohol ,business ,people ,people.professional_field ,Research Paper ,Demography - Abstract
Background: In response to COVID-19, government-mandated health directives including widespread lockdowns were implemented. Changes in alcohol purchasing were reported, with growing concern that alcohol may be consumed as a way to cope with pandemic-associated stressors. Hitherto, there have been limited studies examining alcohol-related harms, including acute harms requiring an ambulance, and their relationship to government announcements or policies related to COVID-19. Methods: Analyses were conducted between January and September 2020, with matched months in 2019, using Victorian data from the National Ambulance Surveillance System in Australia. Interrupted time series (ITS) models with odds ratios (OR) were used to map alcohol-related harms as a function of government policies for both metropolitan and regional areas. Findings: A total of 43,003 alcohol intoxication-related ambulance attendances occurred between January 2019 and September 2020. Attendances in the home increased in 2020 by 9% compared to matched 2019 months. The most socioeconomically advantaged cases showed the highest percentage change. ITS models showed decreased odds of alcohol-related attendances at the beginning of each COVID-19 wave in metropolitan (OR:0•77; 95%CI: 0•71-0•83; p
- Published
- 2021
17. Driving the ambulance: an essential component of emergency medical services: an integrative review.
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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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18. Out of hospital emergency care in Nigeria: A narrative review.
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Oyedokun, Taofiq Olusegun, Islam, Emre Mehrab, Eke, Nkemakolam Obinna, Oladipo, Oladayo, Akinola, Olurotimi Olaolu, and Salami, Olufunmilayo
- Abstract
• Nigeria seeks to meet international standards for Out of Hospital Emergency Care (OHEC). • We highlighted the standard of service in public (government) and privately owned OHEC services. • While improvements have been made, poor-quality prehospital logistics, coordination, and oversight are inhibiting the growth and development of Nigerian OHEC. • This review highlights the importance and challenges of OHEC in Nigeria and outlines recommendations that may apply to other African countries with similar socioeconomic challenges. Out of Hospital Emergency Care (OHEC) in Nigeria, the most populous country with the highest GDP in Africa, is considered inadequate. A better understanding of the current state of OHEC is essential to address the country's unique challenges and offer potential solutions. This paper sought to identify gaps, barriers, and facilitators in implementing an OHEC model in Nigeria and provide recommendations for improvement. We searched MEDLINE (PubMed), Embase (OVID), CINAHL (EBSCO), and Google Scholar, using combinations of "emergency medical care" ('FRC,' 'PHC,' and 'EMS') OR prehospital care OR emergency training' AND 'Nigeria.' We included papers that described OHEC in Nigeria and were published in English. Of the initial 73 papers, those that met our inclusion criteria and those obtained after examination of reference lists comprised the 20 papers that contributed to our final review. Two authors independently reviewed all the papers, extracted data relevant to our objectives and performed a content analysis. All authors reviewed, discussed, and refined the proposed recommendations. For OHEC to meet the needs of Nigerians and achieve international standards, the following challenges need to be addressed: harmful cultural practices, inadequate training of citizens in the provision of first aid or of professionals that provide prehospital care, lack of proper infrastructure, poor communication, absent policy, and poor funding. Based on the available literature, this paper proposes key recommendations to improve OHEC with the hope of improving the standards of living. The federal government should provide general oversight, but this will require political will on the part of the country's leadership and the provision of adequate funding. [ABSTRACT FROM AUTHOR]
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- 2023
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19. A comprehensive study of ambulance performance in Kuwait in terms of traffic congestion using fuzzy logic
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AlKheder, Sharaf and AlSaloumi, Dana
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- 2024
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20. Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review.
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Armstrong, Stephanie, Langlois, Adele, Laparidou, Despina, Dixon, Mark, Appleton, Jason P., Bath, Philip M., Snooks, Helen, and Siriwardena, A. Niroshan
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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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21. Drones in Emergency Medical Services: A Systematic Literature Review with Bibliometric Analysis.
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Pulsiri, Nonthapat and Vatananan-Thesenvitz, Ronald
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EMERGENCY medical services ,COVID-19 pandemic ,BIBLIOMETRICS ,ECOSYSTEMS - Abstract
This paper conducts a systematic literature review with bibliometric analysis for drone-related research in Emergency Medical Services (EMS). Forty publications were extracted from the SCOPUS database during 2015–2019 for further analysis. The results show the current research landscape and guide future research directions. Interestingly, the occurrence of the COVID-19 pandemic made the use of drones necessary to assist EMSs lifesaving tasks to reduce fatality, which has also attracted more attention from the academic community. It was found that the co-evolution of drone technologies and entrepreneurial activities in the EMS ecosystem offers drone uses beyond medical applications. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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22. Factors associated with emergency department service outcomes for people with a mental health problem brought in by police: a retrospective cohort study.
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Wardrop, Rachel, Ranse, Jamie, Chaboyer, Wendy, Young, Jesse T., Kinner, Stuart A., and Crilly, Julia
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MENTAL illness treatment ,LENGTH of stay in hospitals ,EVALUATION of medical care ,SHIFT systems ,STATISTICS ,HOSPITAL emergency services ,PSYCHOTHERAPY patients ,SCIENTIFIC observation ,CONFIDENCE intervals ,MULTIPLE regression analysis ,AGE distribution ,TIME ,MULTIVARIATE analysis ,PATIENTS ,RETROSPECTIVE studies ,HOSPITAL admission & discharge ,RISK assessment ,PSYCHOSOCIAL factors ,EMERGENCY medical services ,DESCRIPTIVE statistics ,RESEARCH funding ,DATA analysis software ,ODDS ratio ,POLICE ,LONGITUDINAL method - Abstract
Objective: This study aimed to identify factors associated with an emergency department (ED) length of stay ≥4 hours (h) and hospital admission for people with a mental health problem brought in by police. Methods: We undertook a retrospective, observational cohort study of state-wide adult ED mental health presentations brought in by police from 1 January 2012 to 31 December 2017. We used multivariable logistic regression to determine factors associated with an ED length of stay ≥4 h and hospital admission. Results: In total, 9325 ED presentations with a mental health problem brought in by police to Queensland EDs were included. Factors most strongly associated with an ED length of stay ≥4 h included an Australasian Triage Score (ATS) of 1, an age of 85 years or older, night shift arrival and subsequent hospital admission. For hospital admission, an ATS of 1, an age of 85 years or older and an ED length of stay ≥4 h were the strongest factors. Conclusion: Findings indicate opportunities for targeted mental health models of care to better support people brought in by police to an ED. Such models should involve ED, pre-hospital providers (police and ambulance) and mental health services to support early intervention and potentially reduce the likelihood of a long ED length of stay and subsequent hospital admission. What is known about the topic? Some people with mental health problems are brought in by police to an emergency department (ED). People brought in by police are recognised as having poorer health profiles compared to other arrival modes. What does this paper add? Several patient and clinical factors influence ED length of stay and hospital admission for people with a mental health problem brought in by police, indicating a need for targeted health care that addresses these factors. What are the implications for practitioners? This study justifies the need to develop specialised pre-hospital models of care and embed early assessment processes in an ED for people with mental health problems brought in by police. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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23. The organization of ambulance decontamination during the COVID-19 pandemic: a process analysis based on the Lean Thinking philosophy.
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Imbriaco, Guglielmo and Flauto, Alfonso
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COVID-19 pandemic ,PHILOSOPHY ,EMERGENCY medical services - Abstract
The COVID-19 pandemic led to massively increased emergency medical services (EMS) activity. The need to decontaminate emergency vehicles after conveying a suspected or confirmed patient to the hospital represented a critical step, slowing the activities and impacting the number of available ambulances. This brief paper analyzes the flow of EMS processes according to the Lean Thinking management approach, which focuses on reducing waste in a production cycle. The different steps of the whole process (arrival to the Emergency Department, handover phase, decontamination, return to service, and the required transfers) and a series of strategies are discussed. The organization (centralized or delocalized), number, and location of the decontamination centers impact transfers and waiting times and, consequently, the availability of ambulances. Optimizing these processes may lead to a global performance improvement, reducing transfers and time, with greater availability of emergency vehicles. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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24. Prehospital Resuscitation Decision Making: A model of ambulance personnel experiences, preparation and support.
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Anderson, Natalie E, Slark, Julia, and Gott, Merryn
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RESEARCH ,FOCUS groups ,RESEARCH methodology ,AMBULANCES ,EMERGENCY medical technicians ,INTERVIEWING ,EMERGENCY medical services ,PSYCHOSOCIAL factors ,DECISION making ,RESUSCITATION ,DECISION making in clinical medicine ,EMERGENCY medicine - Abstract
Objective This paper presents the first Naturalistic Decision Making model of prehospital resuscitation decision‐making, which has clear implications for education, practice and support. Methods: A mixed‐methods exploratory sequential research design consisting of interviews with ambulance personnel (study 1), focus groups with ambulance educators, managers and peer supporters (study 2), and an online survey of graduating paramedic students (study 3). This paper reports the model developed from integrated findings, across all three studies. All research was undertaken in New Zealand and underpinned by a critical realist worldview. Results: The Prehospital Resuscitation Decision Making model identifies key processes, challenges and facilitators before, during and after ambulance personnel attend a cardiac arrest event. It is the only descriptive model of resuscitation decision making which acknowledges the decision‐maker, non‐prognostic factors and the importance of adequate preparation and support. Conclusions: This research project is the first to comprehensively explore and model ambulance personnel perspectives on decisions to start, continue or stop resuscitation. The decision‐making process is complex and difficult to simply formularise. Education and supports must assist ambulance personnel in navigating this complexity. Where resuscitation is withheld or terminated, ambulance personnel need to feel confident that they can effectively provide after‐death care. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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25. Assessment of the availability and utility of the paramedic record in the emergency department.
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O'Connor, Katherine and Golding, Michael
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HOSPITAL emergency services ,PHYSICIAN-patient relations ,MEDICAL records ,DESCRIPTIVE statistics ,HEALTH ,INFORMATION resources ,MEDICAL needs assessment ,PATIENT safety - Abstract
Objective: Clinical handover between pre‐hospital ambulance service and the ED is important for patient safety and quality care. This study assessed the availability and utility of the paramedic record to ED clinicians in their patient assessment. Methods: The document transfer in 110 handovers between ambulance service and a tertiary metropolitan hospital ED was observed. Timestamps were recorded when the electronic paramedic record was printed, when it was placed in the hospital's paper‐based patient medical record, when ED patient assessment occurred and it was noted if there was a verbal handover from paramedic to ED clinician. ED clinicians were surveyed about the availability and usefulness of the paramedic record. Results: The paramedic record was printed prior to the patient being seen in only 49% of encounters and was available in the medical record at the time of initial clinical assessment in 32% of encounters. When available it was reviewed in over 90% of encounters. 87% of these reviews were reported as 'significantly' or 'somewhat useful'. The paramedic record could not be located at all in 21% of encounters. In 98% of encounters the treating ED clinician would have preferred the paramedic record to have been electronic. The ED system data was corrupt in 4% of encounters. Conclusions: The information in the paramedic record was found to be useful to ED clinicians when it was available. Increasing the availability of the paramedic record for ED clinical assessment may be an opportunity to improve patient safety and flow. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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26. Looking back to inform the future: a review of published paramedicine research.
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Cavanagh, N., Blanchard, I. E., Weiss, D., and Tavares, W.
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PARAMEDICINE ,COMMUNITIES ,MEDICAL practice ,DISCOURSE analysis ,CINAHL database - Abstract
Objective: Paramedicine has evolved in ways that may outpace the science informing these changes. Examining the scholarly pursuits of paramedicine may provide insights into the historical academic focus, which may inform future endeavors and evolution of paramedicine. The objective of this study was to explore the existing discourse in paramedicine research to reflect on the academic pursuits of this community. Methods: We searched Medline, Embase, CINAHL, Google Scholar and Web of Science from January, 2006 to April, 2019. We further refined the yield using a ranking formula that prioritized journals most relevant to paramedicine, then sampled randomly in two-year clusters for full text review. We extracted literature type, study topic and context, then used elements of qualitative content, thematic, and discourse analysis to further describe the sample. Results: The initial search yielded 99,124 citations, leaving 54,638 after removing duplicates and 7084 relevant articles from nine journals after ranking. Subsequently, 2058 articles were included for topic categorization, and 241 papers were included for full text analysis after random sampling. Overall, this literature reveals: 1) a relatively narrow topic focus, given the majority of research has concentrated on general operational activities and specific clinical conditions and interventions (e.g., resuscitation, airway management, etc.); 2) a limited methodological (and possibly philosophical) focus, given that most were observational studies (e.g., cohort, case control, and case series) or editorial/commentary; 3) a variety of observed trajectories of academic attention, indicating where the evolution of paramedicine is evident, areas where scope of practice is uncertain, and areas that aim to improve skills historically considered core to paramedic clinical practice. Conclusions: Included articles suggest a relatively narrow topic focus, a limited methodological focus, and observed trajectories of academic attention indicating where research pursuits and priorities are shifting. We have highlighted that the academic focus may require an alignment with aspirational and direction setting documents aimed at developing paramedicine. This review may be a snapshot of scholarly activity that reflects a young medically directed profession and systems focusing on a few high acuity conditions, with aspirations of professional autonomy contributing to the health and social well-being of communities. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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27. A virtual emergency telemedicine serious game in medical training: A quantitative, professional feedback-informed evaluation study
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Nicolaidou, I., Antoniades, Athos, Constantinou, Renos, Marangos, C., Kyriacou, Efthyvoulos C., Bamidis, Panagiotis D., Dafli, E., Pattichis, Constantinos S., Pattichis, Constantinos S. [0000-0003-1271-8151], and Kyriacou, Efthyvoulos C. [0000-0002-4589-519X]
- Subjects
Male ,Serious games ,Ambulances ,Emergency Nursing ,feedback system ,Terminology ,video game ,Learning styles ,Electrocardiography ,User-Computer Interface ,Professional feedback-informed evaluation ,problem solving ,health personnel attitude ,middle aged ,Problem Solving ,education ,learning ,lcsh:Public aspects of medicine ,adult ,Middle Aged ,Telemedicine ,female ,cardiology ,lcsh:R858-859.7 ,Emergency assessment and management ,The Internet ,Female ,User interface ,Psychology ,Adult ,Medical education ,serious games ,Attitude of Health Personnel ,Best practice ,electrocardiography ,Cardiology ,Health Informatics ,computer interface ,lcsh:Computer applications to medicine. Medical informatics ,emergency nursing ,Likert scale ,Feedback ,Emergency telemedicine ,Nursing ,male ,Learning ,Humans ,ambulance ,human ,Research question ,Original Paper ,business.industry ,lcsh:RA1-1270 ,professional feedback-informed evaluation ,Virtual patients ,emergency assessment and management ,virtual patients ,Video Games ,emergency telemedicine ,business ,medical education - Abstract
Background: Serious games involving virtual patients in medical education can provide a controlled setting within which players can learn in an engaging way, while avoiding the risks associated with real patients. Moreover, serious games align with medical students’ preferred learning styles. The Virtual Emergency TeleMedicine (VETM) game is a simulation-based game that was developed in collaboration with the mEducator Best Practice network in response to calls to integrate serious games in medical education and training. The VETM game makes use of data from an electrocardiogram to train practicing doctors, nurses, or medical students for problem-solving in real-life clinical scenarios through a telemedicine system and virtual patients. The study responds to two gaps: the limited number of games in emergency cardiology and the lack of evaluations by professionals. Objective: The objective of this study is a quantitative, professional feedback-informed evaluation of one scenario of VETM, involving cardiovascular complications. The study has the following research question: “What are professionals’ perceptions of the potential of the Virtual Emergency Telemedicine game for training people involved in the assessment and management of emergency cases?” Methods: The evaluation of the VETM game was conducted with 90 professional ambulance crew nursing personnel specializing in the assessment and management of emergency cases. After collaboratively trying out one VETM scenario, participants individually completed an evaluation of the game (36 questions on a 5-point Likert scale) and provided written and verbal comments. The instrument assessed six dimensions of the game: (1) user interface, (2) difficulty level, (3) feedback, (4) educational value, (5) user engagement, and (6) terminology. Data sources of the study were 90 questionnaires, including written comments from 51 participants, 24 interviews with 55 participants, and 379 log files of their interaction with the game. Results: Overall, the results were positive in all dimensions of the game that were assessed as means ranged from 3.2 to 3.99 out of 5, with user engagement receiving the highest score (mean 3.99, SD 0.87). Users’ perceived difficulty level received the lowest score (mean 3.20, SD 0.65), a finding which agrees with the analysis of log files that showed a rather low success rate (20.6%). Even though professionals saw the educational value and usefulness of the tool for pre-hospital emergency training (mean 3.83, SD 1.05), they identified confusing features and provided input for improving them. Conclusions: Overall, the results of the professional feedback-informed evaluation of the game provide a strong indication of its potential as an educational tool for emergency training. Professionals’ input will serve to improve the game. Further research will aim to validate VETM, in a randomized pre-test, post-test control group study to examine possible learning gains in participants’ problem-solving skills in treating a patient’s symptoms in an emergency situation. [J Med Internet Res 2015;17(6):e150]
- Published
- 2015
28. Ambulance Dispatch Center Pilots Proactive Relocation Policies to Enhance Effectiveness.
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Van Buuren, Martin, Jagtenberg, Caroline, Van Barneveld, Thije, Van Der Mei, Rob, and Bhulai, Sandjai
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AMBULANCE service dispatching ,RELOCATION ,MANAGEMENT ,EMERGENCY medical personnel - Abstract
In life-threatening emergency situations in which every second counts, the timely arrival of an ambulance can make the difference between survival and death. In practice, the response-time targets, defined as the maximum time between the moment an incoming emergency call is received the moment when onsite medical aid is provided, are often not met. A promising means to reduce late arrivals by ambulances is to proactively relocate ambulances to ensure good coverage by the available ambulances in real time. This paper evaluates two dynamic relocation policies that an ambulance service provider in the Netherlands modified for operational use and implemented in a software tool for real-time decision support. The policies were used in a pilot program within a dispatch center for 12 weeks. Based on the success of this pilot, our policies were adopted for ongoing use and permanent implementation. This paper describes the relocation methods, evaluates the pilot, provides statistics for efficiency improvements, and discusses the experiences of ambulance dispatchers and management. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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29. Out of hospital emergency care in Nigeria: A narrative review
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Taofiq Olusegun Oyedokun, Emre Mehrab Islam, Nkemakolam Obinna Eke, Oladayo Oladipo, Olurotimi Olaolu Akinola, and Olufunmilayo Salami
- Subjects
Prehospital care ,Emergency medical services ,Emergency care ,Nigeria ,Ambulance ,Medicine ,Medicine (General) ,R5-920 - Abstract
Introduction: Out of Hospital Emergency Care (OHEC) in Nigeria, the most populous country with the highest GDP in Africa, is considered inadequate. A better understanding of the current state of OHEC is essential to address the country's unique challenges and offer potential solutions. Objectives: This paper sought to identify gaps, barriers, and facilitators in implementing an OHEC model in Nigeria and provide recommendations for improvement. Methods: We searched MEDLINE (PubMed), Embase (OVID), CINAHL (EBSCO), and Google Scholar, using combinations of “emergency medical care” (‘FRC,’ ‘PHC,’ and ‘EMS’) OR prehospital care OR emergency training' AND 'Nigeria.' We included papers that described OHEC in Nigeria and were published in English. Of the initial 73 papers, those that met our inclusion criteria and those obtained after examination of reference lists comprised the 20 papers that contributed to our final review. Two authors independently reviewed all the papers, extracted data relevant to our objectives and performed a content analysis. All authors reviewed, discussed, and refined the proposed recommendations. Key recommendations: For OHEC to meet the needs of Nigerians and achieve international standards, the following challenges need to be addressed: harmful cultural practices, inadequate training of citizens in the provision of first aid or of professionals that provide prehospital care, lack of proper infrastructure, poor communication, absent policy, and poor funding. Based on the available literature, this paper proposes key recommendations to improve OHEC with the hope of improving the standards of living. The federal government should provide general oversight, but this will require political will on the part of the country's leadership and the provision of adequate funding.
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- 2023
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30. Ambulance Path Clearance System With Health Monitoring Using Internet of Things.
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Sateesh, Aishwarya, K. S., Ankitha, K. N., Navyashree, B. C., Rakshitha, and Murthy, G. N. Keshava
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AMBULANCES ,INTERNET of things ,INTERNET usage monitoring ,AMBULANCE service ,TRAFFIC congestion ,BLOOD pressure - Abstract
Countless people’s lives are jeopardized in India’s crowded metropolitan metropolises due to ambulances stuck in traffic. Most of the time, commuters are unable to move in these traffic jams to make way for approaching ambulances which has become one of the most pressing issues in India. The main reason in the back of that is growing population which ends up in multiplied number of cars, due to which emergency provider like ambulance gets affected. This paper proposes a solution to make such offerings effortlessly available to those in need. It includes a software application referred to as Ambulance service through which the user can book the ambulance with one faucet and track the ambulance by using Google map on his device, we also use microcontroller-based hardware module to provide an easy flow for ambulance to attain the preferred destination This is achieved by using imposing RF technology which might automatically control the visitors alerts within the course of ambulance accordingly minimizing the time required to reach the destination. Besides this, a portable health monitoring device will be placed in the ambulance which will measure patient’s body temperature, blood pressure which will be displayed in the hospital’s webpage. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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31. Improving ambulance dispatch triage to trauma: A scoping review using the framework of development and evaluation of clinical prediction rules.
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Miller, Matthew, Bootland, Duncan, Jorm, Louisa, and Gallego, Blanca
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- *
MEDICAL triage , *AMBULANCES , *RETROSPECTIVE studies , *EMERGENCY medical services , *IMPACT of Event Scale - Abstract
Objective: Ambulance dispatch algorithms should function as clinical prediction rules, identifying high acuity patients for advanced life support, and low acuity patients for non-urgent transport. Systematic reviews of dispatch algorithms are rare and focus on study types specific to the final phases of rule development, such as impact studies, and may miss the complete value-added evidence chain. We sought to summarise the literature for studies seeking to improve dispatch in trauma by performing a scoping review according to standard frameworks for developing and evaluating clinical prediction rules.Methods: We performed a scoping review searching MEDLINE, EMBASE, CINAHL, the CENTRAL trials registry, and grey literature from January 2005 to October 2021. We included all study types investigating dispatch triage to injured patients in the English language. We reported the clinical prediction rule phase (derivation, validation, impact analysis, or user acceptance) and the performance and outcomes measured for high and low acuity trauma patients.Results: Of 2067 papers screened, we identified 12 low and 30 high acuity studies. Derivation studies were most common (52%) and rule-based computer-aided dispatch was the most frequently investigated (23 studies). Impact studies rarely reported a prior validation phase, and few validation studies had their impact investigated. Common outcome measures in each phase were infrequent (0 to 27%), making a comparison between protocols difficult. A series of papers for low acuity patients and another for pediatric trauma followed clinical prediction rule development. Some low acuity Medical Priority Dispatch System codes are associated with the infrequent requirement for advanced life support and clinician review of computer-aided dispatch may enhance dispatch triage accuracy in studies of helicopter emergency medical services.Conclusions: Few derivation and validation studies were followed by an impact study, indicating important gaps in the value-added evidence chain. While impact studies suggest clinician oversight may enhance dispatch, the opportunity exists to standardize outcomes, identify trauma-specific low acuity codes, and develop intelligent dispatch systems. [ABSTRACT FROM AUTHOR]- Published
- 2022
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32. Hybrid Ethnography: Mixing Participant Observation and Observant Participation.
- Author
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Seim, Josh
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PARTICIPANT observation ,EMERGENCY medical technicians ,ETHNOLOGY ,PARTICIPATION ,EYE contact - Abstract
How much should ethnographers involve themselves with the people, places, and process they study? One answer has become increasingly popular: invert the standard method of "participant observation" into "observant participation." This paper details the trade-offs between these two styles of ethnographic inquiry, underlines some important issues often ignored in the current ethnography debates, and considers the merits of combining participant observation and observant participation. To reach these ends, I drawn on an ethnography of 911 ambulance work in a large and dense California county. My fieldwork included "ride-alongs" with labor and management at a private ambulance firm (participant observation) and short-term employment as a novice emergency medical technician at the same company (observant participation). Reflecting on this study, I identify three issues at stake between participant observation and observant participation: field positioning, analytic gaze, and data assembly. I claim that ethnographers' decisions to lean toward one method over the other inevitably influences where they stand, the direction they tend to look, and the manner in which they extract local knowledge. Where participant observation presents more opportunities for mobile positioning, outward gazing, and inscription, observant participation presents more opportunities for fixed positioning, inward gazing, and incarnation. I detail the relative benefits and drawbacks of each method, but I also argue that there is something to gained by mixing them. What I call hybrid ethnography is promising for a somewhat obvious reason: it allows ethnographers to use the strengths of observant participation to counter the weaknesses of participant observation and vice versa. I close this paper by considering the limitations of a hybrid approach and highlight some directions for future research and reflection. [ABSTRACT FROM AUTHOR]
- Published
- 2019
33. Exploring factors associated with paramedic work-related psychological injury through data linkage.
- Author
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Kearney, Jason, Muir, Carlyn, Smith, Karen, and Meadley, Ben
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- *
EMERGENCY medical technicians , *MEDICAL records , *LOGISTIC regression analysis , *MULTIVARIABLE testing , *EXPLORATORY factor analysis , *AMBULANCE service , *EMERGENCY medical services , *WORK-related injuries - Abstract
• First study to examine paramedic psychological injury through EMS data linkage. • Fatality and cardiac arrest cases increase the odds of psychological injury. • Lower patient age is associated with paramedic psychological injury. • Findings may help facilitate the provision of early interventions to those at risk. Introduction : In comparison to the general population and other emergency services workers, paramedics experience high rates of work-related psychological injury. However, there is limited understanding of the case and practitioner-related factors that increase the risk of psychological injury among these workers. This paper aims to identify case and practitioner-related factors associated with paramedic work-related psychological injury in Victoria, Australia, through data linkage. Methods : Data linkage of 7,223 paramedic injury reports with electronic patient care records, and paramedic demographic data from the single state-wide ambulance service in Victoria, Australia – Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Factors associated with paramedic psychological injury were assessed using multivariable logistic regression analysis. Results : A total of 4,641 (64%) injury reports were successfully linked, of which, 244 (5%) were psychological injuries. Shift hours between 0401 and 0800 (AOR 1.83; 95%CI: 1.12–2.97), cardiac arrest or deceased patient attendances (AOR 2.15; 95%CI: 1.06–4.34), hospital or medical center case locations (AOR 2.44; 95%CI: 1.22–4.91), and Priority 0 (AOR 2.27; 95%CI: 1.26–4.09), Priority 2 (AOR 1.56; 95%CI: 1.04–2.33), and Priority 3 (AOR 1.95; 95%CI: 1.15–3.32) dispatch codes were associated with increased odds of psychological injury. Increasing patient age (AOR 0.98; 95%CI: 0.97–0.99), and the absence of other emergency services on scene (AOR 0.50; 95%CI: 0.34–0.72) were associated with decreased odds of paramedic psychological injury. Conclusions: This is the first study to collectively examine and identify EMS case and practitioner-related characteristics associated with paramedic psychological injury through data linkage of EMS agency-level data sources. Practical application: The findings of this study highlight the dispatch case characteristics that may increase the risk of a paramedic sustaining a work-related psychological injury, and consequently facilitate the early identification, intervention, and support of the individuals most at risk. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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34. INTEnsive ambulance-delivered blood pressure Reduction in hyper-ACute stroke Trial (INTERACT4): study protocol for a randomized controlled trial.
- Author
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Song, Lili, Chen, Chen, Chen, Xiaoying, Guo, Yijia, Liu, Feifeng, Lin, Yapeng, Billot, Laurent, Li, Qiang, Liu, Hueiming, Si, Lei, Ouyang, Menglu, Arima, Hisatomi, Bath, Philip M., Ford, Gary A., Robinson, Thompson, Sandset, Else Charlotte, Saver, Jeffrey L., Sprigg, Nikola, van der Worp, H. Bart, and Zhang, Chunfang
- Subjects
RANDOMIZED controlled trials ,RESEARCH protocols ,BLOOD pressure ,INTRACRANIAL hemorrhage ,ISCHEMIC stroke ,HYPERTENSION ,REPERFUSION ,SYSTOLIC blood pressure - Abstract
Background: Early pre-hospital initiation of blood pressure (BP) lowering could improve outcomes for patients with acute stroke, by reducing hematoma expansion in intracerebral hemorrhage (ICH), and time to reperfusion treatment and risk of intracranial hemorrhage in ischemic stroke (IS). We present the design of the fourth INTEnsive ambulance-delivered blood pressure Reduction in hyper-ACute stroke Trial (INTERACT4).Methods: A multi-center, ambulance-delivered, prospective, randomized, open-label, blinded endpoint (PROBE) assessed trial of pre-hospital BP lowering in 3116 hypertensive patients with suspected acute stroke at 50+ sites in China. Patients are randomized through a mobile phone digital system to intensive BP lowering to a target systolic BP of < 140 mmHg within 30 min, or guideline-recommended BP management according to local protocols. After the collection of in-hospital clinical and management data and 7-day outcomes, trained blinded assessors conduct telephone or face-to-face assessments of physical function and health-related quality of life in participants at 90 days. The primary outcome is the physical function on the modified Rankin scale at 90 days, analyzed as an ordinal outcome with 7 categories. The sample size was estimated to provide 90% power (α = 0.05) to detect a 22% reduction in the odds of a worse functional outcome using ordinal logistic regression.Discussion: INTERACT4 is a pragmatic clinical trial to provide reliable evidence on the effectiveness and safety of ambulance-delivered hyperacute BP lowering in patients with suspected acute stroke.Trial Registration: ClinicalTrials.gov NCT03790800. Registered on 2 January 2019; Chinese Trial Registry ChiCTR1900020534. Registered on 7 January 2019. All items can be found in this protocol paper. [ABSTRACT FROM AUTHOR]- Published
- 2021
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35. Which health-related reasons lead to prehospital emergency care and how does subjective emergency status connect to subsequent care?: Emergency medical service patients' survey linked to health claims data.
- Author
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Piedmont, Silke, Reinhold, Anna Katharina, Bock, Jens-Oliver, Swart, Enno, and Robra, Bernt-Peter
- Abstract
Copyright of Notfall & Rettungsmedizin is the property of Springer Nature 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
- 2021
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36. The Alternative Pre-hospital Pathway team: reducing conveyances to the emergency department through patient centered Community Emergency Medicine.
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Patton, Andrew, O'Donnell, Cathal, Keane, Owen, Henry, Kieran, Crowley, Donal, Collins, Adrian, Redmond, Eoghan, Glynn, Nicky, Dunne, Martin, and Deasy, Conor
- Subjects
EMERGENCY medicine ,EMERGENCY medical technicians ,HOSPITAL emergency services ,CITY dwellers ,AMBULANCE service ,RURAL population ,HOSPITALS ,PATIENT-centered care ,RETROSPECTIVE studies ,EMERGENCY medical services - Abstract
Background: Internationally increasing demand for emergency care is driving innovation within emergency services. The Alternative Pre-Hospital Pathway (APP) Team is one such Community Emergency Medicine (CEM) initiative developed in Cork, Ireland to target low acuity emergency calls. In this paper the inception of the APP Team is described, and an observational descriptive analysis of the APP Team's service data presented for the first 12 months of operation. The aim of this study is to describe and analyse the APP team service.Methods: The APP Team, consisting of a Specialist Registrar (SpR) in Emergency Medicine (EM) and an Emergency Medical Technician (EMT) based in Cork, covers a mixed urban and rural population of approximately 300,000 people located within a 40-min drive time of Cork University Hospital. The team are dispatched to low acuity 112/999 calls, aiming to provide definitive care or referring patients to the appropriate community or specialist service. A retrospective analysis was performed of the team's first 12 months of operation using the prospectively maintained service database.Results: Two thousand and one patients were attended to with a 67.8% non-conveyance rate. The median age was 62 years, with 33.0% of patients aged over 75 years. For patients over 75 years, the non-conveyance rate was 62.0%. The average number of patients treated per shift was 7. Medical complaints (319), falls (194), drug and alcohol related presentations (193), urological (131), and respiratory complaints (119) were the most common presentations.Conclusion: Increased demand for emergency care and an aging population is necessitating a re-design of traditional models of emergency care delivery. We describe the Alternative Pre-Hospital Pathway service, delivered by an EMT and an Emergency Medicine SpR responding to low acuity calls. This service achieved a 68% non-conveyance rate; our data demonstrates that a community emergency medicine outreach team in collaboration with the National Ambulance Service offering Alternative Pre-Hospital Pathways is an effective model for reducing conveyances to hospital. [ABSTRACT FROM AUTHOR]- Published
- 2021
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37. Ambulance Siren Detection using ANN.
- Author
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Kamaladevi, R., Hashir, M. Mohamed, and James, Y. Godbin
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AMBULANCES ,ARTIFICIAL neural networks ,TRAFFIC congestion ,TRAFFIC signs & signals ,TRAFFIC police ,EMERGENCY vehicles - Abstract
Hearing and seeing accidents and deaths happening all over the world due to poor road networking and overriding of traffic rules is just tragic. And these accidents involve an ambulance rushing to nearby hospital in the hope to save the individual's life, and what they undergo on the way is that the congestion of traffic signals. Now the major setback found in this unhealthy situation is that the traffic police couldn't identify the direction of ambulance with only its siren, and they could only intervene and change the light signals only when they see the ambulance. This unawareness of ambulance's direction gave an opportunity to propose a solution to solve the problem by assisting in existing traffic light concept with the modification in its generic system by making use of the ambulance's siren feature. Machine Learning is now permeable in every product or solution that exists, and it really does its job on helping us and it has also given us a way to solve the existing traffic problem during emergency situations making the traffic light system automatically analyse the arrival of Emergency Vehicles (EV) and assist the traffic police beforehand on which direction the ambulance is arriving so that emergency measures like changing the lights to avoid congestion in the intersection can be done. By implementing Artificial Neural Networks (ANN) with Mel-Frequency Cepstral Coefficients (MFCC) feature extraction method the model achieved a 90% accuracy and accurately predicted the siren sound which was then verified by the CSV file given by the dataset-Urbansound8k. The audio data were converted into data points using MFCC and then easily mapped them with their respective classes. With ANN and MFCC, the prediction and accuracy rate are said to be better and by simple neural networks high grade feature extraction method was implemented. [ABSTRACT FROM AUTHOR]
- Published
- 2023
38. A conceptual framework for the exploration of the relationship between systems of paramedicine and system performance.
- Author
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Makrides, Timothy, Ross, Linda, Gosling, Cameron, and O'Meara, Peter
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MEDICAL information storage & retrieval systems ,EVALUATION of organizational effectiveness ,PUBLIC health ,CONCEPTUAL structures ,QUALITY assurance ,PARAMEDICINE - Abstract
Over the past 60 years since its inception, the Anglo-American Paramedic System has continued to grow and evolve. While brief and fragmented accounts of the differences between systems have been noted in the literature, until recently there has been a paucity of research that explores and identifies sub-models of paramedicine within the Anglo-American Paramedic System. This article describes a conceptual framework that sets a roadmap for defining and comparing two newly identified sub-models of the Anglo-American Paramedic System. A conceptual framework for the exploration of these novel sub-models was developed on the basis of the work completed by Donabedian as well as Turncock and Handler. These two sub-models worked to develop a model for quality assessment and performance measurement in the public health system. The conceptual framework consists of six components that are strongly related to each other: system design, macro context, mission and purpose, structure, service delivery models and quality outcome measures. While this framework relates specifically to two novel paramedic systems known as the Professionally Autonomous an Directive paramedic systems, it can be used to measure any integrated health model. The conceptual framework described in this paper provides a stepwise roadmap for the definition and comparison of the newly identified paramedic systems to better inform future research that defines and compares paramedic system design and performance. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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39. Simulation-based design concept evaluation for ambulance patient compartments.
- Author
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Kibira, Deogratias, Lee, Y. Tina, Marshall, Jennifer, Feeney, Allison Barnard, Avery, Larry, and Jacobs, Allie
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COMPUTER simulation ,AMBULANCES ,EMERGENCY medical services ,VEHICLE design & construction - Abstract
To address the inadequacy of ambulance design standards, the Department of Homeland Security Science and Technology Directorate, the National Institute of Standards and Technology, the National Institute for Occupational Safety and Health, and BMT Designers and Planners have collaborated to develop new design standards for ambulance patient compartments. This paper presents a simulation-based approach to evaluate and guide improving patient compartment designs that conform to developed requirements for better performance and safety of ambulance users. Those requirements address hazards stemming from (1) the inability of providers to remain safely restrained while treating patients, and (2) the musculoskeletal damage from awkward body postures. An initial design was developed through the axiomatic design approach with inputs from stakeholders such as emergency medical service providers and ambulance manufacturers. The design was imported into a human task simulation tool. It was tested for performance to identify areas for further improvements, which resulted in a second design concept. This paper shows how computer simulation was used to evaluate the effectiveness of the two successive design concepts in enabling providers to perform a range of medical care tasks while remaining seated and restrained. We also evaluated the musculoskeletal effect of these designs on the providers. The results showed that using a simulation-based evaluation produced patient compartments that better meet user requirements when compared with traditional designs. This research produced a set of requirements and recommendations that we believe will lead to better design standards and guidelines for the next generation of ambulances. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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40. Exploiting population data, uses and methods in uncovering factors associated with suicide and psychological distress
- Author
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Dougall, Nadine, Maxwell, Margaret, and Lambert, Paul
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Routine data ,Population data ,Distress ,Suicide ,Deaths of despair ,Ambulance ,Police ,Social determinants of health ,Health inequalities ,Childhood adversity ,Mental health ,Hospital data ,Emergency department ,Unscheduled care ,Vulnerability ,Disease classification ,Health informatics ,e-Health ,Lived experience ,Self-harm ,Impact ,National workshop ,Age period cohort ,Trajectories ,Health data research ,Case control study ,Longitudinal data ,Cohort study ,Scotland ,England & Wales ,Psychiatric ,Diagnoses - Abstract
Society faces significant challenges caring for people with urgent mental health needs. General hospitals are well equipped for dealing with medical emergencies, but much less skilled in managing mental health problems. Ambulance and policing staff frequently encounter such individuals, with transport to Emergency Department often the only care pathway. In the UK, no evidence existed on general hospital patterns prior to suicide, or on outcomes for pre-hospital mental health emergencies. This thesis contains five papers, consisting of four research studies and one protocol. Three papers report innovative quantitative approaches using linked datasets. Using 30 years of Scottish hospital data, I showed that 10,907 people who died by suicide with hospital records were 3.1 times more frequently last discharged from general, not psychiatric hospital; 24% within three months of last discharge, of whom 58% were from general hospital. Using national deaths registrations, I reported that cohorts of men born around 1965-70 had been at greater vulnerability to suicide in the 1990s, with stark differences in suicide rates between Scotland, and England & Wales. Analyses of data on unscheduled care revealed that within one year of paramedic attendances for 6,802 people with 'psychiatric emergency', 297 had died, 35% of whom were deaths by suicide. Paramedics were in contact with 8% of people in the year before they died by suicide. Police officers encountering people with mental health concerns have no formal means of vulnerability assessment to support triaging. A review of the evidence found no consensus definition for vulnerability or means of assessing vulnerability, a lack of congruence in terminology across policing and health, and a likely barrier to accessing services. Finally, a protocol was published outlining methods for an analysis of childhood adversity as seen in national hospital datasets. This thesis provides evidence to support redesign of more integrated services, highlights areas for suicide prevention, and closes with an impact generation exemplar.
- Published
- 2020
41. A survey of ambulance clinicians' perceptions of recording and communicating patient information electronically.
- Author
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Barrett, Jack William, Eaton-Williams, Pete, Mortimer, Craig ED, Land, Victoria FP, and Williams, Julia
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MEDICAL personnel ,AMBULANCES ,AMBULANCE service ,TELECOMMUNICATION systems ,TECHNOLOGY Acceptance Model - Abstract
Objective: Ambulance services are evolving from use of paper-based recording of patient information to electronic platforms and the impact of this change has yet to be fully explored. The aim of this study is to explore how the introduction of a system permitting electronic information capture and its subsequent sharing were perceived by the ambulance clinicians using it. Methods: An online questionnaire was designed based upon the technology acceptance model and distributed throughout one ambulance service in the south east of England. Closed-ended questions with Likert scales were used to collect data from patient-facing staff who use an online community falls and diabetic referral platform or an electronic messaging system to update GPs following a patient encounter. Results: There were 273 responses from ambulance clinicians. Most participants agreed that they used tablet computers and smartphones to make their life easier (85% and 86%, respectively). Most participants felt that referring patients to a community falls or diabetic team electronically was an efficient use of their time (81% and 81%, respectively) and many believed that these systems improved the communication of confidential patient information. GP summaries were perceived as increasing time spent on scene but most participants (89%) believed they enabled collaborative working. Overall, collecting and sharing patient information electronically was perceived by most participants as beneficial to their practice. Conclusion: In this study, the ability to electronically refer patients to community services and share patient encounters with the GP was predominantly perceived as both safe for patients and an effective use of the participants' clinical time. However, there is often still a need to communicate to GPs in real time, demonstrating that technology could complement, rather than replace, how clinicians communicate. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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- View/download PDF
42. Minimization of Ambulance Response Time Using Image Processing and Critical Path Mapping Based on Traffic Control
- Author
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Rafiq, Shuja, Khanum, Mohammadi Akheela, Ahamad, Faiyaz, Bansal, Jagdish Chand, Series Editor, Deep, Kusum, Series Editor, Nagar, Atulya K., Series Editor, Engelbrecht, Andries, editor, and Shukla, Praveen Kumar, editor
- Published
- 2022
- Full Text
- View/download PDF
43. Procedures in COVID-19 Patients: Part-II.
- Author
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Pande, Rajesh K., Juneja, Deven, Jain, Akansha, Bhalla, Ashish, Myatra, Sheila N., Yaddanpuddi, Lakshmi N., Gupta, Sachin, Sahoo, Tapas K., Kumar, Prashant, Sahu, Tarun A., Gopal, Palepu BN, Chaudhry, Dhruva, Govil, Deepak, and Samavedam, Srinivas
- Subjects
TREATMENT of chronic kidney failure ,ECHOCARDIOGRAPHY ,COVID-19 ,POINT-of-care testing ,CRITICALLY ill ,INTERVENTIONAL radiology ,PATIENTS ,TRANSPORTATION of patients ,MEDICAL protocols ,CRITICAL care medicine ,HEMODIALYSIS ,COMPUTED tomography ,ACUTE kidney failure - Abstract
Critical care in the era of novel coronavirus disease-2019 (COVID-19) infection has multiple challenges including management of the patient, underlying comorbidities, and the complications. With no end in sight to the pandemic, intensive care unit (ICU) practitioners and hospital administrators have to join hands to prepare for the long battle ahead. Critically ill COVID-19 patients need imaging or image-guided interventions in one form or the other including X-rays, ultrasonography (USG), echocardiography (ECHO), and CT scan. These patients often require renal replacement therapy (RRT) for either the preexisting chronic renal insufficiency or acutely developing kidney injury. Another important component of care is transfer of the patient to and fro from the ICU or to higher care centers. Most of the ICUs are equipped with modern facilities but with increasing number of patients a large number of makeshift arrangements are being made for managing these patients. This position paper outlines important tips to formulate protocols and procedures for critically ill patients, who are managed in the ICU. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
44. Cognitive skills of emergency medical services crew members: a literature review.
- Author
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Sedlár, Martin
- Subjects
EMERGENCY medical services ,LITERATURE reviews ,MILITARY personnel ,SITUATIONAL awareness ,ABILITY - Abstract
Background: Situation awareness and decision making, listed in non-technical skills taxonomies, are critical for effective and safe performance in high-risk professions. These cognitive skills and their behavioral markers have been studied less in emergency medical services (EMS) crew members. This paper aims to review the existing literature and identify important aspects and behavioral markers of situation awareness and decision making in EMS crew members - those who work in the role of prehospital emergency care providers - and to synthesize findings as a basis for developing a rating and training tool.Method: The search for relevant articles was conducted using electronic databases, reference lists of relevant reviews and included articles and personal collection of articles. The selection process based on the PRISMA statement yielded a total of 30 articles that met the eligibility criteria. Their findings were qualitatively synthesized using the structured approach, informed by the already known structure: situation awareness and its elements (gathering information, interpreting information, anticipating future states), decision making and its elements (generating and considering options, selecting and implementing an option, reviewing outcome/decision). Moreover, the element of maintaining standards also emerged as highly relevant for cognitive skills.Results: This review found an increased research interest in the non-technical cognitive skills of EMS crew members. The majority of included articles' research designs were qualitative, then mixed, Delphi, and quantitative. It revealed several specifics of cognitive skills, such as EMS crew members need to holistically assess a wide range of cues and information, to make various health- and safety-related decisions and take EMS standards into account. However, there was only a limited number of observable markers of cognitive skills, such as acts and verbalizations, that could be considered as examples of good behavior. In addition, findings indicate a lack of articles focused on mass-casualty incidents and the interconnection of cognitive skills with other non-technical and medical skills.Conclusion: Further research is needed to get a more comprehensive view of behavioral markers of cognitive skills and to develop a rating and training tool to improve EMS crew members' cognitive performance. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
45. Prehospital trauma care evolution, practice and controversies: need for a review.
- Author
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Varghese, Mathew
- Subjects
HOSPITAL care ,REHABILITATION centers ,BIOLOGICAL evolution - Abstract
Modern medicine and surgery is historically very recent, and most interventions that are so commonly done in a hospital now are only 60 to 70 years old. Understanding of emergency care of the injured is more recent; however, for the sake of temporal convenience trauma care has become compartmentalized into phases: first aid, bystander care, prehospital care, emergency care, definitive levels of care and rehabilitation. The injured patient's body physiology is changing continuously from the time of the impact at the injury site.. The outcome of trauma is dependent not only on what is done in the prehospital phase but also on hospital care and rehabilitation. Our understanding of the changes and the response to interventions in a trauma patient has been evolving over the years. This paper discusses the need to review recent advances in our understanding of the care process and how we need to improve it and how there is a pressing need to generate valid evidence on what we do in emergency care. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
46. Ambulances are for emergencies: shifting behaviour through a research-informed behaviour change campaign.
- Author
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Borg, Kim, Dumas, David, Andrew, Emily, Smith, Karen, Walker, Tony, Haworth, Matthew, and Bragge, Peter
- Subjects
AMBULANCES ,AMBULANCE service ,BEHAVIOR ,EMERGENCIES - Abstract
Background: A major review of Victoria's ambulance services identified the need to improve public awareness of the role of ambulances as an emergency service. A communications campaign was developed to address this challenge. This research paper expands on an initial evaluation of the campaign by focusing on the long-term behavioural outcomes.Methods: The behavioural evaluation involved two types of data collection - administrative data (routine collection from various health services) and survey data (cross-sectional community-wide surveys to measure behavioural intentions).Results: Behavioural intentions for accessing two of the targeted non-emergency services increased after the second phase of the campaign commenced. There was also a significant change in the slope of call trends for emergency ambulances. This decrease is also likely attributed to the second phase of the campaign as significant level effects were identified 3 and 9 months after it commenced.Conclusions: A long-term campaign developed through evidence review, stakeholder consultation and behavioural theory was successful in reducing the number of daily calls requesting an emergency ambulance in Victoria and in increasing intentions to use alternative services. This research highlights the importance of collaborative intervention design along with the importance of implementing a robust monitoring and evaluation framework. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
47. BUILDING AN EMERGENCY RADIO CONTROLLED (RC) PLANE THAT WORKS BY SOLAR PANELS.
- Author
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Batawi, Raed and Consigny, Rucele
- Subjects
AIRPLANE radio control ,SOLAR cells ,DRONE aircraft ,SOLAR energy ,REMOTE control ,VEHICLE design & construction - Abstract
The radio controller (RC) is used for an airplane and operated remotely. The (RC) plane isn't a new invention in the world, but what is good about this is that it is supported by solar panels and costs less money. In addition, there is no need for the use of gas or charged battery so it is able to help in first aid activities. In this research paper, the author explained how to build an emergency (RC) Plane that is powered by solar panels. First, it was emphasized that the (RC) plane has different specifications. Second, the role of the electronic engine and solar panel were emphasized. The difficulty in this project was the electrical battery that had to be changed into solar panel. Data collection methodology was in the form of system design and re-engineering because it applied technology. Therefore, in the future it can be expected that an (RC) plane would be designed as an unmanned aerial vehicle and will be used by the plane without remote control so it can fly with simulator programs. Future research studies can hopefully find a solution to enable and (RC) plane to become more effective in an emergency first aid. [ABSTRACT FROM AUTHOR]
- Published
- 2016
48. The accuracy of NEWS-2 in the emergency prehospital setting in Saudi Arabia.
- Author
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Alghamdi, Abdulrhman, Alshibani, Abdullah, Binhotan, Meshary, Alharbi, Meshal, Alabdali, Abdullah, and Albaiz, Saad
- Subjects
MORTALITY risk factors ,RISK assessment ,PATIENTS ,HOSPITAL admission & discharge ,SCIENTIFIC observation ,EMERGENCY medicine ,EMERGENCY medical services ,SEVERITY of illness index ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,INTENSIVE care units ,MEDICAL records ,ACQUISITION of data ,EARLY warning score ,DATA analysis software ,CONFIDENCE intervals ,PREDICTIVE validity ,TIME ,SENSITIVITY & specificity (Statistics) - Abstract
Introduction: Various early warning score tools have been developed to identify clinical deterioration in patients. This study assessed the predictive capacity of the National Early Warning Score 2 (NEWS-2) in the prehospital setting to predict death within 24 hours and 30-day intensive care unit admission. Methods: A single-center observational retrospective study was conducted in the emergency medical services (EMS) of King Abdulaziz Medical City, Riyadh, Saudi Arabia. We included adult patients (> 18 years) who attended the emergency medical service. The primary outcome was 24-hour death and 30-day intensive care unit admission. Sensitivity, specificity, and negative/positive predictive values (NPV/PPV) were determined. Results: The study comprised 1,343 eligible patients. NEWS-2 exhibited a sensitivity of 20% and a specificity of 80% for predicting 24-hour death and a sensitivity of 10% and a specificity of 80% for predicting 30-day intensive care unit admission. The area under the curve for predicting death was 0.529, and for intensive care unit admission was 0.456. Conclusion: Our study underscores the limited utility of NEWS-2 as a predictor of 24-hour death and 30-day intensive care unit admission in adult patients utilizing the emergency medical service. Further extensive studies are warranted to corroborate this study's findings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
49. Chaplaincy and spiritual care in Australian ambulance services: an exploratory cross-sectional study.
- Author
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Tunks Leach, Katie, Demant, Daniel, Simpson, Paul, Lewis, Joanne, and Levett-Jones, Tracy
- Subjects
CROSS-sectional method ,HEALTH services accessibility ,SCALE analysis (Psychology) ,RESEARCH funding ,EMERGENCY medical technicians ,STATISTICAL sampling ,QUESTIONNAIRES ,CHI-squared test ,SURVEYS ,SPIRITUAL care (Medical care) ,AMBULANCES ,RESEARCH ,SOCIAL support ,DATA analysis software ,HOSPITAL chaplains - Abstract
Ambulance staff wellbeing programs aim to support the bio-psycho-social and sometimes spiritual needs of paramedics. While evidence demonstrates strong connections between spirituality and/or religion to wellbeing outcomes, little is known about spiritual care in ambulance services or its impact. The aim of this study was to investigate paramedics' perspectives on the role and value of Australian ambulance chaplains. A cross-sectional online study of registered paramedics in Australia was conducted between November and December 2022. Analysis of the 150 responses identified that paramedics viewed the chaplain's role as one built on professional caring relationships that provided proactive and reactive care in paramedic workplaces. Chaplains were perceived to promote wellbeing by incorporating emotional, psychological, social and spiritual care, and assisting paramedics to access additional support. Perceived religiousness of chaplains and organisational factors were barriers to paramedics accessing chaplains, while pre-existing relationships and shared experiences positively influenced paramedics decision to seek chaplain support. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
50. Nachhaltigkeit im Rettungsdienst – Recyclingpotenzial von Verpackungsmaterialien aus Rettungsdiensteinsätzen
- Author
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Willmann, Lars, Franke, Thomas, Brune, Bastian, Afflerbach, Christian, Weichert, Veronika, Zeiger, Sascha, Dudda, Marcel, and Nohl, André
- Published
- 2024
- Full Text
- View/download PDF
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