ePCR Ambulance

OBJECTIVES: Emergency intubation in children is an infrequent procedure both in the pre-hospital and hospital setting. The anatomical, physiological and situational challenges together with limited clinician exposure can make this a difficult procedure with high risk of adverse events. The aim of this collaborative study between a state-wide ambulance service and a tertiary children's hospital was to describe the characteristics of pre-hospital paediatric intubations by Intensive Care Paramedics...

We derived machine learning models utilizing features generated by natural language processing (NLP) of free-text data from an ambulance services provider to identify fall cases. The data comprised samples of electronic patient care records care records (ePCRs) from St John Western Australia (WA), the sole ambulance services provider in most of WA. We manually labeled fall cases by reviewing the free-text summary. The models used features including case characteristics (e.g., age) and text frequency-inverse document frequency (tf-idf) of each word of the free-text generated by NLP...

BACKGROUND: Demand for both the ambulance service and the emergency department (ED) is rising every year and when this demand is excessive in both systems, ambulance crews queue at the ED waiting to hand patients over. Some transported ambulance patients are 'low-acuity' and do not require the treatment of the ED. However, paramedics can find it challenging to identify these patients accurately. Decision support tools have been developed using expert opinion to help identify these low acuity patients but have failed to show a benefit beyond regular decision-making...

Objective: Ambulance services are evolving from use of paper-based recording of patient information to electronic platforms and the impact of this change has yet to be fully explored. The aim of this study is to explore how the introduction of a system permitting electronic information capture and its subsequent sharing were perceived by the ambulance clinicians using it. Methods: An online questionnaire was designed based upon the technology acceptance model and distributed throughout one ambulance service in the south east of England...

OBJECTIVES: Population density can limit the level of care that can be provided in local facilities in Ontario, and as such, patients with severe illnesses often require interfacility transfers to access specialized care. This study aimed to identify causes of delay in interfacility transport by air ambulance in Ontario. METHODS: Causes of delay were identified by manual review of electronic patient care records (ePCRs). All emergent interfacility transfers conducted by Ornge, the sole provider of air-based medical transport in Ontario, between January 1, 2016 and December 31, 2016 were included...

Introduction Hospitalization due to ambulatory care sensitive conditions (ACSC) is often used as a proxy measure for access to primary care. The prevalence of ACSC has not been measured in the prehospital setting. Emergency medical services (EMS) are being used by patients who lack access to primary care for ACSC. Many novel models of care have been implemented within Canada and internationally, utilizing paramedics to ease the burden of poor primary care access. Recently, a mobile care team (MCT) consisting of a paramedic/nurse configuration has been deployed in the community of New Waterford, Nova Scotia...

INTRODUCTION: Using the Medical Priority Dispatch System (MPDS) - a systematic 911 triage process - to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews...

BACKGROUND: Care for older people with dementia (OPWD) is a major concern across all care settings. Ambulance services are in the spotlight as pressures on emergency services and calls for admission avoidance are policy priorities. Around 1/3 of emergency call-outs are to people 75 and over, a significant proportion of whom may have dementia. There is a perception that dementia may be an issue but we do not understand how much this affects use of emergency services. METHODS: We reviewed 358 ambulance service paper-based patient care records (PCRs) to test the feasibility of using them as a source of information about ambulance service use by OPWD and, conducted critical incident reviews of 999 callouts to understand factors associated with emergency ambulance call-outs...

OBJECTIVES: Georgetown University has a student run Emergency Medical Services (EMS) organization with over 100 emergency medical technicians (EMTs). We set out to determine whether implementing an electronic patient care report (ePCR) system was associated with improved physical exam documentation. METHODS: This study evaluated documentation of the physical exam on prehospital patient care reports (PCRs). An ePCR system was implemented. ePCR documentation was compared to that of the previously used paper PCRs...

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No abstract text is available yet for this article.