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https://www.readbyqxmd.com/read/27344928/dual-defibrillation-in-out-of-hospital-cardiac-arrest-a-retrospective-cohort-analysis
#1
Elliot M Ross, Theodore T Redman, Stephen A Harper, Julian G Mapp, David A Wampler, David A Miramontes
STUDY OBJECTIVES: The goal of our study is to determine if prehospital dual defibrillation (DD) is associated with better neurologically intact survival in out-of-hospital cardiac arrest. METHODS: This study is a retrospective cohort analysis of prospectively collected Quality Assurance/Quality Improvement data from a large urban fire based EMS system out-of-hospital cardiac arrest (OHCA) database between Jan 2013 and Dec 2015. Our inclusion criteria were administration of DD or at least four conventional 200J defibrillations for cases of recurrent and refractory ventricular fibrillation (VF)...
September 2016: Resuscitation
https://www.readbyqxmd.com/read/26953538/the-history-and-evolution-of-the-trauma-program-manager-coordinator
#2
Amy Koestner, Madonna Walters, Mican DeBoer
The role of the trauma program manager (TPM) has evolved since the early 1980s. Duties of TPM historically included broad responsibilities such as education, data collection, system, EMS, clinical activities, research, and quality assurance. The purpose of this study was to use survey sampling to evaluate self-perceived functions and scope of work of TPMs in the United States. Results show that TPMs from higher volume centers spend more time on program administration duties whereas TPMs from lower volume centers focus more on registry and clinical duties...
March 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/26693186/assessment-of-emergency-medical-services-in-the-ashanti-region-of-ghana
#3
N K Mould-Millman, R Oteng, A Zakariah, M Osei-Ampofo, G Oduro, W Barsan, P Donkor, T Kowalenko
BACKGROUND: We aimed to assess the structure, function and performance of Ashanti Region's emergency medical services system in the context of the regional need for prehospital emergency care. DESIGN: A mixed-methods approach was employed, using retrospective collection of quantitative data and prospectively gathered qualitative data. Setting - pertinent data were collected from Ghanaian and international sources; interviews and technical assessments were performed primarily in the Ashanti Region of Ghana...
September 2015: Ghana Medical Journal
https://www.readbyqxmd.com/read/26418390/-quality-indicators-for-the-assessment-of-st-segment-elevation-acute-myocardial-infarction-stemi-networks-how-hospital-discharge-records-could-be-integrated-with-emergency-medical-services-data-the-emilia-romagna-stemi-network-experience
#4
Pier Camillo Pavesi, Paolo Guastaroba, Gianni Casella, Elena Berti, Rossana De Palma, Stefano Di Bartolomeo, Giuseppe Di Pasquale
BACKGROUND: The assessment of the regional network for ST-segment elevation acute myocardial infarction (STEMI) is fundamental for quality assurance. Since 2011 all Italian Health Authorities, in addition to hospital discharge records (HDR), must provide a standardized information flow (ERD) about emergency department (ED) and emergency medical system (EMS) activities. The aim of this study was to evaluate whether data integration of ERD with HDR may allow the development of appropriate quality indicators...
September 2015: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/25987931/knowledge-and-beliefs-of-ems-providers-toward-lights-and-siren-transportation
#5
Joseph Tennyson, Louise Maranda, Adam Darnobid
INTRODUCTION: The use of warning lights and siren (WLS) increases the risk of ambulance collisions. Multiple studies have failed to demonstrate a clinical benefit to the patients. We sought to investigate the degree to which providers understand the data and incorporate it into their practice. METHODS: The authors distributed an anonymous survey to prehospital providers under their medical direction at staff and quality assurance meetings. The surveys asked the providers' degree of agreement with four statements: transport with lights and siren shortens transport times; transport with lights and siren improves patient outcome; transport with lights and siren increases the risk of collision during transport; and transport with lights and siren reduces the utilization of "mutual aid" service...
May 2015: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/25665010/the-price-of-a-helping-hand-modeling-the-outcomes-and-costs-of-bystander-cpr
#6
Andrew J Bouland, Nicholas Risko, Benjamin J Lawner, Kevin G Seaman, Cassandra M Godar, Matthew J Levy
OBJECTIVE: Early, high-quality, minimally interrupted bystander cardio-pulmonary resuscitation (BCPR) is essential for out-of-hospital cardiac arrest survival. However, rates of bystander intervention remain low in many geographic areas. Community CPR programs have been initiated to combat these low numbers by teaching compression-only CPR to laypersons. This study examined bystander CPR and the cost-effectiveness of a countywide CPR program to improve out-of-hospital cardiac arrest survival...
2015: Prehospital Emergency Care
https://www.readbyqxmd.com/read/25290075/description-of-the-2012-nemsis-public-release-research-dataset
#7
N Clay Mann, Lauren Kane, Mengtao Dai, Karen Jacobson
BACKGROUND: The National Emergency Medical Services Information System (NEMSIS) is a federally funded project designed to standardize emergency medical services (EMS) patient care reporting and facilitate state and national data repositories for the assessment of EMS systems of care. The purpose of this assessment is to characterize the annual NEMSIS 2012 Public-Release Research Dataset, detailing the strengths and limitations associated with use of these data for EMS quality assurance and/or research purposes...
April 2015: Prehospital Emergency Care
https://www.readbyqxmd.com/read/25256540/stent-for-life-initiative-leading-example-in-building-stemi-systems-of-care-in-emerging-countries
#8
REVIEW
Zuzana Kaifoszova, Petr Kala, Thomas Alexander, Yan Zhang, Yong Huo, Adriaan Snyders, Rhena Delport, Marco Antonio Alcocer-Gamba, Leslie Marisol Lugo Gavidia
This paper describes the opportunities and challenges in building ST-elevation acute myocardial infarction (STEMI) systems of care in Stent for Life affiliated and collaborating so-called emerging countries, namely India, China, South Africa and Mexico, where CAD mortality is increasing and becoming a significant healthcare problem. The Stent for Life model supports the implementation of ESC STEMI Guidelines in Europe and endeavours to impact on morbidity and mortality by improving services and developing regional STEMI systems of care, whereby STEMI patients' timely access to a primary percutaneous coronary intervention (PPCI) is assured...
August 2014: EuroIntervention
https://www.readbyqxmd.com/read/24112051/the-state-of-innovative-emergency-medical-service-programs-in-the-united-states
#9
Kristy Gonzalez Morganti, Abby Alpert, Gregg Margolis, Jeffrey Wasserman, Arthur L Kellermann
BACKGROUND: The primary objective of this study was to determine how EMS organizations that are piloting patient-centered treatment and transport protocols are approaching the challenges of implementation, reimbursement, and quality assurance. We were particularly interested in determining if these pilot efforts have raised any patient safety concerns. METHODS: We conducted a set of discussions with a small group of key EMS stakeholders regarding the status of pioneering efforts to develop and evaluate innovative approaches to EMS in the United States...
January 2014: Prehospital Emergency Care
https://www.readbyqxmd.com/read/23786454/who-leaves-the-emergency-department-without-being-seen-a-public-hospital-experience-in-georgetown-guyana
#10
Kendra P Parekh, Stephan Russ, David A Amsalem, Navindranauth Rambaran, Seth W Wright
BACKGROUND: Left without being seen (LWBS) proportions are commonly used as quality control indicators, but little data is available on LWBS proportions in the developing world. This study sought to determine the proportion and characteristics of patients who LWBS from the emergency department (ED) of the main public hospital in Georgetown, Guyana. METHODS: This is a retrospective cross-sectional analysis of an ED quality assurance database. Registration personnel collected demographic information on patients presenting to the ED over a 2-week period in July 2010...
2013: BMC Emergency Medicine
https://www.readbyqxmd.com/read/23498882/joint-policy-statement-guidelines-for-care-of-children-in-the-emergency-department
#11
(no author information available yet)
Children who require emergency care have unique needs, especially when emergencies are serious or life-threatening. The majority of ill and injured children are brought to community hospital emergency departments (EDs) by virtue of their geography within communities. Similarly, emergency medical services (EMS) agencies provide the bulk of out-of-hospital emergency care to children. It is imperative, therefore, that all hospital EDs have the appropriate resources (medications, equipment, policies, and education) and staff to provide effective emergency care for children...
March 2013: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/23215958/essential-medicine-policy-in-china-pros-and-cons
#12
Shanlian Hu
OBJECTIVE: To analyze the achievements, issues and policy recommendations for implementing essential medicine system in China after a 3-year effort. METHODS: Policy documents analysis and Literature reviews are conducted. RESULTS: From 2009-2011, a series of national essential medicine (EM) policies has been established which contain EM list, organizing production, quality assurance, pricing, tendering and procurement, distribution, rational use, monitoring and evaluation, etc...
2013: Journal of Medical Economics
https://www.readbyqxmd.com/read/22834854/cardiac-arrest-survival-is-rare-without-prehospital-return-of-spontaneous-circulation
#13
MULTICENTER STUDY
David A Wampler, Lindsey Collett, Craig A Manifold, Christopher Velasquez, Jason T McMullan
BACKGROUND: Emergency medical services (EMS) are crucial in the management of out-of-hospital cardiac arrest (OHCA). Despite accepted termination-of-resuscitation criteria, many patients are transported to the hospital without achieving field return of spontaneous circulation (ROSC). OBJECTIVE: We examine field ROSC influence on OHCA survival to hospital discharge in two large urban EMS systems. METHODS: A retrospective analysis of prospectively collected data was conducted...
October 2012: Prehospital Emergency Care
https://www.readbyqxmd.com/read/22720900/inappropriate-helicopter-emergency-medical-services-transports-results-of-a-national-cohort-utilization-review
#14
John William Hafner, Michael Downs, Kelly Cox, Joy E Johncox, Timothy J Schaefer
BACKGROUND: Medical transport using helicopter emergency medical services (HEMS) has rapidly proliferated over the past decade. Because of issues of cost and safety, appropriate utilization is of increasing concern. OBJECTIVE: This study sought to describe the medical appropriateness of HEMS transports, using established guidelines, in a large national patient cohort. METHODS: A review was performed of all flights designated as inappropriate by a large national air medical company, Air Evac EMS Inc...
October 2012: Prehospital Emergency Care
https://www.readbyqxmd.com/read/22591776/value-generation-and-health-reform-in-emergency-medical-services
#15
EDITORIAL
Marc-David Munk
American Emergency Medical Services (EMS) agencies largely have been untouched by the dramatic health care reform efforts underway, although change seems imminent. Clarifying the role of the modern EMS system, and the yardsticks used to evaluate its performance, will be a challenge.This paper introduces the concept of value (or outcomes to cost ratio) in EMS, and offers value assessment as a means by which reform decisions can be framed. The best reform decisions are those that optimize both costs and outcomes...
April 2012: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/22559761/pre-coverage-assessments-of-new-hospital-interventions-on-austria-methodology-and-3-years-of-experience
#16
Philipp Mad, Sabine Geiger-Gritsch, Gerda Hinterreiter, Stefan Mathis-Edenhofer, Claudia Wild
OBJECTIVES: A new decision-making process was set up by the Austrian Ministry of Health to regulate coverage of new proposed Extra Medical Services (EMS; German: Medizinische Einzel-Leistung [MEL]) in 2008. As part of the annual decision-making process an independent academic institution (LBI-HTA) is evaluating relevant evidence on these new technologies and provides HTAs, including evidence-based recommendations for decision makers. METHODS: About ten EMS assessments are performed annually by the LBI-HTA simultaneously between January and March...
April 2012: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/22403698/prehospital-electronic-patient-care-report-systems-early-experiences-from-emergency-medical-services-agency-leaders
#17
Adam B Landman, Christopher H Lee, Comilla Sasson, Carin M Van Gelder, Leslie A Curry
BACKGROUND: As the United States embraces electronic health records (EHRs), improved emergency medical services (EMS) information systems are also a priority; however, little is known about the experiences of EMS agencies as they adopt and implement electronic patient care report (e-PCR) systems. We sought to characterize motivations for adoption of e-PCR systems, challenges associated with adoption and implementation, and emerging implementation strategies. METHODS: We conducted a qualitative study using semi-structured in-depth interviews with EMS agency leaders...
2012: PloS One
https://www.readbyqxmd.com/read/22354397/-necessity-for-treatment-of-psychiatric-emergencies-in-the-emergency-medical-service-evaluation-of-the-indicator-for-psychiatric-pharmacotherapy
#18
A Biedler, C Helfen, F-G B Pajonk
BACKGROUND: Psychiatric emergency situations (PES) are common in the physician-based emergency medical system (EMS) in Germany. However, many emergency physicians (EP) feel insecure in assessing the necessity for treatment of these patients. The aim of this investigation was to evaluate whether a short, newly developed questionnaire (Indicator for Psychiatric Pharmacotherapy, IPP) is able to help EPs in deciding for or against pharmacological treatment. PATIENTS AND METHODS: The protocols of the EMS at the Saarland University Hospital were prospectively collected over a 1-year period and PESs were identified and analyzed in detail...
February 2012: Der Anaesthesist
https://www.readbyqxmd.com/read/22287070/a-model-for-rural-trauma-care
#19
N McSwain, M Rotondo, P Meade, J Duchesne
BACKGROUND: In the United States and many other countries, there has been limited attempt to develop a trauma system that addresses the unique trauma situations that occur in rural areas. Rather the planners have attempted to simply extend the urban based trauma system into rural communities. This extension does not address the needs of the majority of patients who are injured in rural communities. METHODS: A review of the types of patients seen in the rural communities, the volume of these patients and the destination protocols used in the rural communities as taught by the ACS/ATLS and the implications of the CDC Guidelines for Field Triage of Injured Patients Recommendations of the National Expert Panel on Field Triage were reviewed, assessed and compared to the needs in the rural areas for a rural trauma system...
March 2012: British Journal of Surgery
https://www.readbyqxmd.com/read/21933897/technical-and-organisational-feasibility-of-a-multifunctional-telemedicine-system-in-an-emergency-medical-service-an-observational-study
#20
Sebastian Bergrath, Daniel Rörtgen, Rolf Rossaint, Stefan K Beckers, Harold Fischermann, Jörg Ch Brokmann, Michael Czaplik, Marc Felzen, Marie-Thérèse Schneiders, Max Skorning
We evaluated the technical and organisational feasibility of a multifunctional telemedicine system in an emergency medical service (EMS) from the user's perspective. The telemedicine system was designed to transmit vital signs data and 12-lead-ECG data, send still pictures and allow voice communication and video transmission from an ambulance. The data were sent to a teleconsultation centre staffed with EMS physicians (tele-EMS physician). The system was used in 157 EMS missions. The applications were used successfully on 80% of missions for real-time vital signs transmission and on 97% for video transmission...
2011: Journal of Telemedicine and Telecare
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