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https://www.readbyqxmd.com/read/27913657/cost-benefit-analysis-of-telehealth-in-pre-hospital-care
#1
James R Langabeer, Tiffany Champagne-Langabeer, Diaa Alqusairi, Junghyun Kim, Adria Jackson, David Persse, Michael Gonzalez
OBJECTIVE: There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. METHODS: Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention...
December 2, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27908843/treatment-of-acute-coronary-syndrome-by-telemedically-supported-paramedics-compared-with-physician-based-treatment-a-prospective-interventional-multicenter-trial
#2
Jörg C Brokmann, Clemens Conrad, Rolf Rossaint, Sebastian Bergrath, Stefan K Beckers, Miriam Tamm, Michael Czaplik, Frederik Hirsch
BACKGROUND: Prehospital treatment of acute coronary syndrome (ACS) in German emergency medical services (EMSs) is reserved for EMS physicians due to legal issues. OBJECTIVE: The objective of this prospective, interventional, multicenter trial was to evaluate the quality of telemedically-delegated therapy and the possible complications in patients with ACS. METHODS: After approval by the ethics committee and trial registration, a one-year study phase was started in August 2012 with 5 ambulances, telemedically equipped and staffed with paramedics, in 4 German EMS districts...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27897380/lived-experience-of-involuntary-transport-under-mental-health-legislation
#3
Joanne Bradbury, Marie Hutchinson, John Hurley, Helen Stasa
Police have historically been responsible for transporting people during a mental health crisis in Australia. A major change to the New South Wales (NSW) Mental Health Act (MHA) in 2007 expanded the range of coercive transportation agencies to include NSW Ambulance (paramedics) and NSW Health (mental health nurses). Anecdotal reports, however, describe a lack of clarity around how these changes should be implemented in practice. This research aims to explore this lack of clarity through qualitative analysis of interviews with people with the lived experience of involuntary transport under the MHA...
November 29, 2016: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/27890162/understanding-emergency-workers-behavior-and-perspectives-on-design-and-safety-in-the-workplace
#4
Elizabeth Reuter, Jorge D Camba
Emergency Medical Services (EMS) is a demanding and hazardous industry. Because of the changing roles in the emergency response system, EMS workers are increasingly expected to provide treatment and care in addition to transport, which increases their task load and susceptibility to harm. This paper serves to outline the EMS field from the worker's perspective with the purpose of understanding their views on health, safety, and the work environment, and identify where gaps in worker well-being are exposed. Through direct observation, field studies, and formal interviews with EMS professionals, we discuss where reluctance lies in addressing safety issues and the current efforts to address them...
March 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/27890031/a-national-assessment-of-the-health-and-safety-of-emergency-medical-services-professionals
#5
Melissa A Bentley, Roger Levine
OBJECTIVES: The objectives were to assess changes in (1) health and physical fitness, (2) the prevalence of selected health problems, (3) risk behaviors, (4) ambulance safety issues, and (5) the preparedness of Emergency Medical Services (EMS) professionals. In addition, the incidence of patient-initiated violence directed toward EMS personnel and associated factors were assessed. METHODS: Data were obtained from a sample of nationally certified EMS professionals via annual questionnaires between 1999 and 2008...
November 28, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27887782/ambient-particulate-matter-landscape-fire-smoke-and-emergency-ambulance-dispatches-in-sydney-australia
#6
Farhad Salimi, Sarah B Henderson, Geoffrey G Morgan, Bin Jalaludin, Fay H Johnston
BACKGROUND: Emergency ambulance dispatches (EAD) are a novel outcome for evaluating the public health impacts of air pollution. We assessed the relationships between ambient particulate matter (PM) from all sources, PM from landscape fire smoke (LFS), and EADs likely to be associated with cardiorespiratory problems in the Sydney greater metropolitan region for an 11-year period from 2004 to 2015. METHODS: EAD codes are assigned at the time of the call to emergency services using standard computer assisted algorithms...
November 22, 2016: Environment International
https://www.readbyqxmd.com/read/27886777/characteristics-of-patients-who-are-not-resuscitated-in-out-of-hospital-cardiac-arrests-and-opportunities-to-improve-community-response-to-cardiac-arrest
#7
S Rajagopal, C R Kaye, R Lall, C D Deakin, S Gates, H Pocock, T Quinn, N Rees, M Smyth, G D Perkins
AIM: This study explores why resuscitation is withheld when emergency medical staff arrive at the scene of a cardiac arrest and identifies modifiable factors associated with this decision. METHODS: This is a secondary analysis of unselected patients who sustained an out of hospital cardiac arrest attended by ambulance vehicles participating in a randomized controlled trial of a mechanical chest compression device (PARAMEDIC trial). Patients were categorized as 'non-resuscitation' patients if there was a do-not-attempt-cardiopulmonary-resuscitation (DNACPR) order, signs unequivocally associated with death or resuscitation was deemed futile (15min had elapsed since collapse with no bystander-CPR and asystole recorded on EMS arrival)...
December 2016: Resuscitation
https://www.readbyqxmd.com/read/27886436/factors-that-hinder-or-enable-maternal-health-strategies-to-reduce-delays-in-rural-and-pastoralist-areas-in-ethiopia
#8
Ruth Jackson, Fisaha Haile Tesfay, Tesfay Gebregzabher Gebrehiwot, Hagos Godefay
OBJECTIVES: To document factors that hinder or enable strategies to reduce the first and second delays of the Three Delays in rural and pastoralist areas in Ethiopia. METHODS: A key informant study was conducted with 44 Health Extension Workers in Afar Region, Kafa Zone (Southern Nation, Nationalities and Peoples' Region), and Adwa Woreda (Tigray Region). Health Extension Workers were trained to interview women and ask for stories about their recent experiences of birth...
November 25, 2016: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27881566/association-of-bystander-cardiopulmonary-resuscitation-and-survival-according-to-ambulance-response-times-after-out-of-hospital-cardiac-arrest
#9
Shahzleen Rajan, Mads Wissenberg, Fredrik Folke, Steen M Hansen, Thomas A Gerds, Kristian Kragholm, Carolina Malta Hansen, Lena I M Karlsson, Freddy K Lippert, Lars Køber, Gunnar H Gislason, Christian Torp-Pedersen
BACKGROUND: -Bystander-initiated cardiopulmonary resuscitation (CPR) increases patient survival following out-of-hospital cardiac arrest (OHCA) but it is unknown to what degree bystander CPR remains positively associated with survival with increasing time to potential defibrillation. The main objective was to examine the association of bystander CPR with survival as time to advanced treatment increases. METHODS: -We studied 7,623 OHCA patients between 2005-2011, identified through the nationwide Danish Cardiac Arrest Register...
November 22, 2016: Circulation
https://www.readbyqxmd.com/read/27865775/epidemiology-and-outcomes-from-out-of-hospital-cardiac-arrests-in-england
#10
Claire Hawkes, Scott Booth, Chen Ji, Samantha J Brace-McDonnell, Andrew Whittington, James Mapstone, Matthew W Cooke, Charles D Deakin, Chris P Gale, Rachael Fothergill, Jerry P Nolan, Nigel Rees, Jasmeet Soar, A Niroshan Siriwardena, Terry P Brown, Gavin D Perkins
INTRODUCTION: This study reports the epidemiology and outcomes from out-of-hospital cardiac arrest (OHCA) in England during 2014. METHODS: Prospective observational study from the national OHCA registry. The incidence, demographic and outcomes of patients who were treated for an OHCA between 1st January 2014 and 31st December 2014 in 10 English ambulance service (EMS) regions, serving a population of almost 54 million, are reported in accordance with Utstein recommendations...
November 17, 2016: Resuscitation
https://www.readbyqxmd.com/read/27861870/iatrogenic-burns-of-the-neckline-in-a-patient-with-tetraparesis-during-tracheotomy
#11
Anna Smędra, Ewa Meissner, Maciej Barzdo, Przemysław Grabowski, Michał Kartasiński, Wojciech Krajewski, Jarosław Berent
The paper presents a case of an atypical iatrogenic complication after tracheotomy analyzed on the basis of the case dossier materials submitted to the authors by the court of justice to prepare a forensic medical opinion concerning the correctness of the medical procedure. A 37-year-old woman was brought by the ambulance service to the hospital with acute respiratory failure due to post-tracheostomy tracheal stenosis. Tracheotomy was performed on an emergency basis. The patient suffered severe burns of the chest and neck...
November 10, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27852453/current-use-and-outcomes-of-helicopter-transport-in-pediatric-trauma-a-review-of-18-291-transports
#12
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...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27849462/functional-outcomes-of-service-members-with-bilateral-transfemoral-and-knee-disarticulation-amputations-resulting-from-trauma
#13
Barri L Schnall, Yin-Ting Chen, Elizabeth M Bell, Erik J Wolf, Jason M Wilken
As longitudinal studies for those with bilateral transfemoral amputation (BTFA) or knee disarticulation (KD) are lacking, it is important to quantify performance measures during rehabilitation in an effort to determine reasonable expectations and trends that may influence the rehabilitation process. At initial evaluation (date of first independent ambulation) and follow up (median 135 [range = 47-300] days later), 10 participants with BTFA/KD completed 6 minute walk testing and Activity Specific Balance Confidence and Lower Extremity Functional Scale questionnaires...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849461/differences-in-military-obstacle-course-performance-between-three-energy-storing-and-shock-adapting-prosthetic-feet-in-high-functioning-transtibial-amputees-a-double-blind-randomized-control-trial
#14
M Jason Highsmith, Jason T Kahle, Rebecca M Miro, Derek J Lura, Stephanie L Carey, Matthew M Wernke, Seok Hun Kim, William S Quillen
BACKGROUND: Approximately 683 persons engaged in military service experienced transtibial amputation (TTA) related to recent war in Iraq and Afghanistan. Military TTAs function at a level beyond basic ambulation. No empirical data demonstrate which higher functioning prosthetic feet maximize injured service personnel's ability to continue performing at a level commensurate with return to duty. This study's purpose was to determine which of three high-functioning, energy-storing prosthetic feet maximize performance and preference in a field obstacle course (OC) and to quantify physical performance differences between TTAs and high-functioning nonamputees...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27842598/exploratory-analysis-of-real-personal-emergency-response-call-conversations-considerations-for-personal-emergency-response-spoken-dialogue-systems
#15
Victoria Young, Elizabeth Rochon, Alex Mihailidis
BACKGROUND: The purpose of this study was to derive data from real, recorded, personal emergency response call conversations to help improve the artificial intelligence and decision making capability of a spoken dialogue system in a smart personal emergency response system. The main study objectives were to: develop a model of personal emergency response; determine categories for the model's features; identify and calculate measures from call conversations (verbal ability, conversational structure, timing); and examine conversational patterns and relationships between measures and model features applicable for improving the system's ability to automatically identify call model categories and predict a target response...
November 14, 2016: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/27833678/telehealth-enabled-emergency-medical-services-program-reduces-ambulance-transport-to-urban-emergency-departments
#16
James R Langabeer, Michael Gonzalez, Diaa Alqusairi, Tiffany Champagne-Langabeer, Adria Jackson, Jennifer Mikhail, David Persse
INTRODUCTION: Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system's capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27827326/cutting-the-prehospital-on-scene-time-of-stroke-thrombolysis-in-helsinki-a-prospective-interventional-study
#17
Tuukka Puolakka, Markku Kuisma, Sami Länkimäki, Jyrki Puolakka, Juhana Hallikainen, Kirsi Rantanen, Perttu J Lindsberg
BACKGROUND AND PURPOSE: Significant portion of the prehospital delay consists of minutes spent on the scene with the patient. We implemented a training program for the emergency medical services personnel with the aim to optimize the on-scene time (OST) and to study the impact of different elements of prehospital practice to the OST duration. METHODS: In this prospective interventional study, key operational emergency medical service performance variables were analyzed from all thrombolysis candidates transported to the Helsinki University Hospital emergency department...
November 8, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27825842/hourly-associations-between-heat-and-ambulance-calls
#18
Yuming Guo
BACKGROUND: The response speed of ambulance calls is very crucial to rescue patients suffering immediately life threatening conditions. The serious health outcomes might be caused by exposing to extreme heat only several hours before. However, limited evidence is available on this topic. This study aims to examine the hourly association between heat and ambulance calls, to improve the ambulance services and to better protect health. METHODS: Hourly data on ambulance calls for non-accidental causes, temperature and air pollutants (PM10, NO2, and O3) were collected from Brisbane, Australia, during 2001 and 2007...
January 2017: Environmental Pollution
https://www.readbyqxmd.com/read/27817198/heart-of-the-tropics-delivering-evidence-based-care-for-acute-coronary-syndromes-in-northern-australia
#19
Greg Starmer, Ryan Schrale
Acute coronary syndromes (ACS) are life-threatening medical emergencies that require urgent treatment, posing particular challenges for systems of health care in regional and remote parts of the world characterised by large distances and widely dispersed populations and healthcare facilities. Northern Australia is such an environment. The prevalence of cardiovascular risk factors, coronary artery disease and ACS (myocardial infarction and unstable angina) in northern Australia is amongst the highest in Australia...
October 2016: Rural and Remote Health
https://www.readbyqxmd.com/read/27801359/bed-utilisation-in-an-irish-regional-paediatric-unit-a-cross-sectional-study-using-the-paediatric-appropriateness-evaluation-protocol-paep
#20
Coilín ÓhAiseadha, Mai Mannix, Jean Saunders, Roy K Philip
BACKGROUND: Increasing demand for limited healthcare resources raises questions about appropriate use of inpatient beds. In the first paediatric bed utilisation study at a regional university centre in Ireland, we conducted a cross-sectional study to audit the utilisation of inpatient beds at the Regional Paediatric Unit (RPU) in University Hospital Limerick (UHL), Limerick, Ireland and also examined hospital activity data, to make recommendations for optimal use of inpatient resources...
May 10, 2016: International Journal of Health Policy and Management
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