PubMed Health⌕ Search

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 145 records · Page 8Linked to original sources
PubMedDate not supplied

System implications of the ambulance arrival-to-patient contact interval on response interval compliance.

BACKGROUND: In some emergency medical services (EMS) system designs, response time intervals are mandated with monetary penalties for noncompliance. These times are set with the goal of providing rapid, definitive patient care. The time interval of vehicle at scene-to-patient access (VSPA) has been measured, but its effect on response time interval compliance has not been determined. PURPOSE: To determine the effect of the VSPA interval on the mandated code 1 (< 9 min) and code 2 (< 13 min) response time interval compliance in an urban, public-utility model system. METHODS: A prospective, observational study used independent third-party riders to collect the VSPA interval for emergency life-threatening (code 1) and emergency nonlife-threatening (code 2) calls. The VSPA interval was added to the 9-1-1 call-to-dispatch and vehicle dispatch-to-scene intervals to determine the total time interval from call received until paramedic access to the patient (9-1-1 call-to-patient access). Compliance with the mandated response time intervals was determined using the traditional time intervals (9-1-1 call-to-scene) plus the VSPA time intervals (9-1-1 call-to-patient access). Chi-square was used to determine statistical significance. RESULTS: Of the 216 observed calls, 198 were matched to the traditional time intervals. Sixty-three were code 1, and 135 were code 2. Of the code 1 calls, 90.5% were compliant using 9-1-1 call-to-scene intervals dropping to 63.5% using 9-1-1 call-to-patient access intervals (p < 0.0005). Of the code 2 calls, 94.1% were compliant using 9-1-1 call-to-scene intervals. Compliance decreased to 83.7% using 9-1-1 call-to-patient access intervals (p = 0.012). CONCLUSION: The addition of the VSPA interval to the traditional time intervals impacts system response time compliance. Using 9-1-1 call-to-scene compliance as a basis for measuring system performance underestimates the time for the delivery of definitive care. This must be considered when response time interval compliances are defined.

Ambulances↗
PubMed1994

Telephone triage of cardiac emergency calls by dispatchers: a prospective study of 1386 emergency calls.

OBJECTIVES: To evaluate the handling of potential cardiac emergency calls by dispatchers, to determine their final diagnosis and urgency, and to determine the value of the main complaint in predicting urgency and the ability of the dispatchers to recognise non-urgent conditions. DESIGN: Prospective data collection and recording of main complaint of emergency calls placed via the 06-11 alarm telephone number with follow up to hospital when the patients were transported and the general practitioner when they were not. SETTING: Dispatch centres of the emergency medical services in Amsterdam (urban area) and Enschede (rural area). PATIENTS: 1386 consecutive adult subjects of emergency calls placed by citizens about chest problems or unconsciousness not caused by injury. MAIN OUTCOME MEASURES: Frequency of characteristics of the calls, outcome in diagnosis, and assessment of urgency. RESULTS: 69 (5%) patients were dead when the ambulance arrived. Diagnosis was established in 1071 patients (77%). The disorders most often reported were cardiac, with acute ischaemia in 15% of all subjects. In 28% of cases and for each presenting complaint no organic explanation was found. Overall 39% of all emergency calls were urgent; the urgency rate was lowest for calls for people with abdominal discomfort. Dispatchers correctly identified 90% of the non-urgent calls, but 55% of the calls that they identified as urgent proved to be non-urgent. CONCLUSION: Currently, direct dialling for an ambulance without the intervention of a general practitioner imposes a high work load on emergency systems and hospitals because triage by dispatchers is not sufficiently accurate. It may be possible to increase the accuracy of triage by developing and testing decision algorithms.

Acute Disease↗
PubMed2003

Emergency image transfer system through a mobile telephone in Japan: technical note.

OBJECTIVE: We report the first application and usefulness of image transfer through a mobile telephone, which can be used between the hospital and another location. METHODS: With this system, brain computed tomographic scans, magnetic resonance images, and angiograms obtained from more than 100 patients in the emergency department were transferred and diagnostically analyzed via a mobile phone. The mobile phone had a 110,000-pixel digital camera and a built-in thin-film transistor liquid crystal display. We reviewed the distribution of pathological characteristics on the transferred images and compared them with the diagnoses made using full-scale original film. RESULTS: This system of transferring images was useful in all cases for correct early diagnosis and early treatment. The quality of magnetic resonance images received was better than that of computed tomographic scans. Hemorrhage provided better contrast than infarction for allowing easy identification. Cerebral angiography revealed small aneurysms if the target area was focused properly. Image quality was sufficient for interpretation despite the small dimensions of the monitor. Ease of operation and portability were both satisfactory. The mean time from commencement of image uptake to complete reception was 2 to 3 minutes. CONCLUSION: The mobile phone system is adequately useful for early diagnosis and initiation of treatment in emergent cases. This is attributable to its low cost and ease of handling for sending images to remote areas and between hospitals, despite the small dimensions of the monitor. Better-quality image transfer will be realized through an advanced mobile phone system based on the new International Mobile Telecommunication 2000 standards, which also will be useful in the development of telemedicine and telecare.

Brain Injuries↗
PubMedDate not supplied

EMS systems and managed care integration.

Emergency medical services systems and MCOs must cooperate and educate each other in order to effect delivery of reliable, high-quality emergency health care to the entire community. Shared goals are rapid access, medically appropriate care, and operational efficiency. An integrated approach is necessary in order to maintain the integrity of EMS systems. EMS systems serve as a safety net for patients with perceived emergencies. Changes in form and function should be guided by outcome studies that ensure the continued delivery of quality emergency health care services.

Cooperative Behavior↗
PubMedDate not supplied

Developing research criteria to define medical necessity in emergency medical services.

"The Neely Conference: Developing Research Criteria to Define Medical Necessity in EMS" convened emergency medical services (EMS) physicians, researchers, administrators, providers, and federal agency representatives to begin the development of a set of uniform triage criteria and outcome measures that could be used to study and evaluate medical necessity among EMS patients. These standardized criteria might be used in research studies examining EMS dispatch and response (e.g., dispatch triage protocols, alternative response configurations), and EMS treatment and transport (e.g., field triage protocols, alternative care destinations). The conference process included review and analysis of the literature, expert judgment, and consensus building. There was general agreement on the following: 1. Any dispatch triage or field triage system that is developed must be designed to offer patients alternatives to EMS, not to refuse care to patients. 2. It is theoretically possible to develop a set of clinical criteria for need. Some groups of patients will clearly need a traditional EMS response and other groups will not, but this has yet to be defined. 3. In addition to clinical criteria, certain social and other nonclinical criteria such as pain or potential abuse may be used to justify a response. 4. Communication barriers, patient age, special needs, and other conditions complicate patient assessment but should not exclude patients from consideration for alternate triage or transport. 5. These research questions are important, and standard sets of outcome measures are needed so that different studies and innovative programs can be compared.

Adult↗
PubMedDate not supplied

Personal emergency response systems.

A personal response system is a signaling device that summons help during an emergency. Although personal response systems vary widely, there are three components. The first component is the electronic hardware in the home, which consists of portable and installed sensors and the control console. The second component is the emergency response center, which is either provider-based or manufacturer-based. The third component involves the dispatch of appropriate assistance. The primary users of personal response systems are women in their seventies and eighties who live alone and who have cardiac and musculoskeletal problems, which make them prone to falls. The frequency of personal response system use varies from an average of 0.44 to 0.84 emergencies per subscriber per year. Program coordinators believe that personal response systems help to delay institutionalization, reduce admissions to hospitals, substantially shorten hospital stays, and reduce the duration of home attendant services. The most favorable impact of the personal response system has been its psychologic value to the users and their families.

Aged↗
PubMed2003

Trauma care systems in Australia.

The management of orthopaedic trauma in Australia varies from the urban model common to most developed countries to a model determined by the vast distances of the island continent. The effectiveness of this system is largely dependent on the retrieval system and treatment protocols of severe injuries often revolve around prolonged contamination of traumatic wounds. The place of the Royal Flying Doctor Service (RFDS) in providing the "Mantle of Safety" for remote and rural Australia is highlighted.

Air Ambulances↗
PubMed1995

Critical issues in urban emergency medical services for children.

In order to be effective those wishing to improve emergency care of children in an urban environment must be aware of barriers as well as resources. Urban children are at high risk for requiring emergency care as a result of both illness and injury. These children face a dangerous environment resulting from the problems of poverty, homelessness, overcrowded living conditions, drug abuse, and a shrinking tax base. They face this nation's highest rates of violent injury (intentional and unintentional), immunization delays, and preventable infectious diseases such as TB and measles. In addition, they have poor access to quality primary health care and suffer the greatest morbidity rates from chronic diseases such as asthma and diabetes. On the other hand, there is great opportunity to ensure that urban children receive quality emergency health care. The urban environment is rich in "centers of pediatric excellence," which often have paid full-time EMS systems in operation, and is the locale in which the majority of pediatric emergency medicine specialists and prehospital advanced life support providers practice. The child advocate must work to ensure that the urban child can benefit from these resources.

Ambulances↗
PubMedDate not supplied

The use of emergency medical dispatch protocols to reduce the number of inappropriate scene responses made by advanced life support personnel.

OBJECTIVES: To determine whether implementation of an emergency medical dispatch (EMD) system would reduce the rate of inappropriate advanced life support (ALS) utilization, and enable more accurate identification of those patients requiring ALS care. METHODS: An emergency medical services (EMS) site providing basic life support (BLS) and ALS care to a population of 200,000 served as the study site for calendar year 1996. This study compared the prospective identification of patients as ALS or BLS using EMD with that using chief complaint-based dispatch criteria. Each patient served as his or her own control. The ALS or BLS priority was assigned using both chief complaint and EMD criteria. Chief complaint-based dispatching meant that all patients with preestablished chief complaints received ALS without further triage questions, while EMD allowed the dispatchers to question callers using a scripted set of questions. The outcome measures included the number of calls categorized as ALS or BLS, the number of calls cancelled by BLS, and the number of ALS calls released to BLS care. Yates-corrected chi-square was used for statistical analysis. RESULTS: There were 11,174 patients enrolled. The use of EMD was associated with a significant decrease in the proportion of calls designated as ALS (44.7% vs 55.8%, p < 0.0001), as well as a significant decrease in the number of ALS responses cancelled by BLS (9.2% vs 23.8%, p < 0.0001) and patients released to BLS by medical control (4.7% vs 7.3%, p < 0.0001). CONCLUSIONS: Implementation of an EMD system significantly decreased inappropriate ALS dispatching, as defined by decreased rate of ALS cancellations and BLS releases. Further study is needed to see whether other EMD dispatch models may further refine ALS dispatch.

Emergency Medical Service Communication Systems↗
PubMed1998

EMT defibrillation does not increase survival from sudden cardiac death in a two-tiered urban-suburban EMS system.

OBJECTIVE: The use of automatic external defibrillators (AEDs) by EMS initial responders is widely advocated. Evidence supporting the use of AEDs is based largely on the experience of one metropolitan area, with effect on survival in many systems not yet proved. We conducted this study to determine whether the addition of AEDs to an EMS system with a response time of 4 minutes for first-responder emergency medical technicians (FREMTs) and 10 minutes for paramedics would affect survival from cardiac arrest. METHODS: This prospective, controlled, crossover study (AED versus no AED) of consecutive cardiac arrests managed by 24 FREMT fire companies took place from 1992 to 1995 in Charlotte, North Carolina, a city of 455,000. Patients were stratified using the Utstein criteria. The primary endpoint was survival to hospital discharge among patients with bystander-witnessed arrests of cardiac origin. RESULTS: Of the 627 patients, 243 were bystander-witnessed arrests of cardiac origin. Survival to hospital discharge was accomplished in 5 of 110 patients (4.6%; 95% confidence interval [CI] 0.6% to 8.4%) with AED compared with 7 of 133 (5.3%, 95% CI 1.5% to 9.1%) without AED (P = .8). Both groups were comparable with regard to age, gender, history of myocardial infarction, congestive heart failure or diabetes, arrest at home, bystander CPR, and whether or not ventricular fibrillation (VF) was the initial rhythm. For arrests of any cause, witnessed by bystanders or EMS personnel, with an initial rhythm of VF or ventricular tachycardia (VT), 5 of 77 (6.5%, 95% CI 1.0% to 12.0%) with AED survived compared with 8 of 105 patients (7.6%, 95% CI 2.5% to 12.7%) without AED (P = .8). Statistically significant differences were noted in race and EMS response times between the two groups, which did not affect survival. CONCLUSION: Addition of AEDs to this EMS system did not improve survival from sudden cardiac death. The data do not support routinely equipping initial responders with AEDs as an isolated enhancement, and raise further doubt about such expenditures in similar EMS systems without first optimizing bystander CPR and EMS dispatching.

Aged↗
PubMed1994

A study of Japan's emergency medical care system--emergency transportation and medical care service areas for tuberculosis patients.

Since 1988, there has been a noted increase in the use of emergency transportation by tuberculosis patients in Japan. Therefore it is necessary to build a suitable emergency medical care system for these patients. We evaluated the present emergency medical care system available to them in Tokyo. We also studied emergency medical care service areas (MCSAs) to further aid in the revision of the emergency medical care system for tuberculosis. We used data from tuberculous patients who required the use of the emergency medical care system in Tokyo. The data was collected by the Tokyo Fire Department's emergency care information system from 1978 to 1990. We investigated and analyzed data regarding transportation and patient data. We also analized transportation data from the point of view of municipal districts (wards, cities, towns, villages), MCSAs and the Tokubetsuku region. We concluded that the number of emergency transports for tuberculosis patients has gradually been increasing and that the currently MCSA regions were not ideal for use in developing a transportation system for these patients. Using larger areas such as Tokubetsu-ku and Tokyotoka would be more practical emergency medical care system for tuberculosis patients in Tokyo, it will be necessary to take into account the Tokubetsu-ku area, the vagrant population within it, and the time required to transport the patients from this area to the Tokyotoka area.

Catchment Area, Health↗
PubMed1989

[Operative central unit for coordinating the emergencies-urgencies department. Proposal for a mini-unit to solve the problems caused by the relation between volunteer associations and the public structure].

One of the most important problems, of very difficult solution, in organizing an A/E department is to co-ordinate the emergency in the field. This peculiar task is carried on by an operative central station, the core of an A/E Dept. The organizer in Arezzo try to find out the efficiency and a cost benefit ratio of this central station and try to jump over an historical hindrance to operate by mutual consent with voluntary service. This seems to be possible with the technological development of telephone system and broadcast system. Staff, technical qualifications, connections, reception, modulation, sorting out of different calls are discussed in conjunction with problems of health education concerning the operative central station that coordinates A/E Dept in Arezzo.

Emergency Medical Service Communication Systems↗
PubMedDate not supplied

The emergency care network of a ski marathon.

In this paper we report the system of emergency care that was used in a large-scale cross-country ski marathon. We describe the typical terrain encountered, personnel required, physical facilities, communication system, injury protocol, and types and numbers of injuries seen. We have found that many injuries can occur in a cross-country ski race, given specific race conditions. A complete and efficient emergency care network is essential to the success of any athletic event similar to the one we report. These races are rapidly growing in number and size, yet we could not find any previous reports in the literature pertaining to the medical care necessary. We hope to provide a model for emergency care that can be applied to many different athletic events involving large numbers of participants and covering great distances.

Athletic Injuries↗
PubMed1989

EMS communications: an inside look at New York City.

The opportunity to provide effective EMS begins at the point of citizen access, with successive links to emergency response and medical control. This responsibility places much pressure on the communications division of any EMS system. Communications specialists must be acutely aware that each flashing number on the computer screen represents someone in trouble--a person's life. This unique situation is highlighted when, through emergency medical instructions given over the phone to the caller, a life is saved. This type of event has become more common throughout the United States, with most EMS systems implementing proactive protocols for pre-arrival instructions. The strength of an EMS system directly correlates with the effectiveness of its communications center and the professionalism of communications personnel. Unlike other individuals in the EMS system, communications specialists rarely see their patients "in the flesh" and must experience the rewards of accomplishment vicariously through the actions of the crews dispatched. In the same vein, they also share the tragedies and disappointments that are all too often part of an EMS career.

Allied Health Personnel↗
PubMed2003

Use of ambulance dispatch data as an early warning system for communitywide influenzalike illness, New York City.

In 1998, the New York City Department of Health and the Mayor's Office of Emergency Management began monitoring the volume of ambulance dispatch calls as a surveillance tool for biologic terrorism. We adapted statistical techniques designed to measure excess influenza mortality and applied them to outbreak detection using ambulance dispatch data. Since 1999, we have been performing serial daily regressions to determine the alarm threshold for the current day. In this article, we evaluate this approach by simulating a series of 2,200 daily regressions. In the influenza detection implementation of this model, there were 71 (3.2%) alarms at the 99% level. Of these alarms, 64 (90%) occurred shortly before or during a period of peak influenza in each of six influenza seasons. In the bioterrorism detection implementation of this methodology, after accounting for current influenza activity, there were 24 (1.1%) alarms at the 99% level. Two occurred during a large snowstorm, 1 is unexplained, and 21 occurred shortly before or during a period of peak influenza activity in each of six influenza seasons. Our findings suggest that this surveillance system is sensitive to communitywide respiratory outbreaks with relatively few false alarms. More work needs to be done to evaluate the sensitivity of this approach for detecting nonrespiratory illness and more localized outbreaks.

Ambulances↗
PubMed1991

Advances in pediatric emergency medical service systems.

Only recently has attention turned to the needs of children in the EMS system, and it has been shown that there is work to be done if these needs are to be met. The founders of EMS systems were trained in adult specialties and worked without input from the pediatric community. It is not surprising that the special needs of children within an adult-oriented EMS system were underemphasized. Children make up less than 10% of prehospital runs and less than 5% of the critically ill patients. Numerous EMS systems nationwide are undertaking this work and federal support is evident through the Maternal and Child Health EMSC program. Vital issues include the need for experts in emergency medical services to work together with experts in pediatric emergency care and for sound program evaluations to be performed to demonstrate the efficacy of these new programs.

Child↗
PubMedDate not supplied

Building the Tower of Babel: cross-border urgent medical assistance in Belgium, Germany and The Netherlands.

The border area between Germany, Belgium, and The Netherlands includes a substantial number of cooperative forms in the urgent medical assistance sector. Collaboration usually takes place in densely populated areas with cities or villages situated on or in proximity to the border. In some regions, definitive borders are not apparent to the extent that inhabitants often times are unaware of their existence. The border may pass directly through a built-up area with intense cross-border activity due to population residency, place of work, shopping, and recreational pursuits. To obtain a deeper insight into cross-border Urgent Medical Assistance (UMA), the Ministry of the Interior and Kingdom Relations (IKR) and the Ministry for Health, Welfare, and Sports (HWS) in The Netherlands commissioned research into cross-border UMA impediments and solutions at administrative, judicial, and operational level. The following central questions were presented for research: (1) What opportunities and impediments are presented in the area of cross-border, urgent medical assistance at administrative, legal, operational, and equipment employable level?; and (2) Which solutions may be submitted to tackle existing impediments? Two techniques were employed to answer the research questions. First, relevant documents were studied from extensive file and literature searches. File and literature search findings subsequently were tested in practice through interviews with relevant experts. Dutch ambulance services provide support to both their Belgian and German counterparts and vice versa. In the instance of cross-border ambulance deployment, relevant assistance services are subject to due observance of various legislations and regulations. Such regulations may restrict effective and efficient deployment of personnel and equipment at critical moments, because regulation discrepancies may arise over ambulance personnel's authorities, ambulance content, and deployment sequence. Discrepencies also may exist in the area of financial compensation concerning ambulance deployment and hospital admission. Gaining knowledge on their disparate systems and the opportunity to utilize the medical provisions of a neighboring country potentially in closer proximity to those in the victim's own country serves the best interests of the patient. Survival chances of a traumatized patient increase with the expedited arrival of medical assistance and increased speed of transportation to an appropriate hospital.

Belgium↗