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Ambulance need for transport criteria

Antony Gatebe Kironji, Peter Hodkinson, Sarah Stewart de Ramirez, Trisha Anest, Lee Wallis, Junaid Razzak, Alexander Jenson, Bhakti Hansoti
BACKGROUND: Out-of-hospital emergency care (OHEC), also known as prehospital care, has been shown to reduce morbidity and mortality from serious illness. We sought to summarize literature for low and low-middle income countries to identify barriers to and key interventions for OHEC delivery. METHODS: We performed a systematic review of the peer reviewed literature from January 2005 to March 2015 in PubMed, Embase, Cochrane, and Web of Science. All articles referencing research from low and low-middle income countries addressing OHEC, emergency medical services, or transport/transfer of patients were included...
April 19, 2018: BMC Health Services Research
Max Wintermark, Ying Li, Victoria Y Ding, Yingding Xu, Bin Jiang, Robyn L Ball, Michael Zeineh, Alisa Gean, Pina Sanelli
To develop an outcome-based NeuroImaging Radiological Interpretation System (NIRIS) for acute traumatic brain injury (TBI) patients that would standardize the interpretation of non-contrast head CTs and consolidate imaging findings into ordinal severity categories that would inform specific patient management actions and that could be used as a clinical decision support tool. We retrospectively identified all patients transported to our emergency department by ambulance or helicopter, for whom a trauma alert was triggered per established criteria and who underwent a non-contrast head CT due to suspicion of TBI, between November 2015 and April 2016...
April 18, 2018: Journal of Neurotrauma
Anriada Nassif, Daniel G Ostermayer, Kim B Hoang, Mary K Claiborne, Elizabeth A Camp, Manish I Shah
BACKGROUND: Respiratory distress due to asthma is a common reason for pediatric emergency medical services (EMS) transports. Timely initiation of asthma treatment, including glucocorticoids, improves hospital outcomes. The impact of EMS-administered glucocorticoids on hospital-based outcomes for pediatric asthma patients is unknown. OBJECTIVE: The objective of this study was to evaluate the effect of an evidence-based pediatric EMS asthma protocol update, inclusive of oral glucocorticoid administration, on time to hospital discharge...
January 19, 2018: Prehospital Emergency Care
Anjni Patel, João Ricardo Nickenig Vissoci, Michael Hocker, Enio Molina, Nelly Moraes Gil, Catherine Staton
BACKGROUND: Road traffic injuries (RTIs) are the eighth leading cause of death worldwide, with an estimated 90% of RTIs occurring in low- and middle-income countries (LMICs) like Brazil. There has been minimal research in evaluation of delays in transport of RTI patients to trauma centers in LMICs. The objective of this study is to determine specific causes of delays in prehospital transport of road traffic injury patients to designated trauma centers in Maringá, Brazil. METHODS: A qualitative method was used based on the Consolidated Criteria for Reporting Qualitative Research (COREQ) approach...
December 2, 2017: BMC Health Services Research
Manuel Villarreal, Jonathan Leach, Kandala Ngianga-Bakwin, Jeremy Dale
BACKGROUND: Emergency services are facing increasing workload pressures, and new models of care are needed. We evaluate the impact of a service development involving a partnership between emergency ambulance crews and general practitioners (GPs) on reducing conveyance rates to the Hospital Emergency Department(ED) . METHODS: The service model was implemented in the West Midlands of England. Call handlers identified patients with needs that could be addressed by a GP using locally agreed criteria...
July 2017: Emergency Medicine Journal: EMJ
Brian R Englum, Kristy L Rialon, Jina Kim, Mark L Shapiro, John E Scarborough, Henry E Rice, Obinna O Adibe, Elisabeth T Tracy
PURPOSE: The role of helicopter emergency medical services (HEMS) in pediatric trauma remains controversial. We examined its use in pediatric trauma and its effectiveness in children with moderate/severe injuries. METHODS: All blunt/penetrating trauma patients ≤18years old in the National Trauma Data Bank were evaluated for use of HEMS and in-hospital mortality. In a comparative effectiveness study, only patients treated at level I/II pediatric centers with injury severity score (ISS)≥9 were included...
January 2017: Journal of Pediatric Surgery
Francisco José Clemente López
CPAP (continuous positive airway pressure) is to establish a supraatmosferica pressure throughout the respiratory cycle on which the patient vent spontaneously. Its use improves the clinical and gasometrics parameters when applied with appropriate selection criteria in the context of respiratory failure acute (IRA) hypoxemic. It has been demonstrated that applying CPAP early, decreases the need for intubation and associated complications, as well as survival, reducing health care costs and hospital stay. The use of valve Boussignac for applying a CPAP is spreading especially in the delivered environment and emergencies as a device not mechanical, simple, easy to use and transport, which can manage enough pressures to manage the patient hypoxemia...
February 2016: Revista de Enfermería
Naeem uddin Mian, Mariam Zahid Malik, Sarosh Iqbal, Muhammad Adeel Alvi, Zahid Memon, Muhammad Ashraf Chaudhry, Ashraf Majrooh, Shehzad Hussain Awan
BACKGROUND: Pakistan is far behind in achieving the Millennium Development Goals regarding the reduction of child and maternal mortality. Amongst other factors, transport barriers make the requisite obstetric care inaccessible for women during pregnancy and at birth, when complications may become life threatening for mother and child. The significance of efficient transport in maternal and neonatal health calls for identifying which currently implemented transport interventions have potential for scalability...
November 25, 2015: Health Research Policy and Systems
Samuel M Galvagno, Robert Sikorski, Jon M Hirshon, Douglas Floccare, Christopher Stephens, Deirdre Beecher, Stephen Thomas
BACKGROUND: Although helicopters are presently an integral part of trauma systems in most developed nations, previous reviews and studies to date have raised questions about which groups of traumatically injured people derive the greatest benefit. OBJECTIVES: To determine if helicopter emergency medical services (HEMS) transport, compared with ground emergency medical services (GEMS) transport, is associated with improved morbidity and mortality for adults with major trauma...
December 15, 2015: Cochrane Database of Systematic Reviews
Michael Poppe, Christoph Weiser, Michael Holzer, Patrick Sulzgruber, Philip Datler, Markus Keferböck, Sebastian Zeiner, Elisabeth Lobmeyr, Raphael van Tulder, Andreas Ziegler, Harald Glück, Manfred Meixner, Georg Schrattenbacher, Henrik Maszar, Andreas Zajicek, Fritz Sterz, Andreas Schober
BACKGROUND: The outcome of patients after out-of-hospital cardiac arrest (OHCA) is poor and gets worse after prolonged resuscitation. Recently introduced attempts like an early installed emergency extracorporeal life support (E-ECLS) in patients with persisting cardiac arrest at the emergency department (ED) are tried. The "Vienna Cardiac Arrest Registry" (VICAR) was introduced August 2013 to collect Utstein-style data. The aim of this observational study was to identify the incidence of patients which fulfil "load&go"-criteria for E-ECLS at the ED...
June 2015: Resuscitation
Harald Stordahl, Eva Passas, Andreas Hopland, Erik Waage Nielsen
BACKGROUND: Our aim was to estimate the degree of overtriage (Injury Severity Score [ISS] ≤ 15) of trauma call patients in Nordland Hospital Bodø, Norway. We also determined the transportation time from injury to hospital admission. METHODS: We used data from our Acute Medical Information System, ambulance records and patient charts relating to ISS and estimation of response and transport times. Data were collected for all trauma call patients in the period from the establishment of the trauma call system in June 2008 until the 31st of December 2010...
2015: BMC Emergency Medicine
Maria Michailidou, Seth D Goldstein, Jose Salazar, Jonathan Aboagye, Dylan Stewart, David Efron, Fizan Abdullah, Elliot R Haut
BACKGROUND: Helicopter Emergency Medical Services (HEMS) have been designed to provide faster access to trauma center care in cases of life-threatening injury. However, the ideal recipient population is not fully characterized, and indications for helicopter transport in pediatric trauma vary dramatically by county, state, and region. Overtriage, or unnecessary utilization, can lead to additional patient risk and expense. In this study we perform a nationwide descriptive analysis of HEMS for pediatric trauma and assess the incidence of overtriage in this group...
November 2014: Journal of Pediatric Surgery
Rosamond Dwyer, Belinda Gabbe, Johannes U Stoelwinder, Judy Lowthian
BACKGROUND: residential aged care facility (RACF) resident numbers are increasing. Residents are frequently frail with substantial co-morbidity, functional and cognitive impairment with high susceptibility to acute illness. Despite living in facilities staffed by health professionals, a considerable proportion of residents are transferred to hospital for management of acute deteriorations in health. This model of emergency care may have unintended consequences for patients and the healthcare system...
November 2014: Age and Ageing
Katherine M Hunold, Mark R Sochor, Samuel A McLean, Kaitlyn B Mosteller, Antonio R Fernandez, Timothy F Platts-Mills
Older adults are at greater risk than younger adults for life-threatening injury after motor vehicle collision (MVC). Among those with life-threatening injury, older adults are also at greater risk of not being transported by emergency medical services (EMS) to an emergency department. Despite the greater risk of serious injury and non-transportation among older adults, little is known about the relationship between patient age and EMS transportation rates for individuals experiencing MVC. We describe transport rates across the age-span for adults seen by EMS after experiencing MVC using data reported to the North Carolina Department of Motor Vehicles between 2008 and 2011...
December 2014: Accident; Analysis and Prevention
Andrew Osborne, Louise Taylor, Markus Reuber, Richard A Grünewald, Martin Parkinson, Jon M Dickson
PURPOSE: Seizures are a common presentation to pre-hospital emergency services and they generate significant healthcare costs. This article summarises the United Kingdom (UK) Ambulance Service guidelines for the management of seizures and explores the extent to which these guidelines are evidence-based. METHODS: Summary of the Clinical Practice Guidelines of the UK Joint Royal Colleges Ambulance Liaison Committee relating to the management of seizures. Review of the literature relating to pre-hospital management of seizure emergencies...
January 2015: Seizure: the Journal of the British Epilepsy Association
Philipp Wolf, Marc Bigalke, Bernhard M Graf, Torsten Birkholz, Michael S Dittmar
BACKGROUND: The Amberg-Schwandorf Algorithm for Primary Triage (ASAV) is a novel primary triage concept specifically for physician manned emergency medical services (EMS) systems. In this study, we determined the diagnostic reliability and the time requirements of ASAV triage. METHODS: Seven hundred eighty triage runs performed by 76 trained EMS providers of varying professional qualification were included into the study. Patients were simulated using human dummies with written vital signs sheets...
August 28, 2014: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Veena Manivannan, Robert J Hyde, Daniel G Hankins, M Fernanda Bellolio, Martin G Fedko, Wyatt W Decker, Ronna L Campbell
BACKGROUND: Anaphylaxis is a potentially life-threatening allergic reaction that may require emergency medical system (EMS) transport. Fatal anaphylaxis is associated with delayed epinephrine administration. Patient outcome data to assess appropriateness of EMS epinephrine administration are sparse. OBJECTIVES: The objectives of this study are to (1) determine the frequency of epinephrine administration in EMS-transported patients with allergic complaints, (2) identify predictors of epinephrine administration, and (3) determine frequency of emergency department (ED) epinephrine administration after EMS transport...
September 2014: American Journal of Emergency Medicine
P A D'Andrea, D J van Hoving, D Wood, W P Smith
BACKGROUND: A helicopter emergency medical service (HEMS) was established in 2005 in Richards Bay, KwaZulu-Natal, South Africa, to provide primary response and inter-facility transfers to a largely rural area with a population of 3.4 million people. OBJECTIVE: To describe the first 5 years of operation of the HEMS. METHODS: A chart review of all flights from 1 January 2006 to 31 December 2010 was conducted. RESULTS: A total of 1 429 flights were undertaken; 3 were excluded from analysis (missing folders)...
February 2014: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Raquel R Tello, Darren Braude, Lynne Fullerton, Philip Froman
BACKGROUND: Prehospital selective cervical spine immobilization (CSI) is a relatively new concept. In our emergency medical services (EMS) system, protocols for selective CSI are widely used; yet, some patients who are brought to the hospital without CSI undergo secondary immobilization and cervical spine imaging in the emergency department (ED). Immobilization in the ED, after a decision not to immobilize by EMS, suggests that either the prehospital assessment is not trusted or the patient has developed new symptoms over time...
October 2014: Prehospital Emergency Care
Shelley Cox, Chris Morrison, Peter Cameron, Karen Smith
OBJECTIVE: To describe the association between increasing age, pre-hospital triage destination compliance, and patient outcomes for adult trauma patients. METHODS: A retrospective data review was conducted of adult trauma patients attended by Ambulance Victoria (AV) between 2007 and 2011. AV pre-hospital data was matched to Victorian State Trauma Registry (VSTR) hospital data. Inclusion criteria were adult patients sustaining a traumatic mechanism of injury. Patients sustaining secondary traumatic injuries from non-traumatic causes were excluded...
September 2014: Injury
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