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ambulance service,pre-hospital

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
Phek Hui Jade Kua, Alexander E White, Wai Yee Ng, Stephanie Fook-Chong, Eileen Kai Xin Ng, Yih Yng Ng, Marcus Eng Hock Ong
INTRODUCTION: Victims of out-of-hospital cardiac arrests require timely cardiopulmonary resuscitation (CPR) and early defibrillation. Persons making the call to emergency medical services will be asked to provide dispatcher-guided response until an ambulance arrives. Knowing what to expect in such circumstances should reduce both delay and confusion. METHODS: We conducted this study among schoolchildren aged 11-17 years using ten-item pre- and post-training surveys...
February 12, 2018: Singapore Medical Journal
Eamonn Byrne, Gerard Bury
BACKGROUND: Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring...
February 8, 2018: Irish Journal of Medical Science
Josephine Muhrbeck, Jonas Persson, Claes Hofman-Bang
OBJECTIVE: The use of pre-hospital ECGs (PH-ECG) reduces time to reperfusion for patients with ST-segment elevation myocardial infarction (STEMI). The feasibility of reperfusion therapy within 60 minutes for hospitals with 24/7 PCI capability has been questioned, and current guidelines have set time targets to 90 minutes. Our primary objective was to investigate the proportion of false-positive catheterization laboratory activations by PH-ECG. Our secondary objective was to describe the time intervals from first medical contact to reperfusion and to establish the proportion of patients receiving reperfusion within 60 minutes...
January 23, 2018: Scandinavian Cardiovascular Journal: SCJ
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
BACKGROUND AND PURPOSE: The reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving the chances of a favourable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. METHODS: The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions...
March 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Jamie Miles, Colin O'Keeffe, Richard Jacques, Tony Stone, Suzanne Mason
OBJECTIVES: An NHS England report highlighted key issues in how patients were initially navigating access to healthcare. This has manifested in increased pressure on ambulance services and emergency departments (EDs) to provide high quality, safe and efficient services to manage this demand. This study aims to identify non-urgent conveyances by ambulance services to the ED that would be suitable for care at scene or an alternative response. DESIGN: A retrospective analysis of emergency department data linked to initial pre-hospital call data (either '111' or '999') in 2014 in Yorkshire and Humber...
December 2017: Emergency Medicine Journal: EMJ
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
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
M Rehn, A E Weaver, S Eshelby, J Røislien, D J Lockey
INTRODUCTION: The current management of severely injured patients includes damage control resuscitation strategies that minimise the use of crystalloids and emphasise earlier transfusion of red blood cells (RBC) to prevent coagulopathy. In 2012, London's air ambulance (LAA) became the first UK civilian pre-hospital service to routinely carry RBC to the trauma scene. OBJECTIVE: To investigate the effect of pre-hospital RBC transfusion (phRTx) on overall blood product consumption...
October 24, 2017: Transfusion Medicine
Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati, Owais Raza
BACKGROUND: Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). METHODS: A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire...
October 3, 2017: BMC Emergency Medicine
O Henriksson, U Björnstig, B-I Saveman, P J Lundgren
BACKGROUND: The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre-hospital services. METHODS: A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low-reading thermometers...
November 2017: Acta Anaesthesiologica Scandinavica
Mashyaneh Haddadi, Mohammad Sarvar, Hamid Soori, Elaheh Ainy
INTRODUCTION: Pre-hospital emergency systems provide service by Franco-German and Anglo American models. This study was carried out to compare the Iranian emergency medical service (EMS) with the two models regarding timing and equipment. METHODS: In this cross sectional study, response time, scene time, and transport time to hospital as well as ambulance equipment of five hundred thousand Tehran EMS recorded missions, during one year, were compared with Franco-German and Anglo American models, trying to determine the pattern of EMS delivery in Iran...
2017: Emergency (Tehran, Iran)
Madhu Gupta, Hans Bosma, Federica Angeli, Manmeet Kaur, Venkatesan Chakrapani, Monica Rana, Onno C P van Schayck
BACKGROUND: A multi pronged community based strategy, known as National Rural Health Mission (NRHM), was implemented from 2005-06 to 2012-13 in India to curtail maternal and child health (MCH) disparities between poor and rich, rural and urban areas, and boys and girls,. This study aimed to determine the degree to which MCH plans of NRHM implemented, and resulted in improving the MCH outcomes and reducing the inequalities. METHODS: An explanatory sequential mixed methods study was conducted, first to assess the degree of implementation of MCH plans by estimating the budget utilization rates of each MCH plan, and the effectiveness of these plans by comparing demographic health surveys data conducted post (2012-13), during (2007-08) and pre- (2002-04) NRHM implementation period, in the quantitative study...
September 11, 2017: BMC Public Health
Andy Irving, Janette Turner, Maggie Marsh, Andrea Broadway-Parkinson, Dan Fall, Joanne Coster, A Niroshan Siriwardena
BACKGROUND: Patient and public involvement (PPI) is recognized as an important component of high-quality health services research. PPI is integral to the Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) programme. The PPI event described in detail in this article focusses on the process of involving patients and public representatives in identifying, prioritizing and refining a set of outcome measures that can be used to support ambulance service performance measurement. OBJECTIVE: To obtain public feedback on little known, complex aspects of ambulance service performance measurement...
August 25, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Joanne E Coster, Andy D Irving, Janette K Turner, Viet-Hai Phung, Aloysius N Siriwardena
BACKGROUND: Current ambulance quality and performance measures, such as response times, do not reflect the wider scope of care that services now provide. Using a three-stage consensus process, we aimed to identify new ways of measuring ambulance service quality and performance that represent service provider and public perspectives. DESIGN: A multistakeholder consensus event, modified Delphi study, and patient and public consensus workshop. SETTING AND PARTICIPANTS: Representatives from ambulance services, patient and public involvement (PPI) groups, emergency care clinical academics, commissioners and policymakers...
August 25, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Anna L Mitchell, Kerri Devine, Vikram Lal, Paul Galloway, Matthew House, Katherine White, Julie Watson, Steve Parry, Margaret Miller, Margaret Morris, R Andy James, Petros Perros, Simon H S Pearce, Richard Quinton
No abstract text is available yet for this article.
August 23, 2017: Clinical Endocrinology
Young Taek Kim, Sang Do Shin, Sung Ok Hong, Ki Ok Ahn, Young Sun Ro, Kyoung Jun Song, Ki Jeong Hong
OBJECTIVES: The Utstein ten-step implementation strategy (UTIS) proposed by the Global Resuscitation Alliance, a bundle of community cardiopulmonary resuscitation (CPR) programs to improve outcomes after out-of-hospital cardiac arrests (OHCAs), has been developed. However, it is not documented whether UTIS programs are associated with better outcomes or not. The study aimed to test the association between the UTIS programme and better outcomes after OHCA. METHODS: The study was a before- and after-intervention study...
August 21, 2017: BMJ Open
Gisele O'Dwyer, Mariana Teixeira Konder, Luciano Pereira Reciputti, Cesar Macedo, Monica Guimarães Macau Lopes
The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service...
August 7, 2017: Cadernos de Saúde Pública
Lori L Boland, Michelle B Formanek, Kim K Harkins, Carol L Frazee, Jonathan W Kamrud, Andrew C Stevens, Charles J Lick, Demetris Yannopoulos
AIM: Implementation research that describes how successfully resuscitation guidelines are translated into practice are lacking. We examined whether recent community-based initiatives being conducted as part of the Minnesota Heart Safe (HS) Communities program increase the delivery of CPR and use of automated external defibrillators (AED) by bystanders and first responders prior to ambulance arrival. METHODS: Non-EMS witnessed out-of-hospital cardiac arrests (OHCA) with presumed cardiac etiology treated by a single ambulance service in 2013-2015 were studied...
October 2017: Resuscitation
Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Arul Earnest, Karen Smith, Georgia Soldatos, Helena Teede, Sophia Zoungas
AIMS: This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport. MATERIALS AND METHODS: A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted...
2017: PloS One
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