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https://www.readbyqxmd.com/read/28792986/-implementation-of-the-mobile-emergency-medical-service-in-brazil-action-strategies-and-structural-dimension
#1
Gisele O'Dwyer, Mariana Teixeira Konder, Luciano Pereira Reciputti, Cesar Macedo, Monica Guimarães Macau Lopes
The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service...
August 7, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28760696/simulation-training-to-improve-9-1-1-dispatcher-identification-of-cardiac-arrest-a-randomized-controlled-trial
#2
Hendrika Meischke, Ian S Painter, Scott R Stangenes, Marcia R Weaver, Carol E Fahrenbruch, Tom Rea, Anne M Turner
BACKGROUND: The objective of this study was to test the effectiveness of simulation training, using actors to make mock calls, on improving Emergency Medical Dispatchers' (EMDs) ability to recognize the need for, and reduce the time to, telephone-assisted CPR (T-CPR) in simulated and real cardiac arrest 9-1-1 calls. METHODS: We conducted a parallel prospective randomized controlled trial with n=157 EMDs from thirteen 9-1-1 call centers. Study participants were randomized within each center to intervention (i...
July 29, 2017: Resuscitation
https://www.readbyqxmd.com/read/28756074/-european-guidelines-on-cardiac-arrest-what-s-new
#3
Pascal Cassan
The European recommendations on cardiac arrest are based on the evidence gathered and reviewed by the International Resuscitation Liaison Committee (ILCOR) and were published in October 2015. These recommendations without representing a revolution, constitute an evolution centered on a primary goal to increase survival following cardiac arrest. This improvement in survival depends on four main factors: early identification of cardiac arrest, early access to rescue, early and quality CPR, and access to early defibrillation...
July 26, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28754526/telephone-cardiopulmonary-resuscitation-is-independently-associated-with-improved-survival-and-improved-functional-outcome-after-out-of-hospital-cardiac-arrest
#4
Zhixin Wu, Micah Panczyk, Daniel W Spaite, Chengcheng Hu, Hidetada Fukushima, Blake Langlais, John Sutter, Bentley J Bobrow
AIM OF STUDY: This study aims to quantify the relative impact of Dispatcher-Initiated Telephone cardiopulmonary resuscitation (TCPR) on survival and survival with favorable functional outcome after out-of-hospital cardiac arrest (OHCA) in a population of patients served by multiple emergency dispatch centers and more than 130 emergency medical services (EMS) agencies. METHODS: We conducted a prospective, observational study of EMS-treated adult (≥18 years) patients with OHCA of presumed cardiac origin in Arizona, between January 1, 2011, and December 31, 2014...
July 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#5
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28721549/an-expected-coverage-model-with-a-cutoff-priority-queue
#6
Soovin Yoon, Laura A Albert
Emergency medical services provide immediate care to patients with various types of needs. When the system is congested, the response to urgent emergency calls can be delayed. To address this issue, we propose a spatial Hypercube approximation model with a cutoff priority queue that estimates performance measures for a system where some servers are reserved exclusively for high priority calls when the system is congested. In the cutoff priority queue, low priority calls are not immediately served-they are either lost or entered into a queue-whenever the number of busy ambulances is equal to or greater than the cutoff...
July 19, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28693524/national-consensus-on-communication-in-prehospital-trauma-care-the-denim-study
#7
Annelieke Maria Karien Harmsen, Leo Maria George Geeraedts, Georgios Fredericus Giannakopoulos, Maartje Terra, Herman M T Christiaans, Lidwine Brigitta Mokkink, Frank Willem Bloemers
BACKGROUND: In the Netherlands prehospital trauma care is provided by emergency medical services (EMS) nurses. This care is extended by Physician staffed Helicopter Emergency Medical Services (P-HEMS) for the more severely injured patient. Prehospital communication is a factor of influence on the identification of these patients and the dispatch of P-HEMS. Though prehospital communication it is often perceived to be incomplete and unstructured. To elucidated factors of influence on prehospital triage and the identification of the severely injured patient a Delphi study was performed...
July 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28693491/hypoxia-and-hypotension-in-patients-intubated-by-physician-staffed-helicopter-emergency-medical-services-a-prospective-observational-multi-centre-study
#8
Geir Arne Sunde, Mårten Sandberg, Richard Lyon, Knut Fredriksen, Brian Burns, Karl Ove Hufthammer, Jo Røislien, Akos Soti, Helena Jäntti, David Lockey, Jon-Kenneth Heltne, Stephen J M Sollid
BACKGROUND: The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Several studies describe the impact of pre-hospital hypoxia or hypotension on trauma patients, but few studies compare this in trauma and non-trauma patients...
July 11, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28687709/the-effects-of-public-access-defibrillation-on-survival-after-out-of-hospital-cardiac-arrest-a-systematic-review-of-observational-studies
#9
Josefine Bækgaard, Søren Viereck, Thea Møller, Annette Ersbøll, Freddy Lippert, Fredrik Folke
Background -Despite recent advances, the average survival after out-of-hospital cardiac arrest (OHCA) remains below 10%. Early defibrillation by an automated external defibrillator (AED) is the most important intervention for OHCA patients, showing survival proportions above 50%. Accordingly, placement of AEDs in the community as part of a public access defibrillation program (PAD) is recommended by international guidelines. However, different strategies have been proposed on how exactly to increase and make use of public available AEDs...
July 7, 2017: Circulation
https://www.readbyqxmd.com/read/28684011/-when-the-patient-calls-the-samu-because-his-pacemaker-is-making-beep-beep-study-on-physicians-knowledge-on-pacemaker-sound-alarm
#10
F Lapostolle, N Laghmari, P-G Reuter, H Akodad, F Adnet
INTRODUCTION: More than 60,000 pacemakers are inserted every year in France. This number has been steadily increasing for a decade. Miscellaneous incidents can lead patients with pacemakers or their relatives to contact emergency services. Following the call to the SAMU-Center 15 of a asymptomatic 90-year-old woman reported that her pacemaker was making "beep-beep", we assessed the knowledge of physicians of the SAMU-Center 15 (call center) dispatching center on the existence of pacemaker sound alarms...
July 3, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28661784/identifying-key-words-in-9-1-1-calls-for-stroke-a-mixed-methods-approach
#11
Christopher T Richards, Baiyang Wang, Eddie Markul, Frank Albarran, Doreen Rottman, Neelum T Aggarwal, Patricia Lindeman, Leslee Stein-Spencer, Joseph M Weber, Kenneth S Pearlman, Katie L Tataris, Jane L Holl, Diego Klabjan, Shyam Prabhakaran
OBJECTIVES: Identifying stroke during a 9-1-1 call is critical to timely prehospital care. However, emergency medical dispatchers (EMDs) recognize stroke in less than half of 9-1-1 calls, potentially due to the words used by callers to communicate stroke signs and symptoms. We hypothesized that callers do not typically use words and phrases considered to be classical descriptors of stroke, such as focal neurologic deficits, but that a mixed-methods approach can identify words and phrases commonly used by 9-1-1 callers to describe acute stroke victims...
June 29, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28657797/role-of-emergency-medical-dispatch-in-responding-to-acute-stroke-expanding-beyond-high-priority-dispatch
#12
Mehul D Patel
No abstract text is available yet for this article.
June 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28653327/are-severely-injured-trauma-victims-in-norway-offered-advanced-pre-hospital-care-national-retrospective-observational-cohort
#13
T Wisborg, E N Ellensen, I Svege, T Dehli
BACKGROUND: Studies of severely injured patients suggest that advanced pre-hospital care and/or rapid transportation provides a survival benefit. This benefit depends on the disposition of resources to patients with the greatest need. Norway has 19 Emergency Helicopters (HEMS) staffed by anaesthesiologists on duty 24/7/365. National regulations describe indications for their use, and the use of the national emergency medical dispatch guideline is recommended. We assessed whether severely injured patients had been treated or transported by advanced resources on a national scale...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28616642/-identification-of-common-locations-of-out-of-hospital-cardiac-arrests-in-a%C3%A2-german-metropolis
#14
C Hanefeld, F Rosbund, A Kloppe, C Kloppe
BACKGROUND: Most patients who suffer a sudden cardiac arrest initially have a shockable rhythm. Fast defibrillation and correctly performed cardiopulmonary resuscitation (CPR) are key factors for patient survival. These can be carried out by bystanders if an automated external defibrillator (AED) is available even in the absence of emergency services. AIM: The place and time of CPRs in a German city were investigated and the strategic placement of emergency medical services and AEDs necessary were evaluated...
June 14, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28599999/-tell-me-exactly-what-s-happened-when-linguistic-choices-affect-the-efficiency-of-emergency-calls-for-cardiac-arrest
#15
Marine Riou, Stephen Ball, Teresa A Williams, Austin Whiteside, Kay L O'Halloran, Janet Bray, Gavin D Perkins, Karen Smith, Peter Cameron, Daniel M Fatovich, Madoka Inoue, Paul Bailey, Deon Brink, Judith Finn
BACKGROUND: Clear and efficient communication between emergency caller and call-taker is crucial to timely ambulance dispatch. We aimed to explore the impact of linguistic variation in the delivery of the prompt "okay, tell me exactly what happened" on the way callers describe the emergency in the Medical Priority Dispatch System(®). METHODS: We analysed 188 emergency calls for cases of paramedic-confirmed out-of-hospital cardiac arrest. We investigated the linguistic features of the prompt "okay, tell me exactly what happened" in relation to the format (report vs...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28583860/effectiveness-of-different-compression-to-ventilation-methods-for-cardiopulmonary-resuscitation-a-systematic-review
#16
REVIEW
Huda M Ashoor, Erin Lillie, Wasifa Zarin, Ba' Pham, Paul A Khan, Vera Nincic, Fatemeh Yazdi, Marco Ghassemi, John Ivory, Roberta Cardoso, Gavin D Perkins, Allan R de Caen, Andrea C Tricco
AIM: To compare the effectiveness of different compression-to-ventilation methods during cardiopulmonary resuscitation (CPR) in patients with cardiac arrest. METHODS: We searched MEDLINE and Cochrane Central Register of Controlled Trials from inception until January 2016. We included experimental, quasi-experimental, and observational studies that compared different chest compression-to-ventilation ratios during CPR for all patients and assessed at least one of the following outcomes: favourable neurological outcomes, survival, return of spontaneous circulation (ROSC), and quality of life...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28559037/repeated-emergency-medical-services-use-by-older-adults-analysis-of-a-comprehensive-statewide-database
#17
Christopher S Evans, Timothy F Platts-Mills, Antonio R Fernandez, Joseph M Grover, Jose G Cabanas, Mehul D Patel, Gary M Vilke, Jane H Brice
STUDY OBJECTIVE: The objective of this study is to characterize repeated emergency medical services (EMS) transports among older adults across a large and socioeconomically diverse region. METHODS: Using the North Carolina Prehospital Medical Information System, we analyzed the frequency of repeated EMS transports within 30 days of an index EMS transport among adults aged 65 years and older from 2010 to 2015. We used multivariable logistic regressions to determine characteristics associated with repeated EMS transport...
May 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28520597/key-performance-indicators-assessment-to-develop-best-practices-in-an-emergency-medical-communication-centre
#18
Yann Penverne, Brice Leclere, Julien Labady, Frederic Berthier, Joel Jenvrin, Francois Javaudin, Eric Batard, Emmanuel Montassier
INTRODUCTION: Emergency Medical Communication Centre (EMCC) represents a pivotal link in the chain of survival for those requiring rapid response for out-of-hospital medical emergencies. Assessing and grading the performance of EMCCs are warranted as it can affect the health and safety of the served population. OBJECTIVE: The aim of our work was to describe the activity on an EMCC and to explore the associations between different key performance indicators. METHODS: We carried out our prospective observational study in the EMCC of Nantes, France, from 6 June 2011 to 6 June 2015...
May 17, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28505199/stress-and-salivary-cortisol-in-emergency-medical-dispatchers-a-randomized-shifts-control-trial
#19
Sarah Bedini, François Braun, Laurence Weibel, Michel Aussedat, Bruno Pereira, Frédéric Dutheil
Stress at work is a public health concern. Phone operators in emergency medical dispatch centers are particularly at risk. We aimed to demonstrate that the most stressful time for emergency medical dispatchers is the shift when they receive emergency incoming calls, with cortisol as a biomarker of stress. For each emergency medical dispatcher, we measured outcomes over a control day and during three types of shift: Incoming emergency call, Dispatch and Re-assessment. The pattern of shifts was randomized. Saliva was sampled every 15 minutes for 2 hours, i...
2017: PloS One
https://www.readbyqxmd.com/read/28499459/dispatch-and-prehospital-transport-for-acute-septic-patients-an-observational-study
#20
Peter Bank Pedersen, Daniel Pilsgaard Henriksen, Søren Mikkelsen, Annmarie Touborg Lassen
BACKGROUND: In order to dispatch ambulances with the correct level of urgency, the dispatch center has to balance the perceived urgency and traffic safety considerations with the available resources. As urgency is not clear in all clinical situations, some high urgency patients may end up with a suboptimal mode of transport. Patients with severe sepsis or septic shock suffer from highly time dependent conditions but they present with a wide range of symptoms, which might be difficult to identify in the dispatch system...
May 12, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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