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Ems error

Todd Chassee, Diann Reischmann, Michael Mancera, John D Hoyle
BACKGROUND: Prehospital pediatric drug dosing errors affect 56,000 U.S. children annually. An accurate weight is the first step in accurate dosing. To date, the accuracy of Emergency Medical Dispatcher (EMD) obtained weights has not been evaluated. We hypothesized that EMD could obtain accurate pediatric weights. METHODS: We used a convenience sample of patients 12 years and younger that were transported by EMS to one children's hospital. EMD obtained patient weight (DW) from the 9-1-1 caller...
September 30, 2016: Prehospital Emergency Care
Jeffrey D Ho, Donald M Dawes, Evan M McKay, Jeremy J Taliercio, Scott D White, Blair J Woodbury, Mark A Sandefur, James R Miner
INTRODUCTION: Current Emergency Medical Services (EMS) documentation practices usually occur from memory after an event is over. While this practice is fairly standard, it is unclear if it can introduce significant error. Modern technology has seen the increased use of recorded video by society to more objectively document notable events. Stationary mounted cameras, cell-phone cameras, and law enforcement officer Body-Worn Cameras (BWCs) are increasingly used by society for this purpose...
September 16, 2016: Prehospital Emergency Care
Marie-Sophie Grave, Fritz Sterz, Alexander Nürnberger, Stergios Fykatas, Mathias Gatterbauer, Albert Friedrich Stättermayer, Andreas Zajicek, Reinhard Malzer, Dieter Sebald, Raphael van Tulder
We investigated feasibility and safety of the RhinoChill (RC) transnasal cooling system initiated before achieving a protected airway during cardiopulmonary resuscitation (CPR) in a prehospital setting.In out-of-hospital cardiac arrest (OHCA), transnasal evaporative cooling was initiated during CPR, before a protected airway was established and continued until either the patient was declared dead, standard institutional systemic cooling methods were implemented or cooling supply was empty. Patients were monitored throughout the hypothermia period until either death or hospital discharge...
August 2016: Medicine (Baltimore)
Soumitra Pal, Peng Xiao, Sanguthevar Rajasekaran
BACKGROUND: Motif search is an important step in extracting meaningful patterns from biological data. The general problem of motif search is intractable and there is a pressing need to develop efficient, exact and approximation algorithms to solve this problem. In this paper, we present several novel, exact, sequential and parallel algorithms for solving the (l,d) Edit-distance-based Motif Search (EMS) problem: given two integers l,d and n biological strings, find all strings of length l that appear in each input string with atmost d errors of types substitution, insertion and deletion...
2016: BMC Genomics
Scott A Goldberg, Avital Porat, Christopher G Strother, Nadine Q Lim, H R Sagara Wijeratne, Greisy Sanchez, Kevin G Munjal
OBJECTIVES: Patient handoff occurs when responsibility for patient diagnosis, treatment, or ongoing care is transferred from one healthcare professional to another. Patient handoff is an integral component of quality patient care and is increasingly identified as a potential source of medical error. However, evaluation of handoff from field providers to ED personnel is limited. We here present a quantitative analysis of the information transferred from EMS providers to ED physicians during handoff of critically ill and injured patients...
July 15, 2016: Prehospital Emergency Care
Marc Felzen, Jörg C Brokmann, Stefan K Beckers, Michael Czaplik, Frederik Hirsch, Miriam Tamm, Rolf Rossaint, Sebastian Bergrath
INTRODUCTION: Telemedical concepts in emergency medical services (EMS) lead to improved process times and patient outcomes, but their technical performance has thus far been insufficient; nevertheless, the concept was transferred into EMS routine care in Aachen, Germany. This study evaluated the system's technical performance and compared it to a precursor system. METHODS: The telemedicine system was implemented on seven ambulances and a teleconsultation centre staffed with experienced EMS physicians was established in April 2014...
April 13, 2016: Journal of Telemedicine and Telecare
Matthew Hansen, Kerth O'Brien, Garth Meckler, Anna Marie Chang, Jeanne-Marie Guise
Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance...
July 2016: Emergency Medicine Journal: EMJ
Paul Rostykus, Jamie Kennel, Kristian Adair, Micah Fillinger, Ryan Palmberg, Amy Quinn, Jonathan Ripley, Mohamud Daya
BACKGROUND: In many industries, limiting variability in process has been associated with a reduction in errors. Hypoglycemia is a common prehospital diabetic emergency for which most EMS systems have a treatment protocol. OBJECTIVE: To examine the treatment variability for prehospital hypoglycemia within EMS protocols in the U.S. METHODS: EMS protocols were reviewed in a structured fashion from 2 sources: the website and through manual identification from the 50 largest populated cities in the U...
July 2016: Prehospital Emergency Care
Christopher W C Lee, Shelley L McLeod, Kristine Van Aarsen, Michelle Klingel, Jeffrey M Franc, Michael B Peddle
INTRODUCTION: During mass-casualty incidents (MCIs), patient volume often overwhelms available Emergency Medical Services (EMS) personnel. First responders are expected to triage, treat, and transport patients in a timely fashion. If other responders could triage accurately, prehospital EMS resources could be focused more directly on patients that require immediate medical attention and transport. HYPOTHESIS: Triage accuracy, error patterns, and time to triage completion are similar between second-year primary care paramedic (PCP) and fire science (FS) students participating in a simulated MCI using the Sort, Assess, Life-saving interventions, Treatment/Transport (SALT) triage algorithm...
April 2016: Prehospital and Disaster Medicine
Danielle D Campagne, Megann Young, Jedediah Wheeler, Geoff Stroh
INTRODUCTION: The objective is to evaluate the accuracy of medication dosing and the time to medication administration in the prehospital setting using a novel length-based pediatric emergency resuscitation tape. METHODS: This study was a two-period, two-treatment crossover trial using simulated pediatric patients in the prehospital setting. Each participant was presented with two emergent scenarios; participants were randomized to which case they encountered first, and to which case used the National Park Service (NPS) emergency medical services (EMS) length-based pediatric emergency resuscitation tape...
September 2015: Western Journal of Emergency Medicine
Yun-Wu Zhao, Jing-Ya Wu, Heng Wang, Nian-Nian Li, Cheng Bian, Shu-Man Xu, Peng Li, Hua Lu, Lei Xu
BACKGROUND: The self-consciousness and practicality of preferentially prescribed essential medicines (EMs) are not high enough in county hospitals. The purposes of this study were to use the information-motivation-behavioral skills (IMB) model to identify the predictors of essential medicines prescribing behavior (EMPB) among doctors and to examine the association between demographic variables, IMB, and EMPB. METHODS: A cross-sectional study was carried out to assess predictive relationships among demographic variables and IMB model variables using an anonymous questionnaire administered in nine county hospitals of Anhui province...
November 5, 2015: Chinese Medical Journal
Christopher W C Lee, Shelley L McLeod, Michael B Peddle
BACKGROUND: Mass-casualty incidents (MCIs) present a unique challenge with regards to triage as patient volume often outweighs the number of available Emergency Medical Services (EMS) providers. A possible strategy to optimize existing triage systems includes the use of other first responder groups, namely fire and police, to decrease the triage time during MCIs, allowing for more rapid initiation of life-saving treatment and prioritization of patient transport. Hypothesis First-year primary care paramedic (PCP), fire, and police trainees can apply with similar accuracy an internationally recognized MCI triage tool, Sort, Assess, Life-saving interventions, Treatment/transport (SALT), immediately following a brief training session, and again three months later...
October 2015: Prehospital and Disaster Medicine
John D Hoyle, Deborah Sleight, Rebecca Henry, Todd Chassee, Bill Fales, Brian Mavis
Prehospital dosing errors affect approximately 56,000 US children yearly. To decrease these errors, barriers, enablers and solutions from the paramedic (EMT-P) and medical director (MD) standpoint need to be understood. We conducted a mixed-methods study of EMT-P and MDs in Michigan utilizing focus groups (FG). FGs were held at EMS agencies and state EMS conferences. Questions focused on the drug dose delivery process, barriers and enablers to correct dosing and possible solutions to decrease errors. Responses were coded by the research team for themes and number of response mentions...
2016: Prehospital Emergency Care
Joseph R Mihaljevic, Maxwell B Joseph, Pieter T J Johnson
Two of the most prominent frameworks to develop in ecology over the past decade are metacommunity ecology, which seeks to characterize multispecies distributions across space, and occupancy modeling, which corrects for imperfect detection in an effort to better understand species occurrence patterns. Although their goals are complementary, metacommunity theory and statistical occupancy modeling methods have developed independently. For instance, the elements of metacommunity structure (EMS) framework uses species occurrence data to classify metacommunity structure and link it to underlying environmental gradients...
July 2015: Ecology
Jeanne-Marie Guise, Garth Meckler, Kerth O'Brien, Merlin Curry, Phil Engle, Caitlin Dickinson, Kathryn Dickinson, Matthew Hansen, William Lambert
OBJECTIVE: To characterize emergency medical service (EMS) providers' perceptions of the factors that contribute to safety events and errors in the out-of-hospital emergency care of children. STUDY DESIGN: We used a Delphi process to achieve consensus in a national sample of 753 emergency medicine physicians and EMS professionals. Convergence and stability were achieved in 3 rounds, and findings were reviewed and interpreted by a national expert panel. RESULTS: Forty-four (88%) states were represented, and 66% of participants were retained through all 3 rounds...
November 2015: Journal of Pediatrics
Patrick J Coppler, Rajagopala Padmanabhan, Christian Martin-Gill, Clifton W Callaway, Donald M Yealy, Christopher W Seymour
UNLABELLED: Prehospital treatment protocols call for intravenous (IV) fluid for patients with shock, yet the measurement accuracy of administered fluid volume is unknown. The purpose of the current study was to assess the accuracy of documented and self-reported fluid volumes administered to medical patients by paramedics during prehospital care. We conducted a pilot, observational study nested within a parent cohort study of prehospital biomarkers in a single EMS agency transporting patients to a tertiary care hospital in Pittsburgh, Pennsylvania over 8 months...
2016: Prehospital Emergency Care
Arda Könik, Meredith Kupinski, P Hendrik Pretorius, Michael A King, Harrison H Barrett
In quantitative emission tomography, tumor activity is typically estimated from calculations on a region of interest (ROI) identified in the reconstructed slices. In these calculations, unpredictable bias arising from the null functions of the imaging system affects ROI estimates. The magnitude of this bias depends upon the tumor size and location. In prior work it has been shown that the scanning linear estimator (SLE), which operates on the raw projection data, is an unbiased estimator of activity when the size and location of the tumor are known...
August 21, 2015: Physics in Medicine and Biology
Albert Y Chen, Tsung-Yu Lu, Matthew Huei-Ming Ma, Wei-Zen Sun
The objective of prehospital emergency medical services (EMSs) is to have a short response time. By increasing the operational efficiency, the survival rate of patients could potentially be increased. The geographic information system (GIS) is introduced in this study to manage and visualize the spatial distribution of demand data and forecasting results. A flexible model is implemented in GIS, through which training data are prepared with user-desired sizes for the spatial grid and discretized temporal steps...
July 2016: IEEE Journal of Biomedical and Health Informatics
Javad Malekzadeh, Hojjat Shafaee, Hamidreza Behnam, Amir Mirhaghi
BACKGROUND: The emergency medical service is designed to recognize and transfer critically ill patients. Evidence-based practice has rarely been emphasized in the emergency medical service field, especially in the dispatch center. AIMS: To identify the effect of the Cincinnati Prehospital Stroke Scale (CPSS) on telephone triage of stroke patients by telephone triage nurses at the emergency medical dispatch center and to compare CPSS with the National Guidelines for Telephone Triage Tool (NGTT)...
June 2015: International Journal of Evidence-based Healthcare
Meghan E Groth, Wesley D McMillian, Daniel L Wolfson
PURPOSE: A pharmacist's role in helping Vermont health officials standardize pharmacotherapy-related protocols used by emergency medical services (EMS) personnel across the state is described. SUMMARY: Pharmacists with expertise in emergency medicine (EM) or critical care are ideally positioned to provide guidance on optimizing and standardizing medication-use aspects of state and local EMS protocols. In 2012, the medical director of the EMS division of the Vermont Department of Health requested that an EM pharmacist at a Burlington academic medical center review draft EMS protocols designed to replace the existing patchwork of local protocols with statewide standards of care; among the 92 draft protocols reviewed, 62 pertained to medication use...
January 1, 2015: American Journal of Health-system Pharmacy: AJHP
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