1,030 results
Search Results
2. How important are delays in treatment for health outcomes? The case of ambulance response time and cardiovascular events.
- Author
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Lucchese E
- Subjects
- Humans, Reaction Time, Policy Making, Outcome Assessment, Health Care, Ambulances, Cardiovascular Diseases therapy
- Abstract
The cost effectiveness of medical treatments is not precisely known due to the compounding effect of multiple determining factors. Ambulance response time (RT) to emergency calls is exploited to learn more about the effect of the timing of treatment on health outcomes. This causal relation is identified by exploiting rainfall at the time of the ambulance run as a shock to RT. The analysis focuses on patients who have undergone a cardiac event and shows that a one-minute increase in average RT leads to 105 more deaths each year in one Italian region. Finally, the economic value of the lives that would be saved by reducing RT is quantified to facilitate policymaking., (© 2023 The Authors. Health Economics published by John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
3. Ambulance use and emergency department visits among people with dementia: A cross-sectional survey.
- Author
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Nasu K, Miyashita M, Hirooka K, Endo T, and Fukahori H
- Subjects
- Male, Humans, Cross-Sectional Studies, Caregivers, Emergency Service, Hospital, Ambulances, Dementia complications, Dementia therapy
- Abstract
This study aimed to explore factors associated with ambulance use and emergency department (ED) visits among people with dementia in the month before death. A web-based survey of bereaved family caregivers of people with dementia was conducted in March 2020. Multivariate logistic regression analyses were conducted with ambulance use and ED visits in the month before death as dependent variables. Age and gender of people with dementia and their family caregivers, home care use, decision-makers, comorbidities, degree of independence in daily living, and caregivers' preparedness for death were independent variables. Data were collected from 817 caregivers of people with dementia who had died at hospitals (52.4%), long-term care facilities (25.0%), or own homes (22.4%). Caregivers' lack of preparedness for death was significantly associated with ambulance use in the month before death. Comorbidites and males with dementia were significantly associated with ED visits in the month before death. Better death preparedness of family caregivers may reduce ambulance use for symptoms that can be more effectively addressed by palliative care than acute care for people with dementia., (© 2023 The Authors. Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)
- Published
- 2023
- Full Text
- View/download PDF
4. Prehospital Emergency Medical Services: Paper Versus Technology.
- Author
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Piani, Tommaso, Boccolato, Lorenzo, Ruzza, Gianpaolo, Pausler, Daniele, Trillò, Giulio, Macor, Cristiana, Pascolo, Piero, and De Monte, Amato
- Subjects
- *
AMBULANCES , *DIFFUSION of innovations , *DOCUMENTATION , *EMERGENCY medical services , *EMERGENCY medicine , *EXPERIENTIAL learning , *INTENSIVE care nursing , *PORTABLE computers , *QUALITY assurance , *MEDICAL triage , *WORK , *DIGITAL technology - Abstract
Digital technology has an essential role in the development and application of innovations within the health care system. Its application is not limited to the hospital environment but extends to the emergency medical services system. The experimental phase of the shift to electronic emergency medical services documentation was performed within the Azienda Sanitaria Universitaria Friuli Centrale of Udine (Italy), a local health authority covering about 533 000 inhabitants. Considering the results of this study, we believe it is important to continue to update the methods of data collection and analysis in correlation with the management and outcomes of the patients. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
5. Difference between how ambulance service personnel use paper and electronic patient care records when attending older people at home
- Author
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Marina Buswell, Sarah Amador, Claire Goodman, Jane Fleming, Philip Lumbard, Larissa Prothero, Fleming, Jane [0000-0002-8127-2061], and Apollo - University of Cambridge Repository
- Subjects
Male ,Paper ,Emergency Medical Services ,Ambulances ,Patient care ,Data accuracy ,Emergency medical services ,Ambulance service ,Medicine ,Dementia ,Electronic Health Records ,Humans ,Geriatric Assessment ,Aged ,Aged, 80 and over ,business.industry ,Emergency Responders ,Geriatric assessment ,medicine.disease ,United Kingdom ,Data Accuracy ,Emergency Medicine ,Female ,Medical emergency ,Patient Care ,business ,Older people - Abstract
Marina Buswell, et al, 'Difference between how ambulance service personnel use paper and electronic patient care records when attending older people at home', letter to European Journal of Emergency Medicine, Vol. 22 (2), published on 1 April 2015. © 2015 Wolters Kluwer Health, Inc. All rights reserved.
- Published
- 2015
6. Effect of fluid administration on scene to traffic accident patients by EMS personnel: a propensity score-matched study using population-based ambulance records and nationwide trauma registry in Japan.
- Author
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Katayama Y, Kitamura T, Kiyohara K, Ishida K, Hirose T, Nakao S, Tachino J, Matsuyama T, Kiguchi T, Umemura Y, Noda T, Nakagawa Y, and Shimazu T
- Subjects
- Accidents, Traffic, Humans, Japan epidemiology, Propensity Score, Registries, Retrospective Studies, Ambulances, Emergency Medical Services
- Abstract
Purpose: The aim of this study was to assess the effect of fluid administration by emergency life-saving technicians (ELST) on the prognosis of traffic accident patients by using a propensity score (PS)-matching method., Methods: The study included traffic accident patients registered in the JTDB database from January 2016 to December 2017. The main outcome was hospital mortality, and the secondary outcome was cardiopulmonary arrest on hospital arrival (CPAOA). To reduce potential confounding effects in the comparisons between two groups, we estimated a propensity score (PS) by fitting a logistic regression model that was adjusted for 17 variables before the implementation of fluid administration by ELST at the scene., Results: During the study period, 10,908 traffic accident patients were registered in the JTDB database, and we included 3502 patients in this study. Of these patients, 142 were administered fluid by ELST and 3360 were not administered fluid by ELST. After PS matching, 141 patients were selected from each group. In the PS-matched model, fluid administration by ELST at the scene was not associated with discharge to death (crude OR: 0.859 [95% CI, 0.500-1.475]; p = 0.582). However, the fluid group showed statistically better outcome for CPAOA than the no fluid group in the multiple logistic regression model (adjusted OR: 0.231 [95% CI, 0.055-0.967]; p = 0.045)., Conclusion: In this study, fluid administration to traffic accident patients by ELST was associated not with hospital mortality but with a lower proportion of CPAOA., (© 2021. The Author(s).)
- Published
- 2022
- Full Text
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7. Regulation and registration as drivers of continuous professional competence for Irish pre-hospital practitioners: a discussion paper
- Author
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Colum P. Dunne, M. Hughes, S. Cheeseman, Suzanne S. Dunne, and Shane Knox
- Subjects
Reflective practice ,Ambulances ,education ,competence ,Allied Health Personnel ,CINAHL ,03 medical and health sciences ,0302 clinical medicine ,continuous professional development ,Nursing ,Irish ,Online search ,Health care ,Medicine ,Humans ,030212 general & internal medicine ,Competence (human resources) ,advanced paramedic ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,Professional competence ,professionalism ,paramedic ,emergency medical technician ,humanities ,language.human_language ,Hospitals ,Emergency Medical Technicians ,Continuing professional development ,language ,Clinical Competence ,business ,Ireland - Abstract
peer-reviewed Background The Regulatory Body responsible for the registration of Irish pre-hospital practitioners, the Pre-Hospital Emergency Care Council (PHECC), identified the need to implement a continuing professional competence (CPC) framework. The first cycle of CPC (focused on Emergency Medical Technicians) commenced in November 2013 creating for the first time a formal relationship between continuing competence and registration to practice. Aims To review current literature and to describe benefits and challenges relevant to CPC, regulation, registration and their respective contributions to professionalism of pre-hospital practitioners: advanced paramedics, paramedics and emergency medical technicians. Methods Online search of Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus with Full Text), Allied and Complementary Medicine (AMED) and ‘Pubmed’ databases using: ‘Continuous Professional Development’; ‘Continuous Professional Development’; ‘emergency medical technician’; ‘paramedic’; ‘registration’; ‘regulation’; and “profession’ for relevant articles published since 2004. Additional policy documents, discussion papers, and guidance documents were identified from bibliographies of papers found. Results Reports, governmental policies for other healthcare professions, and professional developments internationally for allied professions (e.g., nursing, physiotherapy and medicine) link maintenance of competence with requirements for registration to practice. Conclusion We suggest that evolving professionalisation of Irish paramedics should be affirmed through behaviours and competencies that incorporate adherence to professional codes of conduct, reflective practice, and commitment to continuing professional development. While the need for ambulance practitioner CPD was identified in Ireland almost a decade ago, PHECC now has the opportunity to introduce a model of CPD for paramedics linking competence and professionalism to annual registration ACCEPTED peer-reviewed
- Published
- 2016
8. Frequency and duration of ambulance officer exposure to nitrous oxide and methoxyflurane in New Zealand.
- Author
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Allison SJ, Docherty PD, Pons D, and Chase JG
- Subjects
- Humans, New Zealand, Pain drug therapy, Retrospective Studies, Risk, Air Pollutants, Occupational, Ambulances, Anesthetics, Inhalation, Health Personnel, Inhalation Exposure, Methoxyflurane, Nitrous Oxide, Occupational Exposure
- Abstract
Objective: Nitrous oxide (Entonox
® ) and methoxyflurane (Penthrox® ) are inhaled analgesics administered in paramedicine. Occupational exposure to nitrous oxide has been associated with negative health effects, and may inhibit professional capability. The effect of occupational exposure to methoxyflurane has not yet been clearly determined. This study identifies the frequency and duration of ambulance officer (AO) occupational exposure to nitrous oxide and methoxyflurane to provide a foundation for future assessments of occupational toxicity risk., Methods: A retrospective database review of Patient Report Forms (PRFs) in 11 months between February 2016 and February 2018 was conducted. Nitrous oxide was available for the first 5 months studied, followed by 6 months methoxyflurane availability. AO-specific measures of attendance, rate of inhaled analgesic use, and duration of analgesic use were determined. Subgroup analysis by AO qualification and rostered work hours was undertaken., Results: A total of 46,759 PRFs were examined, identifying 1,033 cases of nitrous oxide administration and 1456 cases of methoxyflurane was administration. There was a significant increase in the proportion of cases where inhaled analgesia was administered following the replacement of nitrous oxide with methoxyflurane. Relative risk of exposure to methoxyflurane compared with nitrous oxide was 1.22, while median duration of each exposure remained unchanged (32 vs. 33 min)., Conclusions: Methoxyflurane via the Penthrox® inhaler was more likely to be administered than nitrous oxide. Most AOs are infrequently exposed to inhaled analgesics and are exposed for durations slightly greater than previously reported. Relative risk of exposure was greatest for lower-qualified AOs. Peak number of exposures and duration values suggest a subset of AOs with higher occupational health risk., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)- Published
- 2021
- Full Text
- View/download PDF
9. Relationship between different air pollutants and total and cause-specific emergency ambulance dispatches in Shanghai, China.
- Author
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Jiang J, Wu D, Chen Y, Han Y, and Jin W
- Subjects
- China epidemiology, Cities epidemiology, Environmental Exposure analysis, Humans, Nitrogen Dioxide analysis, Ozone analysis, Particulate Matter analysis, Sulfur Dioxide analysis, Air Pollutants analysis, Ambulances statistics & numerical data
- Abstract
Objective: Air pollutants play a crucial role in human health and disease. Emergency ambulance dispatch data have excellent potential for public and environmental health research. This study aimed at investigating the impact of short-term exposure to air pollutants on the emergency ambulance dispatches., Methods: We used data on emergency ambulance dispatches in Shanghai Municipality, China, from April 1, 2016 to December 31, 2017. The association of the daily emergency ambulance dispatches with air pollutants including PM
2.5 (particles ≤ 2.5 μm in aerodynamic diameter), PM10 , O3 , NO2 and SO2 was analyzed with the use of time-series analyses., Results: A total of 310,825 emergency ambulance dispatches for acute illness occurred in Shanghai during the study period. An increase in PM2.5 by 10 μg/m3 at lag1 and lag2 was shown to increase the risk of emergency ambulance dispatches (RR for lag1 = 1.05, 95% CI 1.00-1.11, RR for lag2 = 1.07, 95% CI 1.01-1.12). PM10 , NO2 , and SO2 also showed significant associations with emergency ambulance dispatches in single-pollutant models. Cause-specific analyses showed an elevation in PM2.5 by 10 μg/m3 was associated with an increased risk of emergency ambulance dispatches related to respiratory diseases on the current day (lag0, RR 1.17, 95% CI 1.01-1.33), while the impact on emergency ambulance dispatches related to other diseases presented 1-3 days later. The other pollutants have the similar trend., Conclusions: Our findings show a strong relationship between ambient air pollutants and emergency ambulance dispatches. Our study contributes to the growing body of evidence describing the adverse health effects of ambient air pollution and will benefit ambulance services for early warning and effective ambulatory planning., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)- Published
- 2021
- Full Text
- View/download PDF
10. Exploring patterns of personal alarm system use and impacts on outcomes.
- Author
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Andrew NE, Wang Y, Teo K, Callisaya ML, Moran C, Snowdon DA, Ellmers S, Beare R, Richardson D, and Srikanth V
- Subjects
- Aged, 80 and over, Australia, Cohort Studies, Female, Hospitalization, Humans, Male, Accidental Falls, Ambulances
- Abstract
Objectives: To describe the patterns of personal emergency response systems (PERS) use in a statewide cohort of older Australians., Methods: PERS data from clients enrolled in the Personal Alarm Victoria program between January 2014 and June 2017 were analysed. Alarm activation reasons were extracted, and a medical record audit was performed for a sub-cohort of patients admitted to a local hospital following an alarm event. Descriptive statistics were used., Results: There were 42,180 clients enrolled during the study (mean age 80 years, 80% female, 93% living alone). An ambulance attended 44% of the fall-related events and 81% of events coded as unwell. Activation reasons were distributed equally between a fall and feeling unwell, and a repeating pattern of activation reasons was observed. In our sub-cohort (n = 92), the majority of admissions (86%) followed an alarm activation coded as unwell., Conclusion: We demonstrated recurring patterns associated with the reasons for alarm use., (© 2021 AJA Inc.)
- Published
- 2021
- Full Text
- View/download PDF
11. A systematic review of post-traumatic growth in ambulance personnel: facilitators and prevalence rates.
- Author
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Abdo, Molly and Schlösser, Annette
- Subjects
POST-traumatic stress disorder ,PSYCHOLOGICAL resilience ,WOUNDS & injuries ,CINAHL database ,SEX distribution ,POSTTRAUMATIC growth ,PSYCHOLOGICAL adaptation ,SYSTEMATIC reviews ,MEDLINE ,ALTERNATIVE medicine specialists ,PERSONALITY ,AMBULANCES ,DATA analysis software ,PSYCHOLOGY information storage & retrieval systems ,ERIC (Information retrieval system) ,INTER-observer reliability - Abstract
Introduction: Ambulance personnel are exposed to traumatic and stressful situations, which can increase the risk of mental health conditions, such as post-traumatic stress disorder (PTSD). High rates of PTSD have been found in ambulance personnel (Petrie et al., 2018), but no review is available to examine post-traumatic growth (PTG - positive psychological change following a trauma) in this population. This literature review provides an overview of the prevalence rates and facilitators that may contribute to PTG in ambulance personnel. Methods: A systematic search was conducted on EBSCOhost in January 2024 across the following six databases: Academic Search Ultimate, PsycINFO, PsycARTICLES, MEDLINE, ERIC and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ultimate. Results: Eleven papers were identified for this review. Pooled prevalence of PTG was moderate (52%), and facilitators for PTG were grouped into five categories: coping style/strategies, resilience, personality traits, gender and incident characteristics. Conclusions: Numerous facilitators contributed to the development of PTG, although these did not arise in all papers. The quality of research ranged from satisfactory to excellent. Evidence suggested that adaptive coping style, high levels of resilience, the absence of a personality trait (neuroticism) and being female may facilitate PTG. Further research is needed to support the reliability of findings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
12. Pediatric Transport Practices Among Prehospital Providers.
- Author
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Fidacaro GA Jr, Jones CW, and Drago LA
- Subjects
- Child, Female, Humans, Male, Surveys and Questionnaires, Accidents, Traffic statistics & numerical data, Ambulances statistics & numerical data, Emergency Medical Services standards, Emergency Medical Technicians standards, Health Knowledge, Attitudes, Practice, Transportation of Patients standards
- Abstract
Objective: There are nearly 1000 annual ambulance crashes within the United States involving pediatric patients. In 2012 National Highway Traffic Safety Administration/US Department of Transportation released Best-Practice Recommendations for the Safe Transportation of Children in Emergency Ground Ambulances. The aim of our study was to measure emergency medical services (EMS) providers' knowledge and opinions of how to safely transport pediatric patients. In addition, we aimed to gather information on barriers to safe pediatric transport., Methods: Members of 1 urban and 2 suburban EMS agencies completed an anonymous survey that assessed level of training, years of experience, exposure to pediatric patients, knowledge of best practices, and opinions about barriers to safe transport of pediatric patients., Results: A total of 114 EMS providers answered the survey. Sixty-three percent were basic life support providers who had more than 10 years of experience in EMS. Ninety-six percent reported that they transported 0 to 5 pediatric patients per week. Twenty percent reported being trained on pediatric safe transport practices. Thirty-two percent of providers reported that personnel did not drive faster when transporting a sick pediatric patient. Eighty-six percent reported that it was unsafe to transport a child on a parent's lap, but 27% reported that it was appropriate to transport a newborn on the stretcher with mom. Thirty-eight percent were comfortable identifying proper restraint system/seat for pediatric patients, and only 35% were comfortable installing/using these devices. Provider-reported barriers to safe transport were identified., Discussion: Our survey demonstrates that despite published best practices for the safe transport of children, many providers are unfamiliar with the safest way to transport these patients. In addition, we identified several existing barriers that may contribute to unsafe practices.
- Published
- 2020
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13. V2X-assisted emergency vehicle transit in VANETs.
- Author
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Kaja, Hasita, Stoehr, Jacob M, and Beard, Cory
- Subjects
AMBULANCES ,EMERGENCY vehicles ,VEHICULAR ad hoc networks ,TRAFFIC patterns ,AD hoc computer networks - Abstract
Vehicular ad hoc networks (VANETs) can support safety-critical applications such as the safe and fast movement of emergency vehicles while preventing crashes, delays, and congestion involving emergency vehicles. A simulation approach to evaluate ambulance transit using VANET capabilities is presented in this paper for a real-life road network taken in and around the University of Missouri–Kansas City, USA. Three different VANET functional scenarios are compared with a base scenario (SC-1) which depicts the present-day traffic pattern and vehicle behaviors. In the three scenarios, the second one (SC-2) adds vehicle-to-vehicle (V2V) and vehicle-to-infrastructure (V2I) communications along with the present-day traffic pattern; ambulances use VANETs simply to announce their arrival. The third scenario (SC-3) provides functionalities for ambulances to rerouting when they learn about a current or an anticipated road congestion. And the fourth scenario (SC-4) adds vehicle rerouting capabilities, so ambulance routes can be sent to vehicles, and they can avoid the ambulance path. Performance results are presented and evaluated for metrics such as delay, packet drop ratio, the average speed of the ambulance, average vehicle density, and ambulance message interval time. From the simulation results, it was observed that the ambulance transit time reduces by 12.52%, 14.65%, and 18.75% for SC-2, SC-3, and SC-4, respectively, as compared with SC-1, while the average ambulance speed increases by 14.49%, 15.57%, and 20.90% for SC-2, SC-3, and SC-4, respectively, when compared with SC-1. This paper provides substantial evidence that VANET capabilities for emergency vehicles can enhance crash protection and reduce the commute time for emergency response. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
14. Variations in the care of agitated patients in Australia and New Zealand ambulance services.
- Author
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Nambiar D, Pearce JW, Bray J, Stephenson M, Nehme Z, Masters S, Brink D, Smith K, Arendts G, Fatovich D, Bernard S, Haskins B, Grantham H, and Cameron P
- Subjects
- Australia, Humans, New Zealand, Psychomotor Agitation therapy, Ambulances, Emergency Medical Services
- Abstract
Objective: The objective of the present study is to examine variations in paramedic care of the agitated patient, including verbal de-escalation, physical restraint and sedation, provided by ambulance services in Australia and New Zealand., Methods: To examine the care of agitated patients, we first identified and reviewed all clinical practice guidelines for the management of agitated patients in Australian and New Zealand ambulance services between September and November 2018. We then conducted a structured questionnaire to obtain further information on the training, assessment and care of agitated patients by the ambulance services. Two authors extracted the data independently, and all interpretations and results were reviewed and confirmed by relevant ambulance services., Results: There were 10 independent clinical practice guidelines for the care of agitated patients in the 10 ambulance services. All services reported training in the management of agitated patients, and two services used a validated tool to assess the level of agitation. All services used physical restraint, although six services required police presence to restrain the patient. All ambulance services used some form of sedation, typically divided into the management of mild to moderate, and severe agitation. The most common agent for sedation was midazolam, while ketamine was the most common agent for sedating severely agitated patients. The maximum dose was varied, and contraindications for sedating agents varied between services., Conclusions: There were wide variations across the ambulance services in terms of the assessment of agitation, as well as the use of physical restraint and sedation., (© 2019 Australasian College for Emergency Medicine.)
- Published
- 2020
- Full Text
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15. Prevalence and Characteristics of Ambulance Collisions, a Systematic Literature Review.
- Author
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Delavary, Milad, Ghayeninezhad, Zahra, and Lavallière, Martin
- Subjects
AMBULANCES ,MEDICAL emergencies ,CITIES & towns - Abstract
The risk of dying or being injured as a result of traffic collisions is higher for medical emergency responders than for other professional drivers. This systematic review synthesizes the literature regarding the collisions of ambulances, focusing on the prevalence and characteristics surrounding such events. Keywords including paramedics and traffic collisions were searched in papers available in PubMed from January 1990 to July 2021. Two independent reviewers screened the abstracts of 2494 papers and ended up with 93 full-text articles to assess for eligibility, of which 26 papers were finally kept for this review. There was a total of 18 studies conducted in the United States, followed by 3 in Turkey, 2 in Taiwan, 1 in both the United States and Canada, 1 in France, and 1 in Poland. There is a high record of injury and fatal collisions for ambulances compared to other commercial or similarly sized vehicles. Drivers less than 35 years old with low experience and a history of citations are more likely to be involved in such collisions. Ambulance collisions are more likely to happen in urban areas and intersections are the riskiest locations. Most collisions occur when the ambulance is responding to an emergency call (i.e., going to the patient or the hospital) and using lights and sirens. Tailored preventive policies and programs for improving paramedics' safety should be sought to reduce the burden of these occupational collisions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
16. The zero responder: a definition and report of current literature.
- Author
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Graham, Eloise, Hall, John, and Porter, Keith
- Subjects
FIRST aid equipment ,MASS casualties ,MEDICAL care use ,OCCUPATIONAL roles ,TERMS & phrases ,INTERPROFESSIONAL relations ,FIRST aid in illness & injury ,DIFFUSION of innovations ,EMERGENCY medicine ,DISASTERS ,AMBULANCES ,EMERGENCY medical personnel ,CRITICAL care medicine ,AUTHORITY - Abstract
The term 'zero responder' was initially devised in 2010 to describe those passing by or unharmed in a mass casualty incident, who provide life-saving care for injured persons before qualified professionals arrive. This review aims to determine how the literature defines the role of the zero responder and to explore how they can be better integrated into the emergency response. Current definitions of the zero responder in a medical setting were found through a literature search of several databases and online libraries using defined search terms. Additionally, a manual search of citations in included articles was performed to yield more results. In total, 16 papers defining the zero responder were included. These definitions were evaluated, and a revised definition was suggested to clarify the role in a medical setting relating to mass casualty incidents. The role of the zero responder can be facilitated through authority recognition and adequate equipment provision. Familiarisation with the term and role of zero responders among ambulance services is essential for effective collaboration. Further research and clarity on the integration of these two groups is necessary to facilitate effective and safe working between them. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
17. A systematic review: what factors predict Post-Traumatic Stress Symptoms in ambulance personnel?
- Author
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Brooks, Damian and Brooks, Rachel
- Subjects
POST-traumatic stress ,AMBULANCES ,PSYCHOLOGICAL adaptation ,PERSONALITY ,STRAINS & stresses (Mechanics) - Abstract
Background: Ambulance personnel are frequently exposed to traumatic accidents, which makes them a high risk for poor mental health. High rates of Post-Traumatic Stress Symptoms (PTSS) have been found within ambulance personnel samples but no review has been completed to examine the factors that may be implicated in the development of these symptoms. This literature review provides an overview of the factors that predict PTSS in ambulance personnel. Methods: A systematic search strategy was conducted in April 2020 across the following four databases: PsycINFO, PsycARTICLES, MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Results: Eighteen papers were included in this review, and the predictive factors examined were grouped into four categories: coping style, personal factors, environmental factors and organisational factors. Conclusions: An array of factors across the four categories were implicated in the development of PTSS, but these tended to be indicated in only one or two papers. Evidence was found to suggest that dysfunctional coping styles, reduced levels of some personality traits, proximity and nature of the critical incident and high levels of organisation stress can all lead to PTSS. Further research is needed to support the reliability of findings. [ABSTRACT FROM AUTHOR] - Published
- 2021
- Full Text
- View/download PDF
18. Idaho hospital diverts ambulances, turns to paper charting following cyberattack.
- Author
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Burky, Annie
- Subjects
CYBERTERRORISM ,AMBULANCES ,HOSPITALS ,HEALTH facilities - Abstract
Idaho Falls Community Hospital along with partner clinics and nearbyMountain View Hospital are recovering from a cyberattack that tookplace earlier this week, according to a statement posted on theMountain View Hospital website. HEALTH TECH For more than 24 hours, a hospital in Idaho has been divertingambulances due to a cyberattack. [Extracted from the article]
- Published
- 2023
19. Reports from Tel Aviv University Describe Recent Advances in Heart Failure (Hfa of the Esc Position Paper On the Management of Lvad Supported Patients for the Non Lvad Specialist Healthcare Provider Part 1: Introduction and At the Non-hospital...).
- Subjects
MEDICAL personnel ,HEART failure ,HEART assist devices ,CARDIOLOGISTS ,AMBULANCES ,GENERAL practitioners - Abstract
Keywords for this news article include: Tel-Aviv, Israel, Asia, Heart Failure, Heart Disorders and Diseases, Cardio Device, Health and Medicine, Hospitals, Medical Devices, Technology, Tel Aviv University. Keywords: Tel-Aviv; Israel; Asia; Heart Failure; Heart Disorders and Diseases; Cardio Device; Health and Medicine; Hospitals; Medical Devices; Technology EN Tel-Aviv Israel Asia Heart Failure Heart Disorders and Diseases Cardio Device Health and Medicine Hospitals Medical Devices Technology 97 97 1 05/29/23 20230529 NES 230529 2023 JUN 4 (NewsRx) -- By a News Reporter-Staff News Editor at Heart Disease Weekly -- New research on Heart Disorders and Diseases - Heart Failure is the subject of a report. [Extracted from the article]
- Published
- 2023
20. 'We're just an ambulance at the bottom of the cliff': Strategies and (a)politics of change in Berlin's community food spaces.
- Author
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Véron, Ophélie
- Subjects
COMMUNITY gardens ,KITCHEN gardens ,AMBULANCES ,SOCIAL injustice ,PRACTICAL politics - Abstract
The benefits of community-based, grassroots food practices, such as community gardens or kitchens, are widely acknowledged. However, they have also been shown to support neoliberal and exclusionary dynamics. This paper examines this contradiction on the ground by unpacking the processes and mechanisms through which these initiatives reproduce, reinforce or challenge social inequities and injustices in the city. It suggests the concept of community food space to look at the articulation of practices and intentions within these groups, and highlight emancipatory practices situated around food rather than simply about food. The paper draws upon an ongoing militant ethnography into community food spaces in Berlin, Germany. Exploring the complex and diverse landscape of Berlin food activism, it illuminates the ways in which food may be used to perpetuate unjust social configurations or, on the contrary, to advance social justice at both local and structural levels. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
21. A Context-Aware Framework to Manage the Priority of Injured Persons Arriving at Emergencies.
- Author
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Ouakasse, Fathia, Stitini, Oumaima, and Rakrak, Said
- Subjects
AMBULANCES ,TRAFFIC accidents ,HOSPITAL emergency services - Abstract
Integrating the Internet of Medical Things (IoMT) in the Hospital system has modified the traditional medical service from a reactive system based on hospitalization and diseases to a preventive and interoperable system based mainly on the interactive data flow between patients and health professionals. Medical data is collected and processed using medically connected objects (MCOs). According to gathered data, the new medical system should be able to sort patient states based on urgent and critical vital signs, and consequently, priorities are defined. In this paper, we focus on managing priority in hospital emergencies to adapt dynamic operations and interactions with different stakeholders according to the changes in their execution context. Indeed, based on data sensed from MCOs implemented in ambulances, emergency rooms might be prepared to receive injured persons like victims of road accidents or other incidents. Therefore, we design a context-aware monitoring framework for injured people based on gathered medical data to manage priorities. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
22. Identifying prehospital trauma patients from ambulance patient care records; comparing two methods using linked data in New South Wales, Australia.
- Author
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Miller M, Jorm L, Partyka C, Burns B, Habig K, Oh C, Immens S, Ballard N, and Gallego B
- Subjects
- Humans, Male, Female, New South Wales, Middle Aged, Adult, Aged, Patient Discharge statistics & numerical data, Adolescent, Young Adult, Emergency Service, Hospital statistics & numerical data, Trauma Centers, Hospitalization statistics & numerical data, Ambulances statistics & numerical data, Emergency Medical Services, Wounds and Injuries therapy, Wounds and Injuries mortality, Electronic Health Records statistics & numerical data
- Abstract
Background: Linked datasets for trauma system monitoring should ideally follow patients from the prehospital scene to hospital admission and post-discharge. Having a well-defined cohort when using administrative datasets is essential because they must capture the representative population. Unlike hospital electronic health records (EHR), ambulance patient-care records lack access to sources beyond immediate clinical notes. Relying on a limited set of variables to define a study population might result in missed patient inclusion. We aimed to compare two methods of identifying prehospital trauma patients: one using only those documented under a trauma protocol and another incorporating additional data elements from ambulance patient care records., Methods: We analyzed data from six routinely collected administrative datasets from 2015 to 2018, including ambulance patient-care records, aeromedical data, emergency department visits, hospitalizations, rehabilitation outcomes, and death records. Three prehospital trauma cohorts were created: an Extended-T-protocol cohort (patients transported under a trauma protocol and/or patients with prespecified criteria from structured data fields), T-protocol cohort (only patients documented as transported under a trauma protocol) and non-T-protocol (extended-T-protocol population not in the T-protocol cohort). Patient-encounter characteristics, mortality, clinical and post-hospital discharge outcomes were compared. A conservative p-value of 0.01 was considered significant RESULTS: Of 1 038 263 patient-encounters included in the extended-T-population 814 729 (78.5 %) were transported, with 438 893 (53.9 %) documented as a T-protocol patient. Half (49.6 %) of the non-T-protocol sub-cohort had an International Classification of Disease 10th edition injury or external cause code, indicating 79644 missed patients when a T-protocol-only definition was used. The non-T-protocol sub-cohort also identified additional patients with intubation, prehospital blood transfusion and positive eFAST. A higher proportion of non-T protocol patients than T-protocol patients were admitted to the ICU (4.6% vs 3.6 %), ventilated (1.8% vs 1.3 %), received in-hospital transfusion (7.9 vs 6.8 %) or died (1.8% vs 1.3 %). Urgent trauma surgery was similar between groups (1.3% vs 1.4 %)., Conclusion: The extended-T-population definition identified 50 % more admitted patients with an ICD-10-AM code consistent with an injury, including patients with severe trauma. Developing an EHR phenotype incorporating multiple data fields of ambulance-transported trauma patients for use with linked data may avoid missing these patients., Competing Interests: Declaration of competing interest Matthew Miller reports financial support was provided by New South Wales Institute for Trauma and Injury Management (ITIM). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Matthew Miller is supported in his PhD by an Australian Commonwealth Government Research Training Program (RTP) scholarship., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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23. Ambulance staff's ways of understanding health care encounters in stigmatized neighborhoods - A phenomenographic study.
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Björklund S, Lilja Hagell P, Hagell P, Persson M, and Holmberg M
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- Humans, Qualitative Research, Male, Female, Social Stigma, Ambulances
- Abstract
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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- 2024
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24. Lessons of the COVID-19 Pandemic for Ambulance Service in Kazakhstan.
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Messova, Assylzhan, Pivina, Lyudmila, Ygiyeva, Diana, Batenova, Gulnara, Dyussupov, Almas, Jamedinova, Ulzhan, Syzdykbayev, Marat, Adilgozhina, Saltanat, and Bayanbaev, Arman
- Subjects
CROSS-sectional method ,HELPLINES ,DATA analysis ,RESEARCH funding ,EMERGENCY medical services ,RETROSPECTIVE studies ,AMBULANCES ,RESEARCH methodology ,ANALYSIS of variance ,FRIEDMAN test (Statistics) ,STATISTICS ,DATA analysis software ,COVID-19 pandemic - Abstract
Background: Emergency medical services (EMS) are intended to provide people with immediate, effective, and safe access to the healthcare system. The effects of pandemics on emergency medical services (EMS) have not been studied sufficiently. The aim of this paper is to assess the frequency and structure of calls at an ambulance station in Kazakhstan during the period of 2019–2023. Methods: A retrospective analysis was conducted to estimate the incidence of emergency assistance cases from 2019 to 2023. Results: An analysis of the structure and number of ambulance calls before the pandemic, during the pandemic, and post-pandemic period did not reveal significant changes, except for calls in urgency category IV. Patients of urgency category IV handled by an ambulance decreased by 2 and 1.7 times in 2020 and 2021, respectively, which appears to be related to quarantine measures. In 2022 and 2023, category IV calls were 4.7 and 4.5 times higher than in 2019. Conclusions: This study's findings suggest no changes in the dynamics of ambulance calls, except urgency category IV calls. The number of category IV urgent calls decreased significantly during the COVID-19 pandemic and increased in the post-pandemic period. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Successful Intraosseous (IO) Adenosine Administration for the Termination of Supraventricular Tachycardia (SVT) in a 3.5-Year-Old Child—Case Report and Literature Review.
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Zachaj, Jakub, Kręglicki, Łukasz, Sikora, Tomasz, Moorthi, Katarzyna, Jaśkiewicz, Filip, Nadolny, Klaudiusz, and Gałązkowski, Robert
- Subjects
HALOTHERAPY ,AIRPLANES ,ADENOSINES ,BLOOD vessels ,HOSPITAL admission & discharge ,SUPRAVENTRICULAR tachycardia ,TREATMENT effectiveness ,HOSPITAL emergency services ,INTRAOSSEOUS infusions ,HEART beat ,AMBULANCES ,MEDICAL equipment ,PAIN management ,BLOOD pressure ,CYANOSIS ,LIDOCAINE ,TRANSPORTATION of patients - Abstract
Paediatric supraventricular tachycardia (SVT) is a common arrhythmia of great clinical significance. If not treated promptly, it can cause heart failure and cardiogenic shock. Depending on the patient's condition, SVT treatment involves vagal manoeuvres, pharmacological, or direct current cardioversion. The goal of acute SVT management is to immediately convert SVT to a normal sinus rhythm (NSR) and prevent its recurrence. Adenosine is recommended as the first-line treatment for stable SVT by the European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines, when vagal manoeuvres have proven ineffective. The ERC and AHA guidelines recommend the intravenous route of administration. The intraosseous (IO) administration technique is also possible, but still relatively unknown. The aim of this paper is to describe a 3.5-year-old child with SVT that was converted to NSR following IO administration of adenosine. Successful conversion was achieved after the second attempt with the adenosine dose. In the described case, there was no recurrence of SVT. [ABSTRACT FROM AUTHOR]
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- 2024
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26. 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
27. The Effects of Budget Constraints in the Ministry of Internal Affairs in Romania.
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Corman, Narcis-Alexandru
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BUDGET ,FIRST aid in illness & injury ,PUBLIC policy (Law) ,PUBLIC finance ,AMBULANCES - Abstract
The main purpose of this paper is to demonstrate how important it is for the Ministry of Internal Affairs to have a sufficient budget to carry out the missions entrusted by law. The Ministry of Internal Affairs has very important responsibilities in terms of maintaining public order and intervention in emergency situations. The Romanian Police, the Romanian Gendarmerie, the Romanian Border Police, which are in charge of maintaining public order, as well as the General Inspectorate for Emergency Situations, which is in charge of extinguishing fires and providing first aid through SMURD ambulances, are active within the Ministry of Internal Affairs. In this paper, the possible negative impacts of the application of the Government's Emergency Ordinances regarding some fiscal-budgetary measures, adopted in 2023, will be presented. [ABSTRACT FROM AUTHOR]
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- 2023
28. NUMERICAL STRENGTH STUDY OF ULTRA-LIGHT COMPOSITE SEAT FRAME DESTINED TO PASSENGERS TRANSPORT.
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CZECHOWSKI, LESZEK, KOTEŁKO, MARIA, and JANKOWSKI, MARCIN
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AMBULANCES ,CARBON fibers ,ALUMINUM ,DEAD loads (Mechanics) ,COMPOSITE materials - Abstract
The paper concerns numerical study of the ultra-light seat frame serving transported patients in ambulance. The structure of seat was designed to be built of the carbon fibers, aluminium and steel. The present prototype distinguishes itself with low mass and high strength. During modelling, the stress state and displacement state were verified based on requirements according to regulation ECE14. In simulation, solid, beam and connection elements were employed to consider all the parts of structures. The analysis of the stress state verification based on the assumptions of boundary conditions close to regulation ECE14. The isotropic materials were considered to be in elastic range. In case of composite materials, TSAI-WU (TSW) criterion for assessment of strength was taken into account. Five different variants of seat were taken into consideration to indicate the differences between them. The paper includes the results of analysis of composite structure under static loads which were shown and discussed. [ABSTRACT FROM AUTHOR]
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- 2021
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29. The Role and Value of Chaplains in the Ambulance Service: Paramedic Perspectives
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Paul Simpson, Joanne Lewis, Katie Tunks Leach, and Tracy Levett-Jones
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Value (ethics) ,medicine.medical_specialty ,Social Psychology ,Well-being ,Ambulances ,Allied Health Personnel ,1117 Public Health and Health Services ,Nursing ,medicine ,Emergency medical services ,Ambulance service ,Humans ,Paramedic ,General Nursing ,Original Paper ,business.industry ,Public health ,Religious studies ,Australia ,General Medicine ,Chaplaincy ,Spiritual care ,Emergency Medical Technicians ,business ,Psychology ,Clergy - Abstract
Chaplains are employed by ambulance services in many states across Australia as one element in a suite of initiatives to support the health and wellness of paramedics. The aim of this paper is to present key findings from a study that explored paramedic perspectives on the role and value of chaplains in the ambulance service. Seventeen paramedics participated in semi-structured interviews. Data were analysed using framework analysis. Two themes were identified: scope of the chaplain’s role and organisational factors influencing the chaplain’s role. Paramedics highly valued what they believed to be proactive and reactive support provided by ambulance chaplains, regardless of paramedics’ personal spiritual or religious beliefs.
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- 2021
30. Impact of low-intensity heat events on mortality and morbidity in regions with hot, humid summers: a scoping literature review.
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Strathearn, Melanie, Osborne, Nicholas J., and Selvey, Linda A.
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AMBULANCES ,LITERATURE reviews ,HEAT waves (Meteorology) ,HIGH-income countries ,SUMMER ,MORTALITY - Abstract
The objective of this study is to determine the impacts of low-intensity heat on human health in regions with hot, humid summers. Current literature has highlighted an increase in mortality and morbidity rates during significant heat events. While the impacts on high-intensity events are established, the impacts on low-intensity events, particularly in regions with hot, humid summers, are less clear. A scoping review was conducted searching three databases (PubMed, EMBASE, Web of Science) using key terms based on the inclusion criteria. We included papers that investigated the direct human health impacts of low-intensity heat events (single day or heatwaves) in regions with hot, humid summers in middle- and high-income countries. We excluded papers written in languages other than English. Of the 600 publications identified, 33 met the inclusion criteria. Findings suggest that low-intensity heatwaves can increase all-cause non-accidental, cardiovascular-, respiratory- and diabetes-related mortality, in regions experiencing hot, humid summers. Impacts of low-intensity heatwaves on morbidity are less clear, with research predominantly focusing on hospitalisation rates with a range of outcomes. Few studies investigating the impact of low-intensity heat events on emergency department presentations and ambulance dispatches were found. However, the data from a limited number of studies suggest that both of these outcome measures increase during low-intensity heat events. Low-intensity heat events may increase mortality. There is insufficient evidence of a causal effect of low-intensity heat events on increasing morbidity for a firm conclusion. Further research on the impact of low-intensity heat on morbidity and mortality using consistent parameters is warranted. [ABSTRACT FROM AUTHOR]
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- 2022
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31. 'I was worried if I don’t have a broken leg they might not take it seriously': Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems
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Karen Smith, Emma Sandral, Emma Bosley, Michael Savic, Kate Emond, Dan I. Lubman, Nyssa Ferguson, Louise Roberts, and Terence V. McCann
- Subjects
Adult ,Male ,Attitude of Health Personnel ,Substance-Related Disorders ,media_common.quotation_subject ,Ambulances ,Allied Health Personnel ,ambulance services ,Compassion ,Interviews as Topic ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Ambulance service ,Humans ,030212 general & internal medicine ,Aged ,media_common ,lcsh:R5-920 ,Episode of care ,Communication ,Mental Disorders ,030503 health policy & services ,lcsh:Public aspects of medicine ,Australia ,Public Health, Environmental and Occupational Health ,Men ,lcsh:RA1-1270 ,Professional-Patient Relations ,Emergency department ,Middle Aged ,Mental health ,Original Research Paper ,alcohol and other drugs ,stigma ,paramedics ,Empathy ,Thematic analysis ,0305 other medical science ,Psychology ,lcsh:Medicine (General) ,Original Research Papers ,mental health ,qualitative research ,Qualitative research - Abstract
Background A large proportion of ambulance callouts are for men with mental health and/or alcohol and other drug (AOD) problems, but little is known about their experiences of care. This study aimed to describe men's experiences of ambulance care for mental health and/or AOD problems, and factors that influence their care. Methods Interviews were undertaken with 30 men who used an ambulance service for mental health and/or AOD problems in Australia. Interviews were analysed using the Framework approach to thematic analysis. Results Three interconnected themes were abstracted from the data: (a) professionalism and compassion, (b) communication and (c) handover to emergency department staff. Positive experiences often involved paramedics communicating effectively and conveying compassion throughout the episode of care. Conversely, negative experiences often involved a perceived lack of professionalism, and poor communication, especially at handover to emergency department staff. Conclusion Increased training and organizational measures may be needed to enhance paramedics' communication when providing care to men with mental health and/or AOD problems.
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- 2019
32. Weather Fluctuations May Have an Impact on Stroke Occurrence in a Society: A Population-Based Cohort Study
- Author
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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
33. New care pathway to enable ambulances transfer patients to a model 2 hospital medical assessment unit.
- Author
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O'Flynn AM, Hart C, Munoz-Claros A, Schmidt D, Kiely J, Deasy C, and O'Donnell C
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- Humans, Hospital Units, Hospitalization, Hospitals, Ambulances, Critical Pathways
- Abstract
Background: Reconfiguration of the Irish acute hospital sector resulted in the establishment of a Medical Assessment Unit (MAU) in Mallow General Hospital (MGH). We developed a protocol whereby certain patients deemed to be low risk for clinical deterioration could be brought by the National Ambulance Service (NAS) to the MAU following a 999 or 112 call., Aims: The aim of this paper is to report on the initial experience of this quality improvement initiative., Methods: The Plan-Do-Study-Act (PDSA) Cycle for quality improvement was implemented when undertaking this project. A pathway was established whereby, following discussion between paramedic and physician, patients for whom a 999 or 112 call had been made could be brought directly to the MAU in MGH. Strict inclusion and exclusion criteria were agreed. The protocol was implemented from the 1st of September 2022 for a 3-month pilot period., Results: Of 39 patients discussed, 29 were accepted for review in the MAU. One of the 29 accepted patients declined transfer to MAU. Of 28 patients reviewed in the MAU, 7 were discharged home. One patient required same day transfer to a model 4 centre. Twenty patients were admitted to MGH with an average length of stay of 8 days. Frailty and falls accounted for 7 of the admissions and the mean length of stay for these patients was 12 days., Conclusions: Our results have demonstrated the safety, feasibility and effectiveness of this pathway. With increased resourcing, upscaling of this initiative is possible and should be considered., (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)
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- 2024
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34. Preparing for a hotter climate: A systematic review and meta-analysis of heatwaves and ambulance callouts in Australia.
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Oberai M, Xu Z, Bach AJE, Phung D, Watzek JT, and Rutherford S
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- Humans, Australia, Extreme Heat adverse effects, Emergency Medical Services, Ambulances, Hot Temperature adverse effects
- Abstract
Objective: The objective of this study was to quantify the impact of heatwaves on likelihood of ambulance callouts for Australia., Methods: A systematic review and meta-analysis was conducted to retrieve and synthesise evidence published from 1 January 2011 to 31 May 2023 about the association between heatwaves and the likelihood of ambulance callouts in Australia. Different heatwave definitions were used ranging from excess heat factor to heatwave defined as a continuous period with temperatures above certain defined thresholds (which varied based on study locations)., Results: We included nine papers which met the inclusion criteria for the review. Eight were eligible for the meta-analyses. The multilevel meta-analyses revealed that the likelihood of ambulance callouts for all causes and for cardiovascular diseases increased by 10% (95% confidence interval: 8%, 13%) and 5% (95% confidence interval: 1%, 3%), respectively, during heatwave days., Conclusions: Exposure to heatwaves is associated with an increased likelihood of ambulance callouts, and there is a dose-response association between heatwave severity and the likelihood of ambulance callouts., Implications for Public Health: The number of heatwave days are going to increase, and this will mean an increase in the likelihood of ambulance callouts, thereby, spotlighting the real burden that heatwaves place on our already stressed healthcare system. The findings of this study underscore the critical need for proactive measures, including the establishment of research initiatives and holistic heat health awareness campaigns, spanning from the individual and community levels to the healthcare system, in order to create a more resilient Australia in the face of heatwave-related challenges., Competing Interests: Conflicts of interest Authors declare no conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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35. Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users.
- Author
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Evans BA, Khanom A, Edwards A, Edwards B, Farr A, Foster T, Fothergill R, Gripper P, Gunson I, Porter A, Rees N, Scott J, Snooks H, and Watkins A
- Subjects
- Humans, United Kingdom, Male, Female, Middle Aged, Adult, Interviews as Topic, Aged, Health Services Accessibility, Ambulances, Qualitative Research, Emergency Medical Services
- Abstract
Introduction: People who call emergency ambulances frequently are often vulnerable because of health and social circumstances, have unresolved problems or cannot access appropriate care. They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency services and is available in some UK regions. We report results of interviews with people who use emergency ambulance services frequently to understand their experiences of calling and receiving treatment., Methods: We used a two-stage recruitment process. A UK ambulance service identified six people who were known to them as frequently calling emergency services. Through third-sector organisations, we also recruited nine individuals with healthcare experiences reflecting the characteristics of people who call frequently. We gained informed consent to record and transcribe all telephone interviews. We used thematic analysis to explore the results., Results: People said they make frequent calls to emergency ambulance services as a last resort when they perceive their care needs are urgent and other routes to help have failed. Those with the most complex health needs generally felt their immediate requirements were not resolved and underlying mental and physical problems led them to call again. A third of respondents were also attended to by police and were arrested for behaviour associated with their health needs. Those callers receiving case management did not know they were selected for this. Some respondents were concerned that case management could label frequent callers as troublemakers., Conclusion: People who make frequent calls to emergency ambulance services feel their health and care needs are urgent and ongoing. They cannot see alternative ways to receive help and resolve problems. Communication between health professionals and service users appears inadequate. More research is needed to understand service users' motivations and requirements to inform design and delivery of accessible and effective services., Patient or Public Contribution: People with relevant experience were involved in developing, undertaking and disseminating this research. Two public contributors helped design and deliver the study, including developing and analysing service user interviews and drafting this paper. Eight public members of a Lived Experience Advisory Panel contributed at key stages of study design, interpretation and dissemination. Two more public contributors were members of an independent Study Steering Committee., (© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.)
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- 2024
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36. Effects of COVID‐19 Pandemic on Emergency Medical Services
- Author
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İshak Şan, Semih Korkut, Burak Bekgöz, and Eren Usul
- Subjects
Emergency Medical Services ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Therapy Area: Other ,Coronavirus disease 2019 (COVID-19) ,Ambulances ,030204 cardiovascular system & hematology ,Angina ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Pandemic ,medicine ,Emergency medical services ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Pandemics ,Original Paper ,SARS-CoV-2 ,business.industry ,Significant difference ,COVID-19 ,General Medicine ,medicine.disease ,Original Papers ,Acute abdomen ,medicine.symptom ,business - Abstract
Introduction In this study, we aimed to analyse the changes that occurred after the COVID‐19 pandemic using the data of EMS of Ankara province. Materials and methods EMS data for the same time interval (March 11‐April 24) in the last 3 years (2018, 2019 and 2020) were compared. Results While the number of calls increased by 90.9% during the pandemic period (from 2019 to 2020), the number of cases increased by 9.8%. Of all cases transported to hospital, 15.2% were suspected of and 2.9% were diagnosed with COVID‐19. In the pandemic period, case frequency decreased in the 0‐6 age group (−4.1%) and 7‐18 age group (‐39.9%) while the number of patients in the 19‐65 age group (12.9%) and 65+ age group (21.5%) increased. There was a statistically significant difference between pre‐pandemic and pandemic period in terms of rural area case frequency. During the pandemic period, case frequency of angina pectoris (−35.2%), myocardial infarction (−45%), acute abdomen (−23.8%) and cerebrovascular diseases (−2.9%) decreased contrary to pre‐pandemic period (2019). During the same period, symptoms of fever (+14.1%) and cough (+956.3%) increased. There was a statistically significant difference between pre‐pandemic and pandemic period in terms of forensic case frequency (P < .05). In addition, there was a statistically significant difference between these periods in terms of the frequency of patients who died at the scene. Conclusion Although the use of ambulances has increased in the pandemic process, the use of EMS for time‐sensitive diseases has decreased.
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- 2020
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37. A coproduced patient and public event: An approach to developing and prioritizing ambulance performance measures
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Dan Fall, Andy Irving, Andrea Broadway-Parkinson, A Niroshan Siriwardena, Joanne Coster, Janette Turner, Maggie Marsh, and Chew-Graham, C
- Subjects
Emergency Medical Services ,A300 Clinical Medicine ,Evidence-based practice ,Electronic voting ,Ambulances ,Applied psychology ,pre‐hospital health care ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Ambulance service ,Humans ,Medicine ,Performance measurement ,030212 general & internal medicine ,Set (psychology) ,Qualitative Research ,Reference group ,Quality Indicators, Health Care ,co‐production ,business.industry ,Event (computing) ,030503 health policy & services ,Community Participation ,Public Health, Environmental and Occupational Health ,Health services research ,health service research ,patient and public involvement ,United Kingdom ,Original Research Paper ,B780 Paramedical Nursing ,Health Services Research ,Patient Participation ,0305 other medical science ,business ,Original Research Papers - Abstract
Background\ud \ud Patient and Public Involvement (PPI) is recognised as an important component of high quality health\ud services research. PPI is integral within the Pre-hospital Outcomes for Evidence Based Evaluation\ud (PhOEBE) programme. The PPI event described in detail in this paper focusses on the process of\ud involving patients and public representatives in identifying, prioritising and refining a set of outcome\ud measures that can be used to support ambulance service performance measurement.\ud \ud Objective\ud \ud To obtain public feedback on little known, complex aspects of ambulance service performance\ud measurement.\ud \ud Design\ud \ud The event was co-designed and co-produced with the PhOEBE PPI reference group and PhOEBE\ud research team. The event consisted of: brief researcher-led presentations, group discussions\ud facilitated by the PPI reference group members and electronic voting.\ud \ud Setting and participants\ud \ud Data were collected from eighteen patient and public representatives who attended an event venue\ud in Yorkshire.\ud \ud Results\ud The results of the PPI event showed that this interactive format and mode of delivery was an\ud effective method to obtain public feedback and produced a clear indication of which ambulance\ud performance measures were most highly favoured by event participants.\ud \ud Discussion and Conclusions\ud \ud The event highlighted valuable contributions the PPI reference group made to the design process,\ud supporting participant recruitment and facilitation of group discussions. In addition, the positive\ud team working experience of the event proved a catalyst for further improvements in patient and\ud public involvement within the PhOEBE project. \ud
- Published
- 2017
38. Multimodal detection of ambulance using Jetson nano.
- Author
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Shilaskar, Swati, Kalase, Atharva, Kanitkar, Mihir, Karangale, Kartikesh, Kulkarni, Guruprasad, Bhatlawande, Shripad, and Madake, Jyoti
- Subjects
IMAGE recognition (Computer vision) ,EMERGENCY vehicles ,TRAFFIC signs & signals ,AMBULANCES ,MICROPHONES ,WEBCAMS - Abstract
In today's world, the number of vehicles plying on the road is increasing day by day. Due to huge traffic, emergency vehicles like ambulances are not able to reach their destinations in time, resulting in the loss of human lives. Though people are aware of giving way to ambulances, it may not be always possible. Also, at red traffic signal, ambulances must stop. Else, severe accident may happen due to other vehicles coming from other directions. Hence, there is a need for a solution, that allows the movement of an ambulances on priority, while all other vehicles are halted. This paper has proposed a real-time system based on image and audio modality. It is developed using Nvidia's Jetson nano bord, web camera, and microphone. Combined audio and image classification technique helps in regulating the traffic by detecting the siren sound and then by identifying actual ambulance. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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39. 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
40. Delivery of public health interventions by the ambulance sector: a scoping review.
- Author
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Ablard, Suzanne, Miller, Elisha, Poulton, Steven, Cantrell, Anna, Booth, Andrew, Lee, Andrew, Mason, Suzanne, and Bell, Fiona
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AMBULANCES ,PUBLIC health education ,PUBLIC health ,BIBLIOGRAPHIC databases ,MEDICAL screening ,GREY literature - Abstract
Background: With millions of unscheduled patient contacts every year and increasing call outs clustered around the most deprived communities, it is clear the ambulance sector could have a role to play in improving population health. However, the application and value of a public health approach within the ambulance sector has not been comprehensively explored. A scoping review was undertaken to explore the role of the ambulance sector in the delivery of public health interventions and what impact this has on population health and ambulance sector outcomes. Methods: A search strategy was developed on MEDLINE and translated to other major medical and health related bibliographic databases (Embase; CINAHL; HMIC; Science and Social Sciences Citation Index; Cochrane Library) to identify literature published since 2000 in OECD countries. Targeted grey literature, reference list, and citation searching was also carried out. Search results were downloaded to Microsoft Excel and screened by three reviewers according to pre-determined inclusion / exclusion criteria. Data from included studies, such as the type of activity noted within the paper, the population involved and the public health approach that was utilised, was extracted from within the paper using a data extraction form and narratively synthesised. Results: Fifty-two references were included in the final review (37 database searching; 9 reference list searching; 6 grey literature). Included articles were categorised according to the relevant public health domains and subdomains as articulated by the UK Faculty of Public Health: Health improvement domain: Public health education and advice (Health promotion sub-domain) (n=13) Emergency Services personnel providing vaccines (Disease prevention sub-domain) (n=1) Health care public health domain Paramedicine (Service delivery sub-domain) (n=30) Screening tools and referral pathways used by the ambulance sector (Service delivery sub-domain) (n=28) Health intelligence using ambulance sector data (population health management sub-domain) (n=26) Of note, some domains (e.g. health protection) returned nil results. Discussion: The scoping review demonstrates the breadth of public health related activities in which the ambulance sector is involved. However, an overemphasis on demand management outcomes precludes definitive conclusions on the impact of ambulance sector-led public health initiatives on public health outcomes. Future evaluations of public health initiatives should incorporate wider health system perspectives beyond the immediately apparent remit of the ambulance sector. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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41. Respect for patients' rights in health facilities: experiences of patients during the early period of the COVID-19 pandemic in Ghana.
- Author
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Golo, Harrison Kwame
- Subjects
PATIENT abuse ,HEALTH facilities ,HEALTH services accessibility ,RESEARCH methodology ,AMBULANCES ,POPULATION geography ,INTERVIEWING ,PATIENTS' attitudes ,PATIENTS' rights ,HEALTH ,INFORMATION resources ,ACCESS to information ,SOUND recordings ,JUDGMENT sampling ,DATA analysis software ,COVID-19 pandemic ,MEDICAL record access control ,LEGAL status of patients - Abstract
Purpose: This paper aims to identify human rights violations of patients during the early periods of the COVID-19 pandemic in Ghana by investigating the experiences of people on how health-care professionals discharged their responsibilities during the time in question. Design/methodology/approach: Explanatory design of the mixed methods approach was adopted, with the intention of collecting both quantitative and qualitative data sequentially, and then integrating the results at the interpretation stage. The approach enriched the quality of data collected as it offered the advantage of shedding light on the primary motivations and reasons for attitudes and behaviours and helped to provide an in-depth understanding of how individuals interpret the happenings around them and their experiences. Thus, although some amount of quantitative method was used in the data collection, the core of this paper is based on the qualitative interpretations. Findings: The study reveals that health-care professionals, especially those in the Tema Metropolis, undermined certain fundamental human rights of patients during the early period of the COVID-19 pandemic. This includes failure to provide information to patients about treatment options and potential risks of medications; failure to seek the informed consent of patients before performing medical procedures; denial of access to medical files of patients for transfer; and inability or failure to provide medical ambulances services to patients on time. Originality/value: Although many publications on human rights dimensions and health protective issues on COVID-19 pandemic are available on a global scale, still little information pertaining to experiences of individuals with health-care professionals during the early days of the COVID-19 pandemic, especially in Ghana through the lens of patient's rights exists. This paper, therefore, fills an important gap in health-care management information, critical for policy decision-making processes regarding patient's rights in times of pandemic control. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
42. Exploring the effectiveness of a regional nurse practitioner led, long‐acting injectable buprenorphine‐based model of care for opioid use disorder.
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Strike, Teresa, D'Angelo‐Kemp, Dante, and Searby, Adam
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DRUG addiction ,NARCOTICS ,NEEDLE exchange programs ,PSYCHIATRIC nursing ,AUDITING ,STATISTICS ,INJECTIONS ,EVALUATION of human services programs ,NURSE administrators ,BUPRENORPHINE ,RURAL conditions ,AMBULANCES ,DRUG overdose ,RETROSPECTIVE studies ,REGRESSION analysis ,OUTPATIENT medical care management ,PEARSON correlation (Statistics) ,CONTROLLED release preparations ,COMMUNITY mental health personnel ,STATISTICAL models ,DATA analysis ,DATA analysis software ,PAIN management ,OPIOID abuse ,HEROIN - Abstract
The introduction of long‐acting injectable buprenorphine preparations for opioid use disorder has been widely heralded as a breakthrough treatment, with several studies indicating positive results when using these medications. In many locations, nurse practitioners prescribe, administer, and monitor long‐acting injectable preparations. The objective of this paper is to explore whether a reduction in dispensed needles and syringes is attributable to increased nurse practitioner prescribing of LAIB. We used a retrospective audit of needles dispensed through the health service needle and syringe program vending machine, and individuals treated with long‐acting injectable buprenorphine by the nurse practitioner led model. In addition, we examined potential factors that may influence changes in the number of needles dispensed. Linear regression found that each individual with opioid dependence treated with long‐acting injectable buprenorphine was associated with 90 fewer needles dispensed each month (p < 0.001). The nurse practitioner led model of care for individuals with opioid dependence appears to have influenced the number of needles dispensed at the needle and syringe program. Although all confounding factors could not be discounted entirely, such as substance availability, affordability, and individuals obtaining injecting equipment elsewhere, our research indicates that a nurse practitioner led model of treating individuals with opioid use disorder influenced needle and syringe dispensing in the study setting. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
43. Subject Retention in Prehospital Stroke Research Using a Telephone-Based Physician-Investigator Driven Enrollment Method
- Author
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Scott Hamilton, Sidney Starkman, Nerses Sanossian, Marc Eckstein, Bryant J Rosell, David S Liebeskind, Kristina Shkirkova, Latisha K Sharma, Jeffrey L. Saver, Robin Conwit, and May Kim-Tenser
- Subjects
medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Patient Dropouts ,Time Factors ,Ambulances ,Phases of clinical research ,030204 cardiovascular system & hematology ,California ,Consent ,03 medical and health sciences ,Magnesium Sulfate ,0302 clinical medicine ,Informed consent ,medicine ,Emergency medical services ,Humans ,Stroke ,Acute stroke ,Original Paper ,Informed Consent ,business.industry ,Patient Selection ,Subject (documents) ,Explicit consent ,medicine.disease ,Research Personnel ,Clinical trial ,Emergency Medical Technicians ,Neuroprotective Agents ,Treatment Outcome ,Neurology ,lcsh:RC666-701 ,Physical therapy ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Cell Phone - Abstract
Background and Purpose: Subject retention into clinical trials is vital, and prehospital enrollment may be associated with higher rates of subject withdrawal than more traditional methods of enrollment. We describe rates of subject retention in a prehospital trial of acute stroke therapy. Methods: All subjects were enrolled into the NIH Field Administration of Stroke Therapy-Magnesium (FAST-MAG) phase 3 clinical trial. Paramedics screened eligible subjects and contacted the physician-investigator using a dedicated in-ambulance cellular phone. Physician-investigators obtained explicit informed consent from the subject or on-scene legally authorized representative (LAR) who reviewed and signed a consent form. Exception from informed consent (EFIC) was utilized in later stages of the study. Results: There were 1,700 subjects enrolled; 1,017 provided consent (60%), 662 were enrolled via LAR (39%), and 21 were enrolled via EFIC (1%). Of the 1,700 patients, 1,413 (83%) completed the 90-day visit, 265 (16%) died prior to the 90-day visit, and 22 (1.3%) withdrew from the study before completion. There were no differences in rates of withdrawal by method of study enrolment, i.e., self-consent (n = 14), 1.4%; LAR (n = 8), 1.2%; EFIC (n = 0) 0%. Conclusion: There was a high rate of retention when subjects were enrolled into prehospital stroke research using a phone-based method to obtain explicit consent.
- Published
- 2019
44. Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial
- Author
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Hee Yoon, Won Chul Cha, Taehwan Roh, Min Seob Sim, Tae Gun Shin, Ik Joon Jo, Taerim Kim, Sunyoung Yoon, Hansol Chang, and Sung Yeon Hwang
- Subjects
Adult ,Acute coronary syndrome ,medicine.medical_specialty ,Emergency Medical Services ,Time Factors ,Ambulances ,Myocardial Infarction ,Health Informatics ,Information technology ,030204 cardiovascular system & hematology ,electrocardiogram ,wearable ,law.invention ,03 medical and health sciences ,Electrocardiography ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Myocardial infarction ,Prospective Studies ,cardiovascular diseases ,Lead (electronics) ,Cause of death ,Original Paper ,business.industry ,ECG ,Technician ,cardiovascular ,EMT ,030208 emergency & critical care medicine ,12-lead electrocardiogram ,prehospital ,medicine.disease ,T58.5-58.64 ,electrocardiogram transmission ,Clinical trial ,efficiency ,Emergency medicine ,Ambulance transport ,Public aspects of medicine ,RA1-1270 ,business ,wearable patch device ,feasibility - Abstract
Background Cardiovascular disease is the leading cause of death worldwide. Early recognition, diagnosis, and reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. The absence of a prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measurement and transmission of P12ECG data, P12ECG use has not been widely established. Objective The aim of this study was to verify the time-efficiency and feasibility of the use of a patchy-type 12-lead ECG measuring and transmitting device (P-ECG) by an emergency medical technician (EMT) in an ambulance during patient transport. Methods This was a simulation-based prospective randomized crossover-controlled study that included EMTs. The participants were randomly assigned to one of two groups. Group A began the experiment with a conventional 12-lead ECG (C-ECG) device and then switched to the intervention device (P-ECG), whereas group B began the experiment with the P-ECG and then switched to the C-ECG. All simulations were performed inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of ECG application to completion of sending the results. After the simulation, participants were administered the System Usability Scale questionnaire about usability of the P-ECG. Results A total of 18 EMTs were recruited for this study with a median age of 35 years. The overall interval time for the C-ECG was 254 seconds (IQR 247-270), whereas the overall interval time for the P-ECG was 130 seconds (IQR 112-150), with a significant difference (P Conclusions Performance of 12-lead ECG examination and transmission of the results using P-ECG are faster than those of C-ECG during ambulance transport. With the additional time afforded, EMTs can provide more care to patients and transport patients more rapidly, which may help reduce the symptoms-to-balloon time for patients with acute coronary syndrome. Trial Registration ClinicalTrials.gov NCT04114760; https://www.clinicaltrials.gov/ct2/show/NCT04114760
- Published
- 2021
45. Predicting Urgent Dialysis at Ambulance Transport to the Emergency Department Using Machine Learning Methods.
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Majouni S, Tennankore K, and Abidi SSR
- Subjects
- Humans, Emergency Service, Hospital, Canada, Machine Learning, Renal Dialysis, Ambulances
- Abstract
Hemodialysis patients frequently require ambulance transport to the hospital for dialysis. Some patients require urgent dialysis (UD) within 24 hours of transport to hospital to avoid morbidity and mortality. UD is not available in all hospitals; therefore, predicting patients who need UD prior to hospital transport can help paramedics with destination planning. In this paper, we developed machine learning models for paramedics to predict whether a patient needs UD based on patient characteristics available at the time of ambulance transport. This paper presented a study based on ambulance data collected in Halifax, Canada. Given that relatively few patients need UD, a class imbalance problem is addressed by up-sampling methods and prediction models are developed using multiple machine learning methods. The achieved prediction scores are F1-score=0.76, sensitivity=0.76, and specificity=0.97, confirming that models can predict UD with limited patient characteristics.
- Published
- 2024
- Full Text
- View/download PDF
46. Dynamic ambulance relocation: a scoping review.
- Author
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Becker J, Kurland L, Höglund E, and Hugelius K
- Subjects
- Humans, Emergencies, Prospective Studies, Time, Ambulances, Emergency Medical Services
- Abstract
Objectives: Dynamic ambulance relocation means that the operators at a dispatch centre place an ambulance in a temporary location, with the goal of optimising coverage and response times in future medical emergencies. This study aimed to scope the current research on dynamic ambulance relocation., Design: A scoping review was conducted using a structured search in PubMed, Scopus and Web of Science. In total, 21 papers were included., Results: Most papers described research with experimental designs involving the use of mathematical models to calculate the optimal use and temporary relocations of ambulances. The models relied on several variables, including distances, locations of hospitals, demographic-geological data, estimation of new emergencies, emergency medical services (EMSs) working hours and other data. Some studies used historic ambulance dispatching data to develop models. Only one study reported a prospective, real-time evaluation of the models and the development of technical systems. No study reported on either positive or negative patient outcomes or real-life chain effects from the dynamic relocation of ambulances., Conclusions: Current knowledge on dynamic relocation of ambulances is dominated by mathematical and technical support data that have calculated optimal locations of ambulance services based on response times and not patient outcomes. Conversely, knowledge of how patient outcomes and the working environment are affected by dynamic ambulance dispatching is lacking. This review has highlighted several gaps in the scientific coverage of the topic. The primary concern is the lack of studies reporting on patient outcomes, and the limited knowledge regarding several key factors, including the optimal use of ambulances in rural areas, turnaround times, domino effects and aspects of working environment for EMS personnel. Therefore, addressing these knowledge gaps is important in future studies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
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47. Ambulance deployment without transport: a retrospective difference analysis for the description of emergency interventions without patient transport in Bavaria.
- Author
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Dax F, Trentzsch H, Lazarovici M, Hegenberg K, Kneißl K, Hoffmann F, and Prückner S
- Subjects
- Humans, Emergencies, Retrospective Studies, Cross-Sectional Studies, Ambulances, Emergency Medical Services
- Abstract
Background: Not all patients who call the ambulance service are subsequently transported to hospital. In 2018, a quarter of deployments of an emergency ambulance in Bavaria were not followed by patient transport. This study describes factors that influence patient transport rates., Method: This is a retrospective cross-sectional study based on data from all Integrated Dispatch Centres of the Free State of Bavaria in 2018. Included were ambulance deployments without emergency physician involvement, which were subdivided into ambulance deployments without transport and ambulance deployments with transport. The proportion of transported patients were determined for the primary reasons for deployment and for the different community types. On-scene time was compared for calls with and without patient transport. Differences were tested for statistical significance using Chi
2 tests and the odds ratio was calculated to determine differences between groups., Results: Of 510,145 deployments, 147,621 (28.9%) could be classified as ambulance deployments without transport and 362,524 (71.1%) as ambulance deployments with transport.The lowest proportion of patients transported was found for activations where the fire brigade was involved ("fire alarm system" 0.6%, "fire with emergency medical services" 5.4%) and "personal emergency response system active alarm" (18.6%). The highest transport rates were observed for emergencies involving "childbirth/delivery" (96.9%) and "trauma" (83.2%). A lower proportion of patients is transported in large cities as compared to smaller cities or rural communities; in large cities, the odds ratio for emergencies without transport is 2.02 [95% confidence interval 1.98-2.06] referenced to rural communites. The median on-scene time for emergencies without transport was 20.8 min (n = 141,052) as compared to 16.5 min for emergencies with transport (n = 362,524). The shortest on-scene times for emergencies without transport were identified for activations related to "fire alarm system" (9.0 min) and "personal emergency response system active alarm" (10.6 min)., Conclusion: This study indicates that the proportion of patients transported depends on the reason for deployment and whether the emergency location is urban or rural. Particularly low transport rates are found if an ambulance was dispatched in connection with a fire department operation or a personal emergency medical alert button was activated. The on-scene-time of the rescue vehicle is increased for deployments without transport. The study could not provide a rationale for this and further research is needed. Trial registration This paper is part of the study "Rettungswageneinsatz ohne Transport" ["Ambulance deployment without transport"] (RoT), which was registered in the German Register of Clinical Studies under the number DRKS00017758., (© 2023. The Author(s).)- Published
- 2023
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48. The PRE-hospital Stroke Treatment Organization
- Author
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Stephen M. Davis, Heinrich J. Audebert, James C. Grotta, Anne W. Alexandrov, Guillaume Turc, Ken Uchino, Klaus Fassbender, Martin Ebinger, and M. Shazam Hussain
- Subjects
Intracerebral hemorrhage ,Government ,Telemedicine ,business.industry ,Ambulances ,Staffing ,Professional communication ,030204 cardiovascular system & hematology ,medicine.disease ,Stroke ,03 medical and health sciences ,0302 clinical medicine ,White paper ,Neurology ,Acute Disease ,medicine ,Humans ,Organizational structure ,cardiovascular diseases ,Medical emergency ,business ,Societies, Medical ,030217 neurology & neurosurgery - Abstract
Background The PRE-hospital Stroke Treatment Organization was formed in 2016 as an international consortium of medical practitioners involved in pre-hospital treatment of patients with acute stroke. Aims PRE-hospital Stroke Treatment Organization’s mission is to improve stroke outcomes by supporting research and advocacy for pre-hospital stroke treatment in Mobile Stroke Units. PRE-hospital Stroke Treatment Organization will provide a platform to enhance collaborative research across the spectrum of acute stroke management in the pre-hospital setting. PRE-hospital Stroke Treatment Organization will also facilitate the appropriate proliferation and distribution of Mobile Stroke Units by providing a forum for professional communication, resource for public education, and stimulus for government, industry, and philanthropic support. Summary of review In this “white paper”, we describe the evidence supporting pre-hospital stroke treatment, progress to date, practical issues such as application in various environments and staffing, planned research initiatives, and organizational structure. Conclusions PRE-hospital Stroke Treatment Organization is not-for-profit, with membership open to anyone involved (or hoping to become involved) in pre-hospital stroke care. PRE-hospital Stroke Treatment Organization has a Steering Committee comprised of members from Europe, U.S., Canada, Australia, and other regions having a Mobile Stroke Unit in operation. PRE-hospital Stroke Treatment Organization convenes satellite meetings for membership at the International Stroke Conference and European Stroke Congress each year to address the PRE-hospital Stroke Treatment Organization mission. The first research collaborations agreed upon are to: (1) develop a list of common data elements to be collected by all Mobile Stroke Unit programs and entered into a common research database, and (2) develop a protocol for investigating the natural history of hyper-acute Intracerebral Hemorrhage.
- Published
- 2017
49. Prioritizing novel and existing ambulance performance measures through expert and lay consensus: A three-stage multimethod consensus study
- Author
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Andy Irving, Viet-Hai Phung, Joanne Coster, Aloysius Niroshan Siriwardena, and Janette Turner
- Subjects
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
50. Blockchain based reputation management, data storage and distributed revocation in vehicular energy networks in smart health care systems.
- Author
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Jamal, Abid, Javed, Muhammad Umar, Alrajeh, Nabil, Bouk, Safdar Hussain, and Javaid, Nadeem
- Subjects
REPUTATION ,HEALTH care networks ,AMBULANCES ,BLOCKCHAINS ,CLOUD storage ,DIGITAL signatures ,REVOCATION ,DATA warehousing - Abstract
In vehicular energy networks (VENs) operating in smart health care systems (SHaCarS), reputation of vehicles, i.e., ambulances, plays an important role as all functions depend upon it including message sharing, energy trading, etc. Keeping this in view, this paper presents a reputation management scheme. To ensure that the proposed scheme is secure and transparent, Blockchain (BC) technology is used. In the proposed model, the registration of ambulances is performed through a certificate authority (CA). Later, a pseudo mechanism is designed using Elliptic Curve Digital Signature Algorithm, which ensures conditional anonymity and traceability. The ambulances are provided with the pseudo identities, which are mapped with the real identities to prevent disputes. Besides, the proposed scheme uses a Shamir secret sharing (SSS) algorithm to enable distributed revocation in BC based VENs operating in SHaCarS. In addition, the ambulances' reputation information is stored in interplanetary file system (IPFS) in an efficient manner. The hashes are generated by IPFS upon data storage, which are then stored in BC. The performance evaluation of the proposed system is done via extensive simulations. The results show 18–20% reduction in computational overhead and 35–40% reduction in storage overhead. The proposed system's robustness is tested by inducing the 51% attack and the replay attack. In addition, the security analysis of the smart contract is performed using Oyente. The results show that the system proposed for reputation management in the underlying work is robust and computationally efficient. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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