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Emergency medical dispatch

Marcus Eng Hock Ong, Gavin D Perkins, Alain Cariou
Sudden out-of-hospital cardiac arrest is the most time-critical medical emergency. In the second paper of this Series on out-of-hospital cardiac arrest, we considered important issues in the prehospital management of cardiac arrest. Successful resuscitation relies on a strong chain of survival with the community, dispatch centre, ambulance, and hospital working together. Early cardiopulmonary resuscitation and defibrillation has the greatest impact on survival. If the community response does not restart the heart, resuscitation is continued by emergency medical services' staff...
March 10, 2018: Lancet
H Lemke, W Lenz, J Schiffner, A Lechleuthner, R Hoffmann, D Pennig, U Schweigkofler, H J Bail
The introduction of requirements for a minimum intake capacity of trauma patients by the German Trauma Society (DGU) into the so-called white book of treatment of seriously injured patients, is helpful for a sufficient preparation for threats and for dealing with mass casualties for trauma centers as well as for the emergency medical services (EMS). In the hospital information database provided by the Federation of German Medical Directors of Emergency Medical Services, more than 1300 hospitals are currently listed...
March 12, 2018: Der Unfallchirurg
Brian M Clemency, Christopher T Tanski, Jennifer Gibson Chambers, Michael O'Brien, Andrew S Knapp, Alexander J Clark, Patrick McGoff, Johanna Innes, Heather A Lindstrom, David Hostler
BACKGROUND: Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients...
February 15, 2018: Prehospital Emergency Care
Phek Hui Jade Kua, Alexander E White, Wai Yee Ng, Stephanie Fook-Chong, Eileen Kai Xin Ng, Yih Yng Ng, Marcus Eng Hock Ong
INTRODUCTION: Victims of out-of-hospital cardiac arrests require timely cardiopulmonary resuscitation (CPR) and early defibrillation. Persons making the call to emergency medical services will be asked to provide dispatcher-guided response until an ambulance arrives. Knowing what to expect in such circumstances should reduce both delay and confusion. METHODS: We conducted this study among schoolchildren aged 11-17 years using ten-item pre- and post-training surveys...
February 12, 2018: Singapore Medical Journal
Ellinor Berglund, Andreas Claesson, Per Nordberg, Therese Djärv, Peter Lundgren, Fredrik Folke, Sune Forsberg, Gabriel Riva, Mattias Ringh
BACKGROUND: Dispatch of lay volunteers trained in cardiopulmonary resuscitation (CPR) and equipped with automated external defibrillators (AEDs) may improve survival in cases of out-of-hospital cardiac arrest (OHCA). The aim of this study was to investigate the functionality and performance of a smartphone application for locating and alerting nearby trained laymen/women in cases of OHCA. METHODS: A system using a smartphone application activated by Emergency Dispatch Centres was used to locate and alert laymen/women to nearby suspected OHCAs...
January 31, 2018: Resuscitation
Jeong Ho Park, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, So Yeon Kong
OBJECTIVES: We investigated the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on survival outcomes after out-of-hospital cardiac arrests (OHCAs) that occurred in rural and urban areas. METHODS: This study was a cross-sectional study using nationwide emergency medical services (EMS)-based OHCA registry in Korea. All EMS-treated adults with OHCAs and with presumed cardiac etiology were enrolled between 2012 and 2015, excluding cases witnessed by an EMS provider...
February 1, 2018: Resuscitation
S Wilk, L Siegl, K Siegl, C Hohenstein
BACKGROUND: In an analysis of a critical incident reporting system (CIRS) in out-of-hospital emergency medicine, it was demonstrated that in 30% of cases deficient communication led to a threat to patients; however, the analysis did not show what exactly the most dangerous work processes are. Current research shows the impact of poor communication on patient safety. OBJECTIVES: An out-of-hospital workflow analysis collects data about key work processes and risk areas...
February 5, 2018: Der Anaesthesist
Hanna Vihonen, Markku Kuisma, Jouni Nurmi
BACKGROUND: The current study investigates the incidence, aetiology, and outcome of hypoglycaemia of patients without diabetes in the EMS. METHODS: The study was a retrospective cohort study that utilized electronic EMS patient record system (population of one million). All patients encountered by EMS with plasma glucose ≤3.9 mmol/l from 2009 to 2015 were included in the study and hospital records were screened manually to detect possible reasons for hypoglycaemia...
February 1, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Renee Roggenkamp, Emily Andrew, Ziad Nehme, Shelley Cox, Karen Smith
OBJECTIVE: In many developed countries, a lack of community-based mental health services is driving increased utilization of emergency medical services (EMS). In this descriptive study, we sought to describe the demographic and clinical characteristics of mental health-related EMS presentations in Victoria, Australia. METHODS: A retrospective observational study of EMS presentations occurring between January and December 2015. Computer Aided Dispatch and electronic patient care record data were extracted from an electronic data warehouse...
January 24, 2018: Prehospital Emergency Care
J Adam Oostema, Todd Chassee, Mathew Reeves
OBJECTIVE: As the first point of contact for patients activating emergency medical services (EMS), emergency dispatchers have the earliest opportunity to recognize stroke. We sought to quantify dispatcher stroke recognition and its relationships with EMS stroke recognition and response speed. METHODS: We assembled a cohort of consecutive EMS-transported patients with a dispatcher suspected stroke or a hospital discharge diagnosis of stroke or transient ischemic attack (TIA)...
January 16, 2018: Prehospital Emergency Care
Francine O James, Lauren B Waggoner, Patricia M Weiss, P Daniel Patterson, J Stephen Higgins, Eddy S Lang, Hans P A Van Dongen
BACKGROUND: Work schedules like those of Emergency Medical Services (EMS) personnel have been associated with increased risk of fatigue-related impairment. Biomathematical modeling is a means of objectively estimating the potential impacts of fatigue on performance, which may be used in the mitigation of fatigue-related safety risks. In the context of EMS operations, our objective was to assess the evidence in the literature regarding the effectiveness of using biomathematical models to help mitigate fatigue and fatigue-related risks...
January 11, 2018: Prehospital Emergency Care
M Andersson Hagiwara, B Wireklint Sundström, P Brink, J Herlitz, P-O Hansson
OBJECTIVES: We compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. MATERIALS & METHODS: The Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis)...
January 8, 2018: Acta Neurologica Scandinavica
Kasper Andersen, Søren Mikkelsen, Gitte Jørgensen, Stine Thorhauge Zwisler
BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years...
January 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Hanne Beck Mieritz, Camilla Rønnow, Gitte Jørgensen, Søren Mikkelsen, Stine Thorhauge Zwisler
When general practitioners (GPs) order an ambulance, their calls are handled by staff at the emergency medical dispatch centre (EMDC) who then select an appropriate response. There are currently no data evaluating this mode of communication between the GPs and the staff at the EMDC. 
METHODS: A retrospective study was performed based on evaluation of calls during which GPs requested a rapid response ambulance. Over a period of three months of 2014, 1,334 calls were included for evaluation according to specific parameters including a transactional analysis of the communication...
January 2018: Danish Medical Journal
Klara Torlén, Lisa Kurland, Maaret Castrén, Knut Olanders, Katarina Bohm
BACKGROUND: Emergency medical dispatching should be as accurate as possible in order to ensure patient safety and optimize the use of ambulance resources. This study aimed to compare the accuracy, measured as priority level, between two Swedish dispatch protocols - the three-graded priority protocol Medical Index and a newly developed prototype, the four-graded priority protocol, RETTS-A. METHODS: A simulation study was carried out at the Emergency Medical Communication Centre (EMCC) in Stockholm, Sweden, between October and March 2016...
December 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Jeff J Clawson, Isabel Gardett, Greg Scott, Conrad Fivaz, Tracey Barron, Meghan Broadbent, Christopher Olola
Introduction Early recognition of an acute myocardial infarction (AMI) can increase the patient's likelihood of survival. As the first point of contact for patients accessing medical care through emergency services, emergency medical dispatchers (EMDs) represent the earliest potential identification point for AMIs. The objective of the study was to determine how AMI cases were coded and prioritized at the dispatch point, and also to describe the distribution of these cases by patient age and gender. Hypothesis/Problem No studies currently exist that describe the EMD's ability to correctly triage AMIs into Advanced Life Support (ALS) response tiers...
February 2018: Prehospital and Disaster Medicine
Manali Shah, Cherie Bartram, Kevin Irwin, Kimberly Vellano, Bryan McNally, Timothy Gallagher, Robert Swor
OBJECTIVES: Dispatch-assisted cardiopulmonary resuscitation (DA-CPR) has been shown to improve cardiac arrest survival. Recent literature has proposed dispatch metrics for provision of this intervention. Our objectives are to: use the Cardiac Arrest Registry to Enhance Survival (CARES) to compare current practice to proposed DA-CPR guidelines; describe barriers to DA-CPR; and assess the association of DA-CPR with out-of-hospital cardiac arrest (OHCA) survival. METHODS: We reviewed data from structured dispatch reviews of 911 OHCA calls from 1/1/14-12/31/15...
March 2018: Prehospital Emergency Care
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
BACKGROUND AND PURPOSE: The reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving the chances of a favourable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. METHODS: The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions...
March 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Yu Jin Lee, Kyoung Jun Song, Sang Do Shin, Seung Chul Lee, Eui Jung Lee, Young Sun Ro, Ki Ok Ahn
OBJECTIVES: A dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) is expected to influence the outcomes of pediatric out-of-hospital cardiac arrest (OHCA). Our objective was to measure the effect size of a DA-BCPR on survival outcomes according to location of the event. METHODS: All emergency medical service treated OHCA patients younger than 19 years in Korea from January 2012 through December 2013 were analyzed. Patients with OHCA witnessed by emergency medical service providers and those with missing outcome information were excluded...
December 1, 2017: Pediatric Emergency Care
Jin-Jun Zhang, Tian-Bing Wang, Da Fan, Jun Zhang, Bao-Guo Jiang
BACKGROUND: On August 12, 2015, a hazardous chemical explosion occurred in the Tianjin Port of China. The explosions resulted in 165 deaths, 8 missing people, injuries to thousands of people. We present the responses of emergency medical services and hospitals to the explosions and summarize the lessons that can be learned. METHODS: This study was a retrospective analysis of the responses of emergency medical services and hospitals to the Tianjin explosions. Data on injuries, outcomes, and patient flow were obtained from the government and the hospitals...
December 4, 2017: Disaster Medicine and Public Health Preparedness
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