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https://www.readbyqxmd.com/read/29149432/ebola-in-the-netherlands-2014-2015-costs-of-preparedness-and-response
#1
Anita W M Suijkerbuijk, Corien M Swaan, Marie-Josee J Mangen, Johan J Polder, Aura Timen, Wilhelmina L M Ruijs
The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the cost of staff time spent in preparedness and response activities was calculated based on a time-recording system and interviews with key professionals at the healthcare organizations involved. In addition, the organizations provided cost information on patient days of hospitalization, laboratory tests, personal protective equipment (PPE), as well as the additional cleaning and disinfection required...
November 17, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#2
Stefan Heschl, Emily Andrew, Anthony de Wit, Stephen Bernard, Marcus Kennedy, Karen Smith
OBJECTIVE: The optimal volume and type of intravenous fluid for the treatment of blood loss in the prehospital setting is controversial. The use of red cell concentrates (RCCs) may be associated with improved outcomes; however, the administration of blood products is limited to physicians in many jurisdictions. We sought to describe the characteristics of RCC transfusions in a paramedic-staffed helicopter emergency medical system in Victoria, Australia. METHODS: We performed a retrospective analysis of all cases where paramedics consulted the responsible physician for approval of RCC transfusion between July 2011 and December 2015 in Victoria, Australia...
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29146493/predicting-rosc-in-out-of-hospital-cardiac-arrest-using-expiratory-carbon-dioxide-concentration-is-trend-detection-instead-of-absolute-threshold-values-the-key
#3
Peter Brinkrolf, Matthias Borowski, Camilla Metelmann, Roman-Patrik Lukas, Laura Pidde-Küllenberg, Andreas Bohn
AIM: Guidelines recommend detecting return of spontaneous circulation (ROSC) by a rising concentration of carbon dioxide in the exhalation air. As CO2 is influenced by numerous factors, no absolute cut-off values of CO2 to detect ROSC are agreed on so far. As trends in CO2 might be less affected by influencing factors, we investigated an approach which is based on detecting CO2-trends in real-time. METHODS: We conducted a retrospective case-control study on 169 CO2 time series from out of hospital cardiac arrests resuscitated by Muenster City Ambulance-Service, Germany...
November 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/29141907/emergency-versus-standard-response-time-efficacy-of-london-s-air-ambulance-rapid-response-vehicle
#4
Marius Rehn, Gareth Davies, Paul Smith, David Lockey
OBJECTIVE: The potential increased risk of an emergency response using a rapid response vehicle (RRV) should only be accepted when it allows a clinically significant time saving for management of patients who are critically injured or sick. Air ambulance services often use an RRV to maintain operational resilience. We compared the RRV response time on emergency versus standard driving to inform emergency services of time efficacy of emergency response in an urban environment. METHODS: Prospective observational controlled study of response data of emergency and standard driving...
November 15, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29140748/paramedic-initiated-home-care-referrals-and-use-of-home-care-and-emergency-medical-services
#5
Amol A Verma, John Klich, Adam Thurston, Jordan Scantlebury, Alex Kiss, Gayle Seddon, Samir K Sinha
OBJECTIVE: We examined the association between paramedic-initiated home care referrals and utilization of home care, 9-1-1, and Emergency Department (ED) services. METHODS: This was a retrospective cohort study of individuals who received a paramedic-initiated home care referral after a 9-1-1 call between January 1, 2011 and December 31, 2012 in Toronto, Ontario, Canada. Home care, 9-1-1, and ED utilization were compared in the 6 months before and after home care referral...
November 15, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29132593/the-impact-of-helicopter-emergency-medical-service-night-operations-in-south-east-england
#6
Leigh Curtis, Mark Salmon, Richard M Lyon
OBJECTIVE: This study sought to assess the impact of a helicopter emergency medical service (HEMS) capable of night operations. METHODS: This is a retrospective case review of all night HEMS missions attended by a charity air ambulance service in South East England over a 2-year period (October 1, 2013, to October 1, 2015). RESULTS: During the 2-year trial period, the HEMS service undertook a total of 5,004 missions and attended to 3,728 patients...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29132455/going-beyond-the-9-1-1-call-what-bc-emergency-health-services-is-doing-to-improve-timely-access-to-emergency-care
#7
Kerry Campbell, Jessica Jaiven, Kimberly Banfield, Corinne Begg, Janice Butler, Leanne Thain
British Columbia Emergency Health Services (BCEHS) uses an internationally recognized Medical Priority Dispatch System to assign appropriate responses to 9-1-1 calls based on patients' clinical acuity. In 2015, 71% of Omega calls (classified as calls involving low acuity injuries) were assigned an ambulance. To better meet patients' needs, BCEHS collaborated with HealthLink BC's Nursing Services (HLBC NS) to audit over 2,000 calls. Based on the results, three Plan, Do, Study, Act (PDSA) cycles were implemented, yielding a 35% decrease in ambulances assigned and a 173% increase in referrals to HLBC NS to provide more suitable support...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29130627/temporal-trends-2002-2014-of-incidence-and-shockable-status-of-adult-emergency-medical-service-attended-out-of-hospital-cardiac-arrest-of-presumed-cardiac-aetiology-in-queensland
#8
Katherine Pemberton, Emma Bosley
OBJECTIVE: To describe trends in incidence and shockable status of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014. METHODS: The QAS cardiac arrest registry was used to collect data. Analyses included age-standardised rates by gender for all adults and older adults only (65 years+); age-specific incidence rates of young adults (18-49), middle age adults (50-64) and five groups of older adults (65-69, 70-74, 75-79, 80-84 and 85+); and proportions of shockable versus non-shockable initial rhythm together and by age group (young, middle age and older adults)...
November 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29127541/the-bargaining-of-professionalism-in-emergency-care-practice-nhs-paramedics-and-higher-education
#9
Assaf Givati, Chris Markham, Ken Street
Over the past 2 decades, as part of reforms to the National Health Service and with it organizational changes to ambulance work in the UK, paramedic education has undergone a process of academisation and a shift from in-house, apprenticeship weeks-long occupational training, to university-based undergraduate programs. While the professional regulation and standardization of Allied Health Professionals' education in high-income countries has captured scholarly attention, the study of paramedic practice is still in its infancy and there is a need to explore its evolvement in relation to the fluid societal-political circumstances affecting its provision and demand...
November 10, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29127102/algorithms-to-guide-ambulance-clinicians-in-the-management-of-emergencies-in-patients-with-implanted-rotary-left-ventricular-assist-devices
#10
REVIEW
Christopher T Bowles, Rachel Hards, Neil Wrightson, Paul Lincoln, Shishir Kore, Laura Marley, Jonathan R Dalzell, Binu Raj, Tracey A Baker, Diane Goodwin, Petra Carroll, Jane Pateman, John J M Black, Paul Kattenhorn, Mark Faulkner, Jayan Parameshwar, Charles Butcher, Mark Mason, Alexander Rosenberg, Ian McGovern, Alexander Weymann, Carl Gwinnutt, Nicholas R Banner, Stephan Schueler, Andre R Simon, David W Pitcher
Advances in left ventricular assist device (LVAD) therapy have resulted in increasing numbers of adult LVAD recipients in the community. However, device failure, stroke, bleeding, LVAD thrombosis and systemic infection can be life-threatening emergencies. Currently, four LVAD systems are implanted in six UK transplant centres, each of which provides device-specific information to local emergency services. This has resulted in inconsistent availability and content of information with the risks of delayed or inappropriate decision-making...
November 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29123900/evaluation-of-factors-associated-with-the-difficulty-in-finding-receiving-hospitals-for-traffic-accident-patients-at-the-scene-treated-by-emergency-medical-services-a-population-based-study-in-osaka-city-japan
#11
Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Taku Iwami, Takashi Kawamura, Sumito Hayashida, Hiroshi Ogura, Takeshi Shimazu
Aim: Although the prolongation of the time between injury and hospital arrival of traffic accident patients can influence their prognosis, factors associated with the difficulty in hospital acceptance of these patients have not been sufficiently evaluated in Japan. Methods: We retrospectively analyzed the population-based ambulance records of all traffic accident patients for whom the Osaka Municipal Fire Department (Osaka City, Japan) dispatched an ambulance in 2013...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123870/characteristic-of-the-acute-drug-intoxication-conveyed-by-kanagawa-helicopter-emergency-medical-service
#12
Mariko Sugita, Shigeo Higami, Shigeaki Inoue, Seiji Morita, Yoshihide Nakagawa, Sadaki Inokuchi
Aim: Various critical cases have been transported since the use of the Kanagawa Helicopter Emergency Medical Service (HEMS) started at Tokai University Hospital (Isehara, Japan) in 2002, including cases of acute poisoning. We analyzed the characteristics of acute poisoning cases conveyed by the HEMS. Methods: Kanagawa HEMS conveyed 3,814 cases from July 2002 to March 2013, and acute drug and poison intoxication was diagnosed in 131 of these cases. We undertook a descriptive statistical study of these cases...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122802/emergency-obstetric-care-provision-in-southern-ethiopia-a-facility-based-survey
#13
Mitchell Windsma, Tienke Vermeiden, Floris Braat, Andualem Mengistu Tsegaye, Asheber Gaym, Thomas van den Akker, Jelle Stekelenburg
OBJECTIVES: To assess the provision of basic emergency obstetric and newborn care (BEmONC), knowledge of high-risk pregnancies and referral capacity at health centres in Southern Ethiopia. DESIGN: A facility-based survey, using an abbreviated version of the Averting Maternal Death and Disability needs assessment tool for emergency obstetric and newborn care. Modules included infrastructure, staffing, number of deliveries, maternal and perinatal mortality, BEmONC signal functions, referral capacity and knowledge of risk factors in pregnancy...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29114716/trends-in-fall-related-ambulance-use-and-hospitalisation-among-older-adults-in-nsw-2006-2013-a-retrospective-population-based-study
#14
Serene S Paul, Lara Harvey, Therese Carroll, Qiang Li, Soufiane Boufous, Annabel Priddis, Anne Tiedemann, Lindy Clemson, Stephen R Lord, Sandy Muecke, Jacqueline Ct Close, Serigne Lo, Catherine Sherrington
Objective and importance of study: To describe characteristics and temporal trends of fall-related ambulance service use and hospital admission in older adults in New South Wales (NSW), Australia. Such information will facilitate a more targeted approach to planning and delivery of health services to prevent falls and their adverse sequelae in different groups of older adults. STUDY TYPE: Retrospective population-based descriptive study. METHODS: Fall-related ambulance use and hospital admissions for all falls and injurious falls in NSW residents aged ≥65 years between 2006 and 2013 were obtained from two discrete sources of routinely collected data...
October 11, 2017: Public Health Research & Practice
https://www.readbyqxmd.com/read/29113021/trauma-case-review-a-quality-and-safety-feature-of-the-victorian-state-trauma-system
#15
Carolyn Pinto, Peter A Cameron, Belinda Gabbe, Susan McLellan, Tony Walker
The aim of the present study was to describe the trauma case review process and its role in a regionalised trauma system. Victoria has a population of 5.9 million people, accounting for 26% of Australia's population. Victoria has been serviced by an inclusive, organised trauma system since 2000 comprising 138 health services with trauma designations and three major trauma services. Pre- and interhospital guidelines prescribe the timely transport of patients to the appropriate level of trauma service. A review of the role and contribution of 10 years of operation of the trauma case review group (CRG) was undertaken to describe the aims, processes and governance surrounding the implementation of an individual case review for specified major trauma patients...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29112540/aeromedical-transport-in-children-a-descriptive-analysis-of-96-cases
#16
Guillaume Mortamet, Karen Harrington, Hervé Raffin, Mehdi Oualha, Sylvain Renolleau
OBJECTIVE: Pediatric aeromedical transport (AT) is highly challenging. We aim to describe a series of 96 cases of children requiring medical transport in terms of the indication, modalities, and related adverse events. METHODS: In this single-center retrospective study, we included air-transported patients less than 18 years old. RESULTS: During the study period, 96 patients, with median age of 120 months (range, 0-204), were air transported...
November 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29111768/differences-in-symptoms-first-medical-contact-and-pre-hospital-delay-times-between-patients-with-st-and-non-st-elevation-myocardial-infarction
#17
Karin H Ängerud, Sofia Sederholm Lawesson, Rose-Marie Isaksson, Ingela Thylén, Eva Swahn
AIM: In ST-elevation myocardial infarction, time to reperfusion is crucial for the prognosis. Symptom presentation in myocardial infarction influences pre-hospital delay times but studies about differences in symptoms between patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction are sparse and inconclusive. The aim was to compare symptoms, first medical contact and pre-hospital delay times in patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29108791/improvement-of-blood-loss-volume-estimation-by-paramedics-using-a-pictorial-nomogram-a-developmental-study
#18
Chun Yu Yeung, Wai Wa Yim, Suet Yi Chan, Ronson Sze Long Lo, Ling Yan Leung, Kevin Kei Ching Hung, Colin A Graham
INTRODUCTION: To propose and evaluate a nomogram to assist paramedics to visually estimate the external blood loss on a non-absorbent surface and to identify whether the nomogram improves visual estimation. METHODS: The study was a prospective, paired-control design (pre-training control group & post-training group), utilizing Emergency Medical Assistant (EMA) I and II trainees from the Hong Kong Fire Services Ambulance Command Training School. A nomogram (blood loss volume to area on a non-absorbent surface) was prepared to aid blood loss estimation...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29103361/titrating-the-rig-how-paramedics-work-in-and-on-their-ambulance
#19
Michael K Corman
In this article, I take readers inside of an ambulance and explore how paramedics work in and on their "apparatus unit" to make it a workable fit. This taken-for-granted work is important because much is at stake in the back of the ambulance, particularly in relation to quality of care and safety. I draw on data from an institutional ethnography into the socially organized work and work settings of paramedics, which included more than 200 hr of observations and more than 100 interviews with paramedics. The findings shed light on the situated work processes of paramedics as they orient and respond to their "apparatus unit" and enact quality and safety in practice...
November 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/29100549/low-sensitivity-of-qsofa-sirs-criteria-and-sepsis-definition-to-identify-infected-patients-at-risk-of-complication-in-the-prehospital-setting-and-at-the-emergency-department-triage
#20
Selin Tusgul, Pierre-Nicolas Carron, Bertrand Yersin, Thierry Calandra, Fabrice Dami
BACKGROUND: Sepsis is defined as life-threatening organ dysfunction caused by a host response to infection. The quick SOFA (qSOFA) score has been recently proposed as a new bedside clinical score to identify patients with suspected infection at risk of complication (intensive care unit (ICU) admission, in-hospital mortality). The aim of this study was to measure the sensitivity of the qSOFA score, SIRS criteria and sepsis definitions to identify the most serious sepsis cases in the prehospital setting and at the emergency department (ED) triage...
November 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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