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Ambulance service

Jennifer D H Walthall, Aaron Burgess, Elizabeth Weinstein, Charles Miramonti, Thomas Arkins, Sarah Wiehe
OBJECTIVE: This study aimed to describe spatiotemporal correlates of pediatric violent injury in an urban community. METHODS: We performed a retrospective cohort study using patient-level data (2009-2011) from a novel emergency medical service computerized entry system for violent injury resulting in an ambulance dispatch among children aged 0 to 16 years. Assault location and patient residence location were cleaned and geocoded at a success rate of 98%. Distances from the assault location to both home and nearest school were calculated...
October 17, 2016: Pediatric Emergency Care
Victoria J Ganem, Alejandra G Mora, Nina Nnamani, Vikhyat S Bebarta
BACKGROUND: Drug overdose has become a leading cause of death in the United States and is a growing issue in civilian and military populations. Increasing prescription drug misuse and poisonings translate into greater utilization of medical resources. Our objective was to describe the incidences of overdoses and their associated events and outcomes following emergency department consult. METHODS: We performed a retrospective cohort study on cases evaluated in 2 military hospital emergency departments over 3 years...
October 2016: Military Medicine
Martin Carberry, John Harden
Early identification of patients with sepsis is key to the delivery of the sepsis 6 bundle including antibiotic therapy within an hour.[1-3] Demand versus capacity challenges in the Emergency Department (ED) led to delays in antibiotic and sepsis 6 delivery. An alerting tool was developed that provided criteria for Scottish Ambulance Service (SAS) Paramedics to alert the ED of potential sepsis patients. Data from patients presenting to the ED prior to the alerting process commencing (n=50) and during alerting (n=50) were analysed, a questionnaire was used to ascertain feedback from all staff groups; nurses doctors, and paramedics (n=38)...
2016: BMJ Quality Improvement Reports
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
Efthyvoulos Kyriacou, Iolie Nicolaidou, George Hadjichristofi, Stelios Kyprianou, Synesios Christou, Riana Constantinou
Τhe performance of rescuers and personnel handling major emergencies or crisis events can be significantly improved through continuous training and through technology support. The work done in order to create a system has been discussed which can support both resources and victims during a crisis or major emergency event. More specifically, the system supports real-time management of firefighter teams, rescue teams, health services, and victims during a major disaster. It can be deployed in an ad hoc manner in the disaster area, as a stand-alone infrastructure (using its own telecommunications and power)...
September 2016: Healthcare Technology Letters
Craig D Newgard, Rongwei Fu, Eileen Bulger, Jerris R Hedges, N Clay Mann, Dagan A Wright, David P Lehrfeld, Carol Shields, Gregory Hoskins, Craig Warden, Lynn Wittwer, Jennifer N B Cook, Michael Verkest, William Conway, Stephanie Somerville, Matthew Hansen
Importance: Despite a large rural US population, there are potential differences between rural and urban regions in the processes and outcomes following trauma. Objectives: To describe and evaluate rural vs urban processes of care, injury severity, and mortality among injured patients served by 9-1-1 emergency medical services (EMS). Design, Setting, and Participants: This was a preplanned secondary analysis of a prospective cohort enrolled from January 1 through December 31, 2011, and followed up through hospitalization...
October 12, 2016: JAMA Surgery
Ben Beck, Janet E Bray, Karen Smith, Tony Walker, Hugh Grantham, Cindy Hein, Melanie Thorrowgood, Anthony Smith, Madoka Inoue, Tony Smith, Bridget Dicker, Andy Swain, Emma Bosley, Katherine Pemberton, Michael Mckay, Malcolm Johnston-Leek, Peter Cameron, Gavin D Perkins, Judith Finn
OBJECTIVE: The present study aimed to describe and examine similarities and differences in the current service provision and resuscitation protocols of the ambulance services participating in the Aus-ROC Australian and New Zealand out-of-hospital cardiac arrest (OHCA) Epistry. Understanding these similarities and differences is important in identifying ambulance service factors that might explain regional variation in survival of OHCA in the Aus-ROC Epistry. METHODS: A structured questionnaire was completed by each of the ambulance services participating in the Aus-ROC Epistry...
October 11, 2016: Emergency Medicine Australasia: EMA
Sergey N Samsonov, Veronika I Manykina, Natalia G Kleimenova, Svetlana S Parshina, Alena A Strekalovskaya, Palmira G Petrova
INTRODUCTION: cardiovascular impairment remains one of the most current problems of today's life and the definition of the connection between its development and the state of heliogeophysical storminess is currently important. The results of long-term researches of communication between cardiovascular catastrophes (myocardial infarction) and heliogeophysical storminess in the middle and high latitudes are shown in this work. AIM: to study the influence of space weather parameters on human cardio-vascular system in the high and middle latitudes...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Kimberly S Babiarz, Swaminatha V Mahadevan, Nomita Divi, Grant Miller
India had no large-scale, centralized emergency medical system or ambulance service until 2005. Since then, the GVK Emergency Management and Research Institute (GVK EMRI) has emerged as India's largest ambulance service provider, covering more than 630 million people. This study provides the first quantitative evidence of GVK EMRI's early impact on population-level infant and maternal health outcomes in Andhra Pradesh and Gujarat, two Indian states with a combined population of about 145 million people. We found that GVK EMRI coverage is associated with reductions in the probability of neonatal and infant mortality as well as delivery complications (statewide in Andhra Pradesh and in high-mortality districts in Gujarat)...
October 1, 2016: Health Affairs
Gregory J Hollis, Toby M Keene, Rory M Ardlie, David Ge Caldicott, Stuart G Stapleton
OBJECTIVE: The aim of this study was to describe prehospital use of ketamine by ACT Ambulance Service, and frequency of endotracheal intubation. METHODS: This was a retrospective study of patients receiving prehospital ketamine between 1 January and 31 December 2013. Episodes were identified from the prehospital electronic patient care records, then linkage to ED records at two receiving hospitals. Demographics, dose, indication and occasions of intubation were analysed...
October 3, 2016: Emergency Medicine Australasia: EMA
David Fitzpatrick, Patrick O'Meara, Andrew Cunningham
This short report describes the case of a young adult male who had smoked a synthetic cannabinoid legal high product called 'Exodus Damnation'. The patient's presentation was atypical from that described in the literature, with hypotension and hypoxaemia. Of note was the rapid recovery after pre-hospital intervention with high-flow oxygen therapy and intravenous fluids. The patient refused on-going care, despite repeated advice to attend the Emergency Department. The distinct lack of specialist support and referral to drug treatment for this patient population, with whom ambulance services are coming into contact with increasing frequency, is reported...
September 29, 2016: Scottish Medical Journal
Choong Hyun Jo, Gyu Chong Cho, Chang Hee Lee
OBJECTIVE: The purpose of this study was to determine if the over-the-head 2-thumb encircling technique (OTTT) provides better overall quality of cardiopulmonary resuscitation compared with conventional 2-finger technique (TFT) for a lone rescuer in the setting of infant cardiac arrest in ambulance. METHODS: Fifty medical emergency service students were voluntarily recruited to perform lone rescuer infant cardiopulmonary resuscitation for 2 minutes on a manikin simulating a 3-month-old baby in an ambulance...
September 23, 2016: Pediatric Emergency Care
Dan Bohström, Eric Carlström, Nils Sjöström
BACKGROUND: Ambulance nurses display stress symptoms, resulting from their work with patients in an emergency service. Certain individuals seem, however, to handle longstanding stress better than others and remain in exposed occupations such as ambulance services for many years. This paper examines stress inducing and stress defusing factors among ambulance nurses. METHODS: A qualitative descriptive design using critical incident technique was used. A total of 123 critical incidents were identified, and a total of 61 strategies dealing with stress were confirmed...
September 21, 2016: International Emergency Nursing
Paul-Georges Reuter, Thibaut Desmettre, Sabine Guinemer, Olivier Ducros, Stéphane Begey, Agnès Ricard-Hibon, Laurianne Billier, Océane Grignon, Isabelle Megy-Michoux, Jean-Noël Latouff, Adeline Sourbes, Julien Latier, Isabelle Durand-Zaleski, Frédéric Lapostolle, Eric Vicaut, Frédéric Adnet
BACKGROUND: Telephone consultations in general practice are on the increase. However, data on their efficiency in terms of out-of-hours general practitioner (GP) workload, visits to hospital emergency departments (ED), cost, patient safety and satisfaction are relatively scant. The aim of this trial is to assess the effectiveness of telephone consultations provided by French emergency call centres in patients presenting with isolated fever or symptoms of gastroenteritis, mainly encountered diseases...
2016: Trials
Anne Maree Kelly, Anna Holdgate, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Charles Lawoko, Said Laribi
BACKGROUND: This study aimed to determine epidemiology and outcome for patients presenting to emergency departments (ED) with shortness of breath who were transported by ambulance. METHODS: This was a planned sub-study of a prospective, interrupted time series cohort study conducted at three time points in 2014 and which included consecutive adult patients presenting to the ED with dyspnoea as a main symptom. For this sub-study, additional inclusion criteria were presentation to an ED in Australia or New Zealand and transport by ambulance...
September 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Gavin D Perkins, Tom Quinn, Charles D Deakin, Jerry P Nolan, Ranjit Lall, Anne-Marie Slowther, Matthew Cooke, Sarah E Lamb, Stavros Petrou, Felix Achana, Judith Finn, Ian G Jacobs, Andrew Carson, Mike Smyth, Kyee Han, Sonia Byers, Nigel Rees, Richard Whitfield, Fionna Moore, Rachael Fothergill, Nigel Stallard, John Long, Susie Hennings, Jessica Horton, Charlotte Kaye, Simon Gates
Despite its use since the 1960s, the safety or effectiveness of adrenaline as a treatment for cardiac arrest has never been comprehensively evaluated in a clinical trial. Although most studies have found that adrenaline increases the chance of return of spontaneous circulation for short periods, many studies found harmful effects on the brain and raise concern that adrenaline may reduce overall survival and/or good neurological outcome. The PARAMEDIC-2 trial seeks to determine if adrenaline is safe and effective in out-of-hospital cardiac arrest...
November 2016: Resuscitation
O S Mattila, H Harve, S Pihlasviita, J Ritvonen, G Sibolt, M Pystynen, D Strbian, S Curtze, M Kuisma, T Tatlisumak, P J Lindsberg
OBJECTIVES: Blood-based biomarkers could enable early and cost-effective diagnostics for acute stroke patients in the prehospital setting to support early initiation of treatments. To facilitate development of ultra-acute biomarkers, we set out to implement large-scale prehospital blood sampling and determine feasibility and diagnostic timesavings of this approach. MATERIALS AND METHODS: Emergency medical services (EMS) personnel of the Helsinki metropolitan area were trained to collect prehospital blood samples from thrombolysis candidates using a cannula adapter technique...
September 18, 2016: Acta Neurologica Scandinavica
Travis D Olives, Paul C Nystrom, Jon B Cole, Kenneth W Dodd, Jeffrey D Ho
BACKGROUND: Profound agitation in the prehospital setting confers substantial risk to patients and providers. Optimal chemical sedation in this setting remains unclear. OBJECTIVE: The goal of this study was to describe intubation rates among profoundly agitated patients treated with prehospital ketamine and to characterize clinically significant outcomes of a prehospital ketamine protocol. METHODS: This was a retrospective cohort study of all patients who received prehospital ketamine, per a predefined protocol, for control of profound agitation and who subsequently were transported to an urban Level 1 trauma center from May 1, 2010 through August 31, 2013...
September 19, 2016: Prehospital and Disaster Medicine
Bruno Schnegg, Mathieu Pasquier, Pierre-Nicolas Carron, Bertrand Yersin, Fabrice Dami
: Introduction The concept of response time with minimal interval is intimately related to the practice of emergency medicine. The factors influencing this time interval are poorly understood. Problem In a process of improvement of response time, the impact of the patient's age on ambulance departure intervals was investigated. METHOD: This was a 3-year observational study. Departure intervals of ambulances, according to age of patients, were analyzed and a multivariate analysis, according to time of day and suspected medical problem, was performed...
September 19, 2016: Prehospital and Disaster Medicine
J Stobbe, J R J de Leeuw, C L Mulder
BACKGROUND: No recent information is available concerning the working methods of the ambulatory psychiatric emergency services in The Netherlands.<br/> AIM: To obtain insight into the working methods of the ambulatory psychiatric emergency services.<br/> METHOD: We performed a descriptive research.<br/> RESULTS: Twenty of the 28 ambulatory psychiatric emergency services participated in our study (more than 71 %)...
2016: Tijdschrift Voor Psychiatrie
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