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Ambulance service

Colin B Page, Lachlan E Parker, Stephen J Rashford, Emma Bosley, Katherine Z Isoardi, Frances E Williamson, Geoffrey K Isbister
STUDY OBJECTIVE: Acute behavioral disturbance is a common problem for emergency medical services. We aimed to investigate the safety and effectiveness of droperidol compared to midazolam in the prehospital setting. METHODS: This was a prospective before and after study comparing droperidol to midazolam for prehospital acute behavioral disturbance, when the state ambulance service changed medications. The primary outcome was the proportion of adverse effects (airway intervention, oxygen saturation < 90%, respiratory rate < 12, systolic blood pressure < 90 mmHg, sedation assessment tool score -3 and dystonic reactions) in patients receiving sedation...
March 20, 2018: Prehospital Emergency Care
Jon M Dickson, Zahid B Asghar, A Niroshan Siriwardena
PURPOSE: We aimed to investigate the characteristics of patients presenting to the ambulance service with suspected seizures, the costs of managing these patients and the factors which predicted transport to hospital. METHODS: We employed a cross-sectional design using routine clinical data from a UK regional ambulance service. Logistic regression was used to identify predictors of transport to hospital from ambulance response times, demographics, clinical (physiological) findings and treatments...
March 8, 2018: Seizure: the Journal of the British Epilepsy Association
Marcus Eng Hock Ong, Gavin D Perkins, Alain Cariou
Sudden out-of-hospital cardiac arrest is the most time-critical medical emergency. In the second paper of this Series on out-of-hospital cardiac arrest, we considered important issues in the prehospital management of cardiac arrest. Successful resuscitation relies on a strong chain of survival with the community, dispatch centre, ambulance, and hospital working together. Early cardiopulmonary resuscitation and defibrillation has the greatest impact on survival. If the community response does not restart the heart, resuscitation is continued by emergency medical services' staff...
March 10, 2018: Lancet
H Lemke, W Lenz, J Schiffner, A Lechleuthner, R Hoffmann, D Pennig, U Schweigkofler, H J Bail
The introduction of requirements for a minimum intake capacity of trauma patients by the German Trauma Society (DGU) into the so-called white book of treatment of seriously injured patients, is helpful for a sufficient preparation for threats and for dealing with mass casualties for trauma centers as well as for the emergency medical services (EMS). In the hospital information database provided by the Federation of German Medical Directors of Emergency Medical Services, more than 1300 hospitals are currently listed...
March 12, 2018: Der Unfallchirurg
Michael Owen Kinney, Stephen J Hunt, Ciaran McKenna
INTRODUCTION: Paramedics are increasingly expected to take on wider roles in the management of epilepsy in the community by making nonconveyance decisions after patients have had seizures. Studies have identified barriers to the successful implementation of this clinical role. We sought to determine levels of confidence, training, perceived barriers, and self-identified learning needs and methods to address these needs regarding seizure management. METHODS AND MATERIALS: A questionnaire was developed by consensus and administered to 63 paramedic and prehospital clinicians at various mandatory training days occurring at the central headquarters of the regional ambulance service in Northern Ireland...
March 7, 2018: Epilepsy & Behavior: E&B
Katarzyna Naylor, Anna Torres, Robert Gałązkowski, Kamil Torres
INTRODUCTION: Paramedics are at risk of occupational exposure, increased by the immediacy of provided treatment. However, the issue has not been acknowledged by any research in Europe up to date. METHODS: The research aimed at assessing the occupational blood exposure among paramedics in Poland. Respondents represented 21 Polish medical institutions. Their participation was voluntary and anonymous. Paramedics were provided with a self-directed job specific questionnaire adapted to Polish conditions from an original North American version...
March 9, 2018: International Journal of Occupational Safety and Ergonomics: JOSE
Martin Hulldin, Jonas Kängström, Magnus Andersson Hagiwara, Andreas Claesson
BACKGROUND: Emergency medical services (EMS) facilitate out of hospital care in a wide variety of settings on a daily basis. Stretcher-related adverse events and long term musculoskeletal injuries are commonly reported. Novel stretcher mechanisms may facilitate enhanced movement of patients and reduce workload for EMS personnel. AIM: To describe EMS personnel's perceived exertion using two different stretcher systems. METHODS: The methodology of this explorative simulation study included enrolling twenty (n=20) registered nurses and paramedics who worked in ten pairs (n=10) to transport a conscious, 165lb...
February 27, 2018: American Journal of Emergency Medicine
Louis Staple, Alix Carter, Jan L Jensen, Mark Walker
BACKGROUND: Paramedics participate in continuing medical education (CME) to maintain their skills and knowledge. An understanding of learning styles is important for education to be effective. This study examined the preferred learning styles of ground ambulance paramedics and describes how their preferred learning styles relate to the elective CME activities these paramedics attend. METHODS: All paramedics (n=1,036) employed in a provincial ground ambulance service were invited to participate in a survey containing three parts: demographics, learning style assessed by the Kolb Learning Style Inventory (LSI), and elective CME activity...
2018: Journal of Allied Health
Ben Beck, Janet Bray, Peter Cameron, 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, Gavin D Perkins, Graham Nichol, Judith Finn
INTRODUCTION: The aim of this study was to investigate regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest (OHCA) in Australia and New Zealand. METHODS: This was a population-based cohort study of OHCA using data from the Aus-ROC Australian and New Zealand OHCA Epistry over the period of 01 January 2015 to 31 December 2015. Seven ambulance services contributed data to the Epistry with a capture population of 19.8 million people...
February 27, 2018: Resuscitation
Hang A Park, Ki Ok Ahn, Ju Ok Park, Jungeun Kim, Seungmin Jeong, Meesook Kim
BACKGROUND: The purpose of this study was to identify the characteristics of injuries of school-aged children transported via emergency medical services (EMS) that occurred in schools by comparing with injuries that occurred outside of school. METHODS: Data from the 119 EMS from 2012 to 2014 were analyzed. School and non-school injuries were analyzed in children 6 to 17 years of age. The epidemiologic characteristics were assessed according to school-age groups; low-grade primary (6-8 years), high-grade primary (9-13 years), middle (13-15 years) and high (15-17 years) school...
March 5, 2018: Journal of Korean Medical Science
Zhiwei Xu, Jian Cheng, Wenbiao Hu, Shilu Tong
OBJECTIVES: Temperature observation time and type influenced the assessment of heat impact on mortality, and different health events may have different temperature thresholds beyond which these health events increase substantially. This study aimed to investigate whether temperature observation time and type influenced the assessment of heatwave impact on morbidity, to assess how heatwave duration modified heatwave impact on morbidity, and to examine whether there was a consistent temperature threshold beyond which five different types of health events increased sharply...
February 26, 2018: Science of the Total Environment
Rashida H Woods, Manish Shah, Cara Doughty, Anthony Gilchrest
OBJECTIVES: The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. METHODS: We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed...
March 2018: Pediatric Emergency Care
Rebecca Maria Hasler, Sandra Stucky, Heinz Bähler, Aristomenis K Exadaktylos, Frank Neff
OBJECTIVE: Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel. As there is little epidemiological data about these patients, this paper aims to describe this special population...
2018: PloS One
Paul Childress, Alexander Brinker, Cynthia-May S Gong, Jonathan Harris, David J Olivos, Jeffrey D Rytlewski, David C Scofield, Sungshin Y Choi, Yasaman Shirazi-Fard, Todd O McKinley, Tien-Min G Chu, Carolynn L Conley, Nabarun Chakraborty, Rasha Hammamieh, Melissa A Kacena
Segmental bone defects (SBDs) secondary to trauma invariably result in a prolonged recovery with an extended period of limited weight bearing on the affected limb. Soldiers sustaining blast injuries and civilians sustaining high energy trauma typify such a clinical scenario. These patients frequently sustain composite injuries with SBDs in concert with extensive soft tissue damage. For soft tissue injury resolution and skeletal reconstruction a patient may experience limited weight bearing for upwards of 6 months...
February 2018: Life Sciences in Space Research
Colin O'Keeffe, Suzanne Mason, Richard Jacques, Jon Nicholl
BACKGROUND: The pressures of patient demand on emergency departments (EDs) continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings...
2018: PloS One
Selman Yeniocak, Asım Kalkan, Ozgur Sogut, Gökce Akgül Karadana, Mehmet Toptas
Objective: Since the homeless are at greater risk of encountering health problems than the general population, the reasons for and incidence of their presentations to emergency departments also vary. The purpose of this study was to determine the sociodemographic and clinical characteristics of Turkish homeless patients who brought to the emergency department by ambulance. Materials and methods: The records of homeless adult patients brought to the ED by 112 emergency service ambulance teams over a 1-year period from January to December, 2014, were examined retrospectively...
December 2017: Turkish Journal of Emergency Medicine
(no author information available yet)
This document announces the extension of statewide temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance providers and suppliers and Medicare home health agencies, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey, as applicable, to prevent and combat fraud, waste, and abuse. This extension also applies to the enrollment of new non-emergency ground ambulance suppliers and home health agencies, subunits, and branch locations in Medicaid and the Children's Health Insurance Program in those states...
January 30, 2018: Federal Register
Philip Emerson, Naomi Dodds, David R Green, Jan O Jansen
Background: Critical illness requires specialist and timely management. The aim of this study was to create a geographic accessibility profile of the Scottish population to emergency departments and intensive care units. Methods: This was a descriptive, geographical analysis of population access to 'intermediate' and 'definitive' critical care services in Scotland. Access was defined by the number of people able to reach services within 45 to 60 min, by road and by helicopter...
February 2018: Journal of the Intensive Care Society
Lubna Ansari Baig, Shiraz Shaikh, Maciej Polkowski, Syeda Kausar Ali, Seemin Jamali, Lubna Mazharullah, Marium Soomro, Bhavita Kumari, Sobia Memon, Greesh Maheshwari, Saleema Arif
BACKGROUND: Violence against health care providers (HCPs) remains a significant public health problem in developing countries, affecting their performance and motivation. OBJECTIVES: To report the quantity and perceived causes of violence committed upon HCPs and identify strategies intended to prevent and de-escalate it. METHODS: This was a mixed-methods concurrent study design (QUAN-QUAL). A structured questionnaire was filled in on-site by trained data collectors for quantitative study...
February 12, 2018: Journal of Emergency Medicine
Ming-Ho Wu, Han-Yun Wu
Objective This study was designed to compare the effectiveness and convenience of a drainage bag and a chest bottle following thoracoscopic lobectomy. Methods We conducted a test to ensure that the drainage bag was characterized by easy drainage and an antireflux effect. Thereafter, the drainage bag was used in all thoracic operations in our service. To understand the usefulness of the drainage bag, a retrospective cohort study enrolled 30 patients who had a drainage bag after thoracoscopic lobectomy and compared them with 30 similar patients operated on previously who had chest bottles...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
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