SEARCH · PubMed Health

Results for “Emergency Medical Service Communication Systems”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources

PubMed1991

The St Croix disaster and the National Disaster Medical System.

The National Disaster Medical System was designed to respond to a catastrophic disaster by creating a group of specially trained civilian disaster medical assistance teams. The teams would be transported to the periphery of the event to triage, stabilize, and then prepare victims for evacuation to facilities elsewhere in the United States that have agreed in advance to accept such patients. Hurricane Hugo's devastation in St Croix offered the first opportunity to test the system. The event was an example of a type of medical disaster that resulted in a sudden reduction in medical resources without a great increase in casualties. Background information and operation of the New Mexico disaster medical assistance team are presented with a clinical profile of the patients seen during the disaster. We describe the first actual deployment of a disaster medical assistance team and the issues that must be addressed before future deployments.

Disaster Planning↗

PubMed1984

[Teleconsulting and telediagnosis in emergency surgery].

A colour video picture transmission system in real time with data transmission via a broad wave optical fibre cable has been set up to link Turin University's Orthopaedic Traumatology Centre and Emergency Surgery Clinic. The system consists of two stations. The transmitter station is equipped with a mobile TV camera or TV monitor and various electrical medical equipment. The receiving station consists of a picture reception monitor. The coded video signal is transmitted via the optical fibre; sound transmission is via a special telephone line. This experimental system was set up to see if patients with multiple injuries could receive diagnosis at a distance, thus avoiding unnecessary travelling. Experience of 100 link-ups has demonstrated that the system effectively cuts diagnosis and therapy times and is as efficient as in loco inspection by a surgeon. In addition it can be used to provide specialised consulting services to rural hospitals without special equipment. This reduces waiting times for emergency treatment and can also prevent the pointless transfer of patients to big hospitals in cases where the specialist can prescribe intermediate therapy or surgery.

Diagnosis↗

PubMed1988

A new model for providing prehospital medical care in large stadiums.

To determine proper priorities for the provision of health care in large stadiums, we studied the medical incident patterns occurring in a major college facility and combined this with previously reported information from four other large stadiums. Medical incidents were an uncommon occurrence (1.20 to 5.23 per 10,000 people) with true medical emergencies being even more unusual (0.09 to 0.31 per 10,000 people). Cardiac arrest was rare (0.01 to 0.04 events per 10,000 people). However, the rates of successful resuscitation in three studies were 85% or higher. The previous studies were descriptive in nature and failed to provide specific recommendations for medical aid system configuration or response times. A model is proposed to provide rapid response of advanced life support care to victims of cardiac arrest. We believe that the use of this model in large stadiums throughout the United States could save as many as 100 lives during each football season.

Adolescent↗

PubMed1981

Multiple-address radio systems, allocation of forty-eight 25 kHz channels in the 900 MHz range; and establishment of a new standard for frequency tolerance in the 952-960 MHz band: Federal Communications Commission. Third notice of proposed rulemaking.

In response to a petition, the Commission proposes the reallocation of forty-eight 25 kHz channels in the 928-929 and 952-960 MHz band segments to the Private Operational-Fixed Microwave Service and the Domestic Public Land Mobile Radio Service for distribution automation and wide-area control and repeater operations, respectively. The spectrum from 928 to 929 MHz is presently reserved for Land Mobile. The 952-950 MHz band is currently allocated to the Private Operational-Fixed Microwave Service and the International Control Services.

Emergency Medical Service Communication Systems↗

PubMedDate not supplied

Sensitivity and specificity of the medical priority dispatch system in detecting cardiac arrest emergency calls in Melbourne.

INTRODUCTION: In Australia, cardiac arrest kills 142 out of every 100,000 people each year; with only 3-4% of out-of-hospital patients with cardiac arrest in Melbourne surviving to hospital discharge. Prompt initiation of cardiopulmonary resuscitation (CPR), defibrillation, and advanced cardiac care greatly improves the chances of survival from cardiac arrest. A critical step in survival is identifying by the emergency ambulance dispatcher potential of the probability that the person is in cardiac arrest. The Melbourne Metropolitan Ambulance Service (MAS) uses the computerized call-taking system, Medical Priority Dispatch System (MPDS), to triage incoming, emergency, requests for ambulance responses. The MPDS is used in many emergency medical systems around the world, however, there is little published evidence of the system's efficacy. OBJECTIVE: This study attempts to undertake a sensitivity/specificity analysis to determine the ability of MPDS to detect cardiac arrest. METHODS: Emergency ambulance dispatch records of all cases identified as suspected cardiac arrest by MPDS were matched with ambulance, patient-care records and records from the Victorian Ambulance Cardiac Arrest Registry to determine the number of correctly identified cardiac arrests. Additionally, cases that had cardiac arrests, but were not identified correctly at the point of call-taking, were examined. All data were collected retrospectively for a three-month period (01 January through 31 March 2003). RESULTS: The sensitivity of MPDS in detecting cardiac arrest was 76.7% (95% confidence interval (CI): 73.6%-79.8%) and specificity was 99.2% (95% CI: 99.1-99.3%). These results indicate that cardiac arrests are correctly identified in 76.7% of cases. CONCLUSION: Although the system correctly identified 76.7% of cardiac arrest cases, the number of false negatives suggests that there is room for improvement in recognition by MPDS to maximize chances for survival in out-of-hospital cardiac arrest. This study provides an objective and comprehensive measurement of the accuracy of MPDS cardiac-arrest detection in Melbourne, as well as providing a baseline for comparison with subsequent changes to the MPDS.

Efficiency, Organizational↗

PubMed1982

The rural interhospital disaster plan: some new solutions to old problems.

The rural area is not immune to multi-casualty incidents, and the complete rural EMS System reported here includes a plan to deal with one. The Susquehanna Valley Health Care Consortium was developed with this in mind, and addresses the points pertinent to the rural setting, including the large area served, available medical care, prehospital transport, and communications. Six hospitals in five counties participate. New approaches to these problems, which emerged after three field tests, are: participants must be organized for successful triage and resuscitation; crowd and traffic control by police is mandatory; an overall commander is necessary; two-way communication by several methods must be available; an administrator should track all victims; and air evacuation capability should be arranged.

Disaster Planning↗

PubMed2005

[Disease outbreak monitoring system based on ambulance transport data].

INTRODUCTION: Disease outbreak monitoring is relevant not only for naturally occurring diseases but also for detecting a biological terror event. Surveillance systems are already operational in Denmark, but none of these has the high update frequencies necessary for early warning, and the majority monitor specific infectious diseases. MATERIALS AND METHODS: An early-warning system for detection of disease outbreaks in Denmark based on ambulance transport frequency was developed and tested employing a biological outbreak scenario. RESULTS: The system, termed "Bioalarm", demonstrated an ability to adapt to minor statistical variations due to, e.g., mild influenza epidemics and at the same time to elicit an early warning in the event of a outbreak consistent with a bioterrorist attack. CONCLUSION: Bioalarm not only is relevant for early warning of a disease outbreak as a result of a biological attack but also facilitates early detection of naturally occurring outbreaks.

Ambulances↗

PubMed1991

Role of emergency medical services.

For thrombolytic therapy to be effective in the treatment of acute myocardial infarction, the patient must enter the health care center delivery system in an efficient manner. Some entry delays are due to patient decisions and interactions with others. In the United States, prehospital care is delivered by a variety of different systems, varying from public service types such as fire-department based to private types of service. These personnel vary in level of training from paramedics with a high level of training to Emergency Medical Technicians-Ambulance with basic training (first aid), even less in some areas. The training should be upgraded so that training as an emergency medical technician with the ability to defibrillate would be the minimum level for emergency ambulance personnel; wherever economically and logistically feasible, ambulance personnel should be paramedics. Although the 911 emergency telephone system exists in some areas, there is no centralized, universal system for access, causing confusion and delays in obtaining care in critical situations such as cardiac arrest. There is a need for a national emergency number--911--with the ability to identify the calling number and address. Since dispatchers have little medical dispatch training, needed instructions are not given to the caller, which can reduce the patient's chance of survival. Trained dispatchers are needed to dispatch resources efficiently and to offer assistance until trained rescuers arrive. Ambulances are inefficiently located in some areas of the United States, slowing response to the patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergency Medical Service Communication Systems↗

PubMed2005

802.11 wireless infrastructure to enhance medical response to disasters.

802.11 (WiFi) is a well established network communications protocol that has wide applicability in civil infrastructure. This paper describes research that explores the design of 802.11 networks enhanced to support data communications in disaster environments. The focus of these efforts is to create network infrastructure to support operations by Metropolitan Medical Response System (MMRS) units and Federally-sponsored regional teams that respond to mass casualty events caused by a terrorist attack with chemical, biological, nuclear or radiological weapons or by a hazardous materials spill. In this paper, we describe an advanced WiFi-based network architecture designed to meet the needs of MMRS operations. This architecture combines a Wireless Distribution Systems for peer-to-peer multihop connectivity between access points with flexible and shared access to multiple cellular backhauls for robust connectivity to the Internet. The architecture offers a high bandwidth data communications infrastructure that can penetrate into buildings and structures while also supporting commercial off-the-shelf end-user equipment such as PDAs. It is self-configuring and is self-healing in the event of a loss of a portion of the infrastructure. Testing of prototype units is ongoing.

Computer Communication Networks↗

PubMed1987

A dispersed alarm system for the elderly and its relevance to local general practitioners.

This paper describes the use of a dispersed alarm system for the elderly in the Central region of Scotland. Information from referral forms, questionnaires completed by wardens after a call and client registers were used to investigate the population served, sources of referral and the way the service was used. All the general practitioners working in the area covered by the service were sent a questionnaire asking for their views of the service. In May 1984 the alarm system covered 861 clients in private housing and 1259 in sheltered housing. Over 50% of referrals were from the health services and the most common reasons for referral were poor mobility and falls. False alarms accounted for 40% of calls and they were more likely to be from clients in sheltered housing than in private housing. Of genuine calls 71% were due to illness or disability with 25% due to falls. All of the general practitioners responding to the questionnaire were aware of a patient in their practice covered by the service and considered that the service provided useful 24-hour support for the elderly at risk because of frailty and disability

Aged↗

PubMed2005

International EMS systems in South Africa--past, present, and future.

Emergency medical services (EMS) in South Africa have developed rapidly over the last 20 years. However, there is inequitable distribution of services, with many rural areas being poorly resourced. This is partly as a result of the historical inequalities prevalent in the South African society of the past; efforts are being made to address this. EMS training is provided at basic, intermediate and advanced levels. The advanced level of training is comparable with the best in the world. Emergency care practitioners are registered with the Health Professions Council of South Africa and are thereby subject to the regulations, scope of practice and disciplinary structures of the council. Response times vary from 15 min in sophisticated urban systems to 40 min or longer in some rural services. Emergency departments (ED) are very busy, usually overloaded with patients, often poorly resourced and are similar to "Casualty Departments" that existed in the UK in the past. Facilities, staff and equipment are variable, and until recently there has been no formal career structure for emergency doctors. The introduction of emergency medicine as a new full speciality in 2004 will transform emergency care in Southern Africa, and appropriate training programmes are already being developed, together with progressive upgrading of emergency departments. EMS personnel face a vast spectrum of clinical cases, particularly all forms of trauma. Recent improvements in organisation, education and resources, coupled with better distribution of services, upgraded emergency departments and the development of emergency medicine as a speciality, should provide a significant boost for emergency care for the community.

Emergency Medical Service Communication Systems↗

PubMed2004

Information technology and emergency medical care during disasters.

Disaster response to mass-casualty incidents represents one of the greatest challenges to a community's emergency response system. Rescuers, field medical personnel, and regional emergency departments and hospitals must often provide care to large numbers of casualties in a setting of limited resources, inadequate communication, misinformation, damaged infrastructure, and great personal risk. Emergency care providers and incident managers attempt to procure and coordinate resources and personnel, often with inaccurate data regarding the true nature of the incident, needs, and ongoing response. In this chaotic environment, new technologies in communications, the Internet, computer miniaturization, and advanced "smart devices" have the potential to vastly improve the emergency medical response to such mass-casualty incident disasters. In particular, next-generation wireless Internet and geopositioning technologies may have the greatest impact on improving communications, information management, and overall disaster response and emergency medical care. These technologies have applications in terms of enhancing mass-casualty field care, provider safety, field incident command, resource management, informatics support, and regional emergency department and hospital care of disaster victims.

California↗

PubMed1985

A priority dispatch system for emergency medical services.

A decision tree priority dispatch system for emergency medical services (EMS) was developed and implemented in Atlanta and Fulton County, Georgia. The dispatch system shortened the average response time from 14.2 minutes to 10.4 minutes for the 30% of patients deemed most urgent (P less than or equal to .05); resulted in a significant increase in the use of advanced life support units for this group (P less than or equal to .02); decreased the number of calls that required a backup ambulance service; and significantly increased conformity to national EMS response time standards for critically ill and injured patients (P less than or equal to .0009). Due to dispatch error, 0.3% of calls were dispatched as least severe but subsequently were found to be most urgent.

Emergency Medical Service Communication Systems↗

PubMed2003

Trauma care systems in Japan.

The trauma care system in Japan was set up in the 1960s in response to social problems caused by traffic accidents and has since been altered extensively. First-aid and patient transfer are performed by emergency personnel belonging to a fire station. Instead of 'western-style trauma centres', three types of facilities exist: (1) primary emergency care facilities for treating mild cases not requiring hospitalisation; (2) secondary emergency hospitals directed to treating moderately severe disease or injury; (3) tertiary emergency hospitals corresponding to the emergency departments of university hospitals, or lifesaving emergency centres, able to manage the most severe cases such as myocardial infarction, cerebrovascular accident and polytrauma. Although the quantity of emergency facilities and hospitals appears sufficient, the quality of emergency care needs to be improved. This could be accomplished by the unification of small hospitals to create larger hospitals, and/or by the establishment of trauma centres, as well as by improvements in relevant education and training.

Accidents, Traffic↗

PubMedDate not supplied

Optimal prehospital cardiovascular care.

Optimal prehospital cardiovascular care may improve the morbidity and mortality associated with acute myocardial infarctions (AMIs) that begin in the community. Reducing the time delays from AMI symptom onset to intervention begins with maximizing effective patient education to reduce patient delay in recognizing symptoms and seeking assistance. Transportation delays can be minimized by appropriate use of 911 systems and improving technological 911 support. Patient triage to heart centers from the prehospital setting requires strict and comprehensive definition of the criteria for these centers by competent, unbiased clinical societies or governmental agencies. Prehospital 12-lead electrocardiograms and initiation of thrombolytic therapy can provide acute diagnosis and early treatment, thus facilitating faster processing and more directed in-hospital intervention. They also minimize over- and undertriage of patients to cardiac centers. Although evidence from investigational trials suggests that many of these procedures are effective, more research is required to ensure correct implementation and quality assurance at all emergency service levels.

Chest Pain↗

PubMed1989

On-line medical command in theory and practice.

Paramedics are often required to use on-line medical command (OLMC) when they provide advanced life support. We evaluated the efficacy of OLMC use under this broad patient inclusion rule and limited paramedic discretion. OLMC was associated with an average of an eight-minute longer on-scene time, and an infrequent rate of physician-directed deviation from written treatment protocols (3.7% of all OLMC calls). Of the system's advanced life support patients, 6.1% experienced changes in their prehospital health status, reflected in changes in the patient's level of consciousness. OLMC use was associated with improved health status in 5.5% of patients compared with 3.2% for those treated without OLMC (P = .1). The health status of 1.3% of the patients treated with OLMC deteriorated. This was not significantly different from the 1.1% of patients treated without OLMC whose status deteriorated. We suggest that targeted OLMC use with expanded paramedic discretion may improve the efficacy of OLMC. Further controlled comparative studies of OLMC efficacy under targeted OLMC use versus broad patient inclusion rules are needed.

Efficiency↗

PubMed1990

The potential for prehospital thrombolytic therapy.

Several large trials of thrombolytic therapy have shown that treatment initiated in the first 1 or 2 hours following the onset of symptoms of acute myocardial infarction (AMI) is more effective than therapy started later in the course of illness. From our experience in three thrombolytic trials we concluded it would be difficult to reduce the total time from symptom onset to therapy without a major change in patient management. To accomplish this goal we have initiated MITI (Myocardial Infarction Triage and Intervention Project), a program for the prehospital diagnosis of AMI using specially trained paramedics, a checklist to establish eligibility for and contraindications to thrombolytic therapy, and a portable, battery-powered 12-lead electrocardiography (ECG) cellular telephone system that allows an electrocardiographic diagnosis to be made remotely by an emergency department physician. In the feasibility phase of MITI, 2,472 patients with chest pain of presumed cardiac origin were evaluated; 677 (27%) met the rigorous history and physical exam inclusion and exclusion criteria for potential thrombolytic therapy and had an ECG performed in the field. Of these ECGs, 522 were transmitted successfully by cellular telephone to a base station physician. Of the 522 patients, 107 had ST-segment elevation and met our criteria for initiation of thrombolytic therapy. Of the 2,472 patients with chest pain evaluated by the emergency medical technicians, 453 (18%) were diagnosed with AMI during hospitalization. Of these AMI patients, only 105 (23%) met the clinical examination and ECG criteria for pre-hospital thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergency Medical Service Communication Systems↗

PubMed1995

An assessment of prehospital provider needs in Wisconsin.

The Emergency Medical Systems Advisory Board assessed via questionnaire the needs of Wisconsin prehospital providers. Overall, 323 out of 453 (71.3%) of the services responded to the query. Intermediate and paramedic services were more likely to respond than those prehospital providers offering basic services. Of the respondents, however, 235 (72.8%) identified their service as basic. In addition to providing information about service characteristics, each responding provider also rated its perceived needs. All prehospital providers, regardless of service level, ranked "lack of medical director" as the issue of greatest concern. Continuing on, intermediate and basic providers rated difficulty in recruiting new staff as the second greatest need. Paramedic providers, however, identified dispatching as their second greatest need. Rural providers rated difficulty in recruiting new staff and difficulty in collecting ambulance fees as their second and third greatest needs, respectively. Urban providers, meanwhile, indicated difficulty in collecting ambulance fees and access to local training as the second and third top needs, respectively. With the proposed new curriculum for basic EMT services, the needs for local medical direction will be even greater.

Ambulances↗