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Results for “Emergency Medical Service Communication Systems”

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At least 109 records · Page 6Linked to original sources
PubMed2006

Out-of-hospital resuscitation in Estonia: a bystander-witnessed sudden cardiac arrest.

OBJECTIVE: To evaluate the results of the first epidemiological study on out-of-hospital resuscitation in Estonia. METHODS: A prospective cohort study of 2108 consecutive standardized reports on out-of-hospital resuscitation attempts from 1 January 1999 to 31 December 2002 was conducted according to the Utstein style. RESULTS: In all, 67.3% (1419/2108) of the cardiac arrests were of presumed cardiac aetiology and 60.2% (854/1419) of them were bystander-witnessed. Of these, the 28% bystander cardiopulmonary resuscitation was initiated, and the first rhythm was recorded as ventricular fibrillation or pulseless ventricular tachycardia in 40% of the cases. In the subgroup of patients with bystander-witnessed cardiac arrest of cardiac origin, 10.7% (91/854) were discharged alive in good cerebral performance categories and 7.7% were alive at the 1-year follow-up. The chances of survival increased if the median response time interval was <6 min, cardiac arrest occurred in a public place, patients received bystander cardiopulmonary resuscitation and had an initial rhythm of ventricular fibrillation or pulseless ventricular tachycardia. The discharge rate was 24% (82/343) in the subgroup of patients who had bystander-witnessed cardiac arrest of cardiac origin and an initial rhythm of ventricular fibrillation or pulseless ventricular tachycardia. In this subgroup, the survival rate was 42.6% (40/94) in Tartu urban area, 16.9% (22/130) in Tallinn urban area and 16.8% (20/119) in other regions of Estonia (mostly urban and suburban areas). CONCLUSION: The results demonstrate that despite the progress in the management of out-of-hospital cardiac arrest in Estonia, only one centre (Tartu) achieves a better survival rate. Further improvements are needed to raise the quality of the Estonian emergency medical services system, especially in rural areas.

Aged↗
PubMedDate not supplied

Prehospital consideration of sildenafil-nitrate interactions.

OBJECTIVE: To determine whether paramedics and on-line physicians screen patients for use of sildenafil citrate (Viagra) prior to prehospital administration of nitrates. METHODS: A prospective, observational study was performed over a one-month period in three EMS systems. Consecutive radio communications between on-line physicians and paramedics concerning male patients with cardiac complaints were monitored. Investigators observed the frequency with which on-line physicians screened for sildenafil use prior to ordering nitrates. After observation of the radio communications was completed, a written survey was distributed to all paramedics in the three EMS systems. RESULTS: Seventy-six physician-paramedic interactions were monitored. Nitrates were ordered by on-line physicians in 56 cases. No paramedic reported sildenafil use/nonuse, and no on-line physician inquired about the patient's potential use of the drug. Only half of the surveyed paramedics reported that they routinely screen for sildenafil use, and approximately a fourth reported that its use would not alter their management of chest pain patients. CONCLUSION: In this study, on-line physicians in three EMS settings did not screen for sildenafil use prior to ordering nitrates. While some paramedics do screen for sildenafil use, practice patterns among paramedics in these three systems were inconsistent.

Aged↗
PubMed1990

Mass casualty incident. Integration with prehospital care.

Mass casualty incident involves the use of limited resources for multiple casualties. The emergency physician must be familiar with both prehospital and hospital plans for mass casualty care in order to facilitate optimal care and to maintain the continuum from field care to definitive treatment. It is essential that the emergency physician become involved in the disaster planning processes to ensure that the victims receive the best care available under the circumstances and that the safety and emotional well-being of both prehospital and hospital personnel are assured. Emergency physicians involved in prehospital care should be certain that the local EMS system has adequate training and chances to update their skills and knowledge. Disaster drills of the EMS system are excellent ways to practice, to identify weaknesses, and for preplanning to enhance disaster medical care.

Disaster Planning↗
PubMed2005

Have the implementation of a new specialised emergency medical service influenced the pattern of general practitioners involvement in pre-hospital medical emergencies? A study of geographic variations in alerting, dispatch, and response.

OBJECTIVES: Emergency medical service systems in Norway are based on equity and equality. A toll free number (113) and criteria based dispatch are crucial components. The establishment of an emergency medical system (EMS) manned by an air and ground emergency physician (EP) has challenged the role of the general practitioner (GP) in emergency medical care. We investigated whether there were any geographical differences in the use of 113, alerts to GPs by the emergency medical dispatch centres (EMDCs), and of the presence of GPs on scene in medical emergencies leading to a turnout of the EP manned EMS. METHODS: This was a prospective, observational cohort study of 385,000 inhabitants covered by the two EMDCs of Rogaland county, Norway, including 1035 on scene missions of the EP manned EMS during the period 1998-99. RESULTS: The proportion of emergency calls routed through 113 was significantly lower, the proportion of alerts to GPs significantly higher, and the proportions of GPs on scene significantly higher in rural than urban areas. CONCLUSION: We found geographical differences in the involvement of GPs in pre-hospital emergency medical situations, probably caused by a specialised emergency medical service system including an EMDC and an air and ground EP manned EMS. There were geographical differences in public use of the toll free 113, and alerts to GPs by the EMDCs, which is likely to result from geographical conditions and proximity to medical resources. Future organisation of the EMS has to reflect this to prevent unplanned and unwanted autonomously emerging EMS systems.

Adolescent↗
PubMed2006

Treatment area considerations for mass casualty incidents.

Mass casualty response is one of the most difficult aspects of emergency medical services. The medical incident command system is designed to treat and stabilize patients in a safe and effective manner. At the center of this is the treatment area. A well-thought-out, adequately staffed treatment area will greatly enhance any system's ability to meet and exceed the demands of almost any multicasualty event.

Decision Making, Organizational↗
PubMed2001

Medical direction and EMS.

Excellent training and operating protocols will improve patient care, and that is the ultimate goal of the EMS system. Online communication is a valuable enhancement to written protocols and requires excellent reporting skills on both ends of the conversation.

Communication↗
PubMed1985

Comparison of clinical CPR studies in Milwaukee and elsewhere in the United States.

As we mark the 25th anniversary of the clinical application of closed-chest cardiopulmonary resuscitation (SCPR), it is time to look back and analyze the progress we have made in the resuscitation of sudden death syndrome. Recent studies of SCPR's effectiveness have yielded mixed results, in comparison to early studies that were universally favorable. The continued toll of neurologic injury following SCPR resuscitation, and reinforcement of the importance of defibrillation in resuscitation, stimulate us to find improved forms of SCPR and improved methods of resuscitation delivery in emergency medical systems.

Electric Countershock↗
PubMed1989

[Electronics against fear, emergency call systems for the elderly].

When in a critical situation, the elderly persons living alone at home often can no longer make a telephone call for help. An electronic system for emergency calls is helpful and can even save lives. The system permits to the elderly people to live alone in their homes.

Activities of Daily Living↗
PubMed1982

Computer-aided emergency telecommunications for the deaf.

Computer-aided telecommunications provide deaf teletypewriter users with 24-hour toll-free access to emergency services. An interface and software link the deaf caller's teletypewriter (TDD) with a microprocessor by reducing and inverting voltage levels between the two devices. This system facilitates rapid transmission of linguistically controlled triage questions to meet the communication needs of deaf patients.

Communication Devices for People with Disabilities↗
PubMed2005

Development of the trauma emergency care system based on the three links theory.

The three links theory applied in trauma emergency care system refers to an integrated system with the three important components of trauma emergency care system, viz. prehospital trauma services, hospital trauma services and critical care services. The development of the trauma emergency care system should be guided by the three links theory so as to set up a practical and highly efficient system: a prompt operating and monitoring transportation system, a smooth and real-time information system, a rational and sustainable system of regulations and contingency plans, and a system for cultivating all-round trauma physicians.

China↗
PubMedDate not supplied

A pediatric survey for the National Highway Traffic Safety Administration: emergency medical services system re-assessments.

Emergency medical services for children, or EMSC, is still a relatively underdeveloped component of most state and local EMS systems. Advocacy and funding for EMSC from the federal EMSC Program, availability of many useful EMSC products, and the rapidly enlarging literature in EMSC have created heightened awareness and interest in improving systems for pediatric emergency, trauma, and critical care. The new National Highway Traffic Safety Administration (NHTSA) EMS Technical Assistance (TA) re-assessment program, the second version of the successful original TA Program from 1988 to 1996, provides an ideal opportunity for state EMS professionals to evaluate EMSC capabilities and to integrate new EMSC products and services. The history of the TA Program reflects the evolution of EMS itself and indicates a historical inattention to children's issues, but re-assessment TA teams now have much useful intervening EMSC history to draw upon and a clear philosophical mandate to integrate children more fully in EMS system planning and management. In order to facilitate state-of-theart reviews of EMSC within state EMS systems, a pediatric survey for the NHTSA re-assessments is presented. The survey, developed with the input of EMS administrators and physicians and approved by the National Association of State EMS Directors, follows the original ten-component model for EMS system review. It is intended for optional use within the overall EMS review process.

Child↗
PubMedDate not supplied

Understanding emergency medical dispatch in terms of distributed cognition: a case study.

Emergency medical dispatch (EMD) is typically a team activity, requiring fluid coordination and communication between team members. Such working situations have often been described in terms of distributed cognition (DC), a framework for understanding team working. DC takes account of factors such as shared representations and artefacts to support reasoning about team working. Although the language of DC has been developed over several years, little attention has been paid to developing a methodology or reusable representation which supports reasoning about an interactive system from a DC perspective. We present a case study in which we developed a method for constructing a DC account of team working in the domain of EMD, focusing on the use of the method for describing an existing EMD work system, identifying sources of weakness in that system, and reasoning about the likely consequences of redesign of the system. The resulting DC descriptions have yielded new insights into the design of EMD work and of tools to support that work within a large EMD centre.

Ambulances↗
PubMed1997

Measuring response intervals in a system with a 911 primary and an emergency medical services secondary public safety answering point.

STUDY OBJECTIVE: Measurement of interval data is important in the accurate recording of events that occur in an emergency medical services system. Measurement of intervals should be a simple task. However, when two separate clocks are needed to record the beginning and end of an interval, accurate measurement may be difficult. We sought to accurately measure the 911 call receipt-to-vehicle departure and 911 calls receipt-to-patient access intervals in a system with primary and secondary public safety answering points (PSAPs). METHODS: We conducted a descriptive study between January 1 and July 31, 1993. All 911 calls beginning at the primary PSAP, transferred to the EMS secondary PSAP, and ending with patient access times were eligible. Clock-synchronization errors and unavailability of 911 time logs were the criteria for exclusion. We measured the 911 call receipt-to-vehicle departure interval by adding the primary-PSAP and the EMS secondary-PSAP call-processing intervals. The 911 call receipt-to-patient access interval was the absolute difference between the time when the 911 primary-PSAP phone range and the time of patient access recorded by EMS personnel. RESULTS: The data were best described with median and interquartile ranges (IQRs). We found 1,945 calls that met inclusion criteria. Of these, 270 were deleted because of clock errors and 616 for time log unavailability, yielding 1,059 calls for interval determinations. The median 911 call receipt-to-vehicle departure interval was 1.7 minutes (IQR, 1.2 to 2.2 minutes). The median 911 call receipt-to-patient access interval was 8.2 minutes (IQR, 6.4 to 10.5 minutes). CONCLUSION: The 911 call receipt-to-vehicle departure and 911 call receipt-to-patient access intervals can be accurately measured in a system with two separate PSAP computer-aided dispatch clocks. These intervals are variable and often lengthy.

Ambulances↗
PubMed2001

2000 200-city survey. Operational & clinical EMS trends in large, urban areas.

The year's survey illustrated ongoing stability with respect to providers and operational approaches, and explored relationships that could provide opportunities for improvement. The continued use of hot response to every request for service is a high-risk response strategy. Today's EMD protocol systems can enable systems to safely prioritize requests for service. Response time performance reported by measure interval and averaged response time, while appearing to follow a rational model for transportation providers, fell short with respect to first responder response times which appeared to have no correlation with response clock start times. A possible explanation for this difference is the lower percentage of first responder agencies that are subject to external response-time performance review. The medical direction results suggest an investment in a full-time medical director could reduce online medical control requirements. The use of handheld computing technology could serve as a vehicle for building accurate clinical databases, as well as a means to deliver DS technology to the patient's bedside. Use of this technology could also improve reimburesment through more accurate reporting. The future of EMS has enormous challenges that must be overcome, especially in light of reduced health-care insurance reimbursements. However, these challenges also present an opportunity for EMS to reinvent itself. The capture and analysis of operational and clinical data by EMS systems will prove essential to understanding what changes can be made to enable them to meet future demands.

Data Collection↗
PubMedDate not supplied

Ensuring the chain of recovery for stroke in your community. Chain of Recovery Writing Group.

Until recently, the prehospital and emergency department management of nonhemorrhagic stroke was largely supportive care. Studies now have demonstrated the potential of certain therapeutic interventions to reverse the debilitating consequences of such strokes. But despite the potential benefit, there exists a clear time dependency for such interventions, not only to ensure therapeutic efficacy, but also to diminish the likelihood of significant therapeutic complications. In turn, to optimize the chances of a better outcome for the patient with stroke, each community must establish and continue to refine a chain of recovery for stroke patients. The chain of recovery is a metaphor that describes a series of sequential actions that must take place in a timely fashion to optimize the chances of recovery from stroke. Each of these sequential actions forms an individual link in the chain, and each link must be intact. The links include: identification of the onset of stroke symptoms by the patient or bystanders; dispatch life support services, which preferably include enhanced 9-1-1 and medically supervised and trained dispatchers who can rapidly deploy the closest responders and transport units; emergency medical services (EMS) personnel who can rapidly assess and transport the stroke patient to the closest appropriate center capable of providing advanced stroke diagnostics and interventions; en route notification of the receiving facility so that appropriate personnel can be readied for rapid diagnosis and intervention; and receiving facilities capable of providing rapid diagnosis and advanced treatment of stroke, including the availability of specialists who can evaluate underlying etiologies as well as plan future therapies and rehabilitation. To ensure that the chain of recovery is in place, aggressive public education campaigns should be implemented to increase the probability that stroke symptoms and signs will be recognized as soon as possible by patients and bystanders. In addition, because most of the current training programs for EMS dispatchers and prehospital care personnel are lacking with regard to stroke, it is recommended that such personnel and their EMS system managers be updated on current management and treatment strategies for stroke.

Cerebrovascular Disorders↗
PubMed2003

Implications of the World Trade Center attack for the public health and health care infrastructures.

The September 11, 2001, attack on the World Trade Center had profound effects on the well-being of New York City. The authors describe and assess the strengths and weaknesses of the city's response to the public health, environmental/ occupational health, and mental health dimensions of the attack in the first 6 months after the event. They also examine the impact on the city's health care and social service system. The authors suggest lessons that can inform the development of a post-September 11th agenda for strengthening urban health infrastructures.

Aircraft↗