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https://www.readbyqxmd.com/read/29037168/locating-helicopter-emergency-medical-service-bases-to-optimise-population-coverage-versus-average-response-time
#1
Alan A Garner, Pieter L van den Berg
BACKGROUND: New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate optimal HEMS base locations within NSW using advanced mathematical modelling techniques. METHODS: We used high resolution census population data for NSW from 2011 which divides the state into areas containing 200-800 people...
October 16, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28975883/prehospital-interventions-before-and-after-implementation-of-a-physician-staffed-helicopter
#2
Asger Sonne, Sandra Wulffeld, Jacob Steinmetz, Lars S Rasmussen, Rasmus Hesselfeldt
INTRODUCTION: Implementation of a physician-staffed helicopter emergency medical service (HEMS) in eastern Denmark was associated with increased survival for severely injured patients. This study aimed to assess the potential impact of advanced prehospital interventions by comparing the proportion of patients who received those interventions before and after the HEMS implementation. METHODS: A post-hoc analysis of a prospective before-after study. We included trauma patients with Injury Severity Scores above three who had been admitted to seven emergency departments or one level 1 trauma centre in the course of a five-month period before and a 12-month period after the HEMS implementation...
October 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#3
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28864437/organizational-factors-associated-with-perceived-quality-of-patient-care-in-closed-intensive-care-units
#4
Nathalie McIntosh, Eva Oppel, David Mohr, Mark Meterko
BACKGROUND: Improving patient care quality in intensive care units is increasingly important as intensive care unit services account for a growing proportion of hospital services. Organizational factors associated with quality of patient care in such units have been identified; however, most were examined in isolation, making it difficult to assess the relative importance of each. Furthermore, though most intensive care units now use a closed model, little research has been done in this specific context...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28828300/generalizable-items-and-modular-structure-for-computerised-physician-staffing-calculation-on-intensive-care-units
#5
REVIEW
Manfred Weiss, Gernot Marx, Thomas Iber
Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28739239/acute-coronary-syndrome-evacuated-by-a-helicopter-from-the-scene
#6
Hiromichi Ohsaka, Kazuhio Omori, Ikuto Takeuchi, Kei Jitsuiki, Toshihiko Yoshizawa, Kouhei Ishikawa, Kikuo Isoda, Satoru Suwa, Youichi Yanagawa
OBJECTIVE: The purpose of this study was to investigate the safety of evacuating patients using a physician-staffed helicopter (Dr. Heli). METHODS: We retrospectively investigated all of the patients with acute coronary syndrome (ACS) who were transported by a Dr. Heli between April 2004 and March 2016. The scene group included subjects evacuated from the scene by the Dr. Heli. The interhospital group included subjects transported to a nearby medical facility by a ground ambulance and then transported to our hospital by a Dr...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28693524/national-consensus-on-communication-in-prehospital-trauma-care-the-denim-study
#7
Annelieke Maria Karien Harmsen, Leo Maria George Geeraedts, Georgios Fredericus Giannakopoulos, Maartje Terra, Herman M T Christiaans, Lidwine Brigitta Mokkink, Frank Willem Bloemers
BACKGROUND: In the Netherlands prehospital trauma care is provided by emergency medical services (EMS) nurses. This care is extended by Physician staffed Helicopter Emergency Medical Services (P-HEMS) for the more severely injured patient. Prehospital communication is a factor of influence on the identification of these patients and the dispatch of P-HEMS. Though prehospital communication it is often perceived to be incomplete and unstructured. To elucidated factors of influence on prehospital triage and the identification of the severely injured patient a Delphi study was performed...
July 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28693491/hypoxia-and-hypotension-in-patients-intubated-by-physician-staffed-helicopter-emergency-medical-services-a-prospective-observational-multi-centre-study
#8
Geir Arne Sunde, Mårten Sandberg, Richard Lyon, Knut Fredriksen, Brian Burns, Karl Ove Hufthammer, Jo Røislien, Akos Soti, Helena Jäntti, David Lockey, Jon-Kenneth Heltne, Stephen J M Sollid
BACKGROUND: The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Several studies describe the impact of pre-hospital hypoxia or hypotension on trauma patients, but few studies compare this in trauma and non-trauma patients...
July 11, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28633767/temporal-variation-in-ankle-fractures-and-orthopedic-resident-program-planning-in-an-urban-level-1-trauma-center
#9
Aaron Wynkoop, Osy Ndubaku, Norman Walter, Theresa Atkinson
Previous studies have described the mechanism of ankle fractures, their seasonal variation, and fracture patterns but never in conjunction. In addition, the cohorts previously studied were either not from trauma centers or were often dominated by low-energy mechanisms. The present study aimed to describe the epidemiology of ankle fractures presenting to an urban level 1 trauma center. The records from an urban level 1 trauma center located in the Midwestern United States were retrospectively reviewed, and the injury mechanism and energy, time of injury, day of week, month, and patient characteristics (age, gender, comorbidities, smoking status) were collected...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28593012/potential-benefit-of-physician-staffed-helicopter-emergency-medical-service-for-regional-trauma-care-system-activation-an-observational-study-in-rural-japan
#10
Tomohiro Abe, Takehiko Nagano, Hidenobu Ochiai
Objective: Involvement of all regional medical facilities in a trauma system is challenging in rural regions. We hypothesized that the physician-staffed helicopter emergency medical service potentially encouraged local facilities to participate in trauma systems by providing the transport of patients with trauma to those facilities in a rural setting. Materials and Methods: We performed two retrospective observational studies. First, yearly changes in the numbers of patients with trauma and destination facilities were surveyed using records from the Miyazaki physician-staffed helicopter emergency medical service from April 2012 to March 2014...
May 2017: Journal of Rural Medicine: JRM
https://www.readbyqxmd.com/read/28492412/patients-in-prehospital-transport-to-the-emergency-department-a-cohort-study-of-risk-factors-for-7-day-mortality
#11
Camilla L Noergaard Bech, Mikkel Brabrand, Søren Mikkelsen, Annmarie Lassen
BACKGROUND: Ambulance transfer is the first contact with the healthcare system for many patients in emergency conditions.We aimed to identify prognostic risk factors accessible in the prehospital phase that indicate an increased risk of 7-day mortality. PATIENTS AND METHODS: We included patients aged 18 years or older, transferred by ambulance to the emergency department at Odense University Hospital, from 1 April 2012 to 30 September 2014. We carried out multivariate logistic regressions, adjusted for age and sex, to describe the relationship between vital sign values recorded in the prehospital setting and 7-day mortality...
May 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28489643/factors-influencing-quality-of-pain-management-in-a-physician-staffed-helicopter-emergency-medical-service
#12
Nicole Oberholzer, Alexander Kaserer, Roland Albrecht, Burkhardt Seifert, Mario Tissi, Donat R Spahn, Konrad Maurer, Philipp Stein
BACKGROUND: Pain is frequently encountered in the prehospital setting and needs to be treated quickly and sufficiently. However, incidences of insufficient analgesia after prehospital treatment by emergency medical services are reported to be as high as 43%. The purpose of this analysis was to identify modifiable factors in a specific emergency patient cohort that influence the pain suffered by patients when admitted to the hospital. METHODS: For that purpose, this retrospective observational study included all patients with significant pain treated by a Swiss physician-staffed helicopter emergency service between April and October 2011 with the following characteristics to limit selection bias: Age > 15 years, numerical rating scale (NRS) for pain documented at the scene and at hospital admission, NRS > 3 at the scene, initial Glasgow coma scale > 12, and National Advisory Committee for Aeronautics score < VI...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28460858/analysis-of-out-of-hospital-pediatric-intubation-by%C3%A2-an-australian-helicopter-emergency-medical%C3%A2-service
#13
Brian J Burns, Joanna B Watterson, Sandra Ware, Luke Regan, Cliff Reid
STUDY OBJECTIVE: We examine first-look success in emergency pediatric intubation by a physician-staffed helicopter emergency medical service (EMS). METHODS: A database analysis of all pediatric (<16 years) intubations during a 64-month period was undertaken, using data from a prospectively enrolled electronic airway registry form. Recorded findings included patient demographics, operator background, airway intervention including intubation attempts, complications, and critical timings...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28356134/external-validation-of-the-rosc-after-cardiac-arrest-raca-score-in-a-physician-staffed-emergency-medical-service-system
#14
Petteri Kupari, Markus Skrifvars, Markku Kuisma
BACKGROUND: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. METHODS: We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated...
March 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28351447/near-infrared-spectroscopy-a-promising-prehospital-tool-for-management-of-traumatic-brain-injury
#15
Joost Peters, Bas Van Wageningen, Nico Hoogerwerf, Edward Tan
Introduction Early identification of traumatic brain injury (TBI) is essential. Near-infrared spectroscopy (NIRS) can be used in prehospital settings for non-invasive monitoring and the diagnosis of patients who may require surgical intervention. METHODS: The handheld NIRS Infrascanner (InfraScan Inc.; Philadelphia, Pennsylvania USA) uses eight symmetrical scan points to detect intracranial bleeding. A scanner was tested in a physician-staffed helicopter Emergency Medical Service (HEMS)...
August 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28336014/clinical-significance-of-fibrinogen-degradation-product-among-traumatized-patients
#16
Kouhei Ishikawa, Kazuhiko Omori, Kei Jitsuiki, Hiromichi Ohsaka, Hiroshi Ito, Katsuhito Shimoyama, Toru Fukunaga, Norikazu Urabe, Souichirou Kitamura, Youichi Yanagawa
OBJECTIVE: We retrospectively analyzed trauma patients who were transported by a physician-staffed helicopter (doctor helicopter) to investigate the clinical significance of the fibrinogen degradation product (FDP) level on arrival. METHODS: From February 2011 to July 2016, a medical chart review was retrospectively performed for all patients with trauma who were transported by the doctor helicopter. The subjects were divided into 2 groups: a survival group and a fatal group...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28243016/a-second-analysis-of-patients-with-decompression-illness-transported-via-physician-staffed-emergency-helicopters
#17
Youichi Yanagawa, Kazuhiko Omori, Kouhei Ishikawa, Hiromichi Ohsaka
No abstract text is available yet for this article.
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28202076/developing-quality-indicators-for-physician-staffed-emergency-medical-services-a-consensus-process
#18
Helge Haugland, Marius Rehn, Pål Klepstad, Andreas Krüger
BACKGROUND: There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives. METHODS: A four-step modified nominal group technique process (expert panel method) was used. RESULTS: The expert panel reached consensus on 26 quality indicators for P-EMS...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28154162/outcomes-of-physician-staffed-versus-non-physician-staffed-helicopter-transport-for-st-elevation-myocardial-infarction
#19
Sverrir I Gunnarsson, Joseph Mitchell, Mary S Busch, Brenda Larson, S Michael Gharacholou, Zhanhai Li, Amish N Raval
BACKGROUND: The effect of physician-staffed helicopter emergency medical service (HEMS) on ST-elevation myocardial infarction (STEMI) patient transfer is unknown. The purpose of this study was to evaluate the characteristics and outcomes of physician-staffed HEMS (Physician-HEMS) versus non-physician-staffed (Standard-HEMS) in patients with STEMI. METHODS AND RESULTS: We studied 398 STEMI patients transferred by either Physician-HEMS (n=327) or Standard-HEMS (n=71) for primary or rescue percutaneous coronary intervention at 2 hospitals between 2006 and 2014...
February 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28110985/a-profile-of-indian-health-service-emergency-departments
#20
Kenneth Bernard, Kohei Hasegawa, Ashley Sullivan, Carlos Camargo
STUDY OBJECTIVE: The Indian Health Service provides health care to eligible American Indians and Alaskan Natives. No published data exist on emergency services offered by this unique health care system. We seek to determine the characteristics and capabilities of Indian Health Service emergency departments (EDs). METHODS: All Indian Health Service EDs were surveyed about demographics and operational characteristics for 2014 with the National Emergency Department Inventory survey (available at http://www...
June 2017: Annals of Emergency Medicine
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