WorldWideScience

Sample records for ambulances

  1. Can ambulance personnel intubate?

    OpenAIRE

    Gray, A.J.; Cartlidge, D; Gavalas, M C

    1992-01-01

    To assess the performance of intubation skills by advanced trained ambulance personnel, a prospective study was carried out of the intubation of cardiac arrest victims by ambulance personnel in the field. Twenty-eight ambulance personnel attempted the intubation of 87 patients over 2 years. Eighty-five patients were initially successfully intubated, one endotracheal tube became displaced and cuff leakage occurred on three occasions. This was treated appropriately in each instance. Ambulance p...

  2. Radiology trainer. Surgical ambulance

    International Nuclear Information System (INIS)

    The DVD-ROM contains landmarks for fast anatomical orientation, a training mode showing the most common pathological radiological findings, a practical mode for accurate diagnosis, and textbook texts for background information. Situations encountered in surgical ambulance are simulated close to reality and in a user-friendly manner. The DVD-ROM is lavishly illustrated with more than 1600 X-ray images. (orig.)

  3. Ambulance management system using GIS

    OpenAIRE

    Pasha, Imtiyaz

    2006-01-01

    For emergency service providers, giving their service in least time shows their best performance. Emergency hospitals will be at their best if the ambulance reaches the site in Golden hour where life of injured persons can be saved. Ambulance uses the road network to reach the accident site. Today there are many GIS based systems being developed for routing of ambulance using GPS and other real-time technologies. These systems are useful and play a major role in solving the routing problem. B...

  4. Intelligent Ambulance Traffic Assistance System

    Directory of Open Access Journals (Sweden)

    RONOJOY GHOSH

    2013-09-01

    Full Text Available With the increase in traffic road density, several causalities occur due to delay in taking a patient to the hospital in an ambulance. In this paper, we have developed an algorithm to find the shortest path to reach the required destination. As required the software will identify the present location of the vehicle and ask the user for the destination. Then it will show all the available paths, highlighting the shortest one or in several cases the most optimum one. Further we made the traffic signals automated for special vehicles like an ambulance or a fire-engine such that the signals will go green for the ambulance as it comes in the vicinity of the traffic signal, thus providing them with a clear path to reach its destination. The original signal is restored as soon as the ambulance goes undetected by the Bluetooth scanner of the traffic signal.

  5. A Theory of Ambulance Chasing

    OpenAIRE

    Backović, Mihailo

    2016-01-01

    Ambulance chasing is a common socio-scientific phenomenon in particle physics. I argue that despite the seeming complexity, it is possible to gain insight into both the qualitative and quantitative features of ambulance chasing dynamics. Compound-Poisson statistics suffices to accommodate the time evolution of the cumulative number of papers on a topic, where basic assumptions that the interest in the topic as well as the number of available ideas decrease with time appear to drive the time e...

  6. An ambulance helicopter for emergency calls.

    OpenAIRE

    Sellwood, N

    1992-01-01

    The use of a helicopter as a primary response vehicle for the Cornwall Ambulance Service is presented. A brief analysis of the activities of the First Air Ambulance is described and an appraisal of its effects on the overall performance of the Service is given. Emphasis is given to patient acceptability and also to the flexibility of the helicopter in terms of its response to different situations. In conclusion, The Air Ambulance, as part of an integrated ambulance service, is an effective pr...

  7. A Theory of Ambulance Chasing

    CERN Document Server

    Backović, Mihailo

    2016-01-01

    Ambulance chasing is a common socio-scientific phenomenon in particle physics. I argue that despite the seeming complexity, it is possible to gain insight into both the qualitative and quantitative features of ambulance chasing dynamics. Compound-Poisson statistics suffices to accommodate the time evolution of the cumulative number of papers on a topic, where basic assumptions that the interest in the topic as well as the number of available ideas decrease with time appear to drive the time evolution. It follows that if the interest scales as an inverse power law in time, the cumulative number of papers on a topic is well described by a di-gamma function, with a distinct logarithmic behavior at large times. In cases where the interest decreases exponentially with time, the model predicts that the total number of papers on the topic will converge to a fixed value as time goes to infinity. I demonstrate that the two models are able to fit at least 9 specific instances of ambulance chasing in particle physics us...

  8. Do ambulance crews triage trauma patients?

    OpenAIRE

    Rouse, A

    1991-01-01

    OBJECTIVE. To determine whether ambulance crew triage trauma patients appropriately. DESIGN. A retrospective descriptive study. SETTINGS. Cornwall County Ambulance Service. VARIABLES STUDIED. On-scene times, injury severity, establishment of intravenous infusion and time from scene to A&E department. SUBJECTS. Patients with compound fracture of the lower limb taken to Truro Accident and Emergency department. OUTCOME MEASURES. Ambulance service on-scene times and mission times. RESULTS. Ambula...

  9. Riding Third: Social Work in Ambulance Work

    Science.gov (United States)

    Campbell, Hilary; Rasmussen, Brian

    2012-01-01

    This research explored the possible role of social work alongside emergency ambulance services. An ethnographic study included semistructured interviews and direct observations collected over 300 hours while riding in ambulances in an urban setting. The data suggest that social work could play a role by providing needed psychosocial care during…

  10. Nosocomial infections in ambulances and effectiveness of ambulance fumigation techniques in Saudi Arabia

    OpenAIRE

    Alrazeeni, Daifallah; Al Sufi, Mohammed S.

    2014-01-01

    Objectives: To evaluate infection control and the incidence of bacterial pathogens in Emergency Medical Service (EMS) ambulances in Riyadh, Saudi Arabia. The effectiveness of fumigation techniques used for these ambulances to minimize the spread of infection to transported patients and pre-hospital care providers was also assessed. Methods: Based on previous literature review indicating a higher propensity of microbial load, 3 areas within the ambulance, such as, stretcher handle, oxygen flow...

  11. Ambulance Reasonable Charge Public Use Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulance Reasonable Charge public use files for calendar years (CY) 2003 through 2005 are located in the Downloads section below. These public use files are...

  12. Robotic Assistance During Ambulation by Older Adults

    OpenAIRE

    Matthews, Judith; Engberg, Sandra; Montemerlo, Michael; Pineau, Joelle; Roy, Nicholas; Rogers, Joan; Thrun, Sebastian

    2002-01-01

    Some older adults require assistance with ambulation due to physical mobility limitations. Others lack the cognitive ability, either alone or in combination with physical impairment, to get where they need to go. Investigation of older adults' gait speed, social interaction, and responsiveness to a robot during ambulation is part of the Nursebot Project, a unique collaboration of health care professionals and technologists focused on developing a personal robotic assistant for frail elderly a...

  13. Ambulance officers' use of online clinical evidence

    OpenAIRE

    Westbrook Mary T; Westbrook Johanna I; Gosling A Sophie

    2006-01-01

    Abstract Background Hospital-based clinicians have been shown to use and attain benefits from online evidence systems. To our knowledge there have been no studies investigating whether and how ambulance officers use online evidence systems if provided. We surveyed ambulance officers to examine their knowledge and use of the Clinical Information Access Program (CIAP), an online evidence system providing 24-hour access to information to support evidence-based practice. Methods A questionnaire w...

  14. Improving community ambulation after stroke: the AMBULATE trial

    Directory of Open Access Journals (Sweden)

    Lindley Richard

    2009-02-01

    Full Text Available Abstract Background It has been reported that following rehabilitation, only 7% of stroke survivors are able to walk at a level commensurate with community participation. Previous research indicates that treadmill and overground walking training can improve walking capacity in people living in the community after stroke. The main objectives of the AMBULATE trial are to determine (i whether a 4-month treadmill walking program is more effective than a 2-month program, compared to control, in improving walking capacity, health and community participation and (ii the "threshold" walking speed that results in sufficient walking capacity that makes walking self-sustaining. Methods/Design A prospective randomised controlled trial of unsupported treadmill training with a 12 month follow-up with concealed allocation and blinded assessment will be conducted. 210 community-dwelling people after stroke who are able to walk independently but slowly will be recruited and randomly allocated to either a 4 month training group, 2 month training group or the control (no intervention group. Intervention for the two training groups will occur 3 days per week for 30 minutes each session. Measurements of walking, health and community participation will be taken at baseline, 2 months, 4 months, 6 months and 12 months. This study has obtained ethical approval from the relevant Human Research Ethics Committees. Discussion By improving stroke survivors' walking ability, it is likely also to improve their general wellbeing by promoting better health and greater community participation. Furthermore, if stroke survivors can reach a point where their walking and community participation is self-sustaining, this will reduce the burden of care on family and friends as well as the economic burden on the health system. Given the major demographic shift in developed nations involving significant growth in the aged population, this research will make an important evidence

  15. Ambulance officers' use of online clinical evidence

    Directory of Open Access Journals (Sweden)

    Westbrook Mary T

    2006-07-01

    Full Text Available Abstract Background Hospital-based clinicians have been shown to use and attain benefits from online evidence systems. To our knowledge there have been no studies investigating whether and how ambulance officers use online evidence systems if provided. We surveyed ambulance officers to examine their knowledge and use of the Clinical Information Access Program (CIAP, an online evidence system providing 24-hour access to information to support evidence-based practice. Methods A questionnaire was completed by 278 ambulance officers in New South Wales, Australia. Comparisons were made between those who used CIAP and officers who had heard of, but not used CIAP. Results Half the sample (48.6% knew of, and 28.8% had used CIAP. Users were more likely to have heard of CIAP from a CIAP representative/presentation, non-users from written information. Compared to ambulance officers who had heard of but had not used CIAP, users were more likely to report better computer skills and that their supervisors regarded use of CIAP as a legitimate part of ambulance officers' clinical role. The main reasons for non-use were lack of access(49.0% and training(31.4%. Of users, 51.3% rated their skills at finding information as good/very good, 67.5% found the information sought all/most of the time, 87.3% believed CIAP had the potential to improve patient care and 28.2% had directly experienced this. Most access to CIAP occurred at home. The databases frequently accessed were MIMS (A medicines information database (73.8% and MEDLINE(67.5%. The major journals accessed were Journal of Emergency Nursing(37.5%, American Journal of Medicine(30.0% and JAMA(27.5%. Conclusion Over half of ambulance officers had not heard of CIAP. The proportion who knew about and used CIAP was also low. Reasons for this appear to be a work culture not convinced of CIAP's relevance to pre-hospital patient care and lack of access to CIAP at work. Ambulance officers who used CIAP accessed it

  16. CERN'S Fire and Rescue Group Gets New Ambulance

    CERN Multimedia

    2000-01-01

    The ambulance is to replace another based on the off-road vehicle design which was originally acquired for the civil engineering phase of LEP construction. Just one figure, in 1999, the CERN ambulance was called out 195 times.

  17. User reflection on actions in ambulance telemedicine systems

    DEFF Research Database (Denmark)

    Hansen, Magnus

    2010-01-01

    Much information is shared, interpreted and recreated between caller, emergency dispatch personnel and ambulance crew during an emergency call. This paper studies the use of reflection in the ambulance control center based on the information an ambulance crew produces during patient treatment in ...... understand and use the feedback delivered through the system. The paper argues for broadening the scope of telemedicine use outside the boundaries of communication between ambulance and emergency department....

  18. Post-traumatic stress among Swedish ambulance personnel

    OpenAIRE

    Jonsson, A; Segesten, K; Mattsson, B

    2003-01-01

    Objective: Emergency workers, including ambulance personnel, must cope with a variety of duty related stressors including traumatic incident exposures. Little is known about the variables that might be associated with post-traumatic stress symptom in high risk occupational groups such as ambulance personnel. This study investigated the prevalence of post-traumatic stress disorder among Swedish ambulance personnel.

  19. Rushing Roulette: The State of Canada's Ambulance Services.

    Science.gov (United States)

    Scanlan, L

    1976-02-01

    In a Canada-wide survey, CANADIAN FAMILY PHYSICIAN found a startling divergence in provincial standards for ambulance crews and vehicles.While some provinces had developed a well-integrated ambulance system with central dispatching, rigorous standards for attendants and advanced paramedical training programs, in some the ambulances are run almost entirely by local undertakers. PMID:21308032

  20. Nosocomial infections in ambulances and effectiveness of ambulance fumigation techniques in Saudi Arabia

    Science.gov (United States)

    Alrazeeni, Daifallah; Al Sufi, Mohammed S.

    2014-01-01

    Objectives: To evaluate infection control and the incidence of bacterial pathogens in Emergency Medical Service (EMS) ambulances in Riyadh, Saudi Arabia. The effectiveness of fumigation techniques used for these ambulances to minimize the spread of infection to transported patients and pre-hospital care providers was also assessed. Methods: Based on previous literature review indicating a higher propensity of microbial load, 3 areas within the ambulance, such as, stretcher handle, oxygen flow meter knob, and interior handle of the rear door were selected for specimen collection. Swab samples were collected both in the day and night shift, after the intended disinfection and cleaning (before and after fumigation). Micro-organisms were identified using standard procedures. This phase-I study was conducted at the Emergency Medical Services Department, Prince Sultan Bin Abdulaziz College of Emergency Medical Services, Al Malaz, King Saud University, Riyadh, Saudi Arabia between October and November 2013, wherein a total of 10 ambulances from the Saudi Red Crescent Authority in Riyadh were selected for inclusion in the study. Results: The specimens from all 10 ambulances showed similar results. In post disinfection and before fumigation, swab samples showed positive cultures that grew moderate to large quantities of environmental and skin flora. However, almost all organisms were susceptible to the fumigation technique. Conclusion: This study confirms the importance of evaluating the frequency and efficiency of various fumigation techniques as an ambulance is a potential reservoir for microbial transmission to patients and staff. PMID:25399212

  1. Leg Spasticity and Ambulation in Multiple Sclerosis

    OpenAIRE

    Swathi Balantrapu; Sosnoff, Jacob J.; Pula, John H.; Brian M. Sandroff; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW)...

  2. Prehospital outcomes for ambulance service care: systematic review

    OpenAIRE

    Phung, Viet-Hai; Booth, Andrew; Joanne, Coster; Turner, Janette; Wilson, Richard; Siriwardena, A Niroshan

    2013-01-01

    Background: Ambulance service performance measurement has previously focused on response times and survival. We conducted a systematic review of the international literature on quality measures and outcomes relating to pre-hospital ambulance service care, aiming to identify a broad range of outcome measures to provide a more meaningful assessment of ambulance service care. Methods: We searched a number of electronic databases including CINAHL, the Cochrane Library, EMBASE, Medline, and Web...

  3. Leg Spasticity and Ambulation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Swathi Balantrapu

    2014-01-01

    Full Text Available Background. Spasticity of the legs is common in multiple sclerosis (MS, but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal and 4 (contracted. Patients completed the 6-minute walk (6 MW, timed 25 foot walk (T25FW, and timed up-and-go (TUG, and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc. for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12 and wore an accelerometer over a seven-day period. Results. 52% (n=44 of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P=0.0001, d=-0.86, T25FW (P=0.003,d=0.72, TUG (P=0.001, d=0.84, MSWS-12 (P=0.0001,d=1.09, O2 cost of walking (P=0.001, d=0.75, average steps/day (P<0.05, d=-0.45, and walking velocity (P<0.05, d=-0.53 and cadence (P<0.05, d=-0.46. Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.

  4. Leg Spasticity and Ambulation in Multiple Sclerosis

    Science.gov (United States)

    Balantrapu, Swathi; Sosnoff, Jacob J.; Pula, John H.; Sandroff, Brian M.; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW), timed 25 foot walk (T25FW), and timed up-and-go (TUG), and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc.) for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and wore an accelerometer over a seven-day period. Results. 52% (n = 44) of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P = 0.0001, d = −0.86), T25FW (P = 0.003, d = 0.72), TUG (P = 0.001, d = 0.84), MSWS-12 (P = 0.0001, d = 1.09), O2 cost of walking (P = 0.001, d = 0.75), average steps/day (P < 0.05, d = −0.45), and walking velocity (P < 0.05, d = −0.53) and cadence (P < 0.05, d = −0.46). Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking. PMID:24999434

  5. Swedish ambulance nurses' experiences of nursing patients suffering cardiac arrest.

    Science.gov (United States)

    Larsson, Ricard; Engström, Åsa

    2013-04-01

    Effective pre-hospital treatment of a person suffering cardiac arrest is a challenging task for the ambulance nurses. The aim of this study was to describe ambulance nurses' experiences of nursing patients suffering cardiac arrest. Qualitative personal interviews were conducted during 2011 in Sweden with seven ambulance nurses with experience of nursing patients suffering cardiac arrests. The interview texts were analyzed using qualitative thematic content analysis, which resulted in the formulation of one theme with six categories. Mutual preparation, regular training and education were important factors in the nursing of patients suffering cardiac arrest. Ambulance nurses are placed in ethically demanding situations regarding if and for how long they should continue cardio-pulmonary resuscitation (CPR) to accord with pre-hospital cardiac guidelines and patients' wishes. When a cardiac arrest patient is nursed their relatives also need the attention of ambulance nurses. Reflection is one way for ambulance nurses to learn from, and talk about, their experiences. This study provides knowledge of ambulance nurses' experiences in the care of people with cardiac arrest. Better feedback about the care given by the ambulance nurses, and about the diagnosis and nursing care the patients received after they were admitted to the hospital are suggested as improvements that would allow ambulance nurses to learn more from their experience. Further development and research concerning the technical equipment might improve the situation for both the ambulance nurses and the patients. Ambulance nurses need regularly training and education to be prepared for saving people's lives and also to be able to make the right decisions. PMID:23577977

  6. Ambulation Increases Decompression Sickness in Spacewalk Simulations

    Science.gov (United States)

    Pollock, N. W.; Natoli, M. J.; Conkin, J.; Wessel, J. H., III; Gernhardt, M. L.

    2014-01-01

    Musculoskeletal activity has the potential to both improve and compromise decompression safety. Exercise enhances inert gas elimination during oxygen breathing prior to decompression (prebreathe), but it may also promote bubble nuclei formation (nucleation), which can lead to gas phase separation and bubble growth and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity and the level of tissue supersaturation may be critical to the net effect. Understanding the relationships is important to evaluate exercise prebreathe protocols and quantify decompression risk in gravity and microgravity environments. Data gathered during NASA's Prebreathe Reduction Program (PRP) studies combined oxygen prebreathe and exercise followed by low pressure (4.3 psi; altitude equivalent of 30,300 ft [9,235 m]) microgravity simulation to produce two protocols used by astronauts preparing for extravehicular activity. Both the Phase II/CEVIS (cycle ergometer vibration isolation system) and ISLE (in-suit light exercise) trials eliminated ambulation to more closely simulate the microgravity environment. The CEVIS results (35 male, 10 female) serve as control data for this NASA/Duke study to investigate the influence of ambulation exercise on bubble formation and the subsequent risk of DCS. METHODS Four experiments will replicate the CEVIS exercise-enhanced oxygen prebreathe protocol, each with a different exception. The first of these is currently underway. Experiment 1 - Subjects complete controlled ambulation (walking in place with fixed cadence and step height) during both preflight and at 4.3 psi instead of remaining nonambulatory throughout. Experiment 2 - Subjects remain non-ambulatory during the preflight period and ambulatory at 4.3 psi. Experiment 3 - Subjects ambulate during the preflight period and remain non-ambulatory at 4.3 psi. Experiment 4 - The order of heavy and light exercise employed in the CEVIS protocol is

  7. Understanding the factors that influence patient satisfaction with ambulance services.

    Science.gov (United States)

    Bogomolova, Svetlana; Tan, P J; Dunn, S P; Bizjak-Mikic, M

    2016-01-01

    The quality of ambulance services has an immense impact on patients' future well-being and quality of life. Patient satisfaction is one of the key metrics for evaluating the quality of this service. Yet, the patient satisfaction measurement may be limited in its ability to accurately reflect this service quality, and even reflect factors beyond the patient experiences. We analyze 10 years of survey data to reveal a number of factors that systematically bias ambulance satisfaction ratings. Taking into account these biases provides more robust comparison of ambulance performance over time or across different jurisdictions. PMID:27295008

  8. Older people's use of ambulance services: a population based analysis.

    OpenAIRE

    Clark, M J; Fitzgerald, G

    1999-01-01

    OBJECTIVE: To investigate the use of emergency and non-urgent ambulance transport services by people aged 65 years and over. SETTING: The study was undertaken in Queensland where the Queensland Ambulance Services (QAS) is the sole provider of emergency pre-hospital and non-urgent ambulance services for the entire state. METHODS: The age and sex of 351,000 emergency and non-urgent cases treated and transported by the QAS from July 1995 to June 1996 were analysed. RESULTS: People aged 65 years ...

  9. Ambulation Increases Decompression Sickness in Altitude Exposure

    Science.gov (United States)

    Conkin, Johnny; Pollock, N. W.; Natoli, M. J.; Wessel, J. H., III; Gernhardt, M. L.

    2014-01-01

    INTRODUCTION - Exercise accelerates inert gas elimination during oxygen breathing prior to decompression (prebreathe), but may also promote bubble formation and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of exercise are likely critical to the net effect. The NASA Prebreathe Reduction Program (PRP) combined oxygen prebreathe and exercise preceding a 4.3 psi exposure in non-ambulatory subjects (a microgravity analog) to produce two protocols now used by astronauts preparing for extravehicular activity (CEVIS and ISLE). Additional work is required to investigate whether exercise normal to 1 G environments increases the risk of DCS over microgravity simulation. METHODS - The CEVIS protocol was replicated with one exception. Our subjects completed controlled ambulation (walking in place with fixed cadence and step height) during both preflight and at 4.3 psi instead of remaining non-ambulatory throughout. Decompression stress was graded with aural Doppler (Spencer 0-IV scale). Two-dimensional echocardiographic imaging was used to look for left heart gas emboli (the presence of which prompted test termination). Venous blood was collected at three points to correlate Doppler measures of decompression stress with microparticle (cell fragment) accumulation. Fisher Exact Tests compared test and control groups. Trial suspension would occur when DCS risk >15% or grade IV venous gas emboli (VGE) risk >20% (at 70% confidence). RESULTS - Eleven person-trials were completed (9 male, 2 female) when DCS prompted suspension. DCS was greater than in CEVIS trials (3/11 [27%] vs. 0/45 [0%], respectively, p=0.03). Statistical significance was not reached for peak grade IV VGE (2/11 [18%] vs. 3/45 [7%], p=0.149) or cumulative grade IV VGE observations per subject-trial (8/128 [6%] vs. 26/630 [4%], p=0.151). Microparticle data were collected for 5/11 trials (3 with DCS outcomes), with widely varying patterns that could not be resolved statistically

  10. What do users value about the emergency ambulance service?

    OpenAIRE

    Togher, Fiona; Phung, Viet-Hai; Turner, Janette; Siriwardena, A Niroshan; O'Cathain, Alicia

    2013-01-01

    Introduction Response times have been used as a key quality indicator for measuring the quality of emergency ambulance services in the United Kingdom, but criticised for their narrow focus. As outcomes become the focus of primary care commissioning of ambulance services, wider measures of quality need to be considered. The patient perspective is becoming an increasingly important dimension in primary and pre-hospital outcomes research. To that end, we aimed to investigate patients’ experie...

  11. Private Ambulance Services, ambulance zone, Published in 2008, 1:24000 (1in=2000ft) scale, Box Elder County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Private Ambulance Services dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Other information as of 2008. It is described as...

  12. CERN'S Fire and Rescue Group Gets New Ambulance

    CERN Multimedia

    2000-01-01

    The arrival of a new vehicle is always an important moment in the life of a fire station. So when a new ambulance was delivered to the CERN Fire Brigade on Wednesday 16 September 2000, it was given a warm welcome, attended by staff of the different divisions involved in its purchase. It took a year from the first administrative moves to the day of acquisition. On the one hand there were the calls for tender needed for such a purchase and on the other the development of this custom-designed ambulance with its unique features. Three visits to the manufacturer had to be made, including two to the head office of the Miesen factory at Bonn to study and incorporate in the ambulance the special requirements called for by its future users. These requirements, born from the past experience of CERN’s ambulance crews, concerned not only interior arrangements but also included a new side panel, opening up a stowage compartment where everything will be put that gets dirty during ambulance operations. This will minimize ...

  13. Influence of ambulance use on early reperfusion therapies for acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    SONG Li; HU Da-yi; YAN Hong-bing; YANG Jin-gang; SUN Yi-hong; LI Chao; LIU Shu-shan; WU Dong; FENG Qi

    2008-01-01

    Background Ambulance use expedites the definitive treatment of acute myocardial infarction (AMI). The aim of this study was to evaluate the effect of ambulance use on the administration of early reperfusion therapies for patients with AMI in Beijing, China.Methods Data were prospectively collected from 498 patients with ST-elevation myocardial infarction (STEMI) who were admitted within 12 hours of symptom onset to 19 hospitals in Beijing between November 1,2005 and December 31, 2006. The baseline characteristics of and the initial management of the ambulance users and the non-ambulance users were compared.Results Only 186 (37.3%) patients used an ambulance as transportation to the hospital. Ambulance users were, on average, older and at relatively higher risk on presentation than the non-ambulance users. After adjustment for patient and hospital characteristics, ambulance use was associated with a greater early reperfusion rate, mainly because of a greater incidence of primary percutaneous coronary intervention. In addition, ambulance users had a significantly shorter median door-to-balloon (120 compared with 145 minutes, P<0.001) and symptom onset-to-balloon (223 compared with 300 minutes, P<0.001) time than non-ambulance users.Conclusions Ambulances are underused by AMI patients in Beijing. Ambulance use may lead to more frequent and faster receipt of early reperfusion therapies. New public health strategies should be developed to facilitate an increased use of ambulances by AMI patients.

  14. Efficacy and safety of intravenous fentanyl administered by ambulance personnel

    DEFF Research Database (Denmark)

    Friesgaard, Kristian Dahl; Nikolajsen, Lone; Giebner, Matthias;

    2016-01-01

    BACKGROUND: Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered by...... ambulance personnel. METHODS: Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival....... Secondary outcomes included the number of patients with reduction in pain intensity during transport (NRS ≥ 2), the number of patients with NRS > 3 at hospital arrival, and potential fentanyl-related side effects. RESULTS: Fentanyl reduced pain from before treatment (8, IQR 7-9) to hospital arrival (4, IQR...

  15. Levels of mental health problems among UK emergency ambulance workers.

    Science.gov (United States)

    Bennett, P; Williams, Y; Page, N; Hood, K; Woollard, M

    2004-03-01

    This study examined the prevalence of post-traumatic stress disorder (PTSD), depression, and anxiety in a sample of emergency ambulance personnel. Of 1029 personnel in one ambulance service mailed a questionnaire, 617 were returned. Among respondents, the overall rate of PTSD was 22%. Levels of PTSD did not differ according to grade, but men had a higher prevalence rate than women (23% compared with 15%). Nearly one in ten reported probable clinical levels of depression, 22% reported probable clinical levels of anxiety based on Hospital Anxiety and Depression Scale scores. PMID:14988360

  16. Ambulation in adults with myelomeningocele. Is it possible to predict the level of ambulation in early life?

    DEFF Research Database (Denmark)

    Seitzberg, A.; Lind, M.; Biering-Sørensen, Fin

    2008-01-01

    . Information on muscle strength and ambulatory function in early life was retrieved from medical records. The motor levels determined by the muscle strength were used to predict ambulatory function later in life. At follow-up, a clinical examination was performed. RESULTS: Of 20 MMC individuals assessed with...... life than predicted. Good strength in quadriceps muscles gave significant better prospect for adult walking. Of the 52 participants, 41 retained their ambulation status from 5-8 years of age. CONCLUSION: For MMC individuals with motor levels L3-L5, adult ambulatory function cannot be determined from......OBJECTIVE: The objective of this study was to evaluate the prediction of ambulation in adults with myelomeningocele from muscle strength testing and ambulation in early life. MATERIALS AND METHODS: Fifty-two myelomeningocele (MMC) individuals at the age 18-37 years at follow-up were studied...

  17. The desired competence of the Swedish ambulance nurse according to the professionals - A Delphi study.

    OpenAIRE

    Wihlborg, Jonas; Edgren, Gudrun; Johansson, Anders; Sivberg, Bengt

    2014-01-01

    Nursing is evolving into new fields of health care including ambulance care, where a branch of specialist nursing is growing. Various views exist on the desired competence for the ambulance nurse and valid guidelines are lacking in Sweden. To increase knowledge of the field, professionals were asked to describe what competences an ambulance nurse should possess. The aim of this study was therefore to elucidate the desired professional competence of the specialist ambulance nurse, according to...

  18. Role of Nurses in Early Ambulation of Living Donor Liver Transplant Recipients

    OpenAIRE

    Sato, Orie; Osanai, Yumiko; Urushidate, Chie; Yamaguchi, Tomoko; Narumi, Shunji; Umehara, Minoru; Toyoki, Yoshikazu; Sugai, Michihiro; Hakamada, Kenichi; Kimura, Toshiko

    2013-01-01

    [Introduction] Liver transplant recipients suffer more complications than do patients undergoing other gastroenterological surgeries. Many factors inhibit ambulation in liver transplant patients, such as the level of restriction to bed rest and length of stay in the intensive care unit( ICU). Patients thus face ambulation difficulties. Support for ambulation is one of the major daily tasks of nurses. We reviewed the ambulation situations of patients who underwent living donor liver transplant...

  19. How should we measure ambulance service quality and performance? Results from a Delphi study

    OpenAIRE

    Coster, Jo; Irving, Andy; Turner, Janette; Wilson, Richard; Phung, Viet-Hai; Siriwardena, A Niroshan

    2014-01-01

    Background and objectives The Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) research programme aims to develop better ways of measuring the quality of ambulance service care. Ambulance service care is often measured by the speed of the ambulance response rather than the quality of care provided or patient outcomes. Whilst response times are relevant to a small proportion of seriously ill patients, they are not clinically relevant for most people who contact the ambulance se...

  20. Mathematical model of ambulance resources in Saint-Petersburg

    Science.gov (United States)

    Shavidze, G. G.; Balykina, Y. E.; Lejnina, E. A.; Svirkin, M. V.

    2016-06-01

    Emergency medical system is one of the main elements in city infrastructure. The article contains analysis of existing system of ambulance resource distribution. Paper considers the idea of using multiperiodicity as a tool to increase the efficiency of the Emergency Medical Services. The program developed in programming environment Matlab helps to evaluate the changes in the functioning of the system of emergency medical service.

  1. How should we measure ambulance service quality and performance?

    OpenAIRE

    Coster, Jo; Turner, Janette; Irving, Andy; Wilson, Richard; Siriwardena, A Niroshan; Phung, Viet-Hai

    2014-01-01

    The problem Ambulance services in England treat 6.5 million people per year but get no information about what happens to patients after discharge. This has led to a reliance on measuring response times rather than outcomes to assess how well services perform, and little opportunity for identifying problems and good practice or evaluating service developments. Research aim There is a lack of consensus on which outcome measures are important for pre-hospital care so we set out to addre...

  2. Orthostatic Intolerance Ambulation in Patients Using Patient Controlled Analgesia

    OpenAIRE

    Park, Kwang Ok; Lee, Yoon Young

    2013-01-01

    Background Opioid analgesics are widely used to reduce postoperative pain and to enhance post-operative recovery. However, orthostatic intolerance (OI) induced by opioid containing intravenous patient controlled analgesia (IPCA) may hinder postoperative recovery. This study investigated factors that affect OI in patients receiving IPCA for postoperative pain control. Methods OI was instantly evaluated at the time of first ambulation in 175 patients taking opioid containing IPCA after open and...

  3. The Barbados Emergency Ambulance Service: High Frequency of Nontransported Calls

    Directory of Open Access Journals (Sweden)

    Sherwin E. Phillips

    2012-01-01

    Full Text Available Objectives. There are no published studies on the Barbados Emergency Ambulance Service and no assessment of the calls that end in nontransported individuals. We describe reasons for the nontransport of potential clients. Methods. We used the Emergency Medical Dispatch (Medical Priority Dispatch System instrument, augmented with five local call types, to collect information on types of calls. The calls were categorised under 7 headings. Correlations between call types and response time were calculated. Results. Most calls were from the category medical (54%. Nineteen (19% percent of calls were in the non-transported category. Calls from call type Cancelled accounted for most of these and this was related to response time, while Refused service was inversely related (. Conclusions. The Barbados Ambulance Service is mostly used by people with a known illness and for trauma cases. One-fifth of calls fall into a category where the ambulance is not used often due to cancellation which is related to response time. Other factors such as the use of alternative transport are also important. Further study to identify factors that contribute to the non-transported category of calls is necessary if improvements in service quality are to be made.

  4. Ambulance Work : Relationships between occupational demands, individual characteristics and health-related outcomes

    OpenAIRE

    Aasa, Ulrika

    2005-01-01

    Although musculoskeletal disorders (MSDs) and other health complaints are an occupational problem for ambulance personnel, there is a lack of knowledge regarding work-related factors associated with MSDs and other health complaints. The overall aim of this thesis was to investigate the relationships between occupational demands, individual characteristics and health-related outcomes among ambulance personnel. A random sample of 234 female and 953 male ambulance personnel participated in a nat...

  5. Corticosteroid Treatments in Males With Duchenne Muscular Dystrophy: Treatment Duration and Time to Loss of Ambulation

    OpenAIRE

    Kim, Sunkyung; Campbell, Kimberly A.; Fox, Deborah J.; Matthews, Dennis J.; Valdez, Rodolfo

    2014-01-01

    This population-based study examines the association between corticosteroid treatment and time to loss of ambulation, stratifying by treatment duration (short: 0.25–3 years, long: >3 years), among 477 Duchenne muscular dystrophy cases identified by the Muscular Dystrophy Surveillance Tracking and Research Network (MDSTARnet). Those cases who received short-term corticosteroid treatment had a time to loss of ambulation that was 0.8 years shorter (t test) and an annual risk of losing ambulation...

  6. Family physician decisions following stroke symptom onset and delay times to ambulance call

    OpenAIRE

    Donnan Geoffrey; Nicol Marcus; Mosley Ian; Dewey Helen

    2011-01-01

    Abstract Background For stroke patients, calling an ambulance has been shown to be associated with faster times to hospital than contacting a family physician. However little is known about the impact of decisions made by family physicians on delay times for stroke patients once they have been called. We aimed to test the hypotheses that among ambulance transported stroke patients: • Factors associated with first calling a family physician, could be identified. • Time to ambulance call will b...

  7. Prioritising outcomes measures for ambulance service care: a three stage consensus study

    OpenAIRE

    Coster, Joanne; Turner, Janette; Siriwardena, A Niroshan; Wilson, Richard; Phung, Viet-Hai

    2013-01-01

    Background Historically ambulance care quality and performance has been measured by response times rather than clinical need or effectiveness. This limits the evidence about the effectiveness of the care the ambulance service provides. The Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) project is a 5 year research programme which aims to develop new ways of measuring the performance, quality and impact of ambulance service care that better reflect the care provided. Meth...

  8. Perioperative transfusion threshold and ambulation after hip revision surgery

    DEFF Research Database (Denmark)

    Nielsen, Kamilla; Johansson, Pär I; Dahl, Benny; Wagner, Michael; Frausing, Britt; Børglum, Jens; Jensen, Kenneth; Stürup, Jens; Hvolris, Jesper; Rasmussen, Lars S

    2014-01-01

    BACKGROUND: Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision...... patients received RBC. CONCLUSIONS: A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing....

  9. Masculinity and Lifting Accidents among Danish Ambulance Personnel

    DEFF Research Database (Denmark)

    Hansen, Claus D.; Nielsen, Kent J

    alone. Aim This presentation investigates whether failure to use AT is linked to male ambulance workers’ gender identity? Is lifting patients alone a way of performing masculinity for AP’s? Method Data is taken from MARS, a panel study of AP workers in Denmark (n = 1606). Information from questionnaires...... measuring traditional male role norms (MRNI), safety attitudes and safety behavior will be linked to company register information on work injuries categorized as lifting accidents. Logistic regression is used to analyse associations between masculinity, lifting behavior, and lifting accidents. Results...

  10. Physical fitness and occupational demands of the Belfast ambulance service.

    Science.gov (United States)

    Gamble, R P; Stevens, A B; McBrien, H; Black, A; Cran, G W; Boreham, C A

    1991-09-01

    The objectives of this study were to evaluate the current fitness of an area ambulance service based in Belfast and to quantify the physiological demands of accident and emergency work. From a total staff of 230, 105 (46%) volunteered to undergo a series of fitness tests subject to health state. Results based on body mass indices showed that 52% of subjects could be classified as overweight and 10% of subjects as obese. Fitness levels were similar to other comparable samples and showed the expected but not inevitable decrease with age. A simple work related task (walking at 6 km/h) performed in the laboratory showed that 54% of men over 40 years of age and 24% under 40 found it taxing. This would favour selection for accident and emergency work on the basis of functional capacity rather than chronological age. Accident and emergency work consisted of long periods of inactivity interspersed with shorter periods of relatively intense activity, often above the anaerobic threshold. Lactate concentrations measured during a staged emergency incident also suggested that personnel may work at intensities exceeding their anaerobic threshold. The incorporation of physical fitness standards in the ambulance service may be appropriate and consideration should be given to a reduced age of retirement. PMID:1911401

  11. Basic life support and automated external defibrillator skills among ambulance personnel

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Isbye, Dan Lou; Lippert, Freddy Knudsen; Rasmussen, Lars Simon

    2012-01-01

    Ambulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island....

  12. A national census of ambulance response times to emergency calls in Ireland

    OpenAIRE

    Breen, N; Woods, J.; Bury, G; Murphy, A.; Brazier, H

    2000-01-01

    Background—Equity of access to appropriate pre-hospital emergency care is a core principle underlying an effective ambulance service. Care must be provided within a timeframe in which it is likely to be effective. A national census of response times to emergency and urgent calls in statutory ambulance services in Ireland was undertaken to assess current service provision.

  13. The use and abuse of the emergency ambulance service: some of the factors affecting the decision whether to call an emergency ambulance.

    OpenAIRE

    Gardner, G J

    1990-01-01

    Over a 1-month period all patients arriving in the accident and emergency department by ambulance following a '999' call were questioned using a standard proforma. They were assessed as to whether their medical condition warranted ambulance transfer. A number of social and practical points were analyzed to see whether they would identify any group of patients who used the emergency service without medical need. Overall 289 patients were questioned. Of these 178 (62%) were considered to have m...

  14. Development of Training Programs to Optimize Planetary Ambulation

    Science.gov (United States)

    Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Cohen, H. S.; Miller, C. A.; Brady, R.; Warren, L. E.; Rutley, T. M.; Kozlovskaya, I. B.

    2007-01-01

    Astronauts experience disturbances in functional mobility following their return to Earth due to adaptive responses that occur during exposure to the microgravity conditions of space flight. Despite significant time spent performing in-flight exercise routines, these training programs have not been able to mitigate postflight alterations in postural and locomotor function. Therefore, the goal of our two inter-related projects (NSBRI-ground based and ISS flight study, "Mobility") is to develop and test gait training programs that will serve to optimize functional mobility during the adaptation period immediately following space flight, thereby improving the safety and efficiency of planetary ambulation. The gait training program entails manipulating the sensory conditions of treadmill exercise to systematically challenge the balance and gait control system. This enhances the overall adaptability of locomotor function enabling rapid reorganization of gait control to respond to ambulation in different gravitational environments. To develop the training program, we are conducting a series of ground-based studies evaluating the training efficacy associated with variation in visual flow, body loading, and support surface stability during treadmill walking. We will also determine the optimal method to present training stimuli within and across training sessions to maximize both the efficacy and efficiency of the training procedure. Results indicate that variations in both visual flow and body unloading during treadmill walking leads to modification in locomotor control and can be used as effective training modalities. Additionally, the composition and timing of sensory challenges experienced during each training session has significant impact on the ability to rapidly reorganize locomotor function when exposed to a novel sensory environment. We have developed the capability of producing support surface variation during gait training by mounting a treadmill on a six

  15. Automatic Accident Detection and Ambulance Rescue with Intelligent Traffic Light System

    Directory of Open Access Journals (Sweden)

    S.IYYAPPAN

    2013-04-01

    Full Text Available Nowadays the road accidents in modern urban areas are increased to uncertain level. The loss of human life due to accident is to be avoided. Traffic congestion and tidal flow are major facts that cause delay to ambulance. To bar loss of human life due to accidents we introduce a scheme called ITLS (Intelligent Traffic Light system. The main theme behind this scheme is to provide a smooth flow for the emergency vehicles like ambulance to reach the hospitals in time and thus minimizing the delay caused by traffic congestion. The idea behind this scheme is to implement ITLS which would control mechanically the traffic lights in the path of the ambulance. The ambulance is controlled by the control unit which furnishes adequate route to the ambulance and also controls the traffic light according to the ambulance location and thus reaching the hospital safely. The controller identifies the location of the accident spot through the sensor systems in the vehicle which determined the accident and thus the controller walks through the ambulance to the spot. This scheme is fully automated, thus it finds the accident spot, controls the traffic lights, helping to reach the hospital in time.

  16. INTRODUKSI TEKNOLOGI INOVASI AMBUL UNTUK BUDIDAYA TANAMAN SAYURAN DI KALIMANTAN TENGAH

    Directory of Open Access Journals (Sweden)

    HASTIN ERNAWATI NUR CHUSNUL CHOTIMAH

    2014-04-01

    Full Text Available Arut Bawah is a settlement that is always flooded every year due to Kahayan river run off . Residents perform various activities on the water, and transportation between housing residents with one another, using wooden boards. The conditions is not possible if it is used to grow crops. It is certainly limiting factor for household food needs, including the need for vegetables. Flooded land use around residential has not been done because the technology is not yet known. Through these activities, the community is expected to implement one of the local knowledges of the environment-friendly cultivation in swampy areas with ambul system so that people can still grow crops to sustain life. It consists of meeting nutritional needs, as well as improving food security in water-saturated soil conditions. This community service was conducted by the various stages of 1 outreach and dissemination of technology ambul 2 training of making ambul and 3 planting a variety of vegetables in ambul. The results showed that ambul can be used as a technology for cultivation in flooded areas. The introduction of technology ambul got a positive response from residents Arut Bawah Palangkaraya Central Kalimantan. Keywords: ambul, vegetables and flooded areas.

  17. The Fire Brigade acquires a new ambulance with all the bells and whistles!

    CERN Multimedia

    Anaïs Schaeffer

    2012-01-01

    On 19 April the Fire Brigade unveiled its latest acquisition: a brand-new ambulance specially designed for CERN.   One of the Fire Brigade's two ambulances has just been replaced by a state-of-the-art vehicle tailor-made to meet CERN's unique requirements. At 4.6 metres long it's much more spacious than its predecessors, providing plenty of room for patient, doctor and paramedic. The ambulance's design and manufacture are the result of a successful collaboration between the Fire Brigade and the technicians from Profile Vehicles, the Finnish company that won the contract following a call for tenders launched in June 2011. "It took us six months to finalise the specification for our new ambulance," explains Patrick Berlinghi, who is responsible for the Fire Brigade's logistics. "We wanted it to be spacious enough for us to be able to work comfortably and to have the latest safety and patient care equipment.  We also reques...

  18. Private Ambulance Services, Published in 2008, 1:2400 (1in=200ft) scale, Shawano County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Private Ambulance Services dataset, published at 1:2400 (1in=200ft) scale, was produced all or in part from Published Reports/Deeds information as of 2008....

  19. The Assessment of Competiencies for Ambulance Personnel –Problems and Challenges

    OpenAIRE

    Dambe, Gundega; Atstāja, Dzintra

    2015-01-01

    The purpose of this paper is to clarify whetherperformances assessment at a work place promotes Ambulance professionals for personnel development, and if it providesthe possibility to assess personnel’s competence and professionalism. The results of State Emergency Medical Service ambulance personnel’s performance assessment in years 2013 and 2014 are analysed in the research. The results obtainedthat using existing methods for performance assessment, there are not possibility to assess perso...

  20. Acute and chronic job stressors among ambulance personnel: predictors of health symptoms

    OpenAIRE

    van der Ploeg, E; Kleber, R.J.

    2003-01-01

    Objectives: To predict symptomatology (post-traumatic distress, fatigue, and burnout) due to acute and chronic work related stressors among ambulance personnel. Methods: Data were gathered from 123 ambulance workers in The Netherlands in a longitudinal design. At two measurements they completed standardised questionnaires to assess health symptoms, such as the Impact of Event Scale, the Maslach Burnout Inventory, and the Checklist Individual Strength. Acute stressors were assessed with specif...

  1. Call selection for the Helicopter Emergency Medical Service: implications for ambulance control.

    OpenAIRE

    Coats, T J; Newton, A

    1994-01-01

    The increasing sophistication of pre-hospital care, with paramedics and many types of 'rapid response' units, requires the use of advanced systems of ambulance control. The introduction of call selection by a paramedic in the ambulance control room significantly improved the tasking of the Helicopter Emergency Medical Service. This paper illustrates the need for a system to grade 999 calls, so that the appropriate pre-hospital response can be directed to each patient.

  2. Systematic review of pre-hospital outcomes for evidence-based evaluation of ambulance service care

    OpenAIRE

    Phung, Viet-Hai; Coster, Joanne; Wilson, Richard; Turner, Janette; Booth, Andrew; Siriwardena, A Niroshan

    2013-01-01

    Background: Ambulance service performance measurement has previously focused on response times and survival (particularly from out-of-hospital cardiac arrest). The PhOEBE (Pre-hospital Outcomes for Evidence Based Evaluation) project is a 5-year research programme which aims to develop new ways of measuring the performance, quality and impact of ambulance service care. As part of this programme we conducted a systematic review of the international literature on quality measures and outcomes re...

  3. Developing new ways of measuring the impact of ambulance service care

    OpenAIRE

    Turner, Janette; Coster, Joanne; Wilson, Richard; Siriwardena, A Niroshan; Phung, Viet-Hai

    2014-01-01

    Background Pre-hospital care in England is provided by ambulance services who deliver a diverse range of services to over 9 million patients a year but there is limited evidence about the effectiveness of this care. Historically ambulance performance has been measured by response times rather than clinical need or effectiveness. Progress on developing more appropriate performance measures is constrained by a lack of information about what happens to patients and their outcome after the pre...

  4. Qualitative interview study of patients', ambulance practitioners' and emergency department clinicians' perceptions of prehospital pain management

    OpenAIRE

    Mohammad, Iqbal; Spaight, P. A.; Siriwardena, Niro

    2010-01-01

    Introduction Pre-hospital pain management is increasingly important with most patients (80%) presenting to UK ambulance services in pain and 20% of patients reporting inadequate pain relief. Improving prehospital pain management is important for service quality. Our aim was to investigate perceptions of pain management from patients, ambulance and emergency care staff. Methods Qualitative data were gathered through focus group (5) and interviews (28). Participants were purposively ...

  5. Weather factors in the short-term forecasting of daily ambulance calls

    Science.gov (United States)

    Wong, Ho-Ting; Lai, Poh-Chin

    2014-07-01

    The daily ambulance demand for Hong Kong is rising, and it has been shown that weather factors (temperature and humidity) play a role in the demand for ambulance services. This study aimed at developing short-term forecasting models of daily ambulance calls using the 7-day weather forecast data as predictors. We employed the autoregressive integrated moving average (ARIMA) method to analyze over 1.3 million cases of emergency attendance in May 2006 through April 2009 and the 7-day weather forecast data for the same period. Our results showed that the ARIMA model could offer reasonably accurate forecasts of daily ambulance calls at 1-7 days ahead of time and with improved accuracy by including weather factors. Specifically, the inclusion of average temperature alone in our ARIMA model improved the predictability of the 1-day forecast when compared to that of a simple ARIMA model (8.8 % decrease in the root mean square error, RMSE = 53 vs 58). The improvement in the 7-day forecast with average temperature as a predictor was more pronounced, with a 10 % drop in prediction error (RMSE = 62 vs 69). These findings suggested that weather forecast data can improve the 1- to 7-day forecasts of daily ambulance demand. As weather forecast data are readily accessible from Hong Kong Observatory's official website, there is virtually no cost to including them in the ARIMA models, which yield better prediction for forward planning and deployment of ambulance manpower.

  6. [Comatose patient with neuroleptic malignant syndrome brought by ambulance].

    Science.gov (United States)

    Takinami, Yoshikazu; Kuroda, Yukiko

    2012-01-01

    A 27-year-old woman with schizophrenia showed signs of neuroleptic malignant syndrome with disturbed consciousness, high fever, muscle rigidity, and autonomic dysfunction (including tachycardia and enhancement of saliva secretion). Since the age of 15, she had been treated at a local psychiatric clinic with a diagnosis of schizophrenia. On the day she was brought to the emergency room, she was asleep in the morning, but tachycardia was observed in the evening in the absence of consciousness. The patient was brought to our hospital by ambulance. It was revealed that she had taken a massive dose of chlorpromazine hydrochloride in the morning on the same day. On arrival, the Japan coma scale, pulse, respiratory rate, body temperature, and Sp(O2) were 300, 114 beats x min(-1), 26 breaths x min(-1), 39.0 degrees, and 91% (room air), respectively. The CPK level was 1,776 IU x l(-1). Sp(O2), bilateral pneumonia, and right atelectasis improved 2 hours after admission. Endotracheal intubation was performed for artificial respiration. Salivation, marked sweating, and rigidity of the limbs were noted. Under a diagnosis of neuroleptic malignant syndrome, dantrolene was administered. For pneumonia, ceftriaxone and pazufloxacin were administered. The consciousness became clear 2 days after admission. The patient was discharged 10 days after admission. PMID:22338865

  7. Weather and Age-Gender Effects on the Projection of Future Emergency Ambulance Demand in Hong Kong

    OpenAIRE

    Lai, PC; Wong, FHT

    2012-01-01

    An accurate projection for ambulance demand is essential to enable better resource planning for the future that strives to either maintain current levels of services or reconsider future standards and expectations. More than 2 million cases of emergency room attendance in 2008 were obtained from the Hong Kong Hospital Authority to project the demand for its ambulance services in 2036. The projection of ambulance demand in 2036 was computed in consideration of changes in the age-gender structu...

  8. The effect of a national ambulance Quality Improvement Collaborative on performance in care bundles for acute myocardial infarction and stroke

    OpenAIRE

    Siriwardena, A Niroshan; Shaw, Deborah; Essam, Nadya; Togher, Fiona; Davy, Zowie; Spaight, Anne; Dewey, Michael

    2013-01-01

    Background: National ambulance service indicators showed considerable variation in care for acute myocardial infarction (AMI) and stroke. We aimed to improve reliability of pre-hospital care processes for these conditions using a Quality Improvement Collaborative (QIC). The QIC involved educating ambulance staff in Quality Improvement (QI) methods, and the use of plan-do-study-act cycles (PDSA) to implement changes. Ambulance staff were provided with feedback on the effect of the PDSA cycles ...

  9. Ambulation following spinal cord injury and its correlates

    Directory of Open Access Journals (Sweden)

    Nitin Menon

    2015-01-01

    Full Text Available Objectives: To assess walking ability of spinal cord injury (SCI patients and observe its correlation with functional and neurological outcomes. Patients and Methods: The present prospective, observational study was conducted in a tertiary research hospital in India with 66 patients (46 males between January 2012 and December 2013. Mean age was 32.62 ± 11.85 years (range 16-65 years, mean duration of injury was 85.3 ± 97.6 days (range 14-365 days and mean length of stay in the rehabilitation unit was 38.08 ± 21.66 days (range 14-97 days in the study. Walking Index for spinal cord injury (WISCI II was used to assess ambulation of the SCI patients. Functional recovery was assessed using Barthel Index (BI and Spinal Cord Independence Measures (SCIM. Neurological recovery was assessed using ASIA impairment scale (AIS. We tried to correlate ambulatory ability of the patients with functional and neurological recovery. Results: Ambulatory ability of the patients improved significantly using WISCI II (P < 0.001 when admission and discharge scores were compared (1.4 ± 3.5 vs 7.6 ± 6.03. Similarly, functional (BI: 31.7 ± 20.5 vs 58.4 ± 23.7 and SCIM: 29.9 ± 15.1 vs 56.2 ± 20.6 and neurological recovery were found to be very significant (P < 0.001 when admission vs discharge scores were compared. Improvement in WISCI II scores was significantly correlated with improvement in neurological (using AIS scores and functional status (using BI and SCIM scores (P < 0.001. Conclusions: Significant improvement was seen in WISCI II, BI, and SCIM scores after in-patient rehabilitation. Improvement in WISCI II scores also significantly correlated with functional and neurological recovery.

  10. Ambulation speed and corresponding mechanics are associated with changes in serum cartilage oligomeric matrix protein.

    Science.gov (United States)

    Denning, W Matt; Becker Pardo, Michael; Winward, Jason G; Hunter, Iain; Ridge, Sarah; Hopkins, J Ty; Reese, C Shane; Parcell, Allen C; Seeley, Matthew K

    2016-02-01

    Because serum cartilage oligomeric matrix protein (COMP) has been used to reflect articular cartilage condition, we aimed to identify walking and running mechanics that are associated with changes in serum COMP. Eighteen subjects (9 male, 9 female; age=23 ± 2 yrs.; mass=68.3 ± 9.6 kg; height=1.70 ± 0.08 m) completed 4000 steps on an instrumented treadmill on three separate days. Each day corresponded to a different ambulation speed: slow (preferred walking speed), medium (+50% of slow), and fast (+100% of slow). Synchronized ground reaction force and video data were collected to evaluate walking mechanics. Blood samples were collected pre-, post-, 30-minute post-, and 60-minute post-ambulation to determine serum COMP concentration at these times. Serum COMP increased 29%, 18%, and 5% immediately post ambulation for the fast, medium, and slow sessions (p<0.01). When the speeds were pooled, peak ankle inversion, knee extension, knee abduction, hip flexion, hip extension, and hip abduction moment, and knee flexion angle at impact explained 61.4% of total variance in COMP concentration change (p<0.001). These results indicate that (1) certain joint mechanics are associated with acute change in serum COMP due to ambulation, and (2) increased ambulation speed increases serum COMP concentration. PMID:27004646

  11. Availability of ambulance patient care reports in the emergency department

    Science.gov (United States)

    Shelton, Dominick; Sinclair, Paul

    2016-01-01

    Clinical handovers of patient care among healthcare professionals is vulnerable to the loss of important clinical information. A verbal report is typically provided by paramedics and documented by emergency department (ED) triage nurses. Paramedics subsequently complete a patient care report which is submitted electronically. This emergency medical system (EMS) patient care report often contains details of paramedic assessment and management that is not all captured in the nursing triage note. EMS patient care reports are often unavailable for review by emergency physicians and nurses. Two processes occur in the distribution of EMS patient care reports. The first is an external process to the ED that is influenced by the prehospital emergency medical system and results in the report being faxed to the ED. The second process is internal to the ED that requires clerical staff to distribute the fax report to accompany patient charts. A baseline audit measured the percentage of EMS patient care reports that were available to emergency physicians at the time of initial patient assessments and showed a wide variation in the availability of EMS reports. Also measured were the time intervals from patient transfer from EMS to ED stretcher until the EMS report was received by fax (external process measure) and the time from receiving the EMS fax report until distribution to patient chart (internal process measure). These baseline measures showed a wide variation in the time it takes to receive the EMS reports by fax and to distribute reports. Improvement strategies consisted of: 1. Educating ED clerical staff about the importance of EMS reports 2. Implementing a new process to minimize ED clerical staff handling of EMS reports for nonactive ED patients 3. Elimination of the automatic retrieval of old hospital charts and their distribution for ED patients 4. Introduction of an electronic dashboard for patients arriving by ambulance to facilitate more efficient distribution of

  12. Availability of ambulance patient care reports in the emergency department.

    Science.gov (United States)

    Shelton, Dominick; Sinclair, Paul

    2016-01-01

    Clinical handovers of patient care among healthcare professionals is vulnerable to the loss of important clinical information. A verbal report is typically provided by paramedics and documented by emergency department (ED) triage nurses. Paramedics subsequently complete a patient care report which is submitted electronically. This emergency medical system (EMS) patient care report often contains details of paramedic assessment and management that is not all captured in the nursing triage note. EMS patient care reports are often unavailable for review by emergency physicians and nurses. Two processes occur in the distribution of EMS patient care reports. The first is an external process to the ED that is influenced by the prehospital emergency medical system and results in the report being faxed to the ED. The second process is internal to the ED that requires clerical staff to distribute the fax report to accompany patient charts. A baseline audit measured the percentage of EMS patient care reports that were available to emergency physicians at the time of initial patient assessments and showed a wide variation in the availability of EMS reports. Also measured were the time intervals from patient transfer from EMS to ED stretcher until the EMS report was received by fax (external process measure) and the time from receiving the EMS fax report until distribution to patient chart (internal process measure). These baseline measures showed a wide variation in the time it takes to receive the EMS reports by fax and to distribute reports. Improvement strategies consisted of: 1. Educating ED clerical staff about the importance of EMS reports 2. Implementing a new process to minimize ED clerical staff handling of EMS reports for nonactive ED patients 3. Elimination of the automatic retrieval of old hospital charts and their distribution for ED patients 4. Introduction of an electronic dashboard for patients arriving by ambulance to facilitate more efficient distribution of

  13. Early ambulation following 6 French diagnostic left heart catheterization: a prospective randomized trial.

    Science.gov (United States)

    Wood, R A; Lewis, B K; Harber, D R; Kovack, P J; Bates, E R; Stomel, R J

    1997-09-01

    Outpatient cardiac catheterization is frequently performed, but the optimal recovery time after sheath removal has not been defined. Left heart catheterization was performed via the femoral artery utilizing 6 French catheters on 323 outpatients. One hundred thirty-five patients were randomized to ambulate at a mean of 2.5 hr (group 1) after puncture site compression, whereas 188 patients were randomized to ambulate at a mean of 4.1 hr (group 2). Telephone follow-up occurred within 48 hr. A small hematoma (< 5 cm) occurred in 2 (1.6%) patients in group 1 and in 4 (2.4%) patients in group 2. These results indicate that it is safe to ambulate patients 2.5 hr following 6 French diagnostic heart catheterization. PMID:9286529

  14. Reducing Emergency Medical Service response time via the reallocation of ambulance bases.

    Science.gov (United States)

    Nogueira, L C; Pinto, L R; Silva, P M S

    2016-03-01

    The demand for highly efficient and effective services and consumer goods is an essential prerequisite for modern organizations. In healthcare, efficiency and effectiveness mean reducing disabilities and maintaining human life. One challenge is guaranteeing rapid Emergency Medical Service (EMS) response. This study analyzes the EMS of Belo Horizonte, Brazil, using two modeling techniques: optimization and simulation. The optimization model locates ambulance bases and allocates ambulances to those bases. A simulation of this proposed configuration is run to analyze the dynamic behavior of the system. The main assumption is that optimizing the ambulance base locations can improve the system response time. Feasible solutions were found and the current system may be improved while considering economic and operational changes. PMID:24744263

  15. A Prevalence and Management Study of Acute Pain in Children Attending Emergency Departments by Ambulance.

    Science.gov (United States)

    Murphy, Adrian; McCoy, Siobhan; O'Reilly, Kay; Fogarty, Eoin; Dietz, Jason; Crispino, Gloria; Wakai, Abel; O'Sullivan, Ronan

    2016-01-01

    Pain is the most common symptom in the emergency setting and remains one of the most challenging problems for emergency care providers, particularly in the pediatric population. The primary objective of this study was to determine the prevalence of acute pain in children attending emergency departments (EDs) in Ireland by ambulance. In addition, this study sought to describe the prehospital and initial ED management of pain in this population, with specific reference to etiology of pain, frequency of pain assessment, pain severity, and pharmacological analgesic interventions. A prospective cross-sectional study was undertaken over a 12-month period of all pediatric patients transported by emergency ambulance to four tertiary referral hospitals in Ireland. All children (management of acute pain in children transferred by ambulance to the ED in Ireland is currently poor, with documentary evidence of only 26% receiving prehospital analgesic agents. PMID:26024309

  16. [An ambulance helicopter in Jamtland. A survival necessity in a county of tourism].

    Science.gov (United States)

    Ek, B; Zetterström, H

    2000-03-22

    The county of Jämtland is a sparsely populated area in which an ambulance-helicopter has been in use since the middle of the 1970's. A prospective study was undertaken during a six month period with the aim of evaluating the benefits of the helicopter as compared with the use of road-ambulance transport alone. Total number of patients involved was n = 249. Both flight nurses and receiving doctors found that in most cases, patients transported by helicopter manned with a flight nurse were given higher quality care. A follow-up study by specialists from the receiving departments confirmed that for 3% (n = 8), transport by ambulance-helicopter resulted in "probably better prognosis", and that for 2% (n = 6) the result was "lifesaving". PMID:10765625

  17. Prognostische Indices bei älteren Patienten mit ambulant erworbener Pneumonie

    OpenAIRE

    Niklaus, David

    2010-01-01

    Problem: Die Studie prüft, ob der CURBA-Index dem Pneumonie-Schwere-Index (PSI) bei älteren Patienten mit ambulant erworbener Pneumonie gleichwertig ist für die Abschätzung der Intrahospitalmortalität. Methode: Eine retrospektive Kohortenstudie wertet Daten stationärer Patienten ≥ 65 Jahre mit ambulant erworbener Pneumonie des Marienhospital Herne aus. Die Indices werden daraus generiert und evaluiert. Alle Patienten sind ≥ 65 Jahre, so wird der kürzere CURB-Score verwendet. Er...

  18. The Analysis of Vibration Characteristics and Motion Stability of the Tracked Ambulance Nonlinear Damping System

    Directory of Open Access Journals (Sweden)

    Meng Yang

    2013-01-01

    Full Text Available Considering the impact of the nonlinear stiffness, a 2 DOF dynamic nonlinear vibration model with cubic terms was established according to the structural feature and nonlinear behavior of the tracked ambulance. In the case of primary resonance and 1: 1 internal resonance, multiple scale method was used to obtain a first-order approximate solution for this model. Taking the parameters of the tracked ambulance for instance, the approximate solution was verified and the influence of the parameters on damping effect was investigated. Finally, the motion stability of the damping system was analyzed with singularity theory and the theoretical bases for improving efficiency of the damping system were provided.

  19. Design and methods of European Ambulance Acute Coronary Syndrome Angiography Trial (EUROMAX)

    DEFF Research Database (Denmark)

    Steg, Philippe Gabriel; van 't Hof, Arnoud; Clemmensen, Peter; Lapostolle, Frédéric; Dudek, Dariusz; Hamon, Martial; Cavallini, Claudio; Gordini, Giovanni; Huber, Kurt; Coste, Pierre; Thicoipe, Michel; Nibbe, Lutz; Steinmetz, Jacob; Ten Berg, Jurrien; Eggink, Gerrit Jan; Zeymer, Uwe; Campo Dell' Orto, Marco; Kanic, Vojko; Deliargyris, Efthymios N; Day, Jonathan; Schuette, Diana; Hamm, Christian W; Goldstein, Patrick

    2013-01-01

    In patients with ST-segment elevation myocardial infarction (STEMI) triaged to primary percutaneous coronary intervention (PCI), anticoagulation often is initiated in the ambulance during transfer to a PCI site. In this prehospital setting, bivalirudin has not been compared with standard-of-care ......In patients with ST-segment elevation myocardial infarction (STEMI) triaged to primary percutaneous coronary intervention (PCI), anticoagulation often is initiated in the ambulance during transfer to a PCI site. In this prehospital setting, bivalirudin has not been compared with standard...

  20. Treatment of presumed acute cardiogenic pulmonary oedema in an ambulance system by nurses using Boussignac continuous positive airway pressure

    NARCIS (Netherlands)

    Dieperink, Willem; Weelink, E. E. M.; van der Horst, I. C. C.; de Vos, R.; Jaarsma, T.; Aarts, L. P. H. J.; Zijlstra, F.; Nijsten, M. W. N.

    2009-01-01

    Background: Early initiation of continuous positive airway pressure (CPAP) applied by face mask benefits patients with acute cardiogenic pulmonary oedema (ACPE). The simple disposable Boussignac CPAP (BCPAP) has been used in ambulances by physicians. In the Netherlands, ambulances are manned by nurs

  1. Necessities detected in patients derived to sanitary center in an ambulance of the urgent transport network after being treated by the 061 emergency team

    OpenAIRE

    Sixto Cámara Anguita; Antonio J. Valenzuela Rodríguez

    2007-01-01

    The integral systems of urgencies and sanitary emergencies has, as resources for the urgent transport of patients, with nonwelfare ambulances, ambulances of basic life support and ambulances of advanced life support. In the two first, due to the ambiguity of the norm, the presence of a nurse to give care is not compulsory. Nevertheless, in the present study, it is detected that, the patients of this study, transferred in nonwelfare ambulance of the urgent transport network to a useful hospita...

  2. Cross-cultural validation of the Italian version of the Cumulated Ambulation Score

    DEFF Research Database (Denmark)

    Grana, Elisa; Verzellotti, Simone; Grassi, Federico A;

    2016-01-01

    Hip fractures are common in elderly patients, and walking impairment is a frequent complication. The Cumulated Ambulation Score (CAS) is a validated functional scale used to monitor easily three basic mobility activities in patients with hip fracture. The aim of this study was to translate, cross...

  3. Telemedicin - en mulighed til kvinder der føder ambulant?

    DEFF Research Database (Denmark)

    Danbjørg, Dorthe Boe; Clemensen, Jane; Wagner, Lis;

    2009, s.36). Det overordnede formål er at udforske om telemedicin kan være en mulig løsning, når kvinder udskrives ambulant. Design og metoder: Projektet er et aktionsforskningsprojekt, nærmere bestemt arbejdes der ud fra Participartory Design. Metodologien er baseret på deltagelse af brugerne, og det...

  4. A new vibration isolation bed stage with magnetorheological dampers for ambulance vehicles

    International Nuclear Information System (INIS)

    The vibration experienced in an ambulance can lead to secondary injury to a patient and discourage a paramedic from providing emergency care. In this study, with the goal of resolving this problem, a new vibration isolation bed stage associated with magnetorheological (MR) dampers is proposed to ensure ride quality as well as better care for the patient while he/she is being transported. The bed stage proposed in this work can isolate vibrations in the vertical, rolling and pitching directions to reflect the reality that occurs in the ambulance. Firstly, an appropriate-sized MR damper is designed based on the field-dependent rheological properties of MR fluid, and the damping force characteristics of a MR damper are evaluated as a function of the current. A mechanical model of the proposed vibration isolation bed stage is then established to derive the governing equations of motion. Subsequently, a sliding mode controller is formulated to control the vibrations caused from the imposed excitation signals; those signals are directly measured using a real ambulance subjected to bump-and-curve road conditions. Using the controller based on the dynamic motion of the bed stage, the vibration control performance is evaluated in both the vertical and pitch directions. It is demonstrated that the magnitude of the vibration in the patient compartment of the ambulance can be significantly reduced by applying an input current to the MR dampers installed for the new bed stage. (technical note)

  5. Præhospital behandling. Ambulance-projektet Odense. En prospektiv undersøgelse

    DEFF Research Database (Denmark)

    Larsen, C F; Jørgensen, H R; Nielsen, J R;

    1990-01-01

    by the Danish National Board of Health was also tested. Experience from abroad and recent Danish trial arrangements demonstrate the positive effect of extended professional prehospital treatment. The authors consider, therefore, that an ambulance law is required as this would ensure better and more...

  6. Radiology trainer. Surgical ambulance. 2. rev. and enl. ed.; Roentgen-Trainer. Chirurgische Ambulanz

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, Ole [Wedau-Kliniken Duisburg (Germany). Klinik fuer Unfallchirurgie; Ruchholtz, Steffen [Universitaetsklinikum Giessen und Marburg GmbH, Marburg (Germany). Klinik fuer Unfall-, Hand- und Wiederherstellungschirurgie; Siemann, Holger [LVR Klinikum Essen (Germany); Barkhausen, Joerg [Universitaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin

    2013-08-01

    The radiology trainer for surgical ambulance includes informative X-ray imaging examples for the following issues: zygoma, nasal bone, spinal cord, clavicle, shoulder, upper arms, elbow, forearms, wrist, hand, phalanx, thorax, sternum, pelvis, abdomen, hips, femur, knee, lower leg, ankle, feet.

  7. Educating the ambulance technician, paramedic, and clinical supervisor: using factor analysis to inform the curriculum

    OpenAIRE

    Kilner, T

    2004-01-01

    Methods: Data generated by a Delphi study investigating the desirable attributes of ambulance technician, paramedic, and clinical supervisor were subject to factor analysis to explore inter-relations between the variables or desirable attributes. Variables that loaded onto any factor at a correlation level of >0.3 were included in the analysis.

  8. Time-dependent ambulance allocation considering data-driven empirically required coverage.

    Science.gov (United States)

    Degel, Dirk; Wiesche, Lara; Rachuba, Sebastian; Werners, Brigitte

    2015-12-01

    Empirical studies considering the location and relocation of emergency medical service (EMS) vehicles in an urban region provide important insight into dynamic changes during the day. Within a 24-hour cycle, the demand, travel time, speed of ambulances and areas of coverage change. Nevertheless, most existing approaches in literature ignore these variations and require a (temporally and spatially) fixed (double) coverage of the planning area. Neglecting these variations and fixation of the coverage could lead to an inaccurate estimation of the time-dependent fleet size and individual positioning of ambulances. Through extensive data collection, now it is possible to precisely determine the required coverage of demand areas. Based on data-driven optimization, a new approach is presented, maximizing the flexible, empirically determined required coverage, which has been adjusted for variations due to day-time and site. This coverage prevents the EMS system from unavailability of ambulances due to parallel operations to ensure an improved coverage of the planning area closer to realistic demand. An integer linear programming model is formulated in order to locate and relocate ambulances. The use of such a programming model is supported by a comprehensive case study, which strongly suggests that through such a model, these objectives can be achieved and lead to greater cost-effectiveness and quality of emergency care. PMID:24609684

  9. Ambulance services at hospital universiti sains malaysia and hospital kota bharu: a retrospective study of calls.

    Science.gov (United States)

    Shah Che Hamzah, Mohd Shaharudin; Ahmad, Rashidi; Nik Abdul Rahman, Nik Hisamuddin; Pardi, Kasmah Wati; Jaafar, Naimah; Wan Adnan, Wan Aasim; Jaalam, Kamaruddin; Sahil Jamalullail, Syed Mohsin

    2005-07-01

    This retrospective study attempted to identify the pattern of ambulance calls for the past two years at the Hospital Universiti Sains Malaysia (HUSM) and Hospital Kota Bharu (HKB). This study will provide a simple method of acquiring information related to ambulance response time (ART) and to test whether it met the international standards and needs of the client. Additionally, this paper takes into account the management of emergency calls. This included ambulance response time, which was part of Emergency Medical Services (EMS) episode: onset of ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint had been noted. ART ended when the emergency team arrived at the scene of incident. Information regarding ambulance calls from the record offices of HUSM and HKB was recorded for the year 2001 and 2002, tabulated and analyzed. There was a significant difference in the total number of calls managed by HUSM and HKB in the year 2001. It was noted that 645 calls were managed by HUSM while 1069 calls were recorded at HKB. In the year 2002, however, HUSM led with 613 extra numbers of calls as compare to HKB with 1193 numbers of calls. The pattern of ambulance calls observed is thought to possibly be influenced by social activities like local festivities, school holidays and the seasons. Further, it is observed that no studies were previously undertaken to compare the ART at both the HUSM and HKB to that of the international standards. In fact, a literature review undertaken so far showed no similar studies have been done for the whole Malaysia. PMID:22605956

  10. Weather and age-gender effects on the projection of future emergency ambulance demand in Hong Kong.

    Science.gov (United States)

    Lai, Poh-Chin; Wong, Ho-Ting

    2015-03-01

    An accurate projection for ambulance demand is essential to enable better resource planning for the future that strives to either maintain current levels of services or reconsider future standards and expectations. More than 2 million cases of emergency room attendance in 2008 were obtained from the Hong Kong Hospital Authority to project the demand for its ambulance services in 2036. The projection of ambulance demand in 2036 was computed in consideration of changes in the age-gender structure between 2008 and 2036. The quadratic relation between average daily temperature and daily ambulance demand in 2036 was further explored by including and excluding age-gender demographic changes. Without accounting for changes in the age-gender structure, the 2036 ambulance demand for age groups of 65 and above were consistently underestimated (by 38%-65%), whereas those of younger age groups were overestimated (by 6%-37%). Moreover, changes in the 2008 to 2036 age-gender structure also shift upward and emphasize relationships between average daily temperature and daily ambulance demand at both ends of the quadratic U-shaped curve. Our study reveals a potential societal implication of ageing population on the demand for ambulance services. PMID:23070758

  11. Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting

    Directory of Open Access Journals (Sweden)

    Nielsen Anne

    2012-05-01

    Full Text Available Abstract Background Ambulance personnel play an essential role in the ‘Chain of Survival’. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island. Methods The Basic Life Support (BLS and Automated External Defibrillator (AED skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring sheet. One sample t test was used to analyze the deviation from optimal care according to the 2005 guidelines. After each assessment, individual feedback was given. Results On 3 consecutive days, we assessed the individual EMS teams responding to OHCA on the island. Overall, 70% of the maximal points were achieved. The hands-off ratio was 40%. Correct compression/ventilation ratio (30:2 was used by 80%. A mean compression depth of 40–50 mm was achieved by 55% and the mean compression depth was 42 mm (SD 7 mm. The mean compression rate was 123 per min (SD 15/min. The mean tidal volume was 746 ml (SD 221 ml. Only the mean tidal volume deviated significantly from the recommended (p = 0.01. During the rhythm analysis, 65% did not perform any visual or verbal safety check. Conclusion The EMS providers achieved 70% of the maximal points. Tidal volumes were larger than recommended when mask ventilation was applied. Chest compression depth was optimally performed by 55% of the staff. Defibrillation safety checks were not performed in 65% of EMS providers.

  12. Proposal for periodic verifications of electromedical devices integrated to terrestrial Technical Ambulance Inspection (TAI)

    International Nuclear Information System (INIS)

    In Argentina, electromedical devices may only be commercialized if they meet safety and performance requirements established by current regulations, ensuring their safety and intended performance when leaving the Factory. However, during usage, natural wearing and overloading may change this condition, especially if used in extra hospital services performed by ambulances, which are likely to be subjected to rough handling conditions and hitting. This proposal explains the chosen methodology to address the periodic verification activities of electro medical devices within the process of terrestrial Technical Ambulance Inspection (TAI). Among the results stand out the set of methods for verification and the lists used to record the outcome of this evaluation. Outstanding conclusions include that the operations meet the conditions of an analogous mechanism to that of a Technical Vehicle Inspection (existing for other vehicles), and that the same working structure can be used as a basis for making a manual of procedures for a TAI.

  13. Venous Gas Emboli and Ambulation at 4.3 PSIA (Preliminary)

    Science.gov (United States)

    Conkin, J.; Pollock, N. W.; Natoli, M. J.; Martina, S. D.; Wessel, J. H., III; Gernhardt, M. L.

    2016-01-01

    Introduction: Ambulation imparts compressive and decompressive forces into the lower body[1], potentially creating quasi-stable micronuclei that influence the outcome of hypobaric depressurizations[2-4]. Hypotheses: ambulation before the conclusion of a denitrogenation (prebreathe) protocol at 14.7 pounds per square inch absolute is not sufficient to increase the incidence of venous gas emboli (VGE) at 4.3 pounds per square inch absolute but is sufficient if performed after tissues become supersaturated with nitrogen at 4.3 pounds per square inch absolute. Methods: VGE results from 45 subjects that performed exercise prebreathe without ambulation before or during a 4-hr exposure to 4.3 pounds per square inch absolute (Phase II control) are compared to 21 subjects that performed the same prebreathe but ambulated before and during the hypobaric exposure (Phase II-1) and to 30 subjects that only ambulated before the hypobaric exposure (Phase II-3). VGE in the pulmonary artery were detected at about 16 min intervals using precordial Doppler ultrasound (2.5 megahertz) and assigned a Spencer 0-IV grade. The highest grade assigned during the exposure is one metric, and Grade III or IV were combined as "high VGE grade". We used Fisher's exact directional chi squared for VGE count data. We evaluated survival curves for onset of high VGE grade using non-parametric Kaplan-Meier. Finally, we used logistic regression (LR) to describe the binary response of high VGE grade during an exposure across the three protocols with the three categorical ambulatory states (k) transformed into k-1 dummy variables, plus the following explanatory variables: gender (74 men and 22 women), age (19-57 years), height (155-191 cm), weight (44-115 kg), body mass index (17.5-35.5, as weight in kg/height as square meters), and aerobic fitness through peak oxygen (O (sub 2)) consumption as the volume of oxygen peak (26.1-64.9 milliliters (O (sub 2 (STPD - standard temperature and pressure, dry)) per

  14. Prosthetic ambulation in a paraplegic patient with a transfemoral amputation and radial nerve palsy.

    Science.gov (United States)

    Shin, J C; Park, C; Kim, D Y; Choi, Y S; Kim, Y K; Seong, Y J

    2000-08-01

    Great importance and caution should be placed on prosthetic fitting for a paraplegic patient with an anesthetic residual limb if functional ambulation is to be achieved. The combination of paraplegia with a transfemoral amputation and radial nerve palsy is a complex injury that makes the rehabilitation process difficult. This article describes a case of L2 paraplegia with a transfemoral amputation and radial nerve palsy on the right side. Following the rehabilitation course, the patient independently walked using a walker at indoor level with a transfemoral prosthesis with ischial containment socket, polycentric knee assembly, endoskeletal shank and multiaxis foot assembly and a knee ankle foot orthosis on the sound side. The difficulties of fitting a functional prosthesis to an insensate limb and the rehabilitation stages leading to functional ambulation are reviewed. PMID:10992814

  15. Urban Overdose Hotspots: A 12-Month Prospective Study in Dublin Ambulance Services

    OpenAIRE

    Klimas, Jan; O'Reilly, Martin; Egan, Mairead; Tobin, Helen; Bury, Gerard

    2014-01-01

    Background: Opioid overdose is the primary cause of death among drug users globally. Personal and social determinants of overdose have been studied before, but the environmental factors lacked research attention. Area deprivation or presence of addiction clinics may contribute to overdose. Objectives: To examine the baseline incidence of all new opioid overdoses in an ambulance service, and their relationship with urban deprivation and presence of addiction services. Methods: A prospective ch...

  16. Ambulant jongerenwerk : Vinden, binden, motiveren en doorleiden : de actuele relevantie van de klassieker.

    OpenAIRE

    Metz, Judith

    2011-01-01

    Literatuuronderzoek naar de invloed van 'Welzijn Nieuwe Stijl'. Binnen deze ontwikkeling is er veel aandacht voor outreachend werken (de Eropaf-methode). Een van de acht bakens die richting geven aan de verdere ontwikkeling heet letterlijk ‘Direct eropaf’. Ingegaan wordt op de doelgroepen, de aard van het werk (Wat is ambulant jongerenwerk?), de pedagogische opdracht, methodische uitgangspunten en vaardigheden en randvoorwaarden voor de professional. Ten slotte worden in het onderzoek de resu...

  17. Current challenges in the provision of ambulance services in New Zealand

    OpenAIRE

    Al-Shaqsi, Sultan

    2010-01-01

    Emergency Medical Services (EMS) in New Zealand has been serving the society since the first ambulance in 1892. Since then it has developed rapidly following national health system reforms and changes in lifestyle that increase demands and expectations from local communities. Today, the system provides high-quality pre-hospital emergency care. This article will briefly introduce some of the issues facing EMS that will impact the future of this crucial system in New Zealand. These issues inclu...

  18. Limited benefits of ambulance telemetry in delivering early thrombolysis: a randomised controlled trial

    OpenAIRE

    Woollard, M; Pitt, K.; Hayward, A.; Taylor, N.

    2005-01-01

    Methods: This prospective randomised controlled trial recruited patients using the 999 ambulance service in a rural area of the UK with signs or symptoms of coronary heart disease. Subjects were assigned to receive either standard paramedic treatment or transmission of 12 lead ECG, blood pressure, pulse oximetry, and relevant medical history to a general hospital coronary care unit. Cardiology senior house officers then determined each patient's suitability for pre-hospital thrombolysis time,...

  19. How public ambulance arrivals impact on Emergency Department workload and resource use

    OpenAIRE

    Enrico Ferri; Laura Magrini(INAF Osservatorio Astrofisico di Arcetri, Italy); Marco Alfano; Michele Del Parco; Salvatore Di Somma

    2010-01-01

    Objectives: To examine patient’s characteristics associated with ED arrival mode, and to determine EMS impact on ED clinical resource use, workload and crowding. Methods: This is a retrospective study of patients seen at Sant’Andrea Hospital ED. Comparison focused on visit characteristics, and on resource use. Results: The use of EMS ambulance confirms association to older age, higher rate of hospital admission, longer length of stay, and severity of injury. Moreover our data show...

  20. The effect of early ambulation on the incidence of neurological complication after spinal anesthesia with lidocaine

    Directory of Open Access Journals (Sweden)

    Reihanak Talakoub

    2015-01-01

    Full Text Available Background: Transient neurological symptoms (TNS, was described in patients recovering from spinal anesthesia with lidocaine but its etiology remains unknown this study was evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with lidocaine 5%. Materials and Methods: This randomized clinical trial was conducted on 60 patients with American Society of Anesthesiologists Grades I and II, who were candidates for lower abdominal surgery in supine or lithotomy positions. Patients were randomly divided into early ambulation group (Group A who were asked to start walking as soon as the anesthesia was diminished or to the late ambulation group (Group B who walked after at least 12 h bedridden. Participants were contacted 2 days after spinal anesthesia to assess any type of pain at surgical or anesthesia injection site, muscle weakness, fatigue, vertigo, nausea, vomiting, headache, and difficult urination or defecation. Results: Four subjects (13.3% in Group A and two patients (6.7% in Group B had pain at anesthesia injection site (P = 0.019. Fourteen patients in Group A (46.7% and six patients in Group B (20% had post-dural puncture headache (P = 0.014. Participants in Group B reported difficult urination more than Group A (P = 0.002. there were not statistically significant differences between two groups regarding frequency of fatigue, muscle weakness, vertigo, nausea, vomiting, difficult defecation, paresthesia, and the mean of visual analogue scale at the surgical site. Conclusion: Early ambulation after spinal anesthesia with lidocaine did not increase the risk of neurologic complication.

  1. The effect of early ambulation on the incidence of neurological complication after spinal anesthesia with lidocaine

    OpenAIRE

    Reihanak Talakoub; Mohammad Golparvar; Rezvan Arshi

    2015-01-01

    Background: Transient neurological symptoms (TNS), was described in patients recovering from spinal anesthesia with lidocaine but its etiology remains unknown this study was evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with lidocaine 5%. Materials and Methods: This randomized clinical trial was conducted on 60 patients with American Society of Anesthesiologists Grades I and II, who were candidates for lower abdominal surgery in supine or lithoto...

  2. Symbolic and systemic violence in media representations of aggression towards ambulance personnel in the Netherlands

    OpenAIRE

    Cuijpers, Nicole; Brown, Patrick R.

    2016-01-01

    Violence towards public sector employees is perceived as a growing problem in a number of societies, attracting the attention of mass media, politicians and social scientists alike. In this article we discuss how national newspapers have reported aggression towards ambulance workers in the Netherlands. Our analysis is informed by Žižek’s conceptualisations of less visible yet fundamental formats of violence, which he posits as vital for analysing narratives of subjective experiences of aggres...

  3. Experience of critical incident stress among ambulance service staff and relationship to psychological symptoms.

    Science.gov (United States)

    Gallagher, Sharon; McGilloway, Sinéad

    2009-01-01

    This two-stage study was undertaken to assess the extent and nature of Critical Incident Stress (CIS) amongst frontline staff in a large ambulance service in Ireland. In Stage One, 63% (112/180) of participants completed a Screening Questionnaire and the GHQ-12. In Stage Two, 27 participants, who had experienced a critical incident (CI) during the previous year completed several measures to assess PTSD symptomatology, burnout, health-related Quality of Life, and dispositional optimism. Eighty-one per cent (80/94) of the Stage One group reported that their health had been affected by a CI; 42% (44/106) were identified as 'cases' on the GHQ-12. Stage Two results indicated that 12 participants had PTSD symptoms while this entire group showed moderate levels of emotional exhaustion and depersonalization, despite experiencing high levels of personal accomplishment and optimism. The findings suggest a high prevalence of CIS among ambulance personnel in Ireland and a significant impact on overall health and wellbeing. This has important implications for the effective management of CIS and suggests an important role for occupational health and organizational psychologists in providing routine support to ambulance service staff andpossibly other emergency services personnel. PMID:20524508

  4. Manager-employee interaction in ambulance services: an exploratory study of employee perspectives on management communication.

    Science.gov (United States)

    Nordby, Halvor

    2015-01-01

    Managers of ambulance stations face many communicative challenges in their interaction with employees working in prehospital first-line services. The article presents an exploratory study of how paramedics experience these challenges in communication with station leaders. On the basis of a dialogue perspective in qualitative method, 24 paramedics were interviewed in one-to-one and focus group settings. Naturalistic and phenomenological approaches were used to analyze the interviews. All the paramedics said that they wished to be more involved in decision processes and that station managers should provide better explanations of information "from above." The paramedics understood that it was difficult for the managers to find time for extensive dialogue, but many thought that the managers should give more priority to communication. The paramedics' views correspond to theoretical assumptions in human resource management. According to this model, employees should be involved in decision processes on management levels, as long as it is realistically possible to do so. Furthermore, expressing emotional support and positive attitudes does not take much time, and the study suggests that many ambulance managers should focus more on interpersonal relations to employees. It has been extensively documented that management communication affects organizational performance. The study indicates that managers of ambulance stations should be more aware of how their leadership style affects professional commitment and motivation in the first-line services. PMID:25909398

  5. Reducing Time to First on Scene: An Ambulance-Community First Responder Scheme.

    Science.gov (United States)

    Campbell, Alan; Ellington, Matt

    2016-01-01

    The importance of early access to prehospital care has been demonstrated in many medical emergencies. This work aims to describe the potential time benefit of implementing a student Community First Responder scheme to support ambulance services in an inner-city setting in the United Kingdom. Twenty final and penultimate year medical students in the UK were trained in the "First Person on Scene" Business and Technology Education Council (BTEC) qualification. Over 12 months, they attended 89 emergency calls in an inner-city setting as Community First Responders (CFRs), alongside the West Midlands Ambulance Service, UK. At the end of this period, a qualitative survey investigated the perceived educational value of the scheme. The mean CFR response time across all calls was an average of 3 minutes and 8 seconds less than ambulance crew response times. The largest difference was to calls relating to falls (12 min). The difference varied throughout the day, peaking between 16:00 and 18:00. All questionnaire respondents stated that they felt more prepared in assessing and treating acutely unwell patients. In this paper, the authors present a symbiotic solution which has both reduced time to first on scene and provided training and experience in medical emergencies for senior medical students. PMID:27119024

  6. Feasibility, Reliability and Predictive Value Of In-Ambulance Heart Rate Variability Registration.

    Directory of Open Access Journals (Sweden)

    Laetitia Yperzeele

    Full Text Available Heart rate variability (HRV is a parameter of autonomic nervous system function. A decrease of HRV has been associated with disease severity, risk of complications and prognosis in several conditions.We aim to investigate the feasibility and the reliability of in-ambulance HRV registration during emergency interventions, and to evaluate the association between prehospital HRV parameters, patient characteristics, vital parameters and short-term outcome.We conducted a prospective study using a non-invasive 2-lead ECG registration device in 55 patients transported by the paramedic intervention team of the Universitair Ziekenhuis Brussel. HRV assessment included time domain parameters, frequency domain parameters, nonlinear analysis, and time-frequency analysis. The correlation between HRV parameters and patient and outcome characteristics was analyzed and compared to controls.Artifact and ectopic detection rates were higher in patients during ambulance transportation compared to controls in resting conditions, yet technical reasons precluding in-ambulance HRV analysis occurred in only 9.6% of cases. HRV acquisition was possible without safety issues or interference with routine emergency care. Reliability of the results was considered sufficient for Sample entropy (SampEn, good for the ratio of low frequency and high frequency components (LF/HF ratio in the frequency and the time frequency domain, and excellent for the triangular interpolation of the NN interval histogram (TINN, and for the short-term scaling exponent of the detrended fluctuation analysis (DFA α1. HRV indices were significantly reduced inpatients with unfavorable outcome compared to patients with favorable outcome and controls. Multivariate analysis identified lower DFA α1 as an independent predictor of unfavorable outcome (OR, 0.155; 95% CI 0.024-0.966; p = 0.049.In-ambulance HRV registration is technically and operationally feasible and produces reliable results for parameters

  7. Feasibility, Reliability and Predictive Value Of In-Ambulance Heart Rate Variability Registration

    Science.gov (United States)

    van Hooff, Robbert-Jan; De Smedt, Ann; Nagels, Guy; Hubloue, Ives; De Keyser, Jacques; Brouns, Raf

    2016-01-01

    Background Heart rate variability (HRV) is a parameter of autonomic nervous system function. A decrease of HRV has been associated with disease severity, risk of complications and prognosis in several conditions. Objective We aim to investigate the feasibility and the reliability of in-ambulance HRV registration during emergency interventions, and to evaluate the association between prehospital HRV parameters, patient characteristics, vital parameters and short-term outcome. Methods We conducted a prospective study using a non-invasive 2-lead ECG registration device in 55 patients transported by the paramedic intervention team of the Universitair Ziekenhuis Brussel. HRV assessment included time domain parameters, frequency domain parameters, nonlinear analysis, and time-frequency analysis. The correlation between HRV parameters and patient and outcome characteristics was analyzed and compared to controls. Results Artifact and ectopic detection rates were higher in patients during ambulance transportation compared to controls in resting conditions, yet technical reasons precluding in-ambulance HRV analysis occurred in only 9.6% of cases. HRV acquisition was possible without safety issues or interference with routine emergency care. Reliability of the results was considered sufficient for Sample entropy (SampEn), good for the ratio of low frequency and high frequency components (LF/HF ratio) in the frequency and the time frequency domain, and excellent for the triangular interpolation of the NN interval histogram (TINN), and for the short-term scaling exponent of the detrended fluctuation analysis (DFA α1). HRV indices were significantly reduced inpatients with unfavorable outcome compared to patients with favorable outcome and controls. Multivariate analysis identified lower DFA α1 as an independent predictor of unfavorable outcome (OR, 0.155; 95% CI 0.024–0.966; p = 0.049). Conclusion In-ambulance HRV registration is technically and operationally feasible and

  8. Availability and utilisation of physician-based pre-hospital critical care support to the NHS ambulance service in England, Wales and Northern Ireland

    OpenAIRE

    Hyde, Philip; Mackenzie, Rod; Ng, Gail; Reid, Cliff; Pearson, Gale

    2011-01-01

    Background Every day throughout the UK, ambulance services seek medical assistance in providing critically ill or injured patients with pre-hospital care. Objective To identify the current availability and utilisation of physician-based pre-hospital critical care capability across England, Wales and Northern Ireland. Design A postal and telephone survey was undertaken between April and December 2009 of all 13 regional NHS ambulance services, 17 air ambulance charities, 34 organisations affili...

  9. Automated personnel-assets-consumables-drug tracking in ambulance services for more effective and efficient medical emergency interventions.

    Science.gov (United States)

    Utku, Semih; Özcanhan, Mehmet Hilal; Unluturk, Mehmet Suleyman

    2016-04-01

    Patient delivery time is no longer considered as the only critical factor, in ambulatory services. Presently, five clinical performance indicators are used to decide patient satisfaction. Unfortunately, the emergency ambulance services in rapidly growing metropolitan areas do not meet current satisfaction expectations; because of human errors in the management of the objects onboard the ambulances. But, human involvement in the information management of emergency interventions can be reduced by electronic tracking of personnel, assets, consumables and drugs (PACD) carried in the ambulances. Electronic tracking needs the support of automation software, which should be integrated to the overall hospital information system. Our work presents a complete solution based on a centralized database supported by radio frequency identification (RFID) and bluetooth low energy (BLE) identification and tracking technologies. Each object in an ambulance is identified and tracked by the best suited technology. The automated identification and tracking reduces manual paper documentation and frees the personnel to better focus on medical activities. The presence and amounts of the PACD are automatically monitored, warning about their depletion, non-presence or maintenance dates. The computerized two way hospital-ambulance communication link provides information sharing and instantaneous feedback for better and faster diagnosis decisions. A fully implemented system is presented, with detailed hardware and software descriptions. The benefits and the clinical outcomes of the proposed system are discussed, which lead to improved personnel efficiency and more effective interventions. PMID:26777434

  10. Effects of weather conditions on emergency ambulance calls for acute coronary syndromes.

    Science.gov (United States)

    Vencloviene, Jone; Babarskiene, Ruta; Dobozinskas, Paulius; Siurkaite, Viktorija

    2015-08-01

    The aim of this study was to evaluate the relationship between weather conditions and daily emergency ambulance calls for acute coronary syndromes (ACS). The study included data on 3631 patients who called the ambulance for chest pain and were admitted to the department of cardiology as patients with ACS. We investigated the effect of daily air temperature (T), barometric pressure (BP), relative humidity, and wind speed (WS) to detect the risk areas for low and high daily volume (DV) of emergency calls. We used the classification and regression tree method as well as cluster analysis. The clusters were created by applying the k-means cluster algorithm using the standardized daily weather variables. The analysis was performed separately during cold (October-April) and warm (May-September) seasons. During the cold period, the greatest DV was observed on days of low T during the 3-day sequence, on cold and windy days, and on days of low BP and high WS during the 3-day sequence; low DV was associated with high BP and decreased WS on the previous day. During June-September, a lower DV was associated with low BP, windless days, and high BP and low WS during the 3-day sequence. During the warm period, the greatest DV was associated with increased BP and changing WS during the 3-day sequence. These results suggest that daily T, BP, and WS on the day of the ambulance call and on the two previous days may be prognostic variables for the risk of ACS. PMID:25344902

  11. Effects of weather conditions on emergency ambulance calls for acute coronary syndromes

    Science.gov (United States)

    Vencloviene, Jone; Babarskiene, Ruta; Dobozinskas, Paulius; Siurkaite, Viktorija

    2015-08-01

    The aim of this study was to evaluate the relationship between weather conditions and daily emergency ambulance calls for acute coronary syndromes (ACS). The study included data on 3631 patients who called the ambulance for chest pain and were admitted to the department of cardiology as patients with ACS. We investigated the effect of daily air temperature ( T), barometric pressure (BP), relative humidity, and wind speed (WS) to detect the risk areas for low and high daily volume (DV) of emergency calls. We used the classification and regression tree method as well as cluster analysis. The clusters were created by applying the k-means cluster algorithm using the standardized daily weather variables. The analysis was performed separately during cold (October-April) and warm (May-September) seasons. During the cold period, the greatest DV was observed on days of low T during the 3-day sequence, on cold and windy days, and on days of low BP and high WS during the 3-day sequence; low DV was associated with high BP and decreased WS on the previous day. During June-September, a lower DV was associated with low BP, windless days, and high BP and low WS during the 3-day sequence. During the warm period, the greatest DV was associated with increased BP and changing WS during the 3-day sequence. These results suggest that daily T, BP, and WS on the day of the ambulance call and on the two previous days may be prognostic variables for the risk of ACS.

  12. Lightweight physiologic sensor performance during pre-hospital care delivered by ambulance clinicians.

    Science.gov (United States)

    Mort, Alasdair J; Fitzpatrick, David; Wilson, Philip M J; Mellish, Chris; Schneider, Anne

    2016-02-01

    The aim of this study was to explore the impact of motion generated by ambulance patient management on the performance of two lightweight physiologic sensors. Two physiologic sensors were applied to pre-hospital patients. The first was the Contec Medical Systems CMS50FW finger pulse oximeter, monitoring heart rate (HR) and blood oxygen saturation (SpO2). The second was the RESpeck respiratory rate (RR) sensor, which was wireless-enabled with a Bluetooth(®) Low Energy protocol. Sensor data were recorded from 16 pre-hospital patients, who were monitored for 21.2 ± 9.8 min, on average. Some form of error was identified on almost every HR and SpO2 trace. However, the mean proportion of each trace exhibiting error was <10 % (range <1-50 % for individual patients). There appeared to be no overt impact of the gross motion associated with road ambulance transit on the incidence of HR or SpO2 error. The RESpeck RR sensor delivered an average of 4.2 (±2.2) validated breaths per minute, but did not produce any validated breaths during the gross motion of ambulance transit as its pre-defined motion threshold was exceeded. However, this was many more data points than could be achieved using traditional manual assessment of RR. Error was identified on a majority of pre-hospital physiologic signals, which emphasised the need to ensure consistent sensor attachment in this unstable and unpredictable environment, and in developing intelligent methods of screening out such error. PMID:25804608

  13. Clinical effectiveness of grip strength in predicting ambulation of elderly inpatients

    Directory of Open Access Journals (Sweden)

    Beseler MR

    2014-11-01

    Full Text Available MR Beseler,1 C Rubio,1 E Duarte,1 D Hervás,2 MC Guevara,1 M Giner-Pascual,1 E Viosca1 1Physical Medicine and Rehabilitation, La Fe Hospital, Valencia, Spain; 2Statistical Unit, La Fe Hospital, Valencia, Spain Background: Assessing the clinical effectiveness of measuring grip strength as a prognostic tool in recovering ambulation in bed-confined frail elderly patients. Methods: A prospective study was carried out with 50 elderly inpatients (mean age: 81.6 years old. Manual muscle test was used for checking strength of hip flexor muscles, hip abductor muscles and knee extensor muscles. Grip strength was assessed by hydraulic dynamometer. Walking ability was assessed by functional ambulation categories and Functional Classification of Sagunto Hospital Ambulation. Existence of cognitive impairment (Short Portable Mental Status of Pfeiffer and comorbidity (abbreviated Charlson index were considered to be confounding variables. Statistical analysis: Simple comparisons and mixed models of multiple ordinal regression. Results: The sample presented generalized weakness in scapular (mean 4.22 and pelvic (mean 3.82 muscle. Mean hand grip values were similar: 11.98 kg right hand; 11.70 kg left hand. The patients had lost walking ability. After treatment, there was a statistically significant for scapular waist strength (P=0.001, pelvic waist strength (P=0.005 and walking ability (P=0.001. A statistically significant relationship in the regression analysis was found between the grip (right and left hands and walking ability post-treatment (P=0.009; odds ratio 1.14 and P=0.0014 odds ratio 1.113 for each walking scale. The confounding variables showed no statistical significance in the results.Conclusion: Grip strength is associated with walking ability in hospitalized frail elderly. Grip strength assessment by hydraulic dynamometry is useful in patients with poor collaboration. Walking ability training in frail elderly inpatients is useful. Keywords: gait

  14. The equestrian sport-related injury workload of a regional doctor-led air ambulance unit.

    Science.gov (United States)

    Bleetman, David

    2012-12-01

    The Great Western Ambulance Service Air Support Unit (ASU) was established in July 2007. The helicopter carries a doctor, providing a Helicopter Emergency Medical Service (HEMS) model of care. Equestrian sport-related injuries account for 6.8% of the unit's total attended case load. Horse riding has a higher rate of severe injury than motorcycle racing and 45% of patients admitted with equestrian injuries require surgical intervention. Orthopaedic injuries to the extremities are commonest, superseding head injuries since the introduction of protective headwear. The majority of equestrian sport-related injuries occur in areas inaccessible to land crews. We conducted a retrospective analysis of the ASU mission database from July 2008 to December 2009 (18 months) and identified 29 patients that were attended to by the ASU. The patient cohort had a female majority with an average age of 31.9. 10 Patients (34.5%) were under the age of 20. The ISS ranged from 1 to 75 (mean, 4.8; median, 1) and injuries to the extremities were commonest. The location of the accident was inaccessible to land ambulance in 55.2% of missions. The average mission time was over 2h. Doctors delivered more advanced (medical) interventions in 20.7% of missions. In 41.4% of missions, there were no such interventions performed by the attending doctor and no access to land ambulance. We therefore conclude that a large proportion of ASU dispatches were due to limited access rather than for the delivery of advanced interventions. However, our results support the opinion that horse riding carries some risk of serious injury and when employed appropriately, HEMS doctors on the ASU are a useful resource for a minority of equestrian sport-related injuries. PMID:22015142

  15. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton.

    Science.gov (United States)

    Asselin, Pierre K; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M

    2016-01-01

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment. PMID:27340808

  16. The use of intraluminal strain gauges for recording ambulant small bowel motility.

    Science.gov (United States)

    Gill, R C; Kellow, J E; Browning, C; Wingate, D L

    1990-04-01

    Perfused-tube manometry has hitherto been the standard technique for recording intraluminal intestinal pressure in humans, but it is unsuitable for ambulant use. The aim of our study was to evaluate the ability of resistive strain gauge transducers attached to a fine catheter to detect pressure change. Simultaneous strain gauge and perfused-tube manometry was performed on six fasting subjects; in four, strain gauge activation was continuous and in two, the transducers were activated in a pulsed mode with data encoded as a pulse train with an approximate frequency of 20 Hz. Eight thousand eight hundred eighty-eight pressure waves were recorded by strain gauge, of which 96% were detected by perfused-tube manometry. There was good agreement in both phases II and III of the migrating motor complex. The amplitude of pressure waves recorded by strain gauge was slightly but significantly greater. A proportion (14-17%) of pressure waves recorded by strain gauge were bifid; this was not seen with the perfused tube. These differences are best explained by the greater sensitivity and more rapid rise time of the strain gauges. There was no loss of fidelity in the pulse-interval recording mode. A seventh subject underwent a continuous 72-h recording with the strain gauge catheter attached to a battery-operated encoder and magnetic tape cassette recorder and was freely ambulant during this period. The procedure was well tolerated and motility patterns could be clearly identified. We conclude that intraluminal strain gauge catheters are suitable for prolonged use in ambulant subjects and produce data that are closely comparable to the data acquired from perfused-tube manometry under laboratory conditions. PMID:2333973

  17. Operational implementation and lessons learned from Haiti's first helicopter air ambulance.

    Science.gov (United States)

    DeGennaro, Vincent; Owen, Jordan; Chandler, Jerry; McDaniel, Ralph

    2016-05-01

    Critical-care helicopter transport has demonstrated improvements in morbidity and mortality to those patients who utilise the service, but this has largely excluded developing country populations due to set up costs. Haiti Air Ambulance is the first completely publicly-available helicopter ambulance service in a developing country. US standards were adopted for both aviation and aeromedical care in Haiti due to proximity and relationships. In order to implement properly, standards for aviation, critical care, and insurance reimbursement had to be put in place with local authorities. Haiti Air Ambulance worked with the Ministry of Health to author standards for medical procedures, medication usage, and staff training for aeromedical programs in the country. Utilisation criteria for the helicopter were drafted, edited, and constantly updated to ensure the program adapted to the clinical situation while maintaining US standard of care. During the first year, 76 patients were transferred; 13 of whom were children and 3 pregnant women. Three patients were intubated and two required bi-level mask ventilation. Traumatic injury and non-emergency interfacility transfers were the two most common indications for service. More than half of the transfers (54%) originated at one of six hospitals, mostly as a result of highly-involved staff. The program was limited by weather and the lack of weather reporting, radar, visual flight recognition, thus also causing an inability to fly at night. In partnership with the government and other non-governmental organisations, we seek to implement a more robust pre-hospital system in Haiti over the next 12-24 months, including more scene call capabilities. PMID:26739767

  18. Samarbeid og kompetanseutveksling mellom sykehus og kommune : evaluering av prosjektet "Ambulant team"

    OpenAIRE

    Lorentzen, Catherine

    2008-01-01

    Rapporten er en evaluering av prosjektet ”Ambulant team” som innbefattet ambulerende virksomhet fra Geriatrisk seksjon ved Sykehuset i Vestfold og ut i Horten, Nøtterøy og Sandefjord kommuner i forbindelse med hjemsending av pasienter. Hovedmålene med inneværende undersøkelse har vært å evaluere effekten av den ambulerende virksomheten på samhandlingen og kompetanseutvekslingen behandlingsnivåene imellom, samt å ta stilling til prosjektets videre- og overføringsverdi.

  19. Lightweight physiologic sensor performance during pre-hospital care delivered by ambulance clinicians

    OpenAIRE

    Mort, Alasdair J.; Fitzpatrick, David; Wilson, Philip M. J.; Mellish, Chris; Schneider, Anne

    2015-01-01

    The aim of this study was to explore the impact of motion generated by ambulance patient management on the performance of two lightweight physiologic sensors. Two physiologic sensors were applied to pre-hospital patients. The first was the Contec Medical Systems CMS50FW finger pulse oximeter, monitoring heart rate (HR) and blood oxygen saturation (SpO2). The second was the RESpeck respiratory rate (RR) sensor, which was wireless-enabled with a Bluetooth® Low Energy protocol. Sensor data were ...

  20. Referral to the Hospital And Emergency Ambulance Service Uses Patterns of the Inmates and Convicts

    Directory of Open Access Journals (Sweden)

    Emine Oncu

    2014-03-01

    Full Text Available Aim: The purpose of this study was to determine the reasons for referral to the hospital and 112 emergency ambulance service uses patterns of the inmates and convicts in an E type prison. Material and Method: In this descriptive study, it was evaluated the prison records associated with referral to the hospital and 112 emergency ambulance service uses for one year in 2010- 2011. Of the statistical analysis, descriptive statistics, chi-square test and Fisher%u2019s Exact Test were used. Results: All inmates and convicts were man, the median of age was 30,0 (min 18- max 68 years and substance use was 34,5%. The number of prisoners were referred to the hospital 815, total referrals were 1491; (referrals ranged from one to six and most common in January; and according to frequency, reasons of the referral were eyes problems, musculoskeletal disorders and psychological problems. Emergency medical service was used for in medical causes (78,3%, accident, trauma and injuries (16,4%, suicide (5,3%. Discussion: Findings from the study show that prisoners are more likely to have suffered physical and mental health problems that compared to the rest of society and have significantly high substance use rates.

  1. Kinematics and kinetics with an adaptive ankle foot system during stair ambulation of transtibial amputees.

    Science.gov (United States)

    Alimusaj, Merkur; Fradet, Laetitia; Braatz, Frank; Gerner, Hans J; Wolf, Sebastian I

    2009-10-01

    Conventional prosthetic feet cannot adapt to specific conditions such as walking on stairs or ramps. Amputees are therefore forced to compensate their prosthetic deficits by modifying the kinematics and kinetics of their lower limbs. The Proprio-Foot (Ossur) intends to reduce these compensation mechanisms by automatically increasing dorsiflexion during stair ambulation thanks to an adaptive microprocessor-controlled ankle. The present investigation proposes to analyze the biomechanical effects of the dorsiflexion adaptation in transtibial (TT) amputees during stair ambulation. Sixteen TT amputees and sixteen healthy controls underwent conventional 3D gait analysis. Kinematics and kinetics of the lower limbs were compared during stair ascent and descent performed by patients with the prosthetic foot set to a neutral ankle angle and with an adapted dorsiflexion ankle angle of 4 degrees . Norm distance as well as minimum and maximal values of sagittal kinematics and kinetics were calculated for comparisons between patients and control subjects. For both stair ascent and descent, an improvement of the knee kinematics and kinetics could particularly be noticed on the involved side with an increase of the knee flexion and an increase of the knee moment during stance. Therefore, despite its additional weight compared to a conventional prosthetic ankle, the Proprio-Foot should be beneficial to active TT amputees whose knee musculature strength does not constitute a handicap. PMID:19616436

  2. Assessing post-anterior cruciate ligament reconstruction ambulation using wireless wearable integrated sensors.

    Science.gov (United States)

    Arosha Senanayake, S M N; Ahmed Malik, Owais; Mohammad Iskandar, Pg; Zaheer, Dansih

    2013-11-01

    Abstract A hardware/software co-design for assessing post-Anterior Cruciate Ligament (ACL) reconstruction ambulation is presented. The knee kinematics and neuromuscular data during walking (2-6 km h(-1)) have been acquired using wireless wearable motion and electromyography (EMG) sensors, respectively. These signals were integrated by superimposition and mixed signals processing techniques in order to provide visual analyses of bio-signals and identification of the recovery progress of subjects. Monitoring overlapped signals simultaneously helps in detecting variability and correlation of knee joint dynamics and muscles activities for an individual subject as well as for a group. The recovery stages of subjects have been identified based on combined features (knee flexion/extension and EMG signals) using an adaptive neuro-fuzzy inference system (ANFIS). The proposed system has been validated for 28 test subjects (healthy and ACL-reconstructed). Results of ANFIS showed that the ambulation data can be used to distinguish subjects at different levels of recuperation after ACL reconstruction. PMID:24117351

  3. Humeral fracture in non-ambulant infants - a possible accidental mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Somers, John M.; Halliday, Katharine E. [Nottingham University Hospitals, Radiology Department, Nottingham (United Kingdom); Chapman, Stephen [Birmingham Children' s Hospital, Birmingham (United Kingdom)

    2014-10-15

    Humeral fracture in a non-ambulant infant younger than 1 year is suspicious for a non-accidental injury unless there is a credible accidental explanation. A previously unrecognised accidental mechanism was described in 1996 whereby a 5-month-old infant was rolled by a 3-year-old sibling from a prone to a supine position. To investigate the widely accepted view that an infant with limited mobility cannot sustain a fracture of the humerus by his or her own actions in the absence of the intervention of an external party. We present seven cases of non-ambulant infants between 4 and 7 months of age in whom an isolated humeral fracture was the only injury present. In each case the caregiver described the fracture occurring when the child rolled over, trapping the dependent arm, without the intervention of another party. There is no proof for this mechanism in the form of an independent witness or video recording. However, we propose that this mechanism is worthy of further consideration as a rare and unusual cause for the injury. Further study is required. (orig.)

  4. Evaluation of an algorithm for estimating a patient's life threat risk from an ambulance call

    Directory of Open Access Journals (Sweden)

    Moriwaki Yoshihiro

    2009-10-01

    Full Text Available Abstract Background Utilizing a computer algorithm, information from calls to an ambulance service was used to calculate the risk of patients being in a life-threatening condition (life threat risk, at the time of the call. If the estimated life threat risk was higher than 10%, the probability that a patient faced a risk of dying was recognized as very high and categorized as category A+. The present study aimed to review the accuracy of the algorithm. Methods Data collected for six months from the Yokohama new emergency system was used. In the system, emergency call workers interviewed ambulance callers to obtain information necessary to assess triage, which included consciousness level, breathing status, walking ability, position, and complexion. An emergency patient's life threat risk was then estimated by a computer algorithm applying logistic models. This study compared the estimated life threat risk occurring at the time of the emergency call to the patients' state or severity of condition, i.e. death confirmed at the scene by ambulance crews, resulted in death at emergency departments, life-threatening condition with occurrence of cardiac and/or pulmonary arrest (CPA, life-threatening condition without CPA, serious but not life-threatening condition, moderate condition, and mild condition. The sensitivity, specificity, predictive values, and likelihood ratios of the algorithm for categorizing A+ were calculated. Results The number of emergency dispatches over the six months was 73,992. Triage assessment was conducted for 68,692 of these calls. The study targets account for 88.8% of patients who were involved in triage calls. There were 2,349 cases where the patient had died or had suffered CPA. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of the algorithm at predicting cases that would result in a death or CPA were 80.2% (95% confidence interval

  5. Effect of Planned Early Recommended Ambulation Technique on Selected Post caesarean Biophysiological Health Parameters

    Directory of Open Access Journals (Sweden)

    Jyoti V. Dube

    2014-01-01

    Full Text Available Background: Caesarean section has been a part of human culture since ancient times. It has been used effectively throughout the 20th century and among the major abdominal surgeries, it is the most common, oldest worldwide surgery performed in obstetrics. Despite the life saving advantages, there are several adverse consequences of caesarean delivery for a woman and to her household. The rate and risk of these complications increases due to the increasing incidence mainly in countries like India. The role of nurse midwife is to act in the best interest of patient and newborn and make the patient independent in carrying out the activities of daily living as soon as possible. This can lead to a faster recovery and shorter hospital stay. Also it can indirectly help in reducing the complications associated with prolonged bed rest and can improve the maternal newborn bonding. Aim and Objectives: The present study was done to evaluate the effect of planned early ambulation on selected biophysiological health parameters of post caesarean patients. Material and Methods: The study included total 500 study subjects, 250 in experimental and 250 in control group. Quasi experimental approach with multiple time series design was adopted for the study. The experimental group was given an early planned recommended ambulation technique starting from the day of surgery. This consisted of deep breathing exercise, cough exercise, leg exercise and early mobilization. Over and above, the routine general health care was given by the doctors and nurses. The control group received only by routine general care by doctors and nurses and mobilization on third post operative day as per strategy adopted by the hospital. The deep breathing exercises, coughing exercises and leg exercises were not given routinely and hence were not given to the control group. Post caesarean biophysiological parameters chart was used to assess the selected parameters for first five post operative

  6. A comparison of general and ambulance specific stressors: predictors of job satisfaction and health problems in a nationwide one-year follow-up study of Norwegian ambulance personnel

    Directory of Open Access Journals (Sweden)

    Lau Bjørn

    2011-03-01

    Full Text Available Abstract Objectives To address the relative importance of general job-related stressors, ambulance specific stressors and individual characteristics in relation to job satisfaction and health complaints (emotional exhaustion, psychological distress and musculoskeletal pain among ambulance personnel. Materials and methods A nationwide prospective questionnaire survey of ambulance personnel in operational duty at two time points (n = 1180 at baseline, T1 and n = 298 at one-year follow up, T2. The questionnaires included the Maslach Burnout Inventory, The Job Satisfaction Scale, Hopkins Symptom Checklist (SCL-10, Job Stress Survey, the Norwegian Ambulance Stress Survey and the Basic Character Inventory. Results Overall, 42 out of the possible 56 correlations between job stressors at T1 and job satisfaction and health complaints at T2 were statistically significant. Lower job satisfaction at T2 was predicted by frequency of lack of leader support and severity of challenging job tasks. Emotional exhaustion at T2 was predicted by neuroticism, frequency of lack of support from leader, time pressure, and physical demands. Adjusted for T1 levels, emotional exhaustion was predicted by neuroticism (beta = 0.15, p Psychological distress at T2 was predicted by neuroticism and lack of co-worker support. Adjusted for T1 levels, psychological distress was predicted by neuroticism (beta = 0.12, p Musculoskeletal pain at T2 was predicted by, higher age, neuroticism, lack of co-worker support and severity of physical demands. Adjusted for T1 levels, musculoskeletal pain was predicted neuroticism, and severity of physical demands (beta = 0.12, p Conclusions Low job satisfaction at T2 was predicted by general work-related stressors, whereas health complaints at T2 were predicted by both general work-related stressors and ambulance specific stressors. The personality variable neuroticism predicted increased complaints across all health outcomes.

  7. Cumulated Ambulation Score to evaluate mobility is feasible in geriatric patients and in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Jakobsen, Thomas Linding; Nielsen, Jesper Westphal;

    2012-01-01

    Regaining basic mobility independence is considered important for elderly hospitalised patients. The Cumulated Ambulation Score (CAS) is a valid tool for evaluating these patients' basic mobility (getting in and out of bed, sit-to-stand from a chair and walking) in orthopaedic wards, and its use is...

  8. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Science.gov (United States)

    2010-10-01

    ... representative instructs an enrollee to seek emergency services within or outside the plan; and (v) With a limit... pre-approved ends when— (i) A plan physician with privileges at the treating hospital assumes... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for ambulance services, emergency...

  9. Feasibility of AmbulanCe-Based Telemedicine (FACT) Study : Safety, Feasibility and Reliability of Third Generation Ambulance Telemedicine

    NARCIS (Netherlands)

    Yperzeele, Laetitia; Van Hooff, Robbert-Jan; De Smedt, Ann; Espinoza, Alexis Valenzuela; Van Dyck, Rita; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; Lauwaert, Door; De Keyser, Jacques; Brouns, Raf

    2014-01-01

    Background: Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third

  10. Geographic information system data from ambulances applied in the emergency department: effects on patient reception

    DEFF Research Database (Denmark)

    Raaber, Nikolaj; Pedersen, Iben Duvald; Riddervold, Ingunn Skogstad;

    2016-01-01

    BACKGROUND: Emergency departments (ED) recognize crowding and handover from prehospital to in-hospital settings to be major challenges. Prehospital Geographical Information Systems (GIS) may be a promising tool to address such issues. In this study, the use of prehospital GIS data was implemented...... data was displayed in the ED. Data included real-time estimated time of arrival, distance to ED, dispatch criteria, patient data and ambulance contact information. Data was used by coordinating nurses for time activation of TT and MET involved in the initial treatment of severely-injured or critically...... were reported. DISCUSSION: The contradiction of measured median wait time and nurses perceived improved timing of team activation may result from having both RT- ETA and supplemental patient information not only for seriously-injured or critically-ill patients received by the TT and MET, but for all...

  11. The effects of liberal versus restrictive transfusion thresholds on ambulation after hip fracture surgery

    DEFF Research Database (Denmark)

    Foss, Nicolai B; Kristensen, Morten Tange; Jensen, Pia Søe; Palm, Henrik; Krasheninnikoff, Michael; Kehlet, Henrik

    2009-01-01

    BACKGROUND: Perioperative anemia leads to increased morbidity and mortality and potentially inhibits rehabilitation after hip fracture surgery. As such, the optimum transfusion threshold after hip fracture surgery is unknown. PATIENTS AND METHODS: A total of 120 elderly, cognitively intact hip...... fracture patients admitted from their own home were randomly assigned to receive transfusion at a hemoglobin threshold of 10.0 g per dL (liberal) versus 8.0 g per dL (restrictive) in the entire perioperative period. Patients were treated according to a well-defined multimodal rehabilitation program....... Primary outcome was postoperative functional mobility measured with the cumulated ambulation score (CAS). RESULTS: Patients in the liberal group received transfusions more frequently than those in the restrictive group (44 patients vs. 22 patients; p < 0.01) and received more transfusions during...

  12. The Effect of Early Ambulation on Patient Outcomes for Total Joint Replacement.

    Science.gov (United States)

    Yager, Melissa; Stichler, Jaynelle

    2015-01-01

    The National Association of Orthopaedic Nurses published clinical practice guidelines in 2010 to improve outcomes with day of surgery mobilization in the total joint replacement patient (). With the cost of healthcare skyrocketing and reimbursement marginally covering costs, healthcare professionals must look for ways to reduce length of stay for elective procedures. The purpose of this change project was to provide and measure the effectiveness of an educational intervention on the benefits of day of surgery mobility for nurses and physical therapy staff. Acquisition of caregivers' knowledge, attitudes, and practice was measured along with three patient outcomes (length of stay, discharge destination, and day of ambulation). The findings from this change project resulted in improvements in structure (new practice protocol), processes (nursing and physical therapy care processes), and patient and organization outcomes. PMID:26213872

  13. A Study on Vibration Characteristics and Stability of the Ambulance Nonlinear Damping System

    Directory of Open Access Journals (Sweden)

    Meng Yang

    2013-01-01

    Full Text Available Considering the impact of the nonlinear stiffness, a 2-DOF vibration model with cubic terms was established according to the structural feature and nonlinear behavior. Ignoring the impact of nonlinear terms, the system was linearly analyzed. In the case of primary resonance and 1 : 1 internal resonance, a multiscale method was used to obtain a first-order approximate solution. Taking the parameters of one tracked ambulance for instance, the approximate solution was corroborated and the influence of the parameters on damping effect was investigated. Finally, motion stability of the damping system was analyzed with singularity theory. The theoretical bases for improving efficiency of the damping system were provided.

  14. Design and Development of an Intelligent Mobile Health Tele-assistance System in Ambulance Practice Service

    Directory of Open Access Journals (Sweden)

    Rachid Merzougui

    2013-01-01

    Full Text Available Our attention has focused on the choice of a relevant work. It concerns an implemented and conceived service of medical Teleassistance for monitoring risky persons brought by ambulance service. Thus, a medical bulletin is automatically filled on mobile terminal, immediately transmitted to the service of the emergency (on doctors mobile terminal, data base of clinic. This paper recalls a complete architecture of an economic wireless transmission system with the implementation of an effective application, adapted to the portable phone, allowing the doctor to have the medical information of patients who have a risk of accident. Thus, the stakes of setting up such systems are numerous, so much for patients, medical staff and the society in general.

  15. Use of Functional Ambulation Performance Score as measurement of gait ability: Review

    Directory of Open Access Journals (Sweden)

    Arnaud Gouelle, PhD

    2014-09-01

    Full Text Available Gait analysis systems are widely used for the assessment of gait disabilities and provide more accurate and detailed information than clinical tests. Scores and indexes have been proposed to summarize the large volume of data produced, each emphasizing different aspects of gait. Based on specific spatiotemporal gait parameters, the Functional Ambulation Performance Score (FAPS quantifies gait at a self-selected speed. Integrated within electronic walkways, the FAPS is commonly used for clinical evaluations and has been used in an increasing number of publications over the past few years. However, its use is sometimes distorted by misunderstandings of its composition and calculation, practical and/or conceptual limits, and even the meaning of the score. This technical report reviews the use of the FAPS for the evaluation of gait based on peer-reviewed articles and clinical experience and addresses important issues that must be considered for an optimal unbiased understanding and analysis of the score.

  16. [Idiopathic hemothorax associated with shock during transporting in an ambulance; report of a case].

    Science.gov (United States)

    Mukoyama, Norio; Ishikawa, Y; Toki, S; Tsuzuki, T

    2004-07-01

    A 37-year-old man was admitted to our hospital. The patient noted sudden right back pain after coughing before 1 hour. Loss of consciousness was occurred in an ambulance. Chest X-P revealed whole fluid in the right chest. Enhanced chest computed tomography (CT) revealed extravasation of contrast media into the pleural cavity from the right chest wall. Thoracentesis was performed to relieve dyspnea and 2,000 ml of blood was removed. Then hemoglobin count was dropped to 3.8 g/dl. At thoracotomy whole blood was sucked about 3,900 ml. Bleeding point was found at third intercostal vein. The vein was knotted and sutured by prolene thread. The bleeding lesion was no inflammation and no string like tissue. We report a case of idiopathic hemothorax and enhanced chest CT was useful for diagnosis of bleeding lesion of pleural cavity. PMID:15285390

  17. Evaluation of Bacterial Contamination on Pre Hospital Ambulances in Qom University of Medical Sciences of Iran in 2015

    Directory of Open Access Journals (Sweden)

    Roohollah Farhadloo

    2016-07-01

    Full Text Available Abstract Background & Aims of the Study: When the issue of the quality of the patient's care is addressed, determination of infection degrees in reference to the quality of such cares has gained a high priority. Therefore, infections in ambulance equipment might play a significant role in reduction of the quality of the hospital cares. This study was conducted wishing to determine bacterial infection degrees in ambulances servicing in pre-hospital emergency medical services of Qom University of Medical Sciences, Iran. Materials and Methods: In this analytical cross-sectional study, 132 sampling of the equipments of 12 ambulances were done. Samples were stored on BHI broth as an amplifier for 24 hours. Then, they were introduced to blood agar and Eosin Methylene Blue (EMB agar culture environments. After 24 hours, negative staphylococcus coagulase and bacillus were specified by different environments, solutions, diagnostic discs, gram staining, catalase test, oxidase test and coagulase test. Then data were analyzed by SPSS16. Results: The results showed that the highest infection prevalence rate was observed in stretchers (12 samples, 100% and the lowest in oxygenation moisturizers (1 sample, 8.4%. From infected equipments, in addition, four instruments (37% were mobile and eight of them (63% were immobile. Conclusion: Results indicated that an infection degree of the utensils and instruments which were used in ambulances employed servicing in the Qom Province Medical Emergency Response Center of Iran is high, that might have their roots in non-application of disinfectants for disinfecting ambulance surfaces and equipment. This is a mandatory for healthcare agents to utilize the protective covers, especially medical gloves.

  18. Effects of Weather and Heliophysical Conditions on Emergency Ambulance Calls for Elevated Arterial Blood Pressure

    Directory of Open Access Journals (Sweden)

    Jone Vencloviene

    2015-02-01

    Full Text Available We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009–2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs, in which the conditions for the emergency calls were made coded I.10–I.15. The Kaunas Weather Station provided daily records of air temperature (T, wind speed (WS, relative humidity, and barometric pressure (BP. We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS > 600 km/s increased the daily number of elevated arterial blood pressure (EABP by 12% (RR = 1.12; 95% confidence interval (CI 1.04–1.21; and WS ≥ 3.5 knots during days of T < 1.5 °C and T ≥ 12.5 °C by 8% (RR = 1.08; CI 1.04–1.12. An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T ≥ 17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population’s sensitivity to different weather conditions.

  19. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test.

    Science.gov (United States)

    Pane, Marika; Fanelli, Lavinia; Mazzone, Elena Stacy; Olivieri, Giorgia; D'Amico, Adele; Messina, Sonia; Scutifero, Marianna; Battini, Roberta; Petillo, Roberta; Frosini, Silvia; Sivo, Serena; Vita, Gian Luca; Bruno, Claudio; Mongini, Tiziana; Pegoraro, Elena; De Sanctis, Roberto; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Carlesi, Adelina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bianco, Flaviana; Bonfiglio, Serena; Rolle, Enrica; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Bertini, Enrico; Politano, Luisa; Sormani, Maria Pia; Mercuri, Eugenio

    2015-10-01

    The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naïve or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naïve group (p < 0.001). The 12-month changes ranged between -20 and 4 (mean -4.4). The mean changes were -3.79 in the glucocorticoid group, -5.52 in those who stopped at loss of ambulation and -4.44 in the naïve group. This was more obvious in the patients between 12 and 18 years and at shoulder and elbow levels. Our findings suggest that continuing glucocorticoids throughout teenage years and adulthood after loss of ambulation appears to have a beneficial effect on upper limb function. PMID:26248957

  20. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test

    Science.gov (United States)

    Pane, Marika; Fanelli, Lavinia; Mazzone, Elena Stacy; Olivieri, Giorgia; D'Amico, Adele; Messina, Sonia; Scutifero, Marianna; Battini, Roberta; Petillo, Roberta; Frosini, Silvia; Sivo, Serena; Vita, Gian Luca; Bruno, Claudio; Mongini, Tiziana; Pegoraro, Elena; De Sanctis, Roberto; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Carlesi, Adelina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bianco, Flaviana; Bonfiglio, Serena; Rolle, Enrica; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Bertini, Enrico; Politano, Luisa; Sormani, Maria Pia; Mercuri, Eugenio

    2015-01-01

    The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naïve or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naïve group (p < 0.001). The 12-month changes ranged between −20 and 4 (mean −4.4). The mean changes were −3.79 in the glucocorticoid group, −5.52 in those who stopped at loss of ambulation and −4.44 in the naïve group. This was more obvious in the patients between 12 and 18 years and at shoulder and elbow levels. Our findings suggest that continuing glucocorticoids throughout teenage years and adulthood after loss of ambulation appears to have a beneficial effect on upper limb function. PMID:26248957

  1. Necessities detected in patients derived to sanitary center in an ambulance of the urgent transport network after being treated by the 061 emergency team

    Directory of Open Access Journals (Sweden)

    Sixto Cámara Anguita

    2007-03-01

    Full Text Available The integral systems of urgencies and sanitary emergencies has, as resources for the urgent transport of patients, with nonwelfare ambulances, ambulances of basic life support and ambulances of advanced life support. In the two first, due to the ambiguity of the norm, the presence of a nurse to give care is not compulsory. Nevertheless, in the present study, it is detected that, the patients of this study, transferred in nonwelfare ambulance of the urgent transport network to a useful hospitable center with urgency character, once they have been attended by the 061 emergency team, presented/displayed a group of altered basic human necessities, medical levels of dependency as far as autonomy, nurse diagnoses, medical diagnoses, and necessities of pursuit of the restored evolution of the therapeutic technique and that cause the necessity of benefit of nursing care during this transfer.

  2. L’ambulantage : Représentations du commerce ambulant ou informel et métropolisation

    OpenAIRE

    MONNET, Jérôme

    2006-01-01

    Les représentations sociales font du commerce dit ambulant, informel ou de rue un ensemble flou d’activités liées à l’illégalité, à l’archaïsme et au sous-développement. En première partie, une cybergéographie de ces représentations présente les trois identifications dominantes de ce type de commerce et différencie des approches selon que l’on s’exprime en anglais ou en français et en espagnol. Cependant, elles ont en commun de marginaliser le commerce ambulant, et en particulier de ne pas co...

  3. Use of the emergency ambulance service to an inner city accident and emergency department--a comparison of general practitioner and '999' calls.

    OpenAIRE

    Pennycook, A. G.; Makower, R M; Morrison, W G

    1991-01-01

    Over a 2-week period a prospective study was undertaken of patients brought to an inner city accident and emergency department by the emergency ambulance service. Criteria for assessing the appropriateness of use of the emergency ambulance service are not well defined and at worst entirely subjective. The author's finding that, of patients attending after a '999' call, 49.8% were discharged with no follow-up suggests that many of these journeys represented inappropriate use of the emergency a...

  4. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Hansen Claus D

    2012-07-01

    Full Text Available Abstract Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691 and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%. Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%. The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal

  5. Emergency department visits, ambulance calls, and mortality associated with an exceptional heat wave in Sydney, Australia, 2011: a time-series analysis

    Directory of Open Access Journals (Sweden)

    Schaffer Andrea

    2012-01-01

    Full Text Available Abstract Background From January 30-February 6, 2011, New South Wales was affected by an exceptional heat wave, which broke numerous records. Near real-time Emergency Department (ED and ambulance surveillance allowed rapid detection of an increase in the number of heat-related ED visits and ambulance calls during this period. The purpose of this study was to quantify the excess heat-related and all-cause ED visits and ambulance calls, and excess all-cause mortality, associated with the heat wave. Methods ED and ambulance data were obtained from surveillance and administrative databases, while mortality data were obtained from the state death registry. The observed counts were compared with the average counts from the same period from 2006/07 through 2009/10, and a Poisson regression model was constructed to calculate the number of excess ED visits, ambulance and deaths after adjusting for calendar and lag effects. Results During the heat wave there were 104 and 236 ED visits for heat effects and dehydration respectively, and 116 ambulance calls for heat exposure. From the regression model, all-cause ED visits increased by 2% (95% CI 1.01-1.03, all-cause ambulance calls increased by 14% (95% CI 1.11-1.16, and all-cause mortality increased by 13% (95% CI 1.06-1.22. Those aged 75 years and older had the highest excess rates of all outcomes. Conclusions The 2011 heat wave resulted in an increase in the number of ED visits and ambulance calls, especially in older persons, as well as an increase in all-cause mortality. Rapid surveillance systems provide markers of heat wave impacts that have fatal outcomes.

  6. Differences in police, ambulance, and emergency department reporting of traffic injuries on Karachi-Hala road, Pakistan

    Directory of Open Access Journals (Sweden)

    Lagarde Emmanuel

    2011-03-01

    Full Text Available Abstract Background Research undertaken in developing countries has assessed discrepancies in police reporting of Road Traffic Injury (RTI for urban settings only. The objective of this study was to assess differences in RTI reporting across police, ambulance, and hospital Emergency Department (ED datasets on an interurban road section in Pakistan. Methods The study setting was the 196-km long Karachi-Hala road section. RTIs reported to the police, Edhi Ambulance Service (EAS, and five hospital EDs in Karachi during 2008 (Jan to Dec were compared in terms of road user involved (pedestrians, motorcyclists, four-wheeled vehicle occupants and outcome (died or injured. Further, records from these data were matched to assess ascertainment of traffic injuries and deaths by the three datasets. Results A total of 143 RTIs were reported to the police, 531 to EAS, and 661 to hospital EDs. Fatality per hundred traffic injuries was twice as high in police records (19 per 100 RTIs than in ambulance (10 per 100 RTIs and hospital ED records (9 per 100 RTIs. Pedestrian and motorcyclist involvement per hundred traffic injuries was lower in police records (8 per 100 RTIs than in ambulance (17 per 100 RTIs and hospital ED records (43 per 100 RTIs. Of the 119 deaths independently identified after matching, police recorded 22.6%, EAS 46.2%, and hospital ED 50.4%. Similarly, police data accounted for 10.6%, EAS 43.5%, and hospital ED 54.9% of the 1 095 independently identified injured patients. Conclusions Police reporting, particularly of non-fatal RTIs and those involving vulnerable road users, should be improved in Pakistan.

  7. North Star Ambulatory Assessment, 6-minute walk test and timed items in ambulant boys with Duchenne muscular dystrophy.

    Science.gov (United States)

    Mazzone, Elena; Martinelli, Diego; Berardinelli, Angela; Messina, Sonia; D'Amico, Adele; Vasco, Gessica; Main, Marion; Doglio, Luca; Politano, Luisa; Cavallaro, Filippo; Frosini, Silvia; Bello, Luca; Carlesi, Adelina; Bonetti, Anna Maria; Zucchini, Elisabetta; De Sanctis, Roberto; Scutifero, Marianna; Bianco, Flaviana; Rossi, Francesca; Motta, Maria Chiara; Sacco, Annalisa; Donati, Maria Alice; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Pane, Marika; Pasquini, Elisabetta; Bruno, Claudio; Vita, Giuseppe; de Waure, Chiara; Bertini, Enrico; Mercuri, Eugenio

    2010-11-01

    The North Star Ambulatory Assessment is a functional scale specifically designed for ambulant boys affected by Duchenne muscular dystrophy (DMD). Recently the 6-minute walk test has also been used as an outcome measure in trials in DMD. The aim of our study was to assess a large cohort of ambulant boys affected by DMD using both North Star Assessment and 6-minute walk test. More specifically, we wished to establish the spectrum of findings for each measure and their correlation. This is a prospective multicentric study involving 10 centers. The cohort included 112 ambulant DMD boys of age ranging between 4.10 and 17 years (mean 8.18±2.3 DS). Ninety-one of the 112 were on steroids: 37/91 on intermittent and 54/91 on daily regimen. The scores on the North Star assessment ranged from 6/34 to 34/34. The distance on the 6-minute walk test ranged from 127 to 560.6 m. The time to walk 10 m was between 3 and 15 s. The time to rise from the floor ranged from 1 to 27.5 s. Some patients were unable to rise from the floor. As expected the results changed with age and were overall better in children treated with daily steroids. The North Star assessment had a moderate to good correlation with 6-minute walk test and with timed rising from floor but less with 10 m timed walk/run test. The 6-minute walk test in contrast had better correlation with 10 m timed walk/run test than with timed rising from floor. These findings suggest that a combination of these outcome measures can be effectively used in ambulant DMD boys and will provide information on different aspects of motor function, that may not be captured using a single measure. PMID:20634072

  8. Does a waist-worn ActiGraph accelerometer quantify community ambulation in persons with multiple sclerosis?

    OpenAIRE

    Jacob J. Sosnoff, PhD; Michael J. Socie, MS; Morgan K. Boes, MS; Brian M. Sandroff, MS; Robert W. Motl, PhD

    2012-01-01

    Accelerometry has been recognized as a method of objectively measuring community ambulation in persons with multiple sclerosis (MS). However, the assumption that walking itself serves as a major contributor to the accelerometer signal has yet to be tested. This study examined the assumption that community-based walking is a primary contributor to accelerometer output in MS. Ambulatory persons (5 males/17 females; 13 without aid/9 with aid) with MS wore a triaxial accelerometer (ActiGraph GT3X...

  9. Post-dural Puncture Headache in the Obstetric Patient: Needle Size, Number of Dural Puncture and Timing of Ambulation

    Directory of Open Access Journals (Sweden)

    Sousan Rasooli

    2015-07-01

    Full Text Available Objectives: This prospective study compared the incidence of post-dural puncture headache (PDPH in obstetric patients undergoing spinal anesthesia for caesarean section from April 2012 to April 2013 in one year. We also evaluated the relationship between needle size, number of dural punctures, timing of ambulation and PDPH after cesarean section. Materials and Methods: A total of 319 American Society of Anesthesiologists (ASA I-II full term pregnant women, scheduled for caesarean section under spinal anesthesia from April 2012 to April 2013 were evaluated. Spinal anesthesia was performed with hyperbaric bupivacaine plus fentanyl 10 μg, from L3-4 intervertebral space. We recorded the number of attempts for spinal anesthesia, and the timing of ambulation. Each patient was monitored every day for 4 days following caesarean section. Frequency and severity of PDPH were recorded. SPSS 16 was used for data analysis. Results: Needles used were 25G Quincke spinal needle in 243 patients (76.2% and 27G Quincke spinal needle in 76 patients (21.9%. Of 319 patients, there were 315 (95.6 % in the late ambulation group and 14 (4.4% in the 6 hour bed rest group. In this study only one patient had the classic symptoms of PDPH, whose spinal block were performed with 25G Quincke spinal needle by residents with more than 2 attempts of lumbar puncture (LP. Severe PDPH was not observed in 27G Quincke group. Conclusion: Although our study was performed in a teaching hospital with more residents of anesthesia attempting the procedure, the incidence of PDPH was lower in this study as compared to other studies. This study also concluded that needle size and early ambulation may have some effect on the incidence and characteristics of PDPH.

  10. 6-Minuten-Gehtest bei Patienten mit ambulant erworbener Pneumonie : Belastungsuntersuchung bei der Diagnosestellung und im Verlauf

    OpenAIRE

    Zuber, Martina

    2014-01-01

    Über 6 Wochen erfolgte die Begleitung von 23 Patienten im Verlauf der Rekonvaleszenz nach einer ambulant erworbenen Pneumonie. An vier Zeitpunkten (Diagnosestellung, Entlassung, Ende der Arbeitsunfähigkeit, 6 Wochen nach Diagnosestellung) wurden durch 6-Minuten-Gehtest, Lungenfunktion und Blutgasanalyse die körperlichen Einschränkungen objektiv beurteilt, in der Selbstbeurteilung per St. Georges Respiratory Questionnaire die subjektiven Beschwerden erfasst. Bei Abschluss der Unter...

  11. Powered ankle-foot prosthesis for the improvement of amputee ambulation.

    Science.gov (United States)

    Au, Samuel K; Herr, Hugh; Weber, Jeff; Martinez-Villalpando, Ernesto C

    2007-01-01

    This paper presents the mechanical design, control scheme, and clinical evaluation of a novel, motorized ankle-foot prosthesis, called MIT Powered Ankle-Foot Prosthesis. Unlike a conventional passive-elastic ankle-foot prosthesis, this prosthesis can provide active mechanical power during the stance period of walking. The basic architecture of the prosthesis is a unidirectional spring, configured in parallel with a force-controllable actuator with series elasticity. With this architecture, the anklefoot prosthesis matches the size and weight of the human ankle, and is also capable of delivering high mechanical power and torque observed in normal human walking. We also propose a biomimetic control scheme that allows the prosthesis to mimic the normal human ankle behavior during walking. To evaluate the performance of the prosthesis, we measured the rate of oxygen consumption of three unilateral transtibial amputees walking at self-selected speeds to estimate the metabolic walking economy. We find that the powered prosthesis improves amputee metabolic economy from 7% to 20% compared to the conventional passive-elastic prostheses (Flex-Foot Ceterus and Freedom Innovations Sierra), even though the powered system is twofold heavier than the conventional devices. This result highlights the benefit of performing net positive work at the ankle joint to amputee ambulation and also suggests a new direction for further advancement of an ankle-foot prosthesis. PMID:18002631

  12. Resource planning for ambulance services in mass casualty incidents: a DES-based policy model.

    Science.gov (United States)

    Rauner, Marion S; Schaffhauser-Linzatti, Michaela M; Niessner, Helmut

    2012-09-01

    Due to an increasing number of mass casualty incidents, which are generally complex and unique in nature, we suggest that decision makers consider operations research-based policy models to help prepare emergency staff for improved planning and scheduling at the emergency site. We thus develop a discrete-event simulation policy model, which is currently being applied by disaster-responsive ambulance services in Austria. By evaluating realistic scenarios, our policy model is shown to enhance the scheduling and outcomes at operative and online levels. The proposed scenarios range from small, simple, and urban to rather large, complex, remote mass casualty emergencies. Furthermore, the organization of an advanced medical post can be improved on a strategic level to increase rescue quality, including enhanced survival of injured victims. In particular, we consider a realistic mass casualty incident at a brewery relative to other exemplary disasters. Based on a variety of such situations, we derive general policy implications at both the macro (e.g., strategic rescue policy) and micro (e.g., operative and online scheduling strategies at the emergency site) levels. PMID:22653522

  13. Treadmill measures of ambulation rates in ovine models of spinal cord injury and neuropathic pain.

    Science.gov (United States)

    Safayi, S; Miller, J W; Wilson, S; Shivapour, S K; Oelfke, T F; Ford, A L; Klarmann Staudt, A; Abode-Iyamah, K; Reddy, C G; Jeffery, N D; Fredericks, D C; Gillies, G T; Howard, M A

    2016-01-01

    Our laboratories are developing treadmill-based gait analysis employing sheep to investigate potential efficacy of intra-dural spinal cord stimulation in the treatment of spinal cord injury and neuropathic pain. As part of efforts to establish the performance characteristics of the experimental arrangement, this study measured the treadmill speed via a tachometer, video belt-marker timing and ambulation-rate observations of the sheep. The data reveal a 0.1-0.3% residual drift in the baseline (unloaded) treadmill speed which increases with loading, but all three approaches agree on final speed to within 1.7%, at belt speeds of ≈ 4 km/h. Using the tachometer as the standard, the estimated upper limit on uncertainty in the video belt-marker approach is ± 0.18 km h(-1) and the measured uncertainty is ± 0.15 km h(-1). Employment of the latter method in determining timing differences between contralateral hoof strikes by the sheep suggests its utility in assessing severity of SCI and responses to therapeutic interventions. PMID:26785329

  14. Ambulation During Periods of Supersaturation Increase Decompression Stress in Spacewalk Simulations

    Science.gov (United States)

    Pollock, N. W.; Natoli, M. J.; Martina, S. D.; Conkin, J.; Wessel, J. H., III; Gernhardt, M. L.

    2016-01-01

    Musculoskeletal activity accelerates inert gas elimination during oxygen breathing prior to decompression (prebreathe), but may also promote bubble formation (nucleation) and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity and the level of tissue supersaturation are likely critical to the net effect. Understanding the relationships is important to evaluate exercise prebreathe protocols and quantify decompression risk in gravity and microgravity environments. The NASA Prebreathe Reduction Program (PRP) combined oxygen prebreathe and exercise preceding a low pressure (4.3 psia; altitude equivalent of 30,300 ft [9,235 m]) simulation exposure of non-ambulatory subjects (a microgravity analog) to produce two protocols now used by astronauts preparing for extravehicular activity. One protocol included both upright cycling and non-cycling exercise (CEVIS: 'cycle ergometer vibration isolation system') and one protocol relied on non-cycling exercise only (ISLE: 'in-suit light exercise'). CEVIS trial data serve as control data for the current study to investigate the influence of ambulation exercise in 1G environments on bubble formation and the subsequent risk of DCS.

  15. Calls Forecast for the Moscow Ambulance Service. The Impact of Weather Forecast

    Science.gov (United States)

    Gordin, Vladimir; Bykov, Philipp

    2015-04-01

    We use the known statistics of the calls for the current and previous days to predict them for tomorrow and for the following days. We assume that this algorithm will work operatively, will cyclically update the available information and will move the horizon of the forecast. Sure, the accuracy of such forecasts depends on their lead time, and from a choice of some group of diagnoses. For comparison we used the error of the inertial forecast (tomorrow there will be the same number of calls as today). Our technology has demonstrated accuracy that is approximately two times better compared to the inertial forecast. We obtained the following result: the number of calls depends on the actual weather in the city as well as on its rate of change. We were interested in the accuracy of the forecast for 12-hour sum of the calls in real situations. We evaluate the impact of the meteorological errors [1] on the forecast errors of the number of Ambulance calls. The weather and the Ambulance calls number both have seasonal tendencies. Therefore, if we have medical information from one city only, we should separate the impacts of such predictors as "annual variations in the number of calls" and "weather". We need to consider the seasonal tendencies (associated, e. g. with the seasonal migration of the population) and the impact of the air temperature simultaneously, rather than sequentially. We forecasted separately the number of calls with diagnoses of cardiovascular group, where it was demonstrated the advantage of the forecasting method, when we use the maximum daily air temperature as a predictor. We have a chance to evaluate statistically the influence of meteorological factors on the dynamics of medical problems. In some cases it may be useful for understanding of the physiology of disease and possible treatment options. We can assimilate some personal archives of medical parameters for the individuals with concrete diseases and the relative meteorological archive. As a

  16. Long term natural history data in ambulant boys with Duchenne muscular dystrophy: 36-month changes.

    Directory of Open Access Journals (Sweden)

    Marika Pane

    Full Text Available The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3% lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14% and 11 between 24 and 36 months (12%. The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3 m at 12 months, of -58.9 (SD 125.7 m at 24 months and -104.22 (SD 146.2 m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m (p<0.001. The changes were also significantly different according to steroid treatment (p = 0.01. Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available.

  17. Long term natural history data in ambulant boys with Duchenne muscular dystrophy: 36-month changes.

    Science.gov (United States)

    Pane, Marika; Mazzone, Elena Stacy; Sivo, Serena; Sormani, Maria Pia; Messina, Sonia; D'Amico, Adele; Carlesi, Adelina; Vita, Gianluca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; Lanzillotta, Valentina; Viggiano, Emanuela; D Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Barp, Andrea; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Graziano, Alessandra; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P; Bertini, Enrico; Mercuri, Eugenio

    2014-01-01

    The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3%) lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14%) and 11 between 24 and 36 months (12%). The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3) m at 12 months, of -58.9 (SD 125.7) m at 24 months and -104.22 (SD 146.2) m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m) (p<0.001). The changes were also significantly different according to steroid treatment (p = 0.01). Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available. PMID:25271887

  18. Cross-cultural validation of the Italian version of the Cumulated Ambulation Score.

    Science.gov (United States)

    Grana, Elisa; Verzellotti, Simone; Grassi, Federico A; Ferriero, Giorgio; Kristensen, Morten T; Cisari, Carlo; Invernizzi, Marco

    2016-06-01

    Hip fractures are common in elderly patients, and walking impairment is a frequent complication. The Cumulated Ambulation Score (CAS) is a validated functional scale used to monitor easily three basic mobility activities in patients with hip fracture. The aim of this study was to translate, cross-cultural adapt, and validate the CAS in the Italian language (CAS-I). The translation was carried out according to recommended guidelines. The final version of the CAS-I was administered to 80 geriatric patients with hip fracture admitted to a Traumatology Unit, and allowed full weight-bearing after treatment with hemiarthroplasty. Two raters evaluated each patient 2 days after surgery and then after 3 months. Statistical methods included Cronbach's α coefficient for the scale's internal consistency; the total agreement; and the κ coefficient for the inter-rater reliability. The concurrent validity of the scale was determined by comparing the total CAS-I (0-6 points) with the Index of Independence in Activities of Daily Living score (0-4 points). Internal consistency and inter-rater reliability of the CAS, evaluated with Cronbach's α and κ, respectively, were above 0.84 and 0.94. The SE of measurement for the total CAS-I (0-6 points) 2 days and 3 months after surgery were 0.03 and 0.13 points, respectively. The CAS-I showed a significant correlation with the first four items of the Activities of Daily Living score scale (r≥0.85, P<0.001). This study confirms the validity of the CAS-I for patients with a hemiarthroplasty after hip fracture and provides additional evidence of the psychometric properties of the scale. We suggest that the official CAS-I version be used in other settings to evaluate the basic mobility in patients with hip fracture. PMID:27028288

  19. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Implementation and Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations and Lifting of the Temporary Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations. Extension, implementation, and lifting of temporary moratoria.

    Science.gov (United States)

    2016-08-01

    This document announces the extension of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare home health agencies (HHAs), subunits, and branch locations in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. It also announces the implementation of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare HHAs, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey on a statewide basis. In addition, it announces the lifting of the moratoria on all Part B emergency ground ambulance suppliers. These moratoria, and the changes described in this document, also apply to the enrollment of HHAs and non-emergency ground ambulance suppliers in Medicaid and the Children's Health Insurance Program. PMID:27487581

  20. Response times of ambulances to calls from Midwife Obstetric Units of the Peninsula Maternal and Neonatal Service (PMNS in Cape Town

    Directory of Open Access Journals (Sweden)

    J.K. Marcus

    2009-09-01

    Full Text Available Response times of ambulances to calls from Midwife Obstetric Units, although varied, are perceived as slow. Delays in transporting women experiencing complications during or after their pregnancies to higher levels of care may have negative consequences such as fetal, neonatal or maternal morbidity or death. An exploratory descriptive study was undertaken to investigate the response times of ambulances of the Western Cape Emergency Medical Services to calls from midwife obstetric units (MOUs in the Peninsula Maternal and Neonatal Services (PMNS in Cape Town. Response times were calculated from data collected in specific MOUs using a specifically developed instrument. Recorded data included time of call placed requesting transfer, diagnosis or reason for transfer, priority of call and the time of arrival of ambulance to the requesting facility. Mean, median and range of response times, in minutes, to various MOUs and priorities of calls were calculated. These were then compared using the Kruskal-Wallis test. A comparison was then made between the recorded and analysed response times to national norms and recommendations for ambulance response times and maternal transfer response times respectively.A wide range of response times was noted for the whole sample. Median response times across all priorities of calls and to all MOUs in sample fell short of national norms and recommendations. No statistical differences were noted between various priorities of calls and MOUs.The perception of delayed response times of ambulances to MOUs in the PMNS was confirmed in this pilot study.

  1. Otimização da localização das bases de ambulâncias e do dimensionamento das suas regiões de cobertura em rodovias Optimizing the location of ambulance bases and the districting of their covering regions on highways

    Directory of Open Access Journals (Sweden)

    Ana Paula Iannoni

    2008-01-01

    Full Text Available Neste artigo combinamos extensões do modelo hipercubo de filas com algoritmos genéticos para otimizar a configuração e operação de sistemas médicos emergenciais em rodovias. Inicialmente apresentamos um método para localizar as bases de ambulâncias ao longo da rodovia, de forma a otimizar as principais medidas de desempenho do sistema. Em seguida estendemos a abordagem para apoiar duas decisões combinadas: a localização das bases de ambulâncias e o dimensionamento das regiões de cobertura de cada base na rodovia. Por exemplo, a abordagem permite determinar os locais para posicionar as bases de ambulâncias e dimensionar os tamanhos das suas áreas de atuação, tais que minimizem o tempo médio de resposta aos usuários e/ou o desbalanceamento das cargas de trabalho das ambulâncias do sistema. Para ilustrar a aplicação dos métodos propostos, analisamos os resultados de dois estudos de caso em rodovias brasileiras.In this paper we combine extensions of the hypercube queueing model with genetic algorithms to optimize the configuration and operation of emergency medical systems on highways. Initially we present a method to locate the ambulance bases along the highway so that the main system performance measures are optimized. Then we extend the approach to support combined decisions: the location of ambulance bases and the districting of the covering regions of each base on the highway. For instance, the approach can search for locals to place the ambulance bases and determine the sizes of their operation areas, such that the mean user response time and/or the ambulance workload imbalance are minimized. To illustrate the application of the proposed methods, we analyze the results of two case studies of Brazilian highways.

  2. Feasibility of AmbulanCe-Based Telemedicine (FACT study: safety, feasibility and reliability of third generation in-ambulance telemedicine.

    Directory of Open Access Journals (Sweden)

    Laetitia Yperzeele

    Full Text Available BACKGROUND: Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third generation. METHODS: A routine ambulance was equipped with a system for real-time bidirectional audio-video communication, automated transmission of vital parameters, glycemia and electronic patient identification. All patients ( ≥ 18 years transported during emergency missions by a Prehospital Intervention Team of the Universitair Ziekenhuis Brussel were eligible for inclusion. To guarantee mobility and to facilitate 24/7 availability, the teleconsultants used lightweight laptop computers to access a dedicated telemedicine platform, which also provided functionalities for neurological assessment, electronic reporting and prehospital notification of the in-hospital team. Key registrations included any safety issue, mobile connectivity, communication of patient information, audiovisual quality, user-friendliness and accuracy of the prehospital diagnosis. RESULTS: Prehospital teleconsultation was obtained in 41 out of 43 cases (95.3%. The success rates for communication of blood pressure, heart rate, blood oxygen saturation, glycemia, and electronic patient identification were 78.7%, 84.8%, 80.6%, 64.0%, and 84.2%. A preliminary prehospital diagnosis was formulated in 90.2%, with satisfactory agreement with final in-hospital diagnoses. Communication of a prehospital report to the in-hospital team was successful in 94.7% and prenotification of the in-hospital team via SMS in 90.2%. Failures resulted mainly from limited mobile connectivity and to a lesser extent from software, hardware or human error. The user acceptance was high. CONCLUSIONS: Ambulance-based telemedicine of the third generation is safe, feasible and reliable but further research and

  3. Effects of robot-assisted gait training on the balance and gait of chronic stroke patients: focus on dependent ambulators.

    Science.gov (United States)

    Cho, Duk Youn; Park, Si-Woon; Lee, Min Jin; Park, Dae Sung; Kim, Eun Joo

    2015-10-01

    [Purpose] The purpose of this study was to confirm the effect of robot-assisted gait training on the balance and gait ability of stroke patients who were dependent ambulators. [Subjects and Methods] Twenty stroke patients participated in this study. The participants were allocated to either group 1, which received robot-assisted gait training for 4 weeks followed by conventional physical therapy for 4 weeks, or group 2, which received the same treatments in the reverse order. Robot-assisted gait training was conducted for 30 min, 3 times a week for 4 weeks. The Berg Balance Scale, Modified Functional Reach Test, Functional Ambulation Category, Modified Ashworth Scale, Fugl-Meyer Assessment, Motricity Index, and Modified Barthel Index were assessed before and after treatment. To confirm the characteristics of patients who showed a significant increase in Berg Balance Scale after robot-assisted gait training as compared with physical therapy, subgroup analysis was conducted. [Results] Only lateral reaching and the Functional Ambulation Category were significantly increased following robot-assisted gait training. Subscale analyses identified 3 patient subgroups that responded well to robot-assisted gait training: a subgroup with hemiplegia, a subgroup in which the guidance force needed to be decreased to needed to be decreased to ≤45%, and a subgroup in which weight bearing was decreased to ≤21%. [Conclusion] The present study showed that robot-assisted gait training is not only effective in improving balance and gait performance but also improves trunk balance and motor skills required by high-severity stroke patients to perform activities daily living. Moreover, subscale analyses identified subgroups that responded well to robot-assisted gait training. PMID:26644642

  4. Characterization of Artifacts Produced by Gel Displacement on Non-invasive Brain-Machine Interfaces during Ambulation.

    Science.gov (United States)

    Costa, Álvaro; Salazar-Varas, Rocio; Úbeda, Andrés; Azorín, José M

    2016-01-01

    So far, Brain-Machine Interfaces (BMIs) have been mainly used to study brain potentials during movement-free conditions. Recently, due to the emerging concern of improving rehabilitation therapies, these systems are also being used during gait experiments. Under this new condition, the evaluation of motion artifacts has become a critical point to assure the validity of the results obtained. Due to the high signal to noise ratio provided, the use of wet electrodes is a widely accepted technic to acquire electroencephalographic (EEG signals). To perform these recordings it is necessary to apply a conductive gel between the scalp and the electrodes. This work is focused on the study of gel displacements produced during ambulation and how they affect the amplitude of EEG signals. Data recorded during three ambulation conditions (gait training) and one movement-free condition (BMI motor imagery task) are compared to perform this study. Two phenomenons, manifested as unusual increases of the signals' amplitude, have been identified and characterized during this work. Results suggest that they are caused by abrupt changes on the conductivity between the electrode and the scalp due to gel displacement produced during ambulation and head movements. These artifacts significantly increase the Power Spectral Density (PSD) of EEG recordings at all frequencies from 5 to 90 Hz, corresponding to the main bandwidth of electrocortical potentials. They should be taken into consideration before performing EEG recordings in order to asses the correct gel allocation and to avoid the use of electrodes on certain scalp areas depending on the experimental conditions. PMID:26941601

  5. Model application for rapid detection of the exact location when calling an ambulance using OGC Open GeoSMS Standards

    Science.gov (United States)

    Sukic, Enes; Stoimenov, Leonid

    2016-02-01

    The web has penetrated just about every sphere of human interest and using information from the web has become ubiquitous among different categories of users. Medicine has long being using the benefits of modern technologies and without them it cannot function. This paper offers a proposal of use and mutual collaboration of several modern technologies within facilitating the location and communication between persons in need of emergency medical assistance and the emergency head offices, i.e., the ambulance. The main advantage of the proposed model is the technical possibility of implementation and use of these technologies in developing countries and low implementation cost.

  6. Indications and results of the unilateral /sup 123/I-hippurate-clearance in an ambulant urological-nephrological patients collective

    Energy Technology Data Exchange (ETDEWEB)

    Mariss, P.; Haubold, E.

    1988-02-01

    In 572 nephrological-urological ambulant patients 688 estimations of unilateral renal plasma flow were performed after application of 300 kBq/kg /sup 123/I-hippurate using a large field scintillation camera, external scintillation probe over the right shoulder and a computer system. The indications were patients with hypertension, chronic pyelonephritis, unilateral nephrocirrhosis, exclusion or approval of renal failure, furthermore diverse malformations of the urovesical system, nephrolithiasis and follow-up after urological operations. The unilateral renal clearance by /sup 123/I-hippurate represents an important diagnostic tool in urological-nephrological patients with special diseases in addition to morphological and microbiological methods.

  7. Indications and results of the unilateral 123I-hippurate-clearance in an ambulant urological-nephrological patients collective

    International Nuclear Information System (INIS)

    In 572 nephrological-urological ambulant patients 688 estimations of unilateral renal plasma flow were performed after application of 300 kBq/kg 123I-hippurate using a large field scintillation camera, external scintillation probe over the right shoulder and a computer system. The indications were patients with hypertension, chronic pyelonephritis, unilateral nephrocirrhosis, exclusion or approval of renal failure, furthermore diverse malformations of the urovesical system, nephrolithiasis and follow-up after urological operations. The unilateral renal clearance by 123I-hippurate represents an important diagnostic tool in urological-nephrological patients with special diseases in addition to morphological and microbiological methods. (orig.)

  8. Improvement in the pre-hospital care of recreational drug users through the development of club specific ambulance referral guidelines

    Directory of Open Access Journals (Sweden)

    Heather Kim

    2008-06-01

    Full Text Available Abstract Background Previously developed 'club guidelines' developed for club owners and promoters have tended to focus more on the legislative aspects of clubs, rather than the medical management of unwell clubbers within club environments. Despite this lack of guidance on the management of unwell clubbers, a significant proportion of clubs have 'club medic' rooms for managing these individuals. However, due to the lack of specific guidance on the training of staff working in these rooms and guidelines on when an ambulance should be called for an unwell clubber, there have been instances previously where clubbers have been inappropriately managed within the club environment, and often referred to hospital only after significant physiological derangement has occurred, thereby leading to an increased risk of morbidity and mortality. Methods We identified owners and promoters of local club venues within the catchment area of our Emergency Department and working jointly with them and other key stakeholders, in particular the London Ambulance Service and Metropolitan Police, identified strategies to improve pre-hospital care for clubbers who become unwell as a result of recreational drug use. These included developing guidelines detailing indications for ambulance transfer to hospital for clubbers with recreational drug toxicity and the training of club medic staff to use the guidelines Results Following the initial development of a pilot set of guidelines, an audit of their use identified training needed relating to the assessment of unwell clubbers with recreational drug toxicity and revisions required to the pilot version of the guidelines. After training related to the revised guidelines, all the club medic staff were confident in their ability to assess unwell clubbers with recreational drug toxicity, the use of the guidelines and also when to call an ambulance. Conclusion Working with key stakeholders in the local community, we have developed

  9. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel - a cross-sectional study

    DEFF Research Database (Denmark)

    Hansen, Claus D; Rasmussen, Kurt; Kyed, Morten;

    2012-01-01

    demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional......,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of...... poor self-rated health compared to the core work force (5 % vs. 10 %). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional...

  10. Integration between the tele-cardiology unit and the central laboratory: methodological and clinical evaluation of point-of-care testing cardiac marker in the ambulance.

    Science.gov (United States)

    Di Serio, Francesca; Lovero, Roberto; Leone, Massimo; De Sario, Rosalia; Ruggieri, Vincenzo; Varraso, Lucia; Pansini, Nicola

    2006-01-01

    The aim of this study was to identify patients with myocardial necrosis in pre-hospital phase during transport by ambulance, without ST-segment elevation (NSTE) on the ambulance ECG. The analytical performance of the i-STAT troponin I (cTnI) method was assessed. A total of 53 NSTE ambulance ECG patients admitted to hospital were followed. The ambulance had experimental software able to receive data from the i-STAT device and transmit it to a protected address and server. cTnI mean values from 2.0 to 34 microg/L showed a total CV of 3.0-5.6%. The detection limit was 0.016 microg/L. A mean cTnI concentration of 0.09 microg/L was associated with a CV of 8.0% (decision limit). The i-STAT cTnI method was linear for concentrations from 0 to 35 microg/L. There was no effect (p0.09 microg/L in 20 AMI patients (91%). The median ambulance turnaround time (TAT) was 12 min and median hospital TAT was 40 min, a difference of 28 min. The high sensitivity of the i-STAT cTnI method integrated with tele-medicine procedures could play an important role in the management of acute coronary syndrome patients related to the pre-hospital phase (early diagnosis and treatment in the ambulance). These approaches may allow improvements in patient outcomes and continuous monitoring of the POCT network in the central laboratory, thus meeting quality requirements. PMID:16729867

  11. Does a waist-worn ActiGraph accelerometer quantify community ambulation in persons with multiple sclerosis?

    Directory of Open Access Journals (Sweden)

    Jacob J. Sosnoff, PhD

    2012-12-01

    Full Text Available Accelerometry has been recognized as a method of objectively measuring community ambulation in persons with multiple sclerosis (MS. However, the assumption that walking itself serves as a major contributor to the accelerometer signal has yet to be tested. This study examined the assumption that community-based walking is a primary contributor to accelerometer output in MS. Ambulatory persons (5 males/17 females; 13 without aid/9 with aid with MS wore a triaxial accelerometer (ActiGraph GT3X, Health One Technologies; Fort Walton Beach, Florida as well as an IDEEA system (MiniSun, Inc; Fresno, Florida over the course of a single day. Outcome measures for the accelerometer included movement counts/hour for the vertical, anterior-posterior, and mediolateral axes. Outcomes for the IDEEA system included percent time walking, sitting, and standing, as well as walking speed. Pearson product correlations (r were used to examine the associations between outcomes from the accelerometer and IDEEA system. Significant correlations were observed between percent walking time and movement counts/hour along the vertical (r = 0.84 and anterior-posterior (r = 0.69 axes. Significant correlations were further noted between movement counts/hour along the vertical axis and walking speed (r = 0.45 and self-report walking impairment (r = −0.50 and disability (r = −0.46. Such observations further support accelerometry as an objective marker of community ambulation in persons with MS.

  12. Living in critical times: The impact of critical incidents on frontline ambulance personnel--a qualitative perspective.

    LENUS (Irish Health Repository)

    Gallagher, Sharon

    2007-01-01

    Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel. One-to-one interviews were conducted with 27 participants who had experienced CIs during the previous 12 months in order to: assess the nature and impact of CIs on health and well-being; examine attitudes toward support services; and explore barriers to service use. The results showed that incidents involving children, suicides, and grotesque mutilation were the most distressing. Participants reported a wide range of physical and mental health problems including sleep difficulties, angry outbursts, irrationality and feelings of alienation. Key themes included: low support service uptake due to fears relating to confidentiality and machismo; a perceived lack of concern and support from management; and a need for professional counselling and stress awareness training. Emergency Medical Controllers (EMCs) also reported a number of difficulties unique to their role. The findings suggest that exposure to CIs has a significant impact on health and well-being; this has important implications for recognizing and appropriately addressing the health and training needs of ambulance personnel, including the effective management of Critical Incident Stress.

  13. Minimally Invasive Posterior Stabilization Improved Ambulation and Pain Scores in Patients with Plasmacytomas and/or Metastases of the Spine

    Directory of Open Access Journals (Sweden)

    Joseph H. Schwab

    2011-01-01

    Full Text Available Background. The incidence of spine metastasis is expected to increase as the population ages, and so is the number of palliative spinal procedures. Minimally invasive procedures are attractive options in that they offer the theoretical advantage of less morbidity. Purpose. The purpose of our study was to evaluate whether minimally invasive posterior spinal instrumentation provided significant pain relief and improved function. Study Design. We compared pre- and postoperative pain scores as well as ambulatory status in a population of patients suffering from oncologic conditions in the spine. Patient Sample. A consecutive series of patients with spine tumors treated minimally invasively with stabilization were reviewed. Outcome Measures. Visual analog pain scale as well as pre- and postoperative ambulatory status were used as outcome measures. Methods. Twenty-four patients who underwent minimally invasive posterior spinal instrumentation for metastasis were retrospectively reviewed. Results. Seven (29% patients were unable to ambulate secondary to pain and instability prior to surgery. All patients were ambulating within 2 to 3 days after having surgery (=0.01. The mean visual analog scale value for the preoperative patients was 2.8, and the mean postoperative value was 1.0 (=0.001. Conclusion. Minimally invasive posterior spinal instrumentation significantly improved pain and ambulatory status in this series.

  14. Pre-hospital assessment by a single responder: The Swedish ambulance nurse in a new role: A pilot study.

    Science.gov (United States)

    Magnusson, Carl; Källenius, Christofer; Knutsson, Susanne; Herlitz, Johan; Axelsson, Christer

    2016-05-01

    When a person with vague symptoms calls 112, the dispatchers often have difficulty prioritising the severity of the call. Their only alternative has been to send an ambulance. In Gothenburg, Sweden, a nurse-manned single responder (SR) was initiated to assess this patient group. The study aims to describe patient characteristics and assessment level made by the SR nurse among patients assessed by the dispatcher as low priority and/or vague symptoms. A consecutive journal review was conducted. During six months, 529 patients were assessed; 329 (62%) attended the emergency department (ED) or inpatient care (IC). Of these, 85 patients (26%) were assessed as high priority. Only 108 were assessed as being in need of ambulance transport. ED/IC patients were significantly older. Two hundred (38%) stayed at the scene (SS) (n = 142) or were referred to primary care (PC) (n = 58). Of the 200 SS/PC patients, 38 (19%) attended the ED within 72 hrs with residual symptoms, 20 of whom were admitted to a ward. Nine patients (4% of 200 SS/PC patients) required inpatient treatment and 11 patients stayed overnight for observation. These results suggest a relatively high level of patient safety and the usefulness of an SR among patients assessed by the dispatcher as low priority. PMID:26472522

  15. Partial and full PTSD in Brazilian ambulance workers: prevalence and impact on health and on quality of life.

    Science.gov (United States)

    Berger, William; Figueira, Ivan; Maurat, Ana Maria; Bucassio, Erika P; Vieira, Isabela; Jardim, Sílvia R; Coutinho, Evandro S F; Mari, Jair J; Mendlowicz, Mauro V

    2007-08-01

    A cross-sectional survey for posttraumatic stress disorder (PTSD) was conducted with 234 Brazilian ambulance workers (180 men and 54 women) using a sociodemographic questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Short Form Health Survey-36. Current prevalence rates for full and partial PTSD were 5.6% (men = 6.7%, women = 1.9%) and 15% (men = 13.3%, women = 20.4%), respectively. Male workers with full PTSD were more likely to be nonmarried (75% vs. 43%) and those with partial PTSD reported more emotional problems (65.2% vs. 30%) and medical visits (67% vs. 44%) than the controls. Workers with PTSD showed impairment in the physical and mental domains of the SF-36, whereas workers with partial PTSD had only the later compromised. The characteristics and the level of exposure to trauma of the study population may account for the low prevalence of PTSD. PMID:17721969

  16. The NSW Ambulance Service healthy lifestyle program--a case study in the evaluation of a health promotion program.

    Science.gov (United States)

    Gomel, M; Oldenburg, B

    1990-01-01

    A variety of approaches have been used to reduce Cardiovascular Disease (CVD) risk in the community, including programs based in the workplace. To date, it has been difficult to draw accurate conclusions on the effectiveness of worksite CVD risk reduction programs. Typically, such programs suffer from poor participation and high attrition rates and most lack physical and biochemical validation of self-reported lifestyle changes. The present paper describes an evaluation of four health promotion worksite interventions (screening, education, incentive and lifestyle change) conducted in the NSW Ambulance Service. The study achieved very high participation and low attrition rates. Self-reported changes in lifestyle were validated with physical and biochemical measures. The results suggest greater change in some risk factors for those individuals receiving the incentive and lifestyle change programs compared to screening alone or education. PMID:10109119

  17. Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology.

    Science.gov (United States)

    Takeuchi, Ryohei; Harada, Hiroshi; Masuda, Kohji; Ota, Gen-ichiro; Yokoi, Masaki; Teramura, Nobuyasu; Saito, Tomoyuki

    2008-06-01

    We report the testing of a mobile Robotic Tele-echo system that was placed in an ambulance and successfully transmitted clear real time echo imaging of a patient's abdomen to the destination hospital from where this device was being remotely operated. Two-way communication between the paramedics in this vehicle and a doctor standing by at the hospital was undertaken. The robot was equipped with an ultrasound probe which was remotely controlled by the clinician at the hospital and ultrasound images of the patient were transmitted wirelessly. The quality of the ultrasound images that were transmitted over the public mobile telephone networks and those transmitted over the Multimedia Wireless Access Network (a private networks) were compared. The transmission rate over the public networks and the private networks was approximately 256 Kbps, 3 Mbps respectively. Our results indicate that ultrasound images of far higher definition could be obtained through the private networks. PMID:18444361

  18. Influence of short-term air pollution with carbon monoxide on the risk of ambulance call-outs related to arterial hypertension

    OpenAIRE

    Agnė Brazienė; Jonė Venclovienė; Rūta Babarskienė; Tautvydė Danilčikaitė

    2015-01-01

    Air pollution by carbon monoxide can be possibly related to the increase in arterial blood pressure and the risk of arterial hypertension. The study was made in Kaunas. The concentration of daily carbon monoxide was estimated according to the data provided by the Department of Environment of Kaunas and environmental monitoring stations of Kaunas city municipality. The study aims to determine a short-term impact of air pollution by carbon monoxide on the number of calls for ambulance due to th...

  19. Has increased nursing competence in the ambulance services impacted on pre-hospital assessment and interventions in severe traumatic brain-injured patients?

    OpenAIRE

    Falk, Ann-Charlotte; Alm, Annika; Lindström, Veronica

    2014-01-01

    Objective Trauma is one of the most common causes of morbidity and mortality in modern society, and traumatic brain injuries (TBI) are the single leading cause of mortality among young adults. Pre-hospital acute care management has developed during recent years and guidelines have shown positive effects on the pre-hospital treatment and outcome for patients with severe traumatic brain injury. However, reports of impacts on improved nursing competence in the ambulance services are scarce. Ther...

  20. Pilot Field Test: The Ability to Ambulate After Landing as Assessed with Seat Egress, Walk, and Obstacle Test

    Science.gov (United States)

    Fisher, E. A.; Fomina, E. V.; Reschke, M. F.; Cerisano, J. M.; Kofman, I. S.; Gadd, N. E.; Phillips, T. R.; Lee, S. M. C.; Laurie, S. S.; Stenger, M. B.; Bloomberg, J. J.; Mulavara, A. P.; Kozlovskaya, I. B.; Tomilovskaya, E. S.

    2016-01-01

    Astronauts experience alterations in multiple physiological systems due to exposure to the microgravity conditions of space flight. These changes lead to disruption in the ability to ambulate and perform functional tasks during the initial reintroduction to a gravitational environment. Figure 1 shows a schematic representation of the components involved in postflight ataxia. Full functional recovery has not been sufficiently investigated for long-duration crewmembers. The joint U.S./Russian Pilot Field Test (PFT) experiment (a pre-cursor to Field Test (FT)) was developed to address this gap in knowledge. The PFT was conducted on crewmembers traveling on Soyuz expeditions 34S - 41S and was comprised of several tasks designed to study the recovery of sensorimotor abilities of crewmembers during the first 24 hours after landing and for several days thereafter. Closing this gap will allow us to characterize the ability of crewmembers to perform critical mission tasks that they will be expected to perform after an unassisted landing following 6 to 12 months in microgravity. The Seat Egress, Walk and Obstacle (SEWO) Test will be discussed in this poster.

  1. The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial

    Directory of Open Access Journals (Sweden)

    Naredi Peter

    2011-10-01

    Full Text Available Abstract Background Prevention and treatment of hypothermia by active warming in prehospital trauma care is recommended but scientifical evidence of its effectiveness in a clinical setting is scarce. The objective of this study was to evaluate the effect of additional active warming during road or air ambulance transportation of trauma patients. Methods Patients were assigned to either passive warming with blankets or passive warming with blankets with the addition of an active warming intervention using a large chemical heat pad applied to the upper torso. Ear canal temperature, subjective sensation of cold discomfort and vital signs were monitored. Results Mean core temperatures increased from 35.1°C (95% CI; 34.7-35.5°C to 36.0°C (95% CI; 35.7-36.3°C (p Conclusions In mildly hypothermic trauma patients, with preserved shivering capacity, adequate passive warming is an effective treatment to establish a slow rewarming rate and to reduce cold discomfort during prehospital transportation. However, the addition of active warming using a chemical heat pad applied to the torso will significantly improve thermal comfort even further and might also reduce the cold induced stress response. Trial Registration ClinicalTrials.gov: NCT01400152

  2. Short-term exposure to ambient particulate matter and emergency ambulance dispatch for acute illness in Japan.

    Science.gov (United States)

    Tasmin, Saira; Ueda, Kayo; Stickley, Andrew; Yasumoto, Shinya; Phung, Vera Ling Hui; Oishi, Mizuki; Yasukouchi, Shusuke; Uehara, Yamato; Michikawa, Takehiro; Nitta, Hiroshi

    2016-10-01

    Short-term exposure to air pollution may be linked to negative health outcomes that require an emergency medical response. However, few studies have been undertaken on this phenomenon to date. The aim of this study therefore was to examine the association between short-term exposure to ambient suspended particulate matter (SPM) and emergency ambulance dispatches (EADs) for acute illness in Japan. Daily EAD data, daily mean SPM and meteorological data were obtained for four prefectures in the Kanto region of Japan for the period from 2007 to 2011. The area-specific association between daily EAD for acute illness and SPM was explored using generalized linear models while controlling for ambient temperature, relative humidity, seasonality, long-term trends, day of the week and public holidays. Stratified analyses were conducted to evaluate the modifying effects of age, sex and medical conditions. Area-specific estimates were combined using meta-analyses. For the total study period the mean level of SPM was 23.7μg/m(3). In general, higher SPM was associated with a significant increase in EAD for acute illness [estimated pooled relative risk (RR): 1.008, 95% CI: 1.007 to 1.010 per 10μg/m(3) increase in SPM at lag 0-1]. The effects of SPM on EAD for acute illness were significantly greater for moderate/mild medical conditions (e.g. cases that resulted in 3weeks hospitalization or which resulted in death). Using EAD data, this study has shown the adverse health effects of ambient air pollution. This highlights the importance of reducing the level of air pollution in order to maintain population health and well-being. PMID:27235903

  3. A Movement Monitor Based on Magneto-Inertial Sensors for Non-Ambulant Patients with Duchenne Muscular Dystrophy: A Pilot Study in Controlled Environment

    Science.gov (United States)

    Moraux, Amélie; Annoussamy, Mélanie; Dorveaux, Eric; Gasnier, Erwan; Hogrel, Jean-Yves; Voit, Thomas; Vissière, David; Servais, Laurent

    2016-01-01

    Measurement of muscle strength and activity of upper limbs of non-ambulant patients with neuromuscular diseases is a major challenge. ActiMyo® is an innovative device that uses magneto-inertial sensors to record angular velocities and linear accelerations that can be used over long periods of time in the home environment. The device was designed to insure long-term stability and good signal to noise ratio, even for very weak movements. In order to determine relevant and pertinent clinical variables with potential for use as outcome measures in clinical trials or to guide therapy decisions, we performed a pilot study in non-ambulant neuromuscular patients. We report here data from seven Duchenne Muscular Dystrophy (DMD) patients (mean age 18.5 ± 5.5 years) collected in a clinical setting. Patients were assessed while wearing the device during performance of validated tasks (MoviPlate, Box and Block test and Minnesota test) and tasks mimicking daily living. The ActiMyo® sensors were placed on the wrists during all the tests. Software designed for use with the device computed several variables to qualify and quantify muscular activity in the non-ambulant subjects. Four variables representative of upper limb activity were studied: the rotation rate, the ratio of the vertical component in the overall acceleration, the hand elevation rate, and an estimate of the power of the upper limb. The correlations between clinical data and physical activity and the ActiMyo® movement parameters were analyzed. The mean of the rotation rate and mean of the elevation rate appeared promising since these variables had the best reliability scores and correlations with task scores. Parameters could be computed even in a patient with a Brooke functional score of 6. The variables chosen are good candidates as potential outcome measures in non-ambulant patients with Duchenne Muscular Dystrophy and use of the ActiMyo® is currently being explored in home environment. Trial Registration

  4. Physician presence in an ambulance car is associated with increased survival in out-of-hospital cardiac arrest: a prospective cohort analysis.

    Directory of Open Access Journals (Sweden)

    Akihito Hagihara

    Full Text Available The presence of a physician seems to be beneficial for pre-hospital cardiopulmonary resuscitation (CPR of patients with out-of-hospital cardiac arrest. However, the effectiveness of a physician's presence during CPR before hospital arrival has not been established. We conducted a prospective, non-randomized, observational study using national data from out-of-hospital cardiac arrests between 2005 and 2010 in Japan. We performed a propensity analysis and examined the association between a physician's presence during an ambulance car ride and short- and long-term survival from out-of-hospital cardiac arrest. Specifically, a full non-parsimonious logistic regression model was fitted with the physician presence in the ambulance as the dependent variable; the independent variables included all study variables except for endpoint variables plus dummy variables for the 47 prefectures in Japan (i.e., 46 variables. In total, 619,928 out-of-hospital cardiac arrest cases that met the inclusion criteria were analyzed. Among propensity-matched patients, a positive association was observed between a physician's presence during an ambulance car ride and return of spontaneous circulation (ROSC before hospital arrival, 1-month survival, and 1-month survival with minimal neurological or physical impairment (ROSC: OR = 1.84, 95% CI 1.63-2.07, p = 0.00 in adjusted for propensity and all covariates; 1-month survival: OR = 1.29, 95% CI 1.04-1.61, p = 0.02 in adjusted for propensity and all covariates; cerebral performance category (1 or 2: OR = 1.54, 95% CI 1.03-2.29, p = 0.04 in adjusted for propensity and all covariates; and overall performance category (1 or 2: OR = 1.50, 95% CI 1.01-2.24, p = 0.05 in adjusted for propensity and all covariates. A prospective observational study using national data from out-of-hospital cardiac arrests shows that a physician's presence during an ambulance car ride was independently associated with

  5. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Freeman Jennifer

    2012-04-01

    Full Text Available Abstract Background People with Multiple Sclerosis (MS frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect. This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training 2 Comparing core stability training with standardised physiotherapy exercise 3 Exploring underlying mechanisms of change associated with this intervention Methods This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control. All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12, the Functional Reach (forwards and lateral, a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC Scale. In addition, ultrasound imaging of the

  6. Préambule

    Directory of Open Access Journals (Sweden)

    Emmanuel Grimaud

    2011-06-01

    Full Text Available Courses à la virtuosité Nombreuses sont les pratiques qui ont généré, parfois en leur cœur et souvent en leurs marges, des programmes acrobatiques. Ces programmes ont généralement des finalités comparables. Il s’agit d’apprécier et d’évaluer l’excellence technique, d’explorer plus ou moins librement les possibilités d’un instrument ou de mettre à l’épreuve ses limites. De la musique à la jonglerie, de la prestidigitation à la voltige aérienne ou encore à la cascade à moto, rares sont les arts...

  7. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    OpenAIRE

    Thorley Megan; Donaghey Samantha; Edwards Priya; Copeland Lisa; Kentish Megan; McLennan Kim; Lindsley Jayne; Gascoigne-Pees Laura; Sakzewski Leanne; Boyd Roslyn N

    2012-01-01

    Abstract Background Children with cerebral palsy (CP) whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A) combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V), compared with standard therapy alo...

  8. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    OpenAIRE

    Thorley, Megan; Donaghey, Samantha; Edwards, Priya; Copeland, Lisa; Kentish, Megan; McLennan, Kim; Lindsley, Jayne; Gascoigne-Pees, Laura; Sakzewski, Leanne; Boyd, Roslyn N.

    2012-01-01

    Background Children with cerebral palsy (CP) whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A) combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V), compared with standard therapy alone (cycle...

  9. The Loyal Customer Phenomenon as a Social Relationship: A Study with Ambulant Coffee Salesmen in the City of Ibagué

    Directory of Open Access Journals (Sweden)

    Lady Grey Javela**

    2009-12-01

    Full Text Available The purpose of this research was to study the relationship established between an ambulant coffee salesman (ACSM and his loyal client, in the frame of Michael Argyle’s social relationships model. Thirty couples were interviewed about the ACSM and loyal clients relationship; also interactions among 183 ACSM – loyal clients and 117 ACS M –sporadic clients were registered. Our research found that the commercial relationship between an ACSM and his/her loyal client is a social relationship, taking into account that it brought evidence about the constitutive elements of a relationship of this nature under Argyle’s perspective; and coincidences were observed in the declarations that the actors of the relationship made about it. Additionally, we found that the ACSM’s behavior is different depending on the type of client that he/she is attending –loyal or sporadic–.

  10. An artificial neural network to safely reduce the number of ambulance ECGs transmitted for physician assessment in a system with prehospital detection of ST elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Forberg Jakob L

    2012-02-01

    Full Text Available Abstract Background Pre-hospital electrocardiogram (ECG transmission to an expert for interpretation and triage reduces time to acute percutaneous coronary intervention (PCI in patients with ST elevation Myocardial Infarction (STEMI. In order to detect all STEMI patients, the ECG should be transmitted in all cases of suspected acute cardiac ischemia. The aim of this study was to examine the ability of an artificial neural network (ANN to safely reduce the number of ECGs transmitted by identifying patients without STEMI and patients not needing acute PCI. Methods Five hundred and sixty ambulance ECGs transmitted to the coronary care unit (CCU in routine care were prospectively collected. The ECG interpretation by the ANN was compared with the diagnosis (STEMI or not and the need for an acute PCI (or not as determined from the Swedish coronary angiography and angioplasty register. The CCU physician's real time ECG interpretation (STEMI or not and triage decision (acute PCI or not were registered for comparison. Results The ANN sensitivity, specificity, positive and negative predictive values for STEMI was 95%, 68%, 18% and 99%, respectively, and for a need of acute PCI it was 97%, 68%, 17% and 100%. The area under the ANN's receiver operating characteristics curve for STEMI detection was 0.93 (95% CI 0.89-0.96 and for predicting the need of acute PCI 0.94 (95% CI 0.90-0.97. If ECGs where the ANN did not identify a STEMI or a need of acute PCI were theoretically to be withheld from transmission, the number of ECGs sent to the CCU could have been reduced by 64% without missing any case with STEMI or a need of immediate PCI. Conclusions Our ANN had an excellent ability to predict STEMI and the need of acute PCI in ambulance ECGs, and has a potential to safely reduce the number of ECG transmitted to the CCU by almost two thirds.

  11. 中美救护车车载物品比较%Comparison with the Supplies and Equipment Carried on Ambulance between the United State and China

    Institute of Scientific and Technical Information of China (English)

    郑进

    2013-01-01

    The supplies and equipment carried on ambulance is the foundation and guarantee of pre--hospital emergency care,it is significant for the efficiency and result of pre-hospital emergency care.This paper made a summary and analysis of the characteristic for the supplies and equipment carried on ambulance and the pre-hospital emergency care in American:pay more attention to the personal safety of prehospital emergency personal; pay more attention to the extrication for patient; pay more attention to the utilizing of cardiopulmonary resuscitation (CPR)board; pay more attention to the scientificalness of allocation for the jump kit; pay more attention to the using of ordinary goods; pay more attention to the patient transfer.The emergency medical personal rescued 5,120 sudden death patients out hospital in Seattle of the United States in 1970s,and the rate of successful resuscitation was 28.9%; the emergency medical personal of Shanghai emergency medical center rescued 4,374 sudden death patients out hospital in Shanghai in 1999,and the rate of successful resuscitation was 1.35%; Obviously,the rate of successful resuscitation for sudden death patients out hospital in China is much lower than that in the United States.It is probably related with the difference in ambulance equipment between the United States and China.Knowing this could be beneficial and referential for the pre-hospital emergency care in our country.%救护车车载物品是院前急救的基础和保障,对院前急救的效率和质量具有十分重要的意义.本文总结并分析了美国救护车车载物品和院前急救的特点:更加注重院前急救人员的个人防护;更加注重对患者的救出;更加注重心脏按压板的运用;更加注重急救箱物品配置的科学性;更加注重对普通物品的利用;更加注重患者的转运.美国西雅图20世纪70年代抢救5 120例院外猝死患者,复苏成功至康复出院者达28.9%;

  12. Intervention to prevent further falls in older people who call an ambulance as a result of a fall: a protocol for the iPREFER randomised controlled trial

    Science.gov (United States)

    2013-01-01

    Background An increasing number of falls result in an emergency call and the subsequent dispatch of paramedics. In the absence of physical injury, abnormal physiological parameters or change in usual functional status, it could be argued that routine conveyance by ambulance to the Emergency Department (ED) is not the most effective or efficient use of resources. Further, it is likely that non-conveyed older fallers have the potential to benefit from timely access to fall risk assessment and intervention. The aim of this randomised controlled trial is to evaluate the effect of a timely and tailored falls assessment and management intervention on the number of subsequent falls and fall-related injuries for non-conveyed older fallers. Methods Community dwelling people aged 65 years or older who are not conveyed to the ED following a fall will be eligible to be visited at home by a research physiotherapist. Consenting participants will receive individualised intervention strategies based on risk factors identified at baseline. All pre-test measures will be assessed prior to randomisation. Post-test measures will be undertaken by a researcher blinded to group allocation 6 months post-baseline. Participants in the intervention group will receive individualised pro-active fall prevention strategies from the clinical researcher to ensure that risk factors are addressed adequately and interventions carried out. The primary outcome measure will be the number of falls recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the subsequent use of medical and emergency services and uptake of recommendations. Data will be analysed using the intention-to-treat principle. Discussion As there is currently little evidence regarding the effectiveness or feasibility of alternate models of care following ambulance non-conveyance of older fallers, there is a need to explore assessment and intervention programs to

  13. Integrated Suit Test 1 - A Study to Evaluate Effects of Suit Weight, Pressure, and Kinematics on Human Performance during Lunar Ambulation

    Science.gov (United States)

    Gernhardt, Michael L.; Norcross, Jason; Vos, Jessica R.

    2008-01-01

    In an effort to design the next generation Lunar suit, NASA has initiated a series of tests aimed at understanding the human physiological and biomechanical affects of space suits under a variety of conditions. The first of these tests was the EVA Walkback Test (ICES 2007-01-3133). NASA-JSC assembled a multi-disciplinary team to conduct the second test of the series, titled Integrated Suit Test 1 (IST-1), from March 6 through July 24, 2007. Similar to the Walkback Test, this study was performed with the Mark III (MKIII) EVA Technology Demonstrator suit, a treadmill, and the Partial Gravity Simulator in the Space Vehicle Mock-Up Facility at Johnson Space Center. The data collected for IST-1 included metabolic rates, ground reaction forces, biomechanics, and subjective workload and controllability feedback on both suited and unsuited (shirt-sleeve) astronaut subjects. For IST-1 the center of gravity was controlled to a nearly perfect position while the weight, pressure and biomechanics (waist locked vs. unlocked) were varied individually to evaluate the effects of each on the ability to perform level (0 degree incline) ambulation in simulated Lunar gravity. The detailed test methodology and preliminary key findings of IST-1 are summarized in this report.

  14. Immediate Return to Ambulation and Improved Functional Capacity for Rehabilitation in Complex Regional Pain Syndrome following Early Implantation of a Spinal Cord Stimulation System

    Directory of Open Access Journals (Sweden)

    Brandon Jesse Goff

    2014-01-01

    Full Text Available Complex regional pain syndrome (CRPS is a neuropathic pain condition that is characterized by vasomotor, sensory, sudomotor, and motor symptoms. Spinal cord stimulation (SCS has been successfully utilized for the treatment of pain refractory to conventional therapies. We present a case of a previously highly functioning 54-year-old female who developed a rarely reported case of idiopathic CRPS of the right ankle which spontaneously occurred four months after an uncomplicated anterior cervical disc fusion. This condition resulted in severe pain and functional impairment that was unresponsive to pharmacological management. The patient’s rehabilitation was severely stymied by her excruciating pain. However, with the initiation of spinal cord stimulation, her pain was adequately controlled allowing for progression to full unassisted ambulation, advancing functional capacity, and improving quality of life. This case report supports the concept that rapid progression to neuromodulation, rather than delays that occur due to attempts at serial sympathetic blocks, may better control symptoms leading allowing for a more meaningful recovery.

  15. Monitoring the effect of air pollution episodes on health care consultations and ambulance call-outs in England during March/April 2014: A retrospective observational analysis.

    Science.gov (United States)

    Elliot, Alex J; Smith, Sue; Dobney, Alec; Thornes, John; Smith, Gillian E; Vardoulakis, Sotiris

    2016-07-01

    There is an increasing body of evidence illustrating the negative health effects of air pollution including increased risk of respiratory, cardiac and other morbid conditions. During March and April 2014 there were two air pollution episodes in England that occurred in close succession. We used national real-time syndromic surveillance systems, including general practitioner (GP) consultations, emergency department attendances, telehealth calls and ambulance dispatch calls to further understand the impact of these short term acute air pollution periods on the health seeking behaviour of the general public. Each air pollution period was comparable with respect to particulate matter concentrations (PM10 and PM2.5), however, the second period was longer in duration (6 days vs 3 days) and meteorologically driven 'Sahara dust' contributed to the pollution. Health surveillance data revealed a greater impact during the second period, with GP consultations, emergency department attendances and telehealth (NHS 111) calls increasing for asthma, wheeze and difficulty breathing indicators, particularly in patients aged 15-64 years. Across regions of England there was good agreement between air quality levels and health care seeking behaviour. The results further demonstrate the acute impact of short term air pollution episodes on public health and also illustrate the potential role of mass media reporting in escalating health care seeking behaviour. PMID:27179935

  16. Immediate Return to Ambulation and Improved Functional Capacity for Rehabilitation in Complex Regional Pain Syndrome following Early Implantation of a Spinal Cord Stimulation System.

    Science.gov (United States)

    Goff, Brandon Jesse; Naber, Jeremy Wingseng; McCallin, John Patrick; Lopez, Edward Michael; Guthmiller, Kevin Brant; Lautenschlager, Karl Alan; Lai, Tristan Toll; Hommer, Dean Harry; Marin, Gonzalez Raul

    2014-01-01

    Complex regional pain syndrome (CRPS) is a neuropathic pain condition that is characterized by vasomotor, sensory, sudomotor, and motor symptoms. Spinal cord stimulation (SCS) has been successfully utilized for the treatment of pain refractory to conventional therapies. We present a case of a previously highly functioning 54-year-old female who developed a rarely reported case of idiopathic CRPS of the right ankle which spontaneously occurred four months after an uncomplicated anterior cervical disc fusion. This condition resulted in severe pain and functional impairment that was unresponsive to pharmacological management. The patient's rehabilitation was severely stymied by her excruciating pain. However, with the initiation of spinal cord stimulation, her pain was adequately controlled allowing for progression to full unassisted ambulation, advancing functional capacity, and improving quality of life. This case report supports the concept that rapid progression to neuromodulation, rather than delays that occur due to attempts at serial sympathetic blocks, may better control symptoms leading allowing for a more meaningful recovery. PMID:25525522

  17. Radiation Monitoring Results from the First Year of Operation of a Unique Ambulance-based Computed Tomography Unit for the Improved Diagnosis and Treatment of Stroke Patients.

    Science.gov (United States)

    Gutiérrez, Janet M; Emery, Robert J; Parker, Stephanie A; Jackson, Kamilah; Grotta, James C

    2016-05-01

    When a blood clot blocks the blood supply to the brain or when a blood vessel bursts, resulting in brain cell death, the medical condition is referred to as a "stroke." Stroke is a main cause of death worldwide and is a common cause of disability. A common form of stroke, called ischemic stroke, is when blood flow to the brain is decreased. Clinical research has revealed that treatment within the very first hours of symptom onset is key for ischemic stroke with recanalization of occluded arteries by thrombolysis with alteplase. Computed tomography (CT) is one of the diagnostic tools used to determine if this treatment path is appropriate. To determine if health outcomes of possible stroke patients can be improved by decreasing the time from symptom presentation to treatment, the first mobile stroke ambulance unit in the United States was deployed by The University of Texas Health Science Center at Houston (UTHealth) in 2014, equipped with a computed tomography imaging system. The mobile stroke unit shortens the time to treatment for stroke patients by allowing pre-hospital treatment. Having completed its first year of operation, radiation-monitoring data describing the doses delivered to various entities have been characterized. The CT operator's cumulative deep dose equivalent for 1 y of operation was 1.14 mSv resulting from the care of 106 patients. Area monitors were deployed and measurements performed demonstrating that general public doses did not exceed 0.02 mSv h or 1.0 mSv year. PMID:27023154

  18. An observational study of hand hygiene in 120 ambulance service%“120”救护车手卫生相关状况的观察研究

    Institute of Scientific and Technical Information of China (English)

    杨珊; 王丽媛; 刘茜; 臧渝梨

    2014-01-01

    Objective To investigate into hand hygiene facilities and worker's practice of hand hygiene during 120 ambulance services in a capital city.Methods With the standard Observation Form publicized by the World Health Organization,field observation was carried out to monitor hand hygiene facilities and the practice of hand hygiene in workers during ambulance services provided by four service centers.Results A total of seven ambulances and 80 times of services were observed across a span of 21 days.The provision and position of hand hygiene facilities were found very limited in these ambulances.Of 656 times of presence of indictors for hand hygiene,the overall compliance rate was 3.04% reflecting the practice of hand hygiene in ambulance workers.The compliance rate was found to be 0 (0/291),1.96% (1/51),13.64% (3/22),5.21% (16/307) and 0(0/2) before touching patients,after body fluids exposure risk,before clean/aseptic procedures and after touching patients' surroundings respectively.Conclusions Poor practice of hand hygiene which was revealed in 120 ambulance services suggests the great need for education and training to improve patient safety and occupational health.%目的 深入了解某省会城市“120”救护车的手卫生设施及出诊工作者的手卫生执行情况.方法 采用世界卫生组织标准监督观察表,跟车对某省会城市4所急救分中心“120”救护车的手卫生设施及出车工作者的手卫生行为进行现场观察.结果 21 d观察7辆救护车80次出诊发现,救护车手卫生设施配置与摆放有限;出现手卫生机会656次,总体依从性3.04%,接触患者前、清洁无菌操作前、可能接触患者体液后、接触患者后及接触患者周围环境后的依从性分别为0(0/291)、1.96%(1/51)、13.64%(3/22)、5.21%(16/307)、0(0/2).结论 “120”院前急救手卫生状况不容乐观,亟待加强培训,促进患者安全和职业防护.

  19. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Moratoria-Designated Geographic Locations. Implementation of the waiver demonstration.

    Science.gov (United States)

    2016-08-01

    This notice announces the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in 6 states. The demonstration is being implemented in accordance with section 402 of the Social Security Amendments of 1967 and gives CMS the authority to grant waivers to the statewide enrollment moratoria on a case-by-case basis in response to access to care issues, and to subject providers and suppliers enrolling via such waivers to heightened screening, oversight, and investigations. PMID:27487580

  20. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Thorley Megan

    2012-08-01

    Full Text Available Abstract Background Children with cerebral palsy (CP whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V, compared with standard therapy alone (cycle I, and whether repeated injections with the same regime of adjunctive therapy results in greater benefits compared with a single injecting episode (cycle II. The regime of therapy will include serial casting, splinting and/or provision of orthoses, as indicated, combined with four sessions of goal directed occupational therapy or physiotherapy. Method/design This study is a double blind randomized controlled trial. Forty participants will be recruited. In cycle I, participants will be randomized to either a treatment group who will receive BoNT-A injections into selected upper and/or lower limb muscles, or a control group who will undergo sham injections. Both groups will receive occupational therapy and /or physiotherapy following injections. Groups will be assessed at baseline then compared at 4 and 16 weeks following injections or sham control. Parents, treating clinicians and assessors will be masked to group allocation. In cycle II, all participants will undergo intramuscular BoNT-A injections to selected upper and/or lower limb muscles, followed by therapy. The primary outcome measure will be change in parent ratings in identified areas of concern for their child’s care and comfort, using the Canadian Occupational Performance Measure (COPM. Secondary measures will include the Care and Comfort Hypertonicity Scale (ease of care, the Cerebral Palsy Quality of Life Questionnaire (CP QoL–Child (quality of life, the Caregiver Priorities and Child

  1. Direct ambulance transport to catheterization laboratory reduces door-to-balloon time in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: the DIRECT-STEMI study

    Institute of Scientific and Technical Information of China (English)

    QIU Jian-ping; ZHANG Qi; LU Ji-de; WANG Hai-rong; LIN Jie; GE Zhi-ru; ZHANG Rui-yan; SHEN Wei-feng

    2011-01-01

    Background Primary percutaneous coronary intervention (PCI) has been clearly identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction (STEMI). The importance of reducing door-to-balloon (D2B) time has gained increased recognition. This study aimed to assess the feasibility, safety and efficacy of the strategy of direct ambulance transportation of patients with acute STEMI to catheterization lab to receive primary PCI.Methods The study population included 141 consecutive patients with chest pain and ST-segment elevation who were admitted to the catheterization laboratory directly by the ambulance and underwent primary PCI (DIRECT group).Another 145 patients with STEMI randomly selected from the PCI database, were served as control group (conventional group); they were transported to catheterization laboratory from emergency room (ER). The primary endpoint of D2B time,and secondary endpoint of in-hospital and 30-day major adverse cardiac events (MACE, including death, non-fatal reinfarction, and target vessel revascularization) were compared.Results Baseline and procedural characteristics between the two groups were comparable, except more patients in the DIRECT group presented TIMI 0-1 flow in culprit vessel at initial angiogram (80.1% and 73.8%, P=0.04). Comparing to conventional group, the primary endpoint of D2B time was reduced ((54±18) minutes and (112±55) minutes, P <0.0001)and the percentage of patients with D2B <90 minutes was increased in the DIRECT group (96.9% and 27.0%, P<0.0001).The success rate of primary PCI with stent implantation with final Thrombolysis in Myocardial Infarction (TIMI) 3 flow was significantly higher in the DIRECT group (93.8% and 85.2%, P=0.03). Although no significant difference was found at 30-day MACE free survival rate between the two groups (95.0% and 89.0%, P=0.06), a trend in improving survival status in the DIRECT group was demonstrated by Kaplan-Meier analysis

  2. Aplicação do modelo hipercubo de filas para avaliar a descentralização de ambulâncias em um sistema urbano de atendimento médico de urgência

    OpenAIRE

    Renata Algisi Takeda; João Alexandre Widmer; Reinaldo Morabito

    2004-01-01

    Uma das maiores preocupações de sistemas urbanos de atendimento médico-emergencial é a rapidez no atendimento às vítimas. Os tempos de resposta dependem de diversos fatores como condições de tráfego local, dia da semana e período do dia, tipo e número de veículos disponíveis, localização destes veículos, políticas de despacho, etc. Neste trabalho apresenta-se uma análise dos efeitos da descentralização de ambulâncias que operam no sistema de atendimento médico-emergencial (SAMU-192) de Campin...

  3. Relations of compassion fatigue to occupational stress and job burnout in ambulance nurses%院前急救护士共情疲劳与职业应激、职业倦怠关系研究

    Institute of Scientific and Technical Information of China (English)

    魏华; 黄敬堂; 申培红

    2016-01-01

    Objective To explore the relationship of compassion fatigue and occupational stress and job burnout in ambulance nurses.Methods By stratified cluster random sampling method, a total of 380 ambulance nurses from 5 cities in Henan Province were selected as objects, and 261 emergency nurses from the same hospital were selected as control.A assessment survey was performed using the Chinese version of Professional Quality of Life, the Maslach Burnout Inventory ( MBI) , and the Chinese Nursing Stressor Scale ( NSS) which included the stressor related to working expectation ( factor 1), the stressor related to family (factor 2), the stressor related to interpersonal relationships (factor 3), the stressor related to job specification (factor 4), related to patients (factor 5), and to the working load (factor 6).Results The ambulance nurses had higher compassion fatigue scores than the emergency nurses ( P <0.01 ) .One-way analysis of variance showed that the ambulance nurses with length of service less than 3.0 years had higher compassion fatigue scores than those with 3.0 or more years and those with over 10.0 years of service length ( P<0.05 ) .The compassion fatigue scores of general nurses were higher than those professional titled as senior nurses and nurse supervisors or above ( P<0.05).The correlation analysis showed that the compassion fatigue scores of ambulance nurse were positively correlated with the factor 2, 3, 4, 5 and 6 of NSS scores and MBI scores [the correlation coefficients (r) were 0.15, 0.28, 0.25, 0.34, 0.32 and 0.36, P<0.05].The MBI scores were positively correlated with all the 6 factors of NSS (r were 0.31, 0.25, 0.36, 0.32, 0.37 and 0.31, respectively, P<0.05).The multiple linear regression analysis results showed that the regression correlations among MBI score, NSS factor 5 score, interaction effect of MBI and NSS factor 5 and the compassion fatigue score were confirmed (the standardized partial regression coefficient were 0.39, 0.24 and 0

  4. Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial

    OpenAIRE

    Roberts Stephen; Phillips Judith; Phillips Ceri; Peconi Julie; Merali Yasmin; Mason Suzanne; Lyons Ronan; Humphreys Ioan; Gaze Sarah; Dale Jeremy; Close Jacqueline; Cheung Wai-Yee; Snooks Helen; Russell Ian; Sánchez Antonio

    2010-01-01

    Abstract Background Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS) software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community fall...

  5. Evaluation of group versus individual physiotherapy following lower limb intra-muscular Botulinum Toxin-Type A injections for ambulant children with cerebral palsy: A single-blind randomized comparison trial.

    Science.gov (United States)

    Thomas, Rachel E; Johnston, Leanne M; Sakzewski, Leanne; Kentish, Megan J; Boyd, Roslyn N

    2016-01-01

    This study aimed to evaluate efficacy of group (GRP) versus individual (IND) physiotherapy rehabilitation following lower limb intramuscular injections of Botulinum Toxin-Type A (BoNT-A) for ambulant children with cerebral palsy (CP). Following lower limb BoNT-A injections, 34 children were randomly allocated to GRP (n=17; mean age 7y8m SD 2.0; 13 males; Gross Motor Function Classification System (GMFCS) I=5, II=8, III=4) or IND physiotherapy (n=17; mean age 8y7m SD 2.0; 11 males; GMFCS I=9, II=5, III=3). Primary outcomes were the Canadian Occupational Performance Measure (COPM) and Edinburgh Visual Gait Score (EVGS) assessed at baseline, 10 and 26 weeks post intervention. There were no baseline differences between groups. GRP intervention had greater, but not clinically meaningful, improvement in COPM satisfaction (estimated mean difference EMD 1.7, 95% CI 0.4-3.1; p<0.01) at 26 weeks. Both groups demonstrated clinically significant improvements in COPM performance and satisfaction, but minimal change in quality of gait (EVGS). Six hours of direct physiotherapy (either GRP or IND) with an additional indirect dose (median 16 episodes) of individualized home programme activities following lower limb BoNT-A injections, however, was inadequate to drive clinically meaningful changes in lower limb motor outcomes. PMID:26955912

  6. Effect of High-Dose Vitamin D3 Intake on Ambulation, Muscular Pain and Bone Mineral Density in a Woman with Multiple Sclerosis: A 10-Year Longitudinal Case Report

    Directory of Open Access Journals (Sweden)

    François Feron

    2012-10-01

    Full Text Available Mounting evidence correlate vitamin D3 (cholecalciferol supplementation or higher serum levels of vitamin D (25(OHD with a lower risk of developing multiple sclerosis (MS, reduced relapse rate, slower progression or fewer new brain lesions. We present here the case of a woman who was diagnosed with MS in 1990. From 1980 to 2000, her ability to walk decreased from ~20 to 1 km per day. Since January 2001, a vitamin D3 supplement was ingested daily. The starting dose was 20 mcg (800 IU/day and escalated to 100 mcg (4000 IU/day in September 2004 and then to 150 mcg (6000 IU/day in December 2005. Vitamin D3 intake reduced muscular pain and improved ambulation from 1 (February 2000 to 14 km/day (February 2008. Vitamin D intake over 10 years caused no adverse effects: no hypercalcaemia, nephrolithiasis or hypercalciuria were observed. Bowel problems in MS may need to be addressed as they can cause malabsorption including calcium, which may increase serum PTH and 1,25(OH2D levels, as well as bone loss. We suggest that periodic assessment of vitamin D3, calcium and magnesium intake, bowel problems and the measurement of serum 25(OHD, PTH, Ca levels, UCa/Cr and bone health become part of the integral management of persons with MS.

  7. Role sestry v proktologické ambulanci

    OpenAIRE

    Šulcová, Jana

    2014-01-01

    Theoretical basis: The problems in rectal and anal diseases have had rising tendency, especially haemorrhoidal diseases, on which we put emphasis in our bachelor thesis. 37% of adult population suffers from this disease so we may line it up to civilization illnesses. Their treatment involves wide range of medical methods, from the conservative therapy to semi invasive ways of treatment. The semi invasive treatment is well withstood by patients and it can help up to 90% of clients. This bachel...

  8. Support and Assessment for Fall Emergency Referrals (SAFER 1 trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Roberts Stephen

    2010-01-01

    Full Text Available Abstract Background Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community falls services. Methods/Design Pragmatic cluster randomised trial with a qualitative component. We shall allocate 72 paramedics ('clusters' at random between receiving the intervention and a control group delivering care as usual, of whom we expect 60 to complete the trial. Patients are eligible if they are aged 65 or older, live in the study area but not in residential care, and are attended by a study paramedic following an emergency call for a fall. Seven to 10 days after the index fall we shall offer patients the opportunity to opt out of further follow up. Continuing participants will receive questionnaires after one and 6 months, and we shall monitor their routine clinical data for 6 months. We shall interview 20 of these patients in depth. We shall conduct focus groups or semi-structured interviews with paramedics and other stakeholders. The primary outcome is the interval to the first subsequent reported fall (or death. We shall analyse this and other measures of outcome, process and cost by 'intention to treat'. We shall analyse qualitative data thematically. Discussion Since the SAFER 1 trial received funding in August 2006, implementation has come to terms with ambulance service reorganisation and a new national electronic patient record in England. In response to these hurdles the research team has adapted the research design, including aspects of the intervention, to meet the needs of the ambulance services. In conclusion this complex emergency care

  9. Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial

    Science.gov (United States)

    2010-01-01

    Background Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS) software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community falls services. Methods/Design Pragmatic cluster randomised trial with a qualitative component. We shall allocate 72 paramedics ('clusters') at random between receiving the intervention and a control group delivering care as usual, of whom we expect 60 to complete the trial. Patients are eligible if they are aged 65 or older, live in the study area but not in residential care, and are attended by a study paramedic following an emergency call for a fall. Seven to 10 days after the index fall we shall offer patients the opportunity to opt out of further follow up. Continuing participants will receive questionnaires after one and 6 months, and we shall monitor their routine clinical data for 6 months. We shall interview 20 of these patients in depth. We shall conduct focus groups or semi-structured interviews with paramedics and other stakeholders. The primary outcome is the interval to the first subsequent reported fall (or death). We shall analyse this and other measures of outcome, process and cost by 'intention to treat'. We shall analyse qualitative data thematically. Discussion Since the SAFER 1 trial received funding in August 2006, implementation has come to terms with ambulance service reorganisation and a new national electronic patient record in England. In response to these hurdles the research team has adapted the research design, including aspects of the intervention, to meet the needs of the ambulance services. In conclusion this complex emergency care trial will provide

  10. 新入职院前急救护士职业应激、心理资本与共情疲劳感的关系分析%Relationship of compassion fatigue, occupational stress and psychological capital among new graduate ambulance nurses

    Institute of Scientific and Technical Information of China (English)

    魏华; 董越娟; 邹涛; 王永革; 陈妍; 段梅艳

    2015-01-01

    目的:探讨新入职院前急救护士职业应激、心理资本与共情疲劳感的关系。方法选取入职1个月的253名院前急救护士为研究对象,采用护士专业生活品质量表( ProQOL-V)、心理资本问卷(PCQ-24)和护士应激源量表(CNSS)进行测评,入职后3,6个月进行追踪测评。结果入职后6个月院前急救护士CNSS得分、CNSS-4得分、CNSS-6得分分别为(100.21±14.82),(185.54±50.54),(165.54±51.87)分,分别优于入职后1,3个月,差异有统计学意义(F值分别为14.53,17.41,14.89;P<0.05)。新入职院前急救护士 CNSS得分与 PCQ-24得分呈负相关(r=-0.45,P<0.05),与 CNSS-1、CNSS-2、CNSS-4、CNSS-6得分呈正相关(r=0.28,0.15,0.37,0.36;P<0.05);PCQ-24得分与 CNSS-1、CNSS-2、CNSS-3、CNSS-4、CNSS-6得分呈负相关(r=-0.30,-0.30,-0.27,-0.34,-0.23;P<0.05)。结论新入职院前急救护士共情疲劳感症状严重,可能与职业应激及心理资本的消耗有关。%Objective To explore the relationship of compassion fatigue, occupational stress and psychological capital among new graduate ambulance nurses. Methods A total of 253 new graduate nurses were selected and followed-up in ambulance department. They were assessed by Professional Quality of Life(ProQOL-V), Chinese Nursing Stressor Scale (CNSS) and Psychological Capital Questionnaire-24 (PCQ-24). Results After six months, the scores of CNSS, CNSS-4 and CNSS-6 were (100. 21 ± 14. 82), (185. 54 ± 50. 54) and (165. 54 ± 51. 87), which were significantly higher than those at the first and third month (F=14. 53, 17. 41, 14. 89, respectively;P<0. 05). The score of CNSS was negatively correlated with the score of PCQ-24 (r=-0. 45,P<0. 05) and was positively correlated with the scores of CNSS-1, CNSS-2, CNSS-4 and CNSS-6 (r=0. 28, 0. 15, 0. 37, 0. 36, respectively;P<0. 05). The score of PCQ-24 was negatively correlated with the scores of CNSS-1, CNSS-2, CNSS-3, CNSS-4 and CNSS-6 (r= -0. 30, -0. 30, -0. 27, -0. 34, -0

  11. Adaptação para a língua portuguesa do Questionário de Experiências Dissociativas Peritraumáticas (QEDP numa amostra de bombeiros Portuguese adaptation of the Peritraumatic Dissociation Experiences Questionnaire (PDEQ in a sample of ambulance personal

    Directory of Open Access Journals (Sweden)

    Ângela Costa Maia

    2009-01-01

    Full Text Available CONTEXTO: A dissociação peritraumática é uma resposta no momento da exposição a uma situação ameaçadora que tem se mostrado um preditor significativo de perturbação psicológica a longo prazo, nomeadamente perturbação pós-estresse traumático. OBJETIVOS: Fazer a adaptação para português do Peritraumatic Dissociation Experiences Questionnaire numa população altamente exposta a situações traumáticas, como é o caso dos bombeiros. MÉTODO: Após a tradução e o estudo dos itens, fizeram-se a aplicação e a análise psicométrica com uma amostra de 170 bombeiros, que relataram exposição traumática e que também preencheram uma escala de Perturbação de Pós-Estresse Traumático. RESULTADOS: Os dados indicam que se trata de um instrumento com uma boa consistência interna (alfa de Cronbach = 0,87 e cuja validade de construto o torna adequado para a avaliação das respostas dessa população no exercício da sua profissão. Para além disso, a correlação elevada com os sintomas de perturbação pós-estresse traumático sugere ainda uma boa validade convergente. DISCUSSÃO: Atendendo ao fato de que a dissociação peritraumática prevê PPST, o recurso a um instrumento que revela boas capacidades psicométricas pode ajudar a identificar as pessoas que desenvolverão perturbação após exposição a trauma.BACKGROUND: Peritraumatic dissociation is a reaction that occurs in the moment someone is exposed to a threatening situation and has shown to be an important predictor of long term psychological disorder, including post traumatic stress disorder. OBJECTIVES: To make the psychometric adaptation of Peritraumatic Dissociation Experiences Questionnaire in Portuguese ambulance personnel that report high exposure to trauma. The instrument has been widely used in research, and was initially designed to analyse peritraumatic dissociation in emergency personnel. METHODS: After items translation and study, 170 ambulance

  12. Fractal analysis of the ambulation pattern of Japanese quail.

    Science.gov (United States)

    Kembro, J M; Perillo, M A; Pury, P A; Satterlee, D G; Marín, R H

    2009-03-01

    1. The study examined the practicality and usefulness of fractal analyses in evaluating the temporal organisation of avian ambulatory behaviour by using female Japanese quail in their home boxes as the model system. To induce two locomotion activity levels, we tested half of the birds without disturbance (Unstimulated) and the other half when food was scattered on the floor of the home box after 3 h of feeder withdrawal (Stimulated). 2. Ambulatory activity was recorded during 40 min at a resolution of 1 s and evaluated by: (1) detrended fluctuation analyses (DFA), (2) the frequency distribution of the duration of the walking or non-walking events (FDD-W or FDD-NW, respectively), and (3) the transition probabilities between walking/non-walking states. Conventional measures of total time spent walking and average duration of the walking/non-walking events were also employed. 3. DFA showed a decreased value of the self-similarity parameter (alpha; indicative of a more complex ambulatory pattern) in Stimulated birds compared to their Unstimulated counterparts. The FDD-NW showed a more negative scaling factor in Stimulated than in Unstimulated birds. Stimulated birds also had more transitions between non-walking and walking states, consistent with stimulated exploratory activity. No differences were found between groups in the FDD-W, in percentage of total time spent walking, or in average duration of the walking events. 4. The temporal walking pattern of female Japanese quail has a fractal structure and its organisation and complexity is altered when birds are stimulated to explore. The fractal analyses detected differences between the Unstimulated and Stimulated groups that went undetected by the traditional measurements of the percentage of total time spent walking and the duration of the walking events suggesting its usefulness as a tool for behavioural studies. PMID:19373715

  13. Functional Analysis and Treatment of Socially Stigmatizing Ambulation

    Science.gov (United States)

    Pitman, Melanie J.

    2007-01-01

    A brief functional analysis was conducted in an analogue setting to identify the maintaining variables for upright walking in a woman with developmental disabilities supported in an outpatient setting. All conditions required modification, since treatment outcomes were intended to increase, rather than decrease, the target behavior. The…

  14. Embedded System For Intelligent Ambulance And Traffic Control Management

    OpenAIRE

    Sarika Baburao Kale; Gajanan P. Dhok

    2013-01-01

    The use of Embedded technology has proved to be very beneficial in  present Traffic Light Controller (TLC) and that will minimize waiting time of vehicle and also manage traffic load. In this paper we exploit the emergence of new technology called as Intelligent traffic light controller, This makes the use of sensor n/w along with embedded technology. Where traffic light will be intelligently decided based on the total traffic on all adjacent roads. Thus optimization of traffic light switchin...

  15. Biomechanical analysis of stair ambulation in lower limb amputees.

    Science.gov (United States)

    Schmalz, Thomas; Blumentritt, Siegmar; Marx, Björn

    2007-02-01

    Lower extremity amputees have to cope with many activities in everyday life that are substantially more difficult than walking on level ground, and such demands require a high degree of functionality from their prosthetic components. The present study is a biomechanical evaluation (kinematics, kinetics and EMG) of stair ascent and descent in a group of eight transtibial amputees (mean (standard deviation): age 51(14) years, height 176(7)cm, mass 88(19)kg); a group of 12 transfemoral amputees (age 37(8) years, height 182(7)cm, mass 83(7)kg) fitted with the electronically controlled C-LEG knee joint system; and a group of 12 able bodied persons (age 30(10) years, height 174(12)cm, mass 69(12)kg). During stair descent the transfemoral amputees presented a strong reduction of the prosthetic ankle moments (0.11Nm/kg) compared to transtibial amputees (0.93Nm/kg) and control subjects (1.26Nm/kg). Loading of the prosthetic knee joint in the transfemoral amputees more closely resembles the loading seen in the control population when compared to transtibial amputees (mean maximum flexion moment: controls 1.31Nm/kg, transfemoral amputees 1.00Nm/kg, transtibial amputees 0.50Nm/kg). Overload of the contralateral limb is more prominent in the transfemoral amputee than in the transtibial amputee. During stair ascent, the transtibial amputee presents a significant reduction of the knee flexion moment compared to the controls (mean maximum flexion moment: transtibial amputees 0.28Nm/kg, controls 1.31Nm/kg). These differences correlate with a change in the muscle activity of the knee extensor and hamstring muscles. The results also show adaptations in motor strategies during stair negotiation, for those with the partial loss of a lower limb due to the functional limits of current prosthetic components. The present data may contribute to a further enhancement of the efficiency of prosthetic feet and knee joints. PMID:16725325

  16. Úloha sestry v dermatovenerologické ambulanci

    OpenAIRE

    NOVÁKOVÁ, Tereza

    2009-01-01

    The theme of my bachelor´s work is a nurse´s job in the dermatologic-venerologic outpatients´. Its object was to determine the nurse´s duty in the dermatologic-venerologic outpatients´ and the strenuousness of her work. The chapter of the current situation includes the history and the present of dermatology-venerology and the particularity of the nurse´s treatment of this specialization. It also includes anatomy and epidermis and its other organs physiology. There are analyzed nurse´s individ...

  17. Exposure to human tragedy, empathy, and trauma in ambulance paramedics.

    Science.gov (United States)

    Regehr, Cheryl; Goldberg, Gerald; Hughes, Judy

    2002-10-01

    Paramedics are exposed to events involving human pain and suffering on a daily basis, many of which are the result of violence perpetrated by 1 individual on another. For the most part, these emergency workers have learned to deal with such events and take them in stride. At times, however, certain circumstances lead workers to develop an emotional connection with the victim or his or her family. When this occurs, paramedics report increased symptoms of traumatic stress. Aspects that can trigger this connection include the victim's alienation from others, profound loss, or the abuse of an innocent child. One of the coping strategies described in these circumstances is to manage the events on a cognitive and technical level while maintaining an emotional distance. Although such a strategy may be protective, it may also have long-term negative effects in terms of interpersonal relationships. This mixed-methods study attempts to better understand factors that lead to higher levels of distress among paramedics within the theoretical framework of emotional and cognitive empathy. PMID:15792036

  18. Préambule. Interactions dans le groupe et apprentissages

    OpenAIRE

    Hugon, Marie-Anne; Cunff, Catherine Le

    2014-01-01

    Les échanges oraux entre élèves en classe au sein de travaux de groupes suscitent depuis longtemps l’intérêt des pédagogues ainsi que celui des chercheurs en sciences humaines concernés par les apprentissages à l’école. C’est ainsi qu’aujourd’hui les connaissances sur l’apprentissage coopératif commencent à être bien diffusées comme le montrent des publications récentes. Mais en France pour des raisons d’histoire institutionnelle, les recherches sur les interactions dans les groupes d’apprent...

  19. Feasibility of Suited 10-km Ambulation "Walkback" on the Moon

    Science.gov (United States)

    Norcross, Jason; Lee, Lesley; DeWitt, John K.; Klein, Jill; Wessell, James; Gernhardt, Michael L.

    2008-01-01

    This viewgraph presentation reviews a study that examined the feasibility of having astronauts walk about 10 kilometers to the base in the event of a breakdown of the lunar rover. This was done in part to examine the possibility of having a single rover on the lunar exploration missions. Other objectives of the study are to: (1) Understand specific biomedical and human performance limitations of the suit compared to matched shirt-sleeve controls; (2) Collect metabolic and ground-reaction force data to develop an EVA simulator for use on future prebr eathe protocol verification tests (3) Provide data to estimate consum ables usage for input to suit and portable life support system (PLSS) design (4) Assess the cardiovascular and resistance exercise associa ted with partialgravity EVA for planning appropriate exploration exer cise countermeasures

  20. A implantação do projeto de atendimento Móvel de Urgência em Salvador/BA: panorama e desafios La implantación del proyecto de Atención de Urgencia Móvil en Salvador/BAHIA: panorama y retos Implantation of the Emergency Ambulance Service in Salvador, Bahia: reality and challenges

    Directory of Open Access Journals (Sweden)

    Célia Maria Sales Vieira

    2008-12-01

    retos en la dinámica y calidad de la atención: educación comunitaria, capacitación profesional, evaluación de recursos humanos y materiales.The goal of this study was to describe the implementation of the emergency ambulance service of Salvador, Bahia (SAMU-192. The Ministry of Health provided the legal basis and regulations for its implementation. The main purpose of this service is the provision of free primary level healthcare to individuals, with clinical, surgical, traumatic and psychiatric aggravations that cause suffering, sequels or death and occur outside the hospital environment. The specific goals of SAMU-192 was to grant free healthcare to urgency and emergency situations, under the hierarchy and regulations of the Single Health System (SUS of the Brazilian government, assuring that public resources will be available and integrated to the complementary healthcare network. Investments for the installation of the service were agreed on in the city and with federal and state management commissions. To turn SAMU-192 into reality, several challenges need to be accomplished, including community education, professional qualification and evaluation of human and material resources so as to provide basic emergency care with the appropriate quality.

  1. Reflexões sobre deambulação e posição materna no trabalho de parto e parto Reflexiones sobre deambulación y posición materna en el trabajo de parto y parto Reflection on ambulation and maternal position during labor and delivery

    Directory of Open Access Journals (Sweden)

    Fabiana Villela Mamede

    2007-06-01

    place to other ones that valued the technology, the medicalization and the intervention. Such changes didn't make possible a significant reduction in the mother mortality and neonatal, in other way, they promoted the lack of humanization in the assistance. A new look on the ambulation effect and the position during labor and delivery is been encouraged and giving opportunity to became evident a variety of vantages and benefits to the mother and child.

  2. Dual-energy X-ray absorptiometry, skinfold thickness and waist circumference for assessing body composition in ambulant and non-ambulant wheelchair games players

    Directory of Open Access Journals (Sweden)

    Annika Willems

    2015-11-01

    Full Text Available Field-based assessments provide a cost–effective and accessible alternative to dual-energy X-ray absorptiometry (DXA for practitioners determining body composition in athletic populations. It remains unclear how the range of physical impairments classifiable in wheelchair sports may affect the utility of field-based body composition techniques. The present study assessed body composition using DXA in 14 wheelchair games players who were either wheelchair dependent (non-walkers; n =7 or relied on a wheelchair for sports participation only (walkers; n =7. Anthropometric measurements were used to predict body fat percentage with existing regression equations established for able-bodied persons by Sloan & Weir, Durnin & Womersley, Lean et al, Gallagher et al and Pongchaiyakul et al. In addition, linear regression analysis was performed to calculate the association between body fat percentage and BMI, waist circumference, sum of 6 skinfold thicknesses and sum of 8 skinfold thicknesses. Results showed that non-walkers had significantly lower total lean tissue mass (46.2±=6.6 kg vs. 59.4±8.2 kg, P =.006 and total body mass (65.8 ±4.2 kg vs. 79.4 ±14.9 kg; P =0.05 than walkers. Body fat percentage calculated from most existing regression equations was significantly lower than that from DXA, by 2 to 9% in walkers and 8 to14% in non-walkers. Of the anthropometric measurements, the sum of 8 skinfold thicknesses had the lowest standard error of estimation in predicting body fat content. In conclusion, existing anthropometric equations developed in able-bodied populations substantially underestimated body fat content in wheelchair athletes, particularly non-walkers. Impairment specific equations may be needed in wheelchair athletes.

  3. Dual-Energy X-Ray Absorptiometry, Skinfold Thickness, and Waist Circumference for Assessing Body Composition in Ambulant and Non-Ambulant Wheelchair Games Players

    Science.gov (United States)

    Willems, Annika; Paulson, Thomas A. W.; Keil, Mhairi; Brooke-Wavell, Katherine; Goosey-Tolfrey, Victoria L.

    2015-01-01

    Field-based assessments provide a cost–effective and accessible alternative to dual-energy X-ray absorptiometry (DXA) for practitioners determining body composition in athletic populations. It remains unclear how the range of physical impairments classifiable in wheelchair sports may affect the utility of field-based body composition techniques. The present study assessed body composition using DXA in 14 wheelchair games players who were either wheelchair dependent (non-walkers; n = 7) or relied on a wheelchair for sports participation only (walkers; n = 7). Anthropometric measurements were used to predict body fat percentage with existing regression equations established for able-bodied persons by Sloan and Weir, Durnin and Womersley, Lean et al, Gallagher et al, and Pongchaiyakul et al. In addition, linear regression analysis was performed to calculate the association between body fat percentage and BMI, waist circumference, sum of 6 skinfold thickness and sum of 8 skinfold thickness. Results showed that non-walkers had significantly lower total lean tissue mass (46.2 ± 6.6 kg vs. 59.4 ± 8.2 kg, P = 0.006) and total body mass (65.8 ± 4.2 kg vs. 79.4 ± 14.9 kg; P = 0.05) than walkers. Body fat percentage calculated from most existing regression equations was significantly lower than that from DXA, by 2 to 9% in walkers and 8 to 14% in non-walkers. Of the anthropometric measurements, the sum of 8 skinfold thickness had the lowest standard error of estimation in predicting body fat content. In conclusion, existing anthropometric equations developed in able-bodied populations substantially underestimated body fat content in wheelchair athletes, particularly non-walkers. Impairment specific equations may be needed in wheelchair athletes. PMID:26640442

  4. Legal aspects of incidents with contrast media and of the radiation risk in ambulant diagnostics

    International Nuclear Information System (INIS)

    There is hardly a radiologist or a urologist who won't be confronted with an incident with contrast media in his surgery or at least with the question of if the radiation risk in the diagnostical radiology is in a reasonable proportion to the need for a completely clear diagnose. Complications, hard reactions or hazardous consequences in the diagnostical sphere are often a reason for the patient or his relatives to inform the police or the competent public prosecutor because either all diagnostical measures are thought to be completely undangerous or the physician refuses to release the patients files for inspection. In order to avoid such wrong attitudes of patients and to protect the physician from being sued for damages without valid reason some legal aspects of diagnostical surgery are shown at the example of contrast medium administration. (orig./HP)

  5. Forearm pressure distribution during ambulation with elbow crutches: a cross-sectional study

    OpenAIRE

    Fischer, Jonas; Nüesch, Corina; Göpfert, Beat; Mündermann, Annegret; Valderrabano, Victor; Hügle, Thomas

    2014-01-01

    BackgroundIncreasing numbers of patients require permanent walking aids to maintain mobility. Current elbow crutches are not designed for long-term use, and overuse is often associated with hematoma formation and pain along the forearm. We therefore hypothesized that the highest pressures between the forearm and crutch cuff during walking and stance are located in the ulnar region and that the level of weight-bearing, forearm circumference and kinematic parameters influence peak pressure valu...

  6. The Relationship between Manual Ability and Ambulation in Adolescents with Cerebral Palsy

    Science.gov (United States)

    Majnemer, Annette; Shikako-Thomas, Keiko; Shevell, Michael; Poulin, Chantal; Lach, Lucyna; Law, Mary; Schmitz, Norbert

    2013-01-01

    This study examined the relationship between gross motor function and manual ability in 120 adolescents with cerebral palsy (CP) (15.2, SD 2.1 years, 59.8% male). Adolescents were evaluated using the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). A neurologist classified CP subtype. Most…

  7. Walk-in ambulant lungefunktionsservice for rygere i Kobenhavn--etarsopgorelse

    DEFF Research Database (Denmark)

    Backer, V.; Bolton, S.; Ehlers, H.D.; Thomsen, S.; Pedersen, L.; Porsbjerg, C.; Lund, T.; Harmse, L.; Fuglsang, C.

    2008-01-01

    BACKGROUND: Early prevention of COPD and immediate consultation about tobacco cessation is a major issue in respiratory medicine. Aim: To evaluate if a community-based walk-in lung function service, either in a clinic or a shopping mall, could result in early detection of COPD. Early detection...... would facilitate prevention. MATERIALS AND METHODS: In an area with 1.5 mill inhabitants, a walk-in lung function service opened in 2005/06 once a month for 3 hours at a clinic and on two full days in a mall. The staff consisted of two respiratory nurses and one chest physician. The nurses informed all...... function service at the mall (38% versus 25%) (p < 0.01). The mean tobacco consumption was 32 (18) packs a year, with a difference between those visiting the mall and the clinic (32 (20) versus 23 (16), p<0.05). Among smokers, 54% had normal lung function, 15% had signs of airway obstruction, whereas 31...

  8. And why not thrombolysis in the ambulance (at least for some)?

    Science.gov (United States)

    Rosenberg, Gilad; Steiner, Israel

    2016-07-12

    The fear that alteplase may aggravate primary intracerebral hemorrhages has led to the mandatory prerequisite for prealteplase imaging in all acute stroke patients in order to exclude such hemorrhages. Consequently, in a situation in which "time is brain," administration of alteplase is delayed until the patients are transferred to a hospital where such imaging is available, at the cost of additional ischemic damage to the brain parenchyma. Yet, theoretical considerations and empirical data suggest that alteplase's effects on primary intracerebral hemorrhages may not be that detrimental. Moreover, at least some of the patients who are at a high risk of having primary cerebral bleeds, or at a high risk of developing symptomatic secondary bleeds, can be excluded from alteplase therapy on clinical grounds, and using nonimaging point-of-care devices, before their hospital arrival. We propose that clinical research should be initiated to define a population of stroke patients in whom alteplase may be administered preimaging, resulting in a greater benefit than harm and in improved functional outcome compared to deferred, postimaging, alteplase treatment. PMID:27306629

  9. Objectively measured work load, health status and sickness absence among Danish ambulance personnel. A longitudinal study

    DEFF Research Database (Denmark)

    Hansen, Claus D.

    2013-01-01

    levels of self-rated health (OR: 1.79), higher levels of musculoskeletal pain (OR: 1.16) but was unrelated to mental health. In addition, increasing work load was associated with higher levels of emotional demands and work pace (p < 0.000). The objective measure of work load was also associated with self...

  10. Svær dehydrering hos nyfødt efter ambulant fødsel

    DEFF Research Database (Denmark)

    Thøstesen, Lisbeth Marianne; Fenger-Grøn, Jesper

    2011-01-01

    A nine day-old girl was hospitalised because of breast-feeding problems and life-threatening hypernatremic dehydration; weight loss was 30% of birth weight and s-Na 187 mmol/l. The question is raised whether there could be an association to the current changes in the perinatal health care in...... Denmark. The case emphasizes the necessity of a sufficient safety net beneath the newborn children in order to minimise the risk of breast-feeding problems and re-hospitalizing. Neonatal problems such as marked weight loss, dehydration, hypernatremia and marked jaundice are potentially preventable....

  11. Effects of adductor-canal-blockade on pain and ambulation after total knee arthroplasty

    DEFF Research Database (Denmark)

    Jenstrup, M T; Jæger, P; Lund, J; Fomsgaard, J S; Bache, S; Mathiesen, O; Larsen, T K; Dahl, J B

    2012-01-01

    Total knee arthroplasty (TKA) is associated with intense post-operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this elderly population. The adductor-canal-blockade is theoretically an almost pure sensory blockade. We...

  12. Back to the Future: Preserved Hippocampal Network Activity during Reverse Ambulation

    OpenAIRE

    Maurer, Andrew P.; Lester, Adam W.; Burke, Sara N; Ferng, Jonathan J.; Barnes, Carol A.

    2014-01-01

    During movement, there is a transition of activity across the population, such that place-field centers ahead of the rat are sequentially activated in the order that they will be encountered. Although the mechanisms responsible for this sequence updating are unknown, two classes of models can be considered. The first class involves head-direction information for activating neurons in the order that their place fields will be traversed. An alternative model contends that motion and turn-relate...

  13. 75 FR 62639 - Air Ambulance and Commercial Helicopter Operations, Part 91 Helicopter Operations, and Part 135...

    Science.gov (United States)

    2010-10-12

    ... in the Federal Register published on April 11, 2000 (65 FR 19477-78) or you may visit http://Dockets.... Helicopter air medical transportation was first used prominently during the Korean War to move injured... safety culture, and aeronautical decisionmaking skills. The following provides a summary of many of...

  14. Ambulant neuropsykologisk opfølgning af patienter indlagt med aseptisk meningitis

    DEFF Research Database (Denmark)

    Damsgaard Gunst, Jesper; Klostergaard, Kirsten Rose; Leutscher, Peter Derek Christian

    2014-01-01

    Aseptic meningitis is considered to be a benign illness with mild symptoms, and the prognosis is usually good. However, retrospective studies have demonstrated that these patients may experience cognitive sequelae. A neuropsychologist was affiliated to the Department of Infectious Diseases, and...... neuropsychological findings in patients with aseptic meningitis were assessed. In conclusion, at twelve months of follow-up cognitive dysfunction persist among the majority of patients; 75% had mental fatigue and 45% had changed their work status....

  15. Aseptic procedure in the ambulant wound management – legal and practical issues

    OpenAIRE

    Schwarzkopf, Andreas

    2007-01-01

    A greater part of the care of chronic wounds takes place in private homes in Germany. Not in every case it is possible to perform hygiene control of the environment. Personal hygiene ideas of patients may differ in a wide range. Teamwork together with surgeons is not always easy for wound managers. Aseptic care of wounds is possible under nearly every condition, if well elaborated processes are engaged. Hygiene in home care is defined by laws to protect nursing persons (BiostoffV, TRBA 250) a...

  16. Activation of catheterization lab in ambulance: new direction in ST-elevation myocardial infarction care

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing

    2011-01-01

    @@ Primary percutaneous coronary intervention (PPCI) is the cornerstone of treatment to reduce infarct size and improve outcomes in patients with ST-elevation myocardial infarction (STEMI).1 The optimal site for initiation of reperfusion strategies is the patient's home or place where the infarction occurs.

  17. Decompression Sickness During Simulated Low Pressure Exposure is Increased with Mild Ambulation Exercise

    Science.gov (United States)

    Pollock, N. W.; Natoli, M. J.; Martina, S. D.; Conkin, J.; Wessel, J. H., III; Gernhardt, M. L.

    2016-01-01

    Musculoskeletal activity accelerates inert gas elimination during oxygen breathing prior to decompression (prebreathe), but may also promote bubble formation (nucleation) and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity are likely critical to the net effect. The NASA Prebreathe Reduction Program (PRP) combined oxygen prebreathe and exercise preceding a 4.3 psia exposure in non-ambulatory subjects (a microgravity analog) to produce two protocols now used by astronauts preparing for extravehicular activity - one employing cycling and non-cycling exercise (CEVIS: 'cycle ergometer vibration isolation system') and one relying on non-cycling exercise only (ISLE: 'in-suit light exercise'). Current efforts investigate whether light exercise normal to 1 G environments increases the risk of DCS over microgravity simulation.

  18. Possibility of leg muscle hypertrophy by ambulation in older adults: a brief review

    OpenAIRE

    Ozaki H; Loenneke JP; Thiebaud RS; Stager JM; Abe T

    2013-01-01

    Hayao Ozaki,1 Jeremy P Loenneke,2 Robert S Thiebaud,2 Joel M Stager,3 Takashi Abe31Juntendo University, Inzai, Chiba, Japan; 2Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA; 3Department of Kinesiology, Indiana University, Bloomington, IN, USAAbstract: It is known that ambulatory exercises such as brisk walking and jogging are potent stimuli for improving aerobic capacity, but it is less understood whether ambulatory exercise can increase leg muscle size and...

  19. A validation of ground ambulance pre-hospital times modeled using geographic information systems

    Directory of Open Access Journals (Sweden)

    Patel Alka B

    2012-10-01

    Full Text Available Abstract Background Evaluating geographic access to health services often requires determining the patient travel time to a specified service. For urgent care, many research studies have modeled patient pre-hospital time by ground emergency medical services (EMS using geographic information systems (GIS. The purpose of this study was to determine if the modeling assumptions proposed through prior United States (US studies are valid in a non-US context, and to use the resulting information to provide revised recommendations for modeling travel time using GIS in the absence of actual EMS trip data. Methods The study sample contained all emergency adult patient trips within the Calgary area for 2006. Each record included four components of pre-hospital time (activation, response, on-scene and transport interval. The actual activation and on-scene intervals were compared with those used in published models. The transport interval was calculated within GIS using the Network Analyst extension of Esri ArcGIS 10.0 and the response interval was derived using previously established methods. These GIS derived transport and response intervals were compared with the actual times using descriptive methods. We used the information acquired through the analysis of the EMS trip data to create an updated model that could be used to estimate travel time in the absence of actual EMS trip records. Results There were 29,765 complete EMS records for scene locations inside the city and 529 outside. The actual median on-scene intervals were longer than the average previously reported by 7–8 minutes. Actual EMS pre-hospital times across our study area were significantly higher than the estimated times modeled using GIS and the original travel time assumptions. Our updated model, although still underestimating the total pre-hospital time, more accurately represents the true pre-hospital time in our study area. Conclusions The widespread use of generalized EMS pre-hospital time assumptions based on US data may not be appropriate in a non-US context. The preference for researchers should be to use actual EMS trip records from the proposed research study area. In the absence of EMS trip data researchers should determine which modeling assumptions more accurately reflect the EMS protocols across their study area.

  20. Elderly and Nonelderly Use of a Dedicated Ambulance Corps’ Emergency Medical Services in Taiwan

    Directory of Open Access Journals (Sweden)

    Chien-Chia Huang

    2016-01-01

    Full Text Available Backgrounds and Aim. Taiwan’s population is gradually aging; however, there are no comparative data on emergency medical services (EMS use between the elderly and nonelderly. Methods. We analyzed the emergency calls dealt with between January 1 and April 4, 2014, by EMS in one city in Taiwan. All calls were divided into two groups: elderly (≥65 years and nonelderly (<65 years. Nontransport and transport calls were compared between the groups for demographic characteristics, transport time, reasons for calling EMS, vital signs, and emergency management. Results. There were 1,001 EMS calls: 226 nontransport and 775 transport calls. The elderly accounted for significantly (P<0.05 fewer (28 (9.2% nontransport calls than did the nonelderly (136 (21.4%. In the transport calls, 276 (35.6% were the elderly. The elderly had a higher proportion of histories for cardiovascular disease, cerebrovascular disease, hypertension, diabetes, end-stage renal disease, cancer, Parkinson’s disease, and Alzheimer’s disease. In addition, the elderly had significantly longer total transport time, more nontrauma reasons, and poorer consciousness levels and lower oxygen saturation and needed more respiratory management and more frequent resuscitation during transport than did the nonelderly. Conclusion. The elderly have more specific needs than do the nonelderly. Adapting EMS training, operations, and government policies to aging societies is mandatory and should begin now.

  1. Is Doing More, Doing Better? Basic Versus Advanced Life Support Ambulances for Medical Emergencies

    OpenAIRE

    Sanghavi, Prachi

    2015-01-01

    Deficiencies in the quality of pre-hospital care constitute a serious public health problem that has largely been neglected by the scientific community. Trauma and complications of acute disease produce medical emergencies outside of the hospital setting. Treating patients with these conditions involves an inherent trade-off between providing treatment on-site and reducing time to hospital care. My dissertation compares two models of providing pre-hospital care, and highlights a data-driven a...

  2. A validation of ground ambulance pre-hospital times modeled using geographic information systems

    OpenAIRE

    Patel Alka B; Waters Nigel M; Blanchard Ian E; Doig Christopher J; Ghali William A

    2012-01-01

    Abstract Background Evaluating geographic access to health services often requires determining the patient travel time to a specified service. For urgent care, many research studies have modeled patient pre-hospital time by ground emergency medical services (EMS) using geographic information systems (GIS). The purpose of this study was to determine if the modeling assumptions proposed through prior United States (US) studies are valid in a non-US context, and to use the resulting information ...

  3. Energy expenditure estimation during normal ambulation using triaxial accelerometry and barometric pressure

    International Nuclear Information System (INIS)

    Energy expenditure (EE) is an important parameter in the assessment of physical activity. Most reliable techniques for EE estimation are too impractical for deployment in unsupervised free-living environments; those which do prove practical for unsupervised use often poorly estimate EE when the subject is working to change their altitude by walking up or down stairs or inclines. This study evaluates the augmentation of a standard triaxial accelerometry waist-worn wearable sensor with a barometric pressure sensor (as a surrogate measure for altitude) to improve EE estimates, particularly when the subject is ascending or descending stairs. Using a number of features extracted from the accelerometry and barometric pressure signals, a state space model is trained for EE estimation. An activity classification algorithm is also presented, and this activity classification output is also investigated as a model input parameter when estimating EE. This EE estimation model is compared against a similar model which solely utilizes accelerometry-derived features. A protocol (comprising lying, sitting, standing, walking, walking up stairs, walking down stairs and transitioning between activities) was performed by 13 healthy volunteers (8 males and 5 females; age: 23.8 ± 3.7 years; weight: 70.5 ± 14.9 kg), whose instantaneous oxygen uptake was measured by means of an indirect calorimetry system (K4b2, COSMED, Italy). Activity classification improves from 81.65% to 90.91% when including barometric pressure information; when analyzing walking activities alone the accuracy increases from 70.23% to 98.54%. Using features derived from both accelerometry and barometry signals, combined with features relating to the activity classification in a state space model, resulted in a .VO2 estimation bias of −0.00 095 and precision (1.96SD) of 3.54 ml min−1 kg−1. Using only accelerometry features gives a relatively worse performance, with a bias of −0.09 and precision (1.96SD) of 5.99 ml min−1 kg−1, with the largest errors due to an underestimation of .VO2 when walking up stairs. (paper)

  4. Possibility of leg muscle hypertrophy by ambulation in older adults: a brief review

    Directory of Open Access Journals (Sweden)

    Ozaki H

    2013-03-01

    Full Text Available Hayao Ozaki,1 Jeremy P Loenneke,2 Robert S Thiebaud,2 Joel M Stager,3 Takashi Abe31Juntendo University, Inzai, Chiba, Japan; 2Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA; 3Department of Kinesiology, Indiana University, Bloomington, IN, USAAbstract: It is known that ambulatory exercises such as brisk walking and jogging are potent stimuli for improving aerobic capacity, but it is less understood whether ambulatory exercise can increase leg muscle size and function. The purpose of this brief review is to discuss whether or not ambulatory exercise elicits leg muscle hypertrophy in older adults. Daily ambulatory activity with moderate (>3 metabolic equivalents [METs], which is defined as the ratio of the work metabolic rate to the resting metabolic rate intensity estimated by accelerometer is positively correlated with lower body muscle size and function in older adults. Although there is conflicting data on the effects of short-term training, it is possible that relatively long periods of walking, jogging, or intermittent running for over half a year can increase leg muscle size among older adults. In addition, slow-walk training with a combination of leg muscle blood flow restriction elicits muscle hypertrophy only in the blood flow restricted leg muscles. Competitive marathon running and regular high intensity distance running in young and middle-aged adults may not produce leg muscle hypertrophy due to insufficient recovery from the damaging running bout, although there have been no studies that have investigated the effects of running on leg muscle morphology in older subjects. It is clear that skeletal muscle hypertrophy can occur independently of exercise mode and load.Keywords: aerobic exercise, muscle mass, aging, strength, sarcopenia

  5. INTRODUKSI TEKNOLOGI INOVASI AMBUL UNTUK BUDIDAYA TANAMAN SAYURAN DI KALIMANTAN TENGAH

    OpenAIRE

    HASTIN ERNAWATI NUR CHUSNUL CHOTIMAH; GUSTI IRYA ICHRIANI; ARDIANOR ARDIANOR

    2014-01-01

    Arut Bawah is a settlement that is always flooded every year due to Kahayan river run off . Residents perform various activities on the water, and transportation between housing residents with one another, using wooden boards. The conditions is not possible if it is used to grow crops. It is certainly limiting factor for household food needs, including the need for vegetables. Flooded land use around residential has not been done because the technology is not yet known. Through these activiti...

  6. Searching for the evidence in pre-hospital care: a review of randomised controlled trials. On behalf of the Ambulance Response Time Sub-Group of the National Ambulance Advisory Committee.

    OpenAIRE

    Brazier, H; Murphy, A W; Lynch, C; Bury, G

    1999-01-01

    OBJECTIVES: To identify randomised controlled trials (RCTs) which evaluate aspects of pre-hospital care; to perform categorisation by theme; to compare the sensitivity and precision of the search databases. DATA SOURCES: August 1997 updates of MEDLINE and EMBASE databases, using the Datastar online system. Papers published in 1987 or later were included, with no language restrictions. STUDY SELECTION: A trial was eligible for inclusion if it was judged, by two independent and blinded assessor...

  7. High intertester reliability of the cumulated ambulation score for the evaluation of basic mobility in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Andersen, Lene; Bech-Jensen, Rie;

    2009-01-01

    ) walking ability - was assessed by two independent physiotherapists at postoperative median day 3. Each activity was assessed on a three-point ordinal scale from 0 (not able to) to 2 (independent of human assistance). The cumulated score for each activity provides a total CAS from 0 to 6, with 6 indicating...

  8. Úloha sestry v péči o klienty s Parkinsonovou chorobou v ambulanci neurologa

    OpenAIRE

    Motlová, Eva

    2014-01-01

    Abstract The task of the nurse in care of Parkinson patients at neurology clinic This bachelor thesis focuses on the task of nurses in care of Parkinson patients at neurology clinic. Parkinson disease is a progressive degenerative illness of central nervous system affecting extrapyramidal pathways. It leads mainly to movement problems, stance and gait disorder, muscle rigidity and tremor. It is caused by dopamine insufficiency in basal ganglia. This disease has been described by a London phys...

  9. Controlled Study of the Effects of Continuous Intrathecal Baclofen Infusion in Non-Ambulant Children with Cerebral Palsy

    Science.gov (United States)

    Morton, Richard E.; Gray, Natalie; Vloeberghs, Michael

    2011-01-01

    Aim: To measure changes in children with severe spastic cerebral palsy (CP) after continuous intrathecal baclofen (ITB) infusion over 18 months and to compare the results with those of a comparison group awaiting treatment. Method: Thirty-eight children with severe spastic CP considered suitable for ITB were assessed when first seen, just before…

  10. Pilot Field Test: The Ability to Ambulate Following Landing as Assessed with Seat Egress, Walk and Obstacle Testing

    Science.gov (United States)

    Fisher, E. A.; Fomina, E. V; Reschke, M. F.; Cerisano, J. M.; Kofman, I. S.; Gadd, N. E.; Phillips, T. R.; Lee, S. M. C.; Laurie, S. S.; Stenger, M. B.; Bloomberg, J. J.; Mulavara, A. P.; Kozlovskaya, I. B.; Tomilovskaya, E. S.

    2016-01-01

    To date, changes in functional performance have been systematically studied after short-duration space flight. As important as the postflight functional changes have been, full functional recovery has never been investigated or established for long-duration flights. The Pilot Field Test (PFT) experiment, conducted with participation of ISS crewmembers traveling on Soyuz expeditions 34S - 41S, is comprised of several tasks designed to study the recovery of sensorimotor abilities of astronauts during the first 24 hours after landing and beyond. The objective of the Seat Egress - Walk and Obstacle Test, developed by NASA's Russian collaborators at the Institute for Biomedical Problems, is to address this gap in knowledge. This will allow us to characterize the ability of crewmembers to perform critical mission requirements that they will be expected to perform after an unassisted landing following 6 to 12 months in microgravity.

  11. Using Surveillance Data to Inform Community Action: The Effect of Alcohol Sale Restrictions on Intentional Injury-related Ambulance Pickups

    OpenAIRE

    Masho, Saba W.; Bishop, Diane L.; Edmonds, Torey; Farrell, Albert D.

    2013-01-01

    Youth violence disproportionately affects inner city, urban minority communities in the USA. This article illustrates the use of surveillance data to inform and evaluate community action directed at this serious problem. Community efforts in response to surveillance data indicating high rates of violence surrounding convenience stores with unrestricted alcohol beverage licenses provided a natural experiment to examine the impact of imposing licensing restrictions on intentional injury rates. ...

  12. Threshold electrical stimulation (TES) in ambulant children with CP: a randomized double-blind placebo-controlled clinical trial

    DEFF Research Database (Denmark)

    Dali, Christine í; Hansen, Flemming Juul; Pedersen, Søren Anker;

    2002-01-01

    A randomized double-blind placebo-controlled clinical trial was carried out to determine whether a group of stable children with cerebral palsy (36 males, 21 females; mean age 10 years 11 months, range 5 to 18 years) would improve their motor skills after 12 months of threshold electrical......). There was no significant difference between active and placebo treatment in any of the tested groups, nor combined. Visual and subjective assessments favoured TES (ns), whereas objective indices showed the opposite trend. We conclude that TES in these patients did not have any significant clinical effect during the test...

  13. The Angio-Seal™ femoral closure device allows immediate ambulation after coronary angiography and percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Jeger, Raban; Osterwalder, Remo;

    2011-01-01

    Aims: To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device. Methods and results: First, a randomised controlled trial of immediate mobilisation vs. delayed...

  14. The Angio-Seal™ femoral closure device allows immediate ambulation after coronary angiography and percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Jeger, Raban; Osterwalder, Remo;

    2011-01-01

    To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device.......To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device....

  15. Improvement in the pre-hospital care of recreational drug users through the development of club specific ambulance referral guidelines

    OpenAIRE

    Heather Kim; Moore Fionna; Chapman Kerry; Nicolaou Michelle; Huggett Denise; Alldus Graham; Greene Shaun L; Wood David M; Drake Nicola; Dargan Paul I

    2008-01-01

    Abstract Background Previously developed 'club guidelines' developed for club owners and promoters have tended to focus more on the legislative aspects of clubs, rather than the medical management of unwell clubbers within club environments. Despite this lack of guidance on the management of unwell clubbers, a significant proportion of clubs have 'club medic' rooms for managing these individuals. However, due to the lack of specific guidance on the training of staff working in these rooms and...

  16. The use of segmented regression in analysing interrupted time series studies: an example in pre-hospital ambulance care

    OpenAIRE

    Taljaard, Monica; McKenzie, Joanne E; Ramsay, Craig R; Grimshaw, Jeremy M

    2014-01-01

    Background An interrupted time series design is a powerful quasi-experimental approach for evaluating effects of interventions introduced at a specific point in time. To utilize the strength of this design, a modification to standard regression analysis, such as segmented regression, is required. In segmented regression analysis, the change in intercept and/or slope from pre- to post-intervention is estimated and used to test causal hypotheses about the intervention. We illustrate segmented r...

  17. Threshold electrical stimulation (TES) in ambulant children with CP: a randomized double-blind placebo-controlled clinical trial

    DEFF Research Database (Denmark)

    Dali, Christine í; Hansen, Flemming Juul; Pedersen, Søren Anker;

    2002-01-01

    A randomized double-blind placebo-controlled clinical trial was carried out to determine whether a group of stable children with cerebral palsy (36 males, 21 females; mean age 10 years 11 months, range 5 to 18 years) would improve their motor skills after 12 months of threshold electrical...... stimulation (TES). Two thirds received active and one third received inactive stimulators. For the primary outcome we constructed a set of plausible motor function tests and studied the change in summary indices of the performance measurements. Tests were videotaped and assessed blindly to record qualitative...... changes that might not be reflected in performance measurements. We also judged range of motion, degree of spasticity, and muscle growth measured by CT. Fifty seven of 82 outpatients who were able to walk at least with a walker, completed all 12 months of treatment (hemiplegia n=25, diplegia n=32). There...

  18. Autonomous regulation mode moderates the effect of actual physical activity on affective states : an ambulant assessment approach to the role of self-determination

    OpenAIRE

    Kanning, Martina; Ebner-Priemer, Ulrich; Brand, Ralf

    2012-01-01

    Studies have shown that physical activity influences affective states. However, studies have seldom depicted these associations in ongoing real-life situations, and there is no investigation showing that motivational states (i.e., more or less autonomously regulated) would moderate these effects in situ. To investigate the interaction of autonomous regulation and actual physical activity (aPA) with affective states, we use an ambulatory assessment approach. The participants were 44 university...

  19. Community falls prevention for people who call an emergency ambulance after a fall: an economic evaluation alongside a randomised controlled trial

    OpenAIRE

    Sach, Tracey H; Logan, Philippa A.; Coupland, Carol A. C.; Gladman, John R. F.; Sahota, Opinder; Stoner-Hobbs, Valarie; Robertson, Kate; Tomlinson, Vicki; Ward, Marie; Avery, Anthony J

    2012-01-01

    Objective: we estimated the cost-effectiveness of a community falls prevention service compared with usual care from a National Health Service and personal social services perspective over the 12 month trial period.

  20. [Post-traumatic stress disorder in the Ares 118 voluntary ambulance staff in the Latina area: preliminary study to validate the PTSS-10].

    Science.gov (United States)

    Capodilupo, Antonio; Danieli, Micaela; Sansoni, Julita

    2012-01-01

    The study investigates and describes post-traumatic stress testing for the Italian validation of the abbreviated form of the Scale for the Symptoms of Post Traumatic Stress Disorder (PTSS-10). It's a scale comprising 10 items and the article takes into consideration the German version, derived from the original Norwegian. The scale is based on the concept of multidirectional stress supported by Lazarus. Its validation and testing was conducted on a group of 60 ARES 118 volunteers of Latina. The study reports the internal reliability of the translated instrument, calculated using Cronbach's alpha and compared to German study. 'Factor Analysis is calculated and the results are discussed. Some remarks, also, are made by relating scores indicating a suspected PTSD with socio-demographic variables. The results demonstrate the reliability of the instrument, but for a generalization, it should be tested on a larger sample and apply the test -retest. PMID:22463753

  1. Immediate Return to Ambulation and Improved Functional Capacity for Rehabilitation in Complex Regional Pain Syndrome following Early Implantation of a Spinal Cord Stimulation System

    OpenAIRE

    2014-01-01

    Complex regional pain syndrome (CRPS) is a neuropathic pain condition that is characterized by vasomotor, sensory, sudomotor, and motor symptoms. Spinal cord stimulation (SCS) has been successfully utilized for the treatment of pain refractory to conventional therapies. We present a case of a previously highly functioning 54-year-old female who developed a rarely reported case of idiopathic CRPS of the right ankle which spontaneously occurred four months after an uncomplicated anterior cervic...

  2. Step‐Monitored Home Exercise Improves Ambulation, Vascular Function, and Inflammation in Symptomatic Patients With Peripheral Artery Disease: A Randomized Controlled Trial

    OpenAIRE

    Gardner, Andrew W.; Parker, Donald E.; Montgomery, Polly S.; Blevins, Steve M.

    2014-01-01

    Background This prospective, randomized, controlled clinical trial compared changes in primary outcome measures of claudication onset time (COT) and peak walking time (PWT), and secondary outcomes of submaximal exercise performance, daily ambulatory activity, vascular function, inflammation, and calf muscle hemoglobin oxygen saturation (StO2) in patients with symptomatic peripheral artery disease (PAD) following new exercise training using a step watch (NEXT Step) home‐exercise program, a sup...

  3. Functional performance, nutritional status, and body composition in ambulant community-dwelling individuals 1–3 years after suffering from a cerebral infarction or intracerebral bleeding

    OpenAIRE

    Vahlberg, Birgit; Zetterberg, Lena; Hellström, Karin; Lindmark, Birgitta; Cederholm, Tommy

    2016-01-01

    Background Muscle wasting and obesity may complicate the post-stroke trajectory. We investigated the relationships between nutritional status, body composition, and mobility one to 3 years after stroke. Methods Among 279 eligible home-dwelling individuals who had suffered a stroke (except for subarachnoid bleeding) 1–3 years earlier, 134 (74 ± 5 years, 69 % men) were examined according to the Mini Nutritional Assessment-Short Form (MNA-SF, 0–14 points), including body mass index (BMI, kg/m2),...

  4. Farmacevtske kognitivne storitve pri zdravljenju z zdravili - pogled farmacevta svetovalca v ambulanti: Pharmaceutical cognitive services in pharmacotherapy - pharmacist's consultant perspective at an ambulance:

    OpenAIRE

    Premuš Marušič, Alenka

    2013-01-01

    Pharmacist cognitive services in different countries in Europe and around the world are carried out in various ways. The range of responsibilities of clinical pharmacists is ranging from prescribing medicine in the United Kingdom and the United States, to pharmacotherapy groups and pharmacist consultant in the Netherlands. Pharmacotherapy Groups and Clinical Pharmacist's Consultation is a currently ongoing development program in Slovenia. Within the program, the clinical pharmacist reviews th...

  5. L’arrivée des centres commerciaux dans les marges urbaines de Rabat : Des lieux inédits de sociabilité et de déambulation urbaine

    OpenAIRE

    Harroud, Tarik

    2015-01-01

    La contribution porte sur l’analyse des recompositions spatiales et socioculturelles induites par la multiplication des centres commerciaux dans la périphérie de Rabat. Apparus au cours de la décennie 90, ces espaces marchands se sont fortement multipliés au cours de ces dernières années au point de constituer l’un des pôles les plus attractifs à l’échelle de la capitale. Il suffit d’observer l’importance des flux qui y convergent à la fin de la semaine pour attester de l’importance qu’ils oc...

  6. Fire and EMS Districts, Areas defining emergency response assignments for fire, ambulance, first responders, and law enforcement., Published in 2008, 1:2400 (1in=200ft) scale, Portage County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Fire and EMS Districts dataset, published at 1:2400 (1in=200ft) scale, was produced all or in part from Published Reports/Deeds information as of 2008. It is...

  7. Fire and EMS Districts, Ambulance and first responder territories are combined to create emergency medical service boundaries for use in dispatching., Published in 2013, 1:2400 (1in=200ft) scale, Manitowoc County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Fire and EMS Districts dataset, published at 1:2400 (1in=200ft) scale, was produced all or in part from Hardcopy Maps information as of 2013. It is described...

  8. Case management in oncology rehabilitation (CAMON: The effect of case management on the quality of life in patients with cancer after one year of ambulant rehabilitation. A study protocol for a randomized controlled clinical trial in oncology rehabilitation

    Directory of Open Access Journals (Sweden)

    Bardheci Katarina

    2011-04-01

    Full Text Available Abstract Background Cancer diseases and their therapies have negative effects on the quality of life. The aim of this study is to assess the effectiveness of case management in a sample of oncological outpatients with the intent of rehabilitation after cancer treatment. Case management wants to support the complex information needs of the patients in addition to the segmented structure of the health care system. Emphasis is put on support for self-management in order to enhance health - conscious behaviour, learning to deal with the burden of the illness and providing the opportunity for regular contacts with care providers. We present a study protocol to investigate the efficacy of a case management in patients following oncology rehabilitation after cancer treatment. Methods The trial is a multicentre, two-arm randomised controlled study. Patients are randomised parallel in either 'usual care' plus case management or 'usual care' alone. Patients with all types of cancer can be included in the study, if they have completed the therapy with chemo- and/or radiotherapy/surgery with curative intention and are expected to have a survival time >1 year. To determine the health-related quality of life the general questionnaire FACT G is used. The direct correlation between self-management and perceived self-efficacy is measured with the Jerusalem & Schwarzer questionnaire. Patients satisfaction with the care received is measured using the Patient Assessment of Chronic Illness Care 5 As (PACIC-5A. Data are collected at the beginning of the trial and after 3, 6 and 12 months. The power analysis revealed a sample size of 102 patients. The recruitment of the centres began in 2009. The inclusion of patients began in May 2010. Discussion Case management has proved to be effective regarding quality of life of patients with chronic diseases. When it comes to oncology, case management is mainly used in cancer treatment, but it is not yet common in the rehabilitation of cancer patients. Case management in oncology rehabilitation is not well-established in Switzerland. A major challenge of the study will therefore probably be the recruitment of the patients due to the physicians' and patients' scarcely existing awareness of this issue. Trial registration ISRCTN41474586

  9. Effect of High-Dose Vitamin D3 Intake on Ambulation, Muscular Pain and Bone Mineral Density in a Woman with Multiple Sclerosis: A 10-Year Longitudinal Case Report

    OpenAIRE

    François Feron; van Amerongen, Barbara M.

    2012-01-01

    Mounting evidence correlate vitamin D3 (cholecalciferol) supplementation or higher serum levels of vitamin D (25(OH)D) with a lower risk of developing multiple sclerosis (MS), reduced relapse rate, slower progression or fewer new brain lesions. We present here the case of a woman who was diagnosed with MS in 1990. From 1980 to 2000, her ability to walk decreased from ~20 to 1 km per day. Since January 2001, a vitamin D3 supplement was ingested daily. The starting dose was 20 mcg (800 IU)/day ...

  10. Screening Education And Recognition in Community pHarmacies of Atrial Fibrillation to prevent stroke in an ambulant population aged ≥65 years (SEARCH-AF stroke prevention study): a cross-sectional study protocol

    OpenAIRE

    Lowres, Nicole; Freedman, Saul Benedict; Redfern, Julie; McLachlan, Andrew; Krass, Ines; Bennett, Alexandra; Briffa, Thomas; Bauman, Adrian; Neubeck, Lis

    2012-01-01

    Background Atrial fibrillation (AF) is associated with a high risk of stroke and may often be asymptomatic. AF is commonly undiagnosed until patients present with sequelae, such as heart failure and stroke. Stroke secondary to AF is highly preventable with the use of appropriate thromboprophylaxis. Therefore, early identification and appropriate evidence-based management of AF could lead to subsequent stroke prevention. This study aims to determine the feasibility and impact of a community ph...

  11. Ambulanssjuksköterskans erfarenhet av att vårda patienter utan ett akut prehospitalt vårdbehov

    OpenAIRE

    Dahl-Bergkvist, Cecilia; Hammarbäck, Kalle

    2013-01-01

    The Swedish ambulance service has in recent decades evolved from being a pure transport organization to an advanced based nursing care facility. Treatment and care can be started already in the patient's home. The use of ambulances has increased markedly in recent years. Many of the patients who disposed ambulance have no acute prehospital care needs. There are several reasons why people without an acute prehospital care feel the need to call an ambulance. The aim of this study was to expl...

  12. Rushing Roulette

    Science.gov (United States)

    Scanlan, Larry

    1976-01-01

    In a Canada-wide survey, CANADIAN FAMILY PHYSICIAN found a startling divergence in provincial standards for ambulance crews and vehicles. While some provinces had developed a well-integrated ambulance system with central dispatching, rigorous standards for attendants and advanced paramedical training programs, in some the ambulances are run almost entirely by local undertakers. PMID:21308032

  13. Simulation of Emergency Medical Services Delivery Performance Based on Real Map

    Directory of Open Access Journals (Sweden)

    Mohd Hafiz Azizan

    2013-06-01

    Full Text Available Performance of Emergency Medical Services (EMS delivery is normally measured via ambulance response time. Quick ambulance response can effectively reduce the disability, morbidity and mortality of the emergency patients. Ambulance dispatch policy and ambulance location model both have a significant impact on the ambulance response time. In this paper, we present a prototype of simulation framework to study the performance of local EMS delivery in terms of a simulation model that consists of both ambulance dispatch policy and ambulance location model. Several real-life dispatch policies are simulated in a real map to evaluate the efficiency of local EMS delivery in Johor Bahru. By using a suitable dispatch policy, the results show an improvement in average response time for higher priority call. The total calls covered are also found to increase significantly with the application of Maximal Covering Location Problem (MCLP, especially at a bigger fleet size.

  14. The relationship between motor recovery and gait velocity during dual tasks in patients with chronic stroke.

    Science.gov (United States)

    Lee, Kyoung Bo; Kim, Jang Hwan; Lee, Kang Sung

    2015-04-01

    [Purpose] The aims of this study were to identify the relationship between motor recovery and gait velocity during dual tasks in patients with chronic stroke and determine automatic gait ability following stroke. [Subjects and Methods] Thirty-three outpatients and twelve healthy subjects participated in a cross-sectional assessment. Community ambulation was assessed using a self-administered questionnaire. Outcome measures included the Motricity index, Berg Balance Scale, and gait speed under three conditions (self-paced ambulation for 10 m, ambulation while performing dual cognitive tasks, and ambulation while performing dual manual tasks). Gait automaticity was calculated. [Results] No significant differences were observed for muscle strength or balance between the limited community ambulation and the community ambulation groups. However, a significant difference in gait velocity was observed between the groups under the three conditions. In particular, a significant difference was detected only in the limited community ambulation group depending on the level of motor function recovery during cognitive and manual dual task ambulation. Additionally, we revealed that the community ambulation group had a lower level of gait automaticity compared with that in the normal group. [Conclusion] Our results show the influence of motor recovery on the change in gait velocity depending on the task if a patient is limitedly ambulatory. We revealed that community ambulators did not have a sufficient level of gait automaticity. PMID:25995582

  15. Pain to Hospital Times After Myocardial Infarction in Patients from Dalmatian Mainland and Islands, Southern Croatia

    OpenAIRE

    Novak, Katarina; Aljinović, Jure; Kostić, Sandra; Čapkun, Vesna; Novak Ribičić, Kristijana; Batinić, Tonći; Štula, Ivana; Puljak, Livia

    2010-01-01

    Aim To analyze pre-hospital delay in patients with myocardial infarction from mainland and islands of Split-Dalmatian County, southern Croatia. Methods The study included all patients with myocardial infarction transported by ambulance to the University Hospital Split in 1999, 2003, and 2005. Pre-hospital delay was analyzed in the following intervals: pain-to-call, call-to-ambulance, ambulance-to-door, and door-to-coronary care unit interval. Patients were categorized ...

  16. 76 FR 22381 - National Fire Codes: Request for Comments on NFPA Technical Committee Reports

    Science.gov (United States)

    2011-04-21

    ... Standard for Reducing Structure P Ignition Hazards from Wildland Fire. NFPA 1221 Standard for the... 1917 Standard for Automotive N Ambulance. P = Partial revision; W = Withdrawals; R = Reconfirmation;...

  17. 7 CFR 1739.3 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... Community Center and every public school or education center, public library, public medical clinic, public hospital, community college, public university, or law enforcement, fire and ambulance stations in...

  18. O efeito da deambulação na duração da faze ativa do trabalho de parto El efecto de la deambulación en la duración de la fase activa del trabajo de parto The ambulation effect in the active stage duration of the labor

    Directory of Open Access Journals (Sweden)

    Fabiana Villela Mamede

    2007-09-01

    Full Text Available O trabalho teve como objetivo analisar a associação entre a deambulação e a duração da fase ativa do trabalho de parto. Metodologia: estudo analítico de intervenção do tipo quase experimental. Fizeram parte do estudo 80 parturientes primíparas, admitidas em trabalho de parto espontâneo, no início da fase ativa. Instrumentos de coleta de dados: podômetro para medir a distância percorrida em metros, Escala Visual Numérica (EVN de dor, formulário para o registro de dados. Resultados: as participantes percorreram uma distância média de 1.624 metros, 63,09% da fase ativa do trabalho de parto e em um tempo médio de 5 horas. Verificou-se que a quantidade deambulada durante as três primeiras horas da fase ativa está associada a um encurtamento do trabalho de parto, sendo que a cada 100 metros percorridos ocorreu uma diminuição de 22 minutos na primeira hora, 10 minutos na segunda hora e 6 minutos na terceira hora.La finalidad de este trabajo fue la de analizar la asociación entre la deambulación y el tiempo de la fase activa del trabajo de parto. Metodología: estudio analítico de intervención del tipo casi experimental. Participaron del estudio 80 parturientes primíparas, admitidas en trabajo de parto espontáneo, en el inicio de la fase activa. Instrumentos de recopilación de datos: podómetro para medir la distancia transcurrida en metros, Escala visual numérica de dolor, Formulario para el registro de datos. Resultados: las participantes transcurrieron una distancia media de 1624metros, 63,09% de la fase activa del trabajo de parto y en un tiempo promedio de 5 horas. Se verificó que la cantidad deambulada durante las tres primeras horas de la fase activa está asociada a un acortamiento del trabajo de parto. Para cada 100 metros transcurridos ocurrió una disminución de 22 minutos en la primera hora, 10 minutos en la segunda hora y 6 minutos en la tercera hora.This study aimed to analyze the association between walking and the duration of the active phase of labor. Methodology: We realized an analytic, an almost experimental intervention study. Study participants were 80 primiparous parturient women, who were admitted during spontaneous labor, at the start of the active phase. Data collection instruments: podometer to measure the distance walked in meters, numerical visual pain scale, and form for data registration. Results: the parturient women walked an average distance of 1624 meters, 63.09% of the active phase of labor and during an average time of 5 hours. We observed that the distance walked during the first three hours of the active phase is associated with a shorter labor time. For every 100 meters walked, duration decreased by 22 minutes during the first hour, by 10 minutes during the second hour and by 6 minutes during the third hour.

  19. Atemmechanische Unterschiede bei Patienten mit akutem Lungenversagen auf dem Boden einer Influenza-A(H1N1)pdm09-Pneumonie im Vergleich zu Patienten mit schweren ambulant erworbenen Pneumonien anderer Genese unter besonderer Berücksichtigung von extrakorporalen Gasaustauschverfahren

    OpenAIRE

    Töpfer, Lars

    2014-01-01

    Introduction The pandemic caused by influenza A(H1N1)pdm09 virus (“swine flu”) in 2009/2010 was innocuous to the majority of those affected. In a subset of infected patients, however, a life-threatening acute respiratory distress syndrome (ARDS) developed within a short period. It is unclear, to which extent the ICU course of this H1N1-ARDS differs from an ARDS on the ground of a severe community-acquired pneumonia (sCAP), which was not caused by the influenza A(H1N1)pdm09 (non-H1N1-ARDS)....

  20. 75 FR 79345 - Privacy Act of 1974; System of Records

    Science.gov (United States)

    2010-12-20

    ... treatment facility, clinic, pharmacy, laboratory/radiology, ambulance), name and location of military... bill type (military treatment facility, clinic, pharmacy, laboratory/radiology, ambulance), name and..., 1996 (February 20, 1996, 61 FR 6427). Dated: December 10, 2010. Morgan F. Park, Alternate OSD...

  1. Striding Towards Better Physical Therapy

    Science.gov (United States)

    2003-01-01

    This paper presents a discussion on a new rehabilitative device that promises to improve physical therapy for patients working to regain the ability to walk after facing traumatic injuries or a degenerative illness. Produced by Enduro Medical Technology, of East Hartford, Connecticut, the Secure Ambulation Module (S.A.M.) creates a stable and secure environment for patients as they stand during ambulation therapy.

  2. Ergonomics

    Science.gov (United States)

    ... moving patients. These devices allow ambulance technicians or emergency evacuation personnel to safely move a loaded hospital cot or gurney down stairs or any steep decline. The Device easily attaches to any ambulance cot currently in the pre-hospital care market. When not in use, the DCS simply ...

  3. Prehospital care in Indonesia

    OpenAIRE

    Pitt, E.; Pusponegoro, A

    2005-01-01

    Current system: Hospitals of varying standards are widespread but have no system of emergency ambulance or patient retrieval. Indonesia's only public emergency ambulance service, 118, is based in five of the biggest cities and is leading the way in paramedic training and prehospital care.

  4. Balancing Machine Work, Comfort Work, and Sentimental Work

    DEFF Research Database (Denmark)

    Pedersen, Maria Ie; Hansen, Magnus; Hertzum, Morten

    2011-01-01

    attention. We investigate ambulance care in three of Denmark’s five healthcare regions, which staff ambulances with emergency medical technicians, paramedics, and physicians. Using the concept of illness trajectory we analyse how the ambulance crews balance machine work, which involves continuously...... monitoring the equipment, comfort work, which is actions taken to relieve the pain or discomfort of the patient, and sentimental work, which is care for the patient’s physical and mental well-being, often verbal in nature. The analysis shows that comfort and sentimental work often takes priority over machine...... work, but also that this has negative consequences. Equipment for use in ambulances should aim at supporting the ambulance crews in competently and dynamically balancing the different types of work and should, consequently, avoid binding the crew’s attention for unbroken periods of time....

  5. Prehospital Management of Gunshot Patients at Major Trauma Care Centers: Exploring the Gaps in Patient Care

    Directory of Open Access Journals (Sweden)

    Amir Norouzpour

    2013-09-01

    Full Text Available Background: Prehospital management of gunshot-wounded (GW patients influences injury-induced morbidity and mortality.Objectives: To evaluate prehospital management to GW patients emphasizing the protocol of patient transfer to appropriate centers.Patients and Methods: This prospective study, included all GW patients referred to four major, level-I hospitals in Mashhad, Iran. We evaluated demographic data, triage, transport vehicles of patients, hospitalization time and the outcome.Results: There were 66 GW patients. The most affected body parts were extremities (60.6%, n = 40; 59% of cases (n = 39 were transferred to the hospitals with vehicles other than an ambulance. Furthermore, 77.3% of patients came to the hospitals directly from the site of event, and 22.7% of patients were referred from other medical centers. EMS action intervals from dispatchers to scene departure was not significantly different from established standards; however, arrival to hospital took longer than optimal standards. Additionally, time spent at emergency wards to stabilize vital signs was significantly less in patients who were transported by EMS ambulances (P = 0.01, but not with private ambulances (P = 0.47. However, ambulance pre-hospital care was not associated with a shorter hospital stay. Injury Severity was the only determinant of hospital stay duration (β = 0.36, P = 0.01 in multivariate analysis.Conclusions: GW was more frequent in extremities and the most patients were directly transferred from the accident site. EMS (but not private ambulance transport improved patients' emergency care and standard time intervals were achieved by EMS; however more than a half of the cases were transferred by vehicles other than an ambulance. Nevertheless, ambulance transportation (either by EMS or by private ambulance was not associated with a shorter hospital stay. This showed that upgrade of ambulance equipment and training of private ambulance personnel may be needed.

  6. GPS Tracking System Coupled With Image Processing in Traffic Signals to Enhance Life Security

    Directory of Open Access Journals (Sweden)

    Manoj Prabhakar k

    2013-08-01

    Full Text Available In modern and crowded traffic life, it becomes mandatory to save the human life by reaching the hospitalvery sooner than possible. This paper explains about the advancement in tracking the ambulance presenceamidst the traffic with the usage of GPS tracking system calculating the position of the ambulance from thetraffic signal which replaces the RF transmitter receiver circuitry. This paper also retains the use of theimage capturing technology available from the base paper (IMPACT OF IMAGE PROCESSING INSAVING THE HUMAN LIFE BY AUTOMATING TRAFFIC SIGNALS to identify the presence of theambulance, thereby changing the signalto green automatically in favour of ambulance

  7. Hjertestop uden for hospital. Retrospektiv undersøgelse i Odense

    DEFF Research Database (Denmark)

    Frandsen, F; Nielsen, J R; Gram, L;

    1989-01-01

    arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement of...... treatment include: 1. Information to the population. 2. Training of first-aid staff in treatment of cardiac arrest. 3. Quicker arrival of ambulances and 4. Better staffing and training of ambulance staff in the use of a defibrillator possibly with participation of a doctor....

  8. Mass Psychogenic Illness

    Science.gov (United States)

    ... been exposed to something harmful. An outbreak of mass psychogenic illness is a time of anxiety and worry. During an outbreak, a lot of media coverage and the presence of ambulances or emergency ...

  9. 42 CFR 414.605 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... professionals in an appropriate specialty area, for example, nursing, emergency medicine, respiratory care... Health Resources and Services Administration. Specialty care transport (SCT) means interfacility transportation of a critically injured or ill beneficiary by a ground ambulance vehicle, including...

  10. The Walk to Save: Benefits of Inpatient Cardiac Rehabilitation.

    Science.gov (United States)

    Rion, Joann H; Kautz, Donald D

    2016-01-01

    Hospital immobilization after a cardiac event can cause complications. The pathophysiology of complications, research concerning benefits of early ambulation, and recommendations from the American College of Sports Medicine are discussed. PMID:27522842

  11. [Emergency medical services for the elderly: present fact and future challenge].

    Science.gov (United States)

    Aruga, Yuichiro

    2013-06-01

    The Tokyo Fire Department (TFD) ambulance units are transporting more people than ever before with elderly patients on the increase. The TFD then set up the Emergency Telephone Consultation Center in 2007 to help citizens properly use EMS services, asking non-emergency cases to go to the hospital by themselves or sending the ambulance to serious cases. Transportation of all "home patients" (receiving medical services at home, not in the hospital) by fire department ambulances would leave really serious patients behind. Consequently, it is important to make the most of private sector ambulances and hospital ones. For community life safety, making the most of local resources, as well as the fire department-hospital cooperation, is much more needed now. PMID:23855196

  12. Kolmekesi ühest Peipsi-äärsest asjast / Tiit Lepp

    Index Scriptorium Estoniae

    Lepp, Tiit

    2007-01-01

    Annika Haasi, Birgit Püve ja Age Petersoni fotonäitus "Prichudie, Revisited" Peipsiääre valla inimestest ja elust-olust kunstikeskuses AmbulARToorium Tartumaaal. Kommenteerinud Annika Haas, Birgit Püve, Age Peterson

  13. State-of-the-Art Hip Surgeries for Active Adults

    Medline Plus

    Full Text Available ... average will be more in men than in women. So the final reduction is being obtained here; ... the day of surgery, and they start ambulating right away. We looked at the results of our ...

  14. 76 FR 54917 - National Preparedness Month, 2011

    Science.gov (United States)

    2011-09-02

    ..., Missouri, pickup trucks became ambulances, doors served as stretchers, and a university transformed itself.... (Presidential Sig.) [FR Doc. 2011-22768 Filed 9-1-11; 11:15 am] Billing code 3195-W1-P...

  15. Impact of Arterial Access Site on Outcomes After Primary Percutaneous Coronary Intervention

    DEFF Research Database (Denmark)

    Hamon, Martial; Coste, Pierre; Van't Hof, Arnoud;

    2015-01-01

    BACKGROUND: In European Ambulance Acute Coronary Syndrome Angiography (EUROMAX), bivalirudin improved 30-day clinical outcomes with reduced major bleeding compared with heparins plus optional glycoprotein IIb/IIIa inhibitors. We assessed whether choice of access site (radial or femoral) had...

  16. Praehospital-hjertestopbehandling med semiautomatisk defibrillator--Heartstart 2000

    DEFF Research Database (Denmark)

    Fonsmark, L; Sandøe, E; Kastrup, J;

    1989-01-01

    In order to test the efficacy of a semiautomatic defibrillator (Heartstart 2000) in connection with cardiac arrest outside hospital, the apparatus was installed in two of the ambulances belonging to the Copenhagen Fire Service. The ambulance district involved was also equipped with an ambulance...... staffed by a doctor. A total of 48 patients with cardiac arrest were found and 16 of these had ventricular fibrillation. Six of the 16 patients have since been discharged from hospital (37.5%). The defibrillator had a high diagnostic certainty with a sensitivity of 96.5% and a specificity of 100%. No...... practical problems of note occurred in connection with employment of the defibrillator. The ambulance staffs underwent six hours of training and this appeared to be adequate. It is concluded that Heartstart 2000 functions well and effectively in connection with revival of patients with cardiac arrest...

  17. Association of Geographical Factors With Administration of Tissue Plasminogen Activator for Acute Ischemic Stroke

    OpenAIRE

    Kunisawa, Susumu; Morishima, Toshitaka; Ukawa, Naoto; Ikai, Hiroshi; Otsubo, Tetsuya; Ishikawa, Koichi B.; Yokota, Chiaki; Minematsu, Kazuo; Fushimi, Kiyohide; Imanaka, Yuichi

    2013-01-01

    Background Intravenous tissue plasminogen activator (tPA) is an effective treatment for acute ischemic stroke if administered within a few hours of stroke onset. Because of this time restriction, tPA administration remains infrequent. Ambulance use is an effective strategy for increasing tPA administration but may be influenced by geographical factors. The objectives of this study are to investigate the relationship between tPA administration and ambulance use and to examine how patient trave...

  18. An Integer Programming Model for the Dynamic Location and Relocation of Emergency Vehicles: A Case Study

    OpenAIRE

    Moeini, Mahdi; Jemai, Zied; Sahin, Evren

    2014-01-01

    In this paper, we address the dynamic Emergency Medical Service (EMS) systems. A dynamic location model is presented that tries to locate and relocate the ambulances. The proposed model controls the movements and locations of ambulances in order to provide a better coverage of the demand points under different fluctuation patterns that may happen during a given period of time. Some numerical experiments have been carried out by using some real-world data sets that have been collected through ...

  19. Optimizing Bone Health in Duchenne Muscular Dystrophy

    OpenAIRE

    Buckner, Jason L.; Bowden, Sasigarn A.; Mahan, John D

    2015-01-01

    Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder characterized by progressive muscle weakness, with eventual loss of ambulation and premature death. The approved therapy with corticosteroids improves muscle strength, prolongs ambulation, and maintains pulmonary function. However, the osteoporotic impact of chronic corticosteroid use further impairs the underlying reduced bone mass seen in DMD, leading to increased fragility fractures of long bones and vertebrae. These serio...

  20. Disability and quality of life in Charcot-Marie-Tooth disease type 1

    OpenAIRE

    PFEIFFER, G; Wicklein, E; Ratusinski, T; Schmitt, L; Kunze, K

    2001-01-01

    OBJECTIVES—Charcot-Marie-Tooth disease type I (CMT1) is a hereditary sensorimotor neuropathy causing variable degrees of handicap. The risk for relevant disability in respect to genetic counselling is unknown. An attempt was made to define it.
METHODS—Disability and ambulation of 50 patients with CMT1 were scored by the Hauser ambulation index score and the Rankin scale. Rankin score 2 was subdivided into 2a (independent without relevant slowness) and 2b (independent, ...

  1. Subjektive Krankheitskonzepte im soziokulturellen Vergleich

    OpenAIRE

    Rolf, Ivo Arne

    2010-01-01

    Objectives: The study explores to what extent the dimensions of cultural heritage, gender, age and types of complaints influence the subjective notion of ambulance-patients regarding the reason of their complaints. The study aims to assess the relevance and meaning of this notion in doctor-patient-relationships. Methods: In a sample of 635 ambulance-patients 357 German patients and 278 migrant patients from Muslim countries were asked in standardized interviews about their subjective reaso...

  2. Simulated flying altitude and performance of continuous positive airway pressure devices

    OpenAIRE

    Sehlin, Maria; Brändström, Helge; Winsö, Ola; Haney, Michael; Wadell, Karin; Öhberg, Fredrik

    2014-01-01

    INTRODUCTION: Continuous positive airway pressure (CPAP) is used in air ambulances to treat patients with impaired oxygenation. Differences in mechanical principles between CPAP devices may affect their performance at different ambient air pressures as will occur in an air ambulance during flight. METHODS: Two different CPAP systems, a threshold resistor device and a flow resistor device, at settings 5 and 10 cm H2O were examined. Static pressure, static airflow and pressure during simulated ...

  3. Magnetic resonance imaging to detect vesico-symphyseal fistula following robotic prostatectomy

    OpenAIRE

    Ryan C. Hutchinson; Thiel, David D.; Joseph M. Bestic

    2013-01-01

    Pubic complications following radical prostatectomy are rare. Osteitis pubis typically presents with symptoms related to irritation of the pubic rami including pain with ambulation and adduction of the leg. A 60-year-old male with prostatic adenocarcinoma underwent uneventful robotic assisted laparoscopic prostatectomy. The patient noted the onset of severe pubic pain exacerbated by ambulation approximately one month post-surgery. An abdominal/pelvic CT scan was negative for acute pathology. ...

  4. GPS Tracking System Coupled With Image Processing in Traffic Signals to Enhance Life Security

    OpenAIRE

    Manoj Prabhakar k; Manoj Kumar S

    2013-01-01

    In modern and crowded traffic life, it becomes mandatory to save the human life by reaching the hospitalvery sooner than possible. This paper explains about the advancement in tracking the ambulance presenceamidst the traffic with the usage of GPS tracking system calculating the position of the ambulance from thetraffic signal which replaces the RF transmitter receiver circuitry. This paper also retains the use of theimage capturing technology available from the base paper (IMPACT OF IMAGE PR...

  5. Organisationsprofile und Gesundheit im bundesdeutschen Rettungsdienst

    OpenAIRE

    Hering, Thomas

    2016-01-01

    Introduction. Research into the stress and demands of ambulance services is dominated by studies which mainly focus on psychologically highly stressful traumatizing emergencies and their pathological consequences such as posttraumatic stress disorder. Little research has been done on specific aspects of working conditions that the ambulance services are enduring and their importance for the characteristics of work-related health as well as for the indicators of commitment. So far, research ai...

  6. An Observational Study of Patient Characteristics Associated with the Mode of Admission to Acute Stroke Services in North East, England

    OpenAIRE

    Price, Christopher; Rae, Victoria; Duckett, Jay; Wood, Ruth; Gray, Joanne; McMeekin, Peter; Rodgers, Helen; Portas, Karen; Ford, Gary

    2013-01-01

    Objective Effective provision of urgent stroke care relies upon admission to hospital by emergency ambulance and may involve pre-hospital redirection. The proportion and characteristics of patients who do not arrive by emergency ambulance and their impact on service efficiency is unclear. To assist in the planning of regional stroke services we examined the volume, characteristics and prognosis of patients according to the mode of presentation to local services. Study design and settin...

  7. The role of general practitioners in the pre hospital setting, as experienced by emergency medicine technicians: a qualitative study

    OpenAIRE

    Hjortdahl, Magnus; Zakariassen, Erik; Wisborg, Torben

    2014-01-01

    Background: Together with the ambulances staffed with emergency medical technicians (EMTs), general practitioners (GPs) on call are the primary resources for handling emergencies outside hospitals in Norway. The benefit of the GP accompanying the ambulance to pre-hospital calls is a matter of controversy in Norway. The purpose of the present study was to gain better insight into the EMT ’ s experiences with the role of the GPs in the care for critically ill patients in the pre-hospital ...

  8. Providing Rapid Out of Hospital Acute Cardiovascular Treatment 4 (PROACT‐4)

    OpenAIRE

    Ezekowitz, Justin A.; Welsh, Robert C.; Weiss, Dale; Chan, Michael; Keeble, William; Khadour, Fadi; Sharma, Sanjay; Tymchak, Wayne; Sookram, Sunil; Brass, Neil; Knapp, Darren; Koshy, Thomas L.; Zheng, Yinggan; Armstrong, Paul W.

    2015-01-01

    Background Whether prehospital point‐of‐care (POC) troponin further accelerates the time to diagnosis in patients with chest pain (CP) is unknown. We conducted a randomized trial of POC‐Troponin testing in the ambulance. Methods and Results Patients with chest pain presenting by ambulance were randomized to usual care (UC) or POC‐Troponin; ST‐elevation myocardial infarction patients or those with noncardiovascular symptoms were excluded. Pre‐hospital high‐sensitivity troponin was analyzed on ...

  9. What outcome measures should be developed for pre-hospital care?: results of a consensus event

    OpenAIRE

    Turner, Janette; Coster, Joanne; Wilson, Richard; Phung, Viet-Hai; Siriwardena, A Niroshan

    2013-01-01

    Background: The PhOEBE (Pre-hospital Outcomes for Evidence Based Evaluation) project is a 5-year research programme which aims to develop new ways of measuring the performance, quality and impact of ambulance service care. As part of this programme we conducted 2 systematic reviews to identify potential measures and held a consensus event to prioritise these measures. Methods: Actual or potential measures or indicators for assessing ambulance service performance or quality of care were ide...

  10. METROPOLDE 112 ACİL SAĞLIK HİZMETİ

    OpenAIRE

    KARAKUS YILMAZ, Banu; ÇEVİK, Erdem; DOGAN, Hatice; SAM, Mehmet; KUTUR, Ahmet

    2014-01-01

    Background: In this study, we aimed to evaluate the transport time of pre-hospital emergency medical service and the demographic characteristics of the patients. Methods: All patients admitted to a tertiary emergency service by a 112 emergency medical service ambulance between 01-31 January 2013 were enrolled to the study. Patients’ data were collected from ambulance transfer forms and hospital records. Results: 1590 patients were admitted to the emergency service during the study time. Time ...

  11. Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study

    OpenAIRE

    Grusd, Eystein; Kramer-Johansen, Jo

    2016-01-01

    Background The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current dispatch triage tools could reliably identify patients who only required transport, and not pre-hospital medical care. This could allow selection of such patients for designated transport units, free...

  12. Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study

    OpenAIRE

    2016-01-01

    Background: The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current dispatch triage tools could reliably identify patients who only required transport, and not pre-hospital medical care. This could allow selection of such patients for designated transport units, fre...

  13. General practitioners and emergency treatment for patients with suspected myocardial infarction: last chance for excellence?

    OpenAIRE

    Rawles, J.

    1992-01-01

    Pre-hospital coronary care usually consists of a medically staffed coronary care ambulance going into the community from a hospital base, as pioneered in Northern Ireland. In today's medicopolitical and economic climate, this model is not viable in mainland United Kingdom. Current proposals seem to favour a 'scoop and run' policy for heart attack victims, that utilizes the ambulance service but bypasses the general practitioner. Since the majority of telephone calls from people with suspected...

  14. Ergonomic redesign using quality improvement for pre-hospital care of acute myocardial infarction

    OpenAIRE

    Essam, Nadya; Wood, Kate; Hall, Mark; Shaw, Deborah; Spaight, Anne; Baird, Andrew; Siriwardena, A Niroshan

    2012-01-01

    Context: Frontline emergency ambulance clinicians collaborated in a national quality improvement (QI) initiative to improve pre-hospital care for patients with acute myocardial infarction (AMI). Problem: The National Ambulance Clinical Performance Indicator (CPI) care bundle for AMI (consisting of aspirin, GTN, pain assessment and administration of analgesia) highlighted a consistent shortfall in patient pain assessment and inadequate provision of analgesia. Ineffective pain management in...

  15. Psychosocial care for persons affected by emergencies and major incidents: a Delphi study to determine the needs of professional first responders for education, training and support

    OpenAIRE

    Drury, John; Kemp, Verity; Newman, Jonathan; Novelli, David; Doyle, Christopher; Walter, Darren; Williams, Richard

    2013-01-01

    Background The role of ambulance clinicians in providing psychosocial care in major incidents and emergencies is recognised in recent Department of Health guidance. The study described in this paper identified NHS professional first responders’ needs for education about survivors’ psychosocial responses, training in psychosocial skills, and continuing support. Method Ambulance staff participated in an online Delphi questionnaire, comprising 74 items (Round 1) on 7-point Likert sca...

  16. Foot Deformities in Patients with Cerebral Palsy

    OpenAIRE

    E Ameri; A. Yeganeh

    2007-01-01

    Introduction & Objective: In patients with cerebral palsy (CP) the most common presentation is lower extremity deformity specially foot deformity. Inability to ambulation is the one of the most important disabilities, that dependent to the variety of factors such as severity of disease, kind of CP, etc. This study was aimed to assess prevalence of kinds of foot deformity in CP and communication between kind of CP and foot deformity and another hand inability to ambulation.Materials & Methods...

  17. A method to reduce response times in prehospital care: the motorcycle experience.

    Science.gov (United States)

    Lin, C S; Chang, H; Shyu, K G; Liu, C Y; Lin, C C; Hung, C R; Chen, P H

    1998-11-01

    This study compared the response times of a motorcycle and a standard ambulance in a congested urban emergency medical services (EMS) setting. The study was performed in Taipei, Taiwan, a densely populated urban area. A basic life support (BLS) motorcycle (without defibrillation capability) and an advanced life support (ALS) ambulance were based at three study hospitals and simultaneously dispatched when there was a perceived need for ALS ambulance transport. Over a 3-month period, prehospital personnel evaluated 307 medical and trauma emergencies. Time data were insufficient for analysis in 33 cases, leaving a study population of 274. Response times of the motorcycle and the ambulance were prospectively assessed and compared. During rush hours, the response times of the motorcycle and ambulance were 4.9+/-3.0 minutes and 6.3+/-3.4 minutes (P motorcycles to transport EMTs to the emergency scene significantly reduced response time compared with a standard ambulance in a congested urban setting. Large prospective studies are required to determine the impact on patient outcome of shorter EMS response times using motorcycles. EMS motorcycles appear feasible and deserve consideration to help expedite prehospital care in other systems in densely populated cities. PMID:9827757

  18. Association between Bone Mineral Density and Clinical Parameters in Traumatic Brain Injury Patients

    Directory of Open Access Journals (Sweden)

    Murat Ersöz,

    2016-04-01

    Full Text Available Objective: Determine the association between the bone mineral density and traumatic brain injury (TBI. Materials and Methods: Twenty-two patients with TBI included to the study. Dual energy X-ray absorptiometry measurements which determines the femur neck and L1-4 vertebrate T scores in patients was performed via Lunar Prodigy DPX system. Clinical parameters such as types of involvements (plegia, upper-lower extremity spasticity values, presence of heterotypic ossification, ambulation levels were determined and their relations with femur neck and L1-4 vertebrate T scores were examined with Mann-Whitney U Test. Results: In the comparison of sub groups of type of plegia (tetraplegic/hemi-paraplegic, lower extremity spasticity values [Ascworth score 0/1-2-3-4, presence of heterotopic ossification no statistically significant (p>0.05 difference was found in the femur neck and L1-4 vertebrate T scores. On the other hand, in the subgroups determined according to ambulatory levels of the patients (confined to bed-wheelchair/ ambulated (orthesis-hand support-independent] significant difference was observed in the femur neck T scores (p=0.044. Femur neck T scores were significantly high in ambulated patients (p=0.044. Conclusion: In TBI cases ambulation level is a factor which significantly affect bone mineral density. It is necessary to ambulate patients with potential as soon as possible and to plan alternative approaches in patient could not be ambulated.

  19. Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana

    Science.gov (United States)

    Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Zakariah, Ahmed N; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Campbell, Thomas B

    2015-01-01

    Background: Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana’s national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. Methods: A survey instrument was developed using Pechansky and Thomas’s model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability. The instrument was used in a cross-sectional survey in 2013 in Accra, Ghana; eligible participants were those 18 years and older who spoke English, French, or Twi. Although the analysis was mainly descriptive, logistic regression was used to identify factors associated with reported intention to call for an ambulance in the case of a medical emergency. Results: 468 participants completed surveys, with a response rate of 78.4%. Few (4.5%) respondents had ever used an ambulance in prior emergency situations. A substantial proportion (43.8%) knew about the public access medical emergency telephone number, but of those only 37.1% knew it was a toll-free call. Most (54.7%) respondents believed EMTs offered high-quality care, but 78.0% believed taxis were faster than ambulances and 69.2% thought the number of ambulances in Accra insufficient. Many (23.4%) thought using ambulances to transport corpses would be appropriate. In two hypothetical emergency scenarios, respondents most commonly reported taxis as the preferred transportation (63.6% if a family member were burned in a house fire, 64.7% if a pedestrian were struck by a vehicle). About 1 in 5 respondents said they would call an ambulance in either scenario (20.7% if a family member were burned in a house fire, 23.3% if a pedestrian were struck by a vehicle) while 15.5% and 10.2%, respectively, would use any available vehicle. Those aged 18–35 years were more likely than older respondents to prefer an ambulance (odds

  20. The Emergency Medical Service personnel's perception of the transportation of young children.

    Science.gov (United States)

    Öberg, Marjut; Vicente, Veronica; Wahlberg, Anna C

    2015-04-01

    To our knowledge no previous studies have been made which describe the Emergency Medical Service (EMS) personnel's perceptions of transporting children and the care encounter between the child, the parent and the EMS personnel when separating the child and the parent specifically in an ambulance. The aim of this study was to gain an understanding of how EMS personnel perceive ambulance transport of children. The study was carried out in 2012 at one of three ambulance contractors in Stockholm. Twelve semi-structured interviews were conducted and the content analysis showed that transporting children induces stress and is deemed a precarious task by EMS personnel mainly because children are considered more vulnerable than adults and because of the necessity to separate the child from the parent during transport. There is a conflict between medical- and emotional wellbeing and traffic-safety during the transportation of children and a fear of insufficient ability to care for the child. The EMS personnel's vulnerability is evident in the complicated care situation associated with transporting children in an ambulance. These findings may be considered a first step in assessing if action is needed to improve care and patient safety during ambulance transportation of children. PMID:25082416

  1. Gastrocnemius and soleus spasticity and muscle length in Friedreich's ataxia.

    Science.gov (United States)

    Milne, Sarah C; Corben, Louise A; Yiu, Eppie; Delatycki, Martin B; Georgiou-Karistianis, Nellie

    2016-07-01

    Lower limb spasticity compromises the independence of people with Friedreich's ataxia (FRDA). This study sought to examine lower limb spasticity in FRDA in order to offer new insight as to the best approach and timing of spasticity management. Gastrocnemius and soleus spasticity and muscle length were measured by the Modified Tardieu Scale (MTS) in 31 participants with typical and late-onset FRDA. Relationships between the MTS and the Friedreich Ataxia Rating Scale (FARS), Functional Independence Measure (FIM), and disease duration were analysed. Differences between ambulant (n=18) and non-ambulant (n=13) participants were also examined. All participants had spasticity in at least one muscle, and 38.9% of ambulant and 69.2% of non-ambulant participants had contracture in one or both of their gastrocnemius muscles. Significant negative correlations were found between both gastrocnemius and soleus angle of catch and the FARS score. The FIM score also demonstrated significant correlations with gastrocnemius muscle length and angle of catch. Gastrocnemius and soleus spasticity and contracture is apparent in people with FRDA. Spasticity is evident early in the disease and in ambulant participants. Management of spasticity and reduced muscle length should be considered in people with FRDA at disease onset to optimise function. PMID:27021226

  2. ’n Ondersoek na die gehalte van interhospitaalvervoer van siek neonate deur geselekteerde ambulanse aan die Witwatersrand

    Directory of Open Access Journals (Sweden)

    J.C. Roux

    1989-09-01

    Full Text Available The quality o f the inter hospital transport o f ill neonates, by selected ambulances in the Witwatersrand area, was investigated by means o f the case study method. O f the fifteen case studies investigated, eleven neonates were transported by a private ambulance and four by provincial ambulances. Data regarding the maternal- and neonatal history, the optimal maintenance o f the neonate's condition, the communication system, as well as aspects relating to the transport personnel, were collected by means o f a structured instrument. Retrospective auditing o f records, structured interviewing and direct observation/inspection were utilised as the research techniques. The quality o f the inter hospital transport o f ill neonates, especially by the private ambulance, is not up to standard. Deterioration o f the neonate’s body temperature, heart and respiration rates, as well as the serum glucose values after transport, were o f the more important findings. The lack o f equipment, especially in the private ambulance, increases the risk o f transport. Staff development and form al control by a local committee, as well as a national control body, are recommended.

  3. [Long-haul intensive care transports by air].

    Science.gov (United States)

    Graf, Jürgen; Seiler, Olivier; Pump, Stefan; Günther, Marion; Albrecht, Roland

    2013-03-01

    The need for inter-hospital transports over long distances aboard air ambulances or airlines has increased in recent years, both in the civil as well as the military sector. More often severely ill intensive care patients with multiple organ failure and appropriate supportive care (e.g. mechanical ventilation, catecholamines, dialysis, cardiac assist devices) are transported by air. Despite the fact that long-haul intensive care transports by air ambulance and airlines via Patient Transport Compartment (PTC) are considered established modes of transport they always provide a number of challenges. Both modes of transport have distinct logistical and medical advantages and disadvantages. These-as well as the principal risks of an air-bound long-haul intensive care transport -have to be included in the risk assessment and selection of means of transport. Very often long-haul intensive care transports are a combination of air ambulance and scheduled airlines utilizing the PTC. PMID:23504461

  4. Obesity and Premature Loss of Mobility in Two Adolescents with Becker Muscular Dystrophy After HeartMate II Implantation.

    Science.gov (United States)

    Hollander, Seth A; Rizzuto, Sandra; Hollander, Amanda M; Lin, Aileen; Liu, Esther; Murray, Jenna M; Almond, Christopher S; Rosenthal, David N

    2016-01-01

    Weight gain is common after implantation of continuous-flow ventricular assist devices. Obesity can have a significant negative impact on mobility. For adolescents with Becker muscular dystrophy (BMD), for whom the ability to ambulate often persists into the mid-3rd decade, preservation of functional ability is critical. We report two cases of Thoratec HeartMate II left ventricular assist device (LVAD) implantation in adolescents with BMD for whom postoperative weight gain contributed significantly to an accelerated loss of ambulation and, in one case, driveline fracture in the context of repeated falls. As LVADs become an increasingly common therapy for endstage heart failure in adolescents with BMD, care must be focused not only on maintenance of device functionality, but also on management of aggressive weight, and preservation of ambulation, and skeletal muscle strength. PMID:26461240

  5. Relaxation and music reduce pain following intestinal surgery.

    Science.gov (United States)

    Good, Marion; Anderson, Gene Cranston; Ahn, Sukhee; Cong, Xiaomei; Stanton-Hicks, Michael

    2005-06-01

    Three nonpharmacological nursing interventions, relaxation, chosen music, and their combination, were tested for pain relief following intestinal (INT) surgery in a randomized clinical trial. The 167 patients were randomly assigned to one of three intervention groups or control and were tested during ambulation and rest on postoperative days 1 and 2. Pain sensation and distress were measured with visual analog scales (VAS). Multivariate analysis of covariance showed significantly less post-test pain in the intervention groups than in the control group on both days after rest and at three of six ambulation post-tests (p = .024-.001), resulting in 16-40% less pain. Mixed effects after ambulation were due to the large variation in pain and difficulty relaxing while returning to bed; but post hoc explorations showed effects for those with high and low pain. These interventions are recommended along with analgesics for greater postoperative relief without additional side effects. PMID:15884029

  6. Equestrian injuries: a comparison of professional and amateur injuries in Berkshire.

    Science.gov (United States)

    Whitlock, M R; Whitlock, J; Johnston, B

    1987-03-01

    A retrospective study of horse riding injuries in Berkshire was undertaken over a one year period from November 1983. The information was obtained from the Ambulance Service, the Jockey Club and the St. John Ambulance Brigade. There was a total of 103 injured persons with no deaths. Information from the Jockey Club was compared with the other two groups, the former sustaining more limb injuries and the latter more head injuries. A questionnaire was sent to all 42 ambulance patients. Thirty-eight had radiographs taken, 16 of which showed a fracture. Forty-one were wearing some form of hard hat, but if a safety strap was available it was attached in 24 cases. The dangers of riding are highlighted and the importance of adequate protective clothing emphasised. PMID:3580723

  7. Clinical usefulness of Adeli suit therapy for improving gait function in children with spastic cerebral palsy: a case study

    Science.gov (United States)

    Lee, Byoung-Hee

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of Adeli suit therapy (AST) on gross motor function and gait function in children with cerebral palsy. [Subjects and Methods] Two participants with spastic cerebral palsy were recruited to undergo AST. AST was applied in 60-minute sessions, five times per week, with 20 sessions total over 4 weeks. Assessments of gross motor function, spatiotemporal parameters, and functional ambulation performance for gait were conducted. [Results] Gross motor function, cadence, and functional ambulation performance improved after the intervention in both cases. [Conclusion] Although additional follow-up studies are required, the results demonstrated improved gross motor function and functional ambulation performance in the children with cerebral palsy. These findings suggest a variety of applications for conservative therapeutic methods that require future clinical trials in children with cerebral palsy. PMID:27390453

  8. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

    Directory of Open Access Journals (Sweden)

    Staff Trine

    2011-03-01

    Full Text Available Abstract Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs. Methods Records from police, Emergency Medical Communication Centers (EMCC, ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS, respiratory rate (RR, and systolic blood pressure (SBP was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend. Results 25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: p Conclusion EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our finding indicates a need for improved procedures, training, and tools for EMS documentation. Documentation is in itself a quality criterion for appropriate care and is crucial to trauma research.

  9. Prehospital transported patients

    DEFF Research Database (Denmark)

    Bech, Camilla Louise Nørgaard; Brabrand, M.; Lassen, Annmarie Touborg

    2015-01-01

    assessing potential risk factors associated with adverse outcomes and mortality. Our aim was to describe ambulance transports to the ED and identify prognostic factors accessible in the prehospital phase and associated with 7-day mortality. Methods We included all adult patients (>18 years) with a first......-based healthcare registers in order to identify comorbid conditions and information on mortality. Demographic factors and first registered vital sign were analysed by univariate logistic regression analysis, with 7-day mortality as outcome. Results In total, 18,572 first-time ambulance contacts were identified in...

  10. Componentry for lower extremity prostheses.

    Science.gov (United States)

    Friel, Karen

    2005-09-01

    Prosthetic components for both transtibial and transfemoral amputations are available for patients of every level of ambulation. Most current suspension systems, knees, foot/ankle assemblies, and shock absorbers use endoskeletal construction that emphasizes total contact and weight distribution between bony structures and soft tissues. Different components offer varying benefits to energy expenditure, activity level, balance, and proprioception. Less dynamic ambulators may use fixed-cadence knees and non-dynamic response feet; higher functioning walkers benefit from dynamic response feet and variable-cadence knees. In addition, specific considerations must be kept in mind when fitting a patient with peripheral vascular disease or diabetes. PMID:16148358

  11. Telemedicinsk praehospital diagnostik og visitation af en patient med aortadissektion

    DEFF Research Database (Denmark)

    Terkelsen, Astrid Juhl; Lambrechtsen, Jess; Kaltoft, Anne; Egeblad, Henrik; Andersen, Henning Rud; Lassen, Jens Flensted

    2008-01-01

    Thoracic aortic dissection is a life-threatening emergency that must be met and surmounted immediately to increase survival. In this case, telemedicine involving ECG and GSM-based communication between the patient in the ambulance and the centre doctor was used to obtain remote pre-hospital...... suspicion of aorta dissection. Thus, the ambulance was re-routed directly to a specialized unit where the diagnosis was confirmed and immediate and successful surgical treatment was performed. Telemedicine allowing direct communication between the patient and the doctor is recommended....

  12. Telemedicinsk praehospital diagnostik og visitation af en patient med aortadissektion

    DEFF Research Database (Denmark)

    Terkelsen, Astrid J.; Lambrechtsen, Jess; Kaltoft, Anne; Egeblad, Henrik; Andersen, Henning Rud; Lassen, Jens Flensted

    2008-01-01

    Thoracic aortic dissection is a life-threatening emergency that must be met and surmounted immediately to increase survival. In this case, telemedicine involving ECG and GSM-based communication between the patient in the ambulance and the centre doctor was used to obtain remote pre-hospital...... suspicion of aorta dissection. Thus, the ambulance was re-routed directly to a specialized unit where the diagnosis was confirmed and immediate and successful surgical treatment was performed. Telemedicine allowing direct communication between the patient and the doctor is recommended. Udgivelsesdato: 2008...

  13. Telemedicinsk praehospital diagnostik og visitation af en patient med akut lungeemboli

    DEFF Research Database (Denmark)

    Terkelsen, Astrid J.; Nielsen-Kudsk, Jens Erik; Andersen, Henning Rud; Lassen, Jens Flensted

    2008-01-01

    Mortality in untreated pulmonary embolism is high and short-term outcome depends on a timely diagnosis. In this case telemedicine involving 12-lead ECG and GSM-based communication between the patient in the ambulance and the telemedical staff resulted in remote pre-hospital suspicion of acute...... pulmonary embolism. The ambulance was referred directly to the nearest department of cardiology where acute CT and echocardiography confirmed the diagnosis. Acute trombolysis was successful. Telemedicine may be beneficial in other medical emergencies than acute myocardial infarction. Udgivelsesdato: 2008...

  14. Hjertestop uden for hospital. Prospektiv undersøgelse af forskellige typer af udvidet præhospital behandling i Odense

    DEFF Research Database (Denmark)

    Nielsen, J R; Lybecker, H; Andersen, C;

    1990-01-01

    Danish National Board of Health (6 months]. Out of 28 patients brought in by the medically staffed ambulance, two (7%) were discharged alive. Out of 57 patients brought in the phase with the motorized doctor nine (16%) were discharged alive. Out of 78 patients brought in by heart ambulance one (1%) was...... discharged alive. The results of this investigation reveal that the prehospital treatment of cardiac arrest in Odense can be improved by participation of a doctor in the treatment, (particularly the rendezvous model). Suggested improvements consist of 1) improved alarm system, 2) intensification of training...

  15. Immobilisering av extremitetsfrakturer inom ambulanssjukvård : Ett pilotprojekt med SAM-splint

    OpenAIRE

    Edin, Åsa; Danér, Kathrina

    2010-01-01

    Within the ambulance care in Uppsala County a vacuum splint is used to immobilize fractures on extremities. The research available on which method of immobilizing to prefer during pre-hospital treatment is limited.   The purpose of this pilot study was to examine the perceptions of the ambulance personal in Uppsala County on the issue of usability of SAM-splint and vacuum splint when immobilizing extremities. The project was also aimed at researching if SAM-splint could be seen as an alternat...

  16. Salud/Servicios Personales. Libro del Profesor. (Health/Personal Services. Teacher's Guide). B2. CHOICE (Challenging Options in Career Education).

    Science.gov (United States)

    Mid-Hudson Migrant Education Center, New Paltz, NY.

    Written in Spanish, the guide comprises the first grade unit of a career education curriculum developed for migrant students. The guide covers 12 health and personal service occupations--blacksmith, television repairer, hairdresser/barber, day care worker, waitress, gas station attendant, family doctor, ambulance driver/attendant, dietician,…

  17. Healthcare PANs: Personal Area Networks for trauma care and home care

    NARCIS (Netherlands)

    Jones, V.M.; Bults, R.G.A.; Konstantas, D.; Vierhout, P.A.M.

    2001-01-01

    The first hour following the trauma is of crucial importance in trauma care. The sooner treatment begins, the better the ultimate outcome for the patient. Generally the initial treatment is handled by paramedical personnel arriving at the site of the accident with an ambulance. There is evidence to

  18. Selected contents in J Head Trauma Rehabilitation%精 选 目 次 :

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Supported treadmill ambulation training after spinal cord injury: A pilot study. 2001 Jun;82(6):825-831   脊 髓 损 伤 后 的 支 持 性 踏 车 运 动 训 练 : 实 验 性 研 究   

  19. A CLINICAL STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE (LCP - PF) IN THE MANAGEMENT OF COMMUNITED INTERTROCHANTERIC AND SUBTROCHANTERIC FRACTURES OF THE FEMUR

    OpenAIRE

    Hari Babu; Satish; Suresh Babu; Anand

    2015-01-01

    Fractures of proximal femur and hip are relatively common injuries in elderly individuals . The incidence of peritrochanteric and intertrochanteric fracture is also increasing among young population, who sustain high energy trauma Rigid Internal fixation and early mobilization has been the standard method of treatment. A combination of orthopaedic surgery and early postoperative physiotherapy and ambulation is the bes...

  20. Joint Modelling of Survival and Emergency Medical Care Usage in Spanish Insureds Aged 65+

    OpenAIRE

    Piulachs Lozada-Benavente, Xavier; Alemany Leira, Ramon; Guillén, Montserrat

    2016-01-01

    We study the longevity and medical resource usage of a large sample of insureds aged 65 years or older drawn from a large health insurance dataset. Yearly counts of each subject's emergency room and ambulance service use and hospital admissions are made. Occurrence of mortality is also monitored. The study aims to capture the simultaneous dependence between their demand for healthcare and survival.

  1. 32 CFR 154.16 - Security clearance.

    Science.gov (United States)

    2010-07-01

    ..., such as guards, emergency service personnel, firemen, doctors, nurses, police, ambulance drivers, or... shall be accomplished in accordance with 32 CFR part 159. The investigative requirement shall be the... be processed for a security clearance in accordance with 32 CFR part 353 and the provisions of...

  2. Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis

    Directory of Open Access Journals (Sweden)

    Shimpei Miyamoto, MD

    2014-03-01

    Conclusions: This study demonstrates that early mobilization after free-flap transfer to the lower extremity is made possible by flow-through anastomosis for both arteries and veins. Flow-through flaps have stable circulation from the acute phase and can tolerate early dangling and ambulation.

  3. Foot Deformities in Patients with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    E. Ameri

    2007-04-01

    Full Text Available Introduction & Objective: In patients with cerebral palsy (CP the most common presentation is lower extremity deformity specially foot deformity. Inability to ambulation is the one of the most important disabilities, that dependent to the variety of factors such as severity of disease, kind of CP, etc. This study was aimed to assess prevalence of kinds of foot deformity in CP and communication between kind of CP and foot deformity and another hand inability to ambulation.Materials & Methods: 100 patients with cerebral palsy with age 3-20 y (average 12.9y were assessed in Shafa Yahyaian Orthopedic Center and kinds of CP & foot deformity was evaluated. In these patients, 84 subjects were selected with age 7-20 y and were evaluated for ability to walking.Results: The most common type of CP was spastic and the most common form of CP was (Quadri-Di-hemi-para plegic respectively. The most common form of foot deformity was equines. Inability to walking in patients with foot deformity was more than without it (P<0.03, and in quadriplegic CP more than another types and in hemiplegic less than others.Conclusion: The most common deformity in foot in patients with CP was equines and then equino varus & equines valgus respectively. Foot deformity is the one of the factors that effect on ability to ambulation in patients with CP. Inability to ambulation in quadriplegic CP is more than others and in hemiplegic CP less than other types of CP.

  4. Swivel walkers in Duchenne muscular dystrophy.

    OpenAIRE

    Sibert, J R; Williams, V; Burkinshaw, R; Sibert, S

    1987-01-01

    Swivel walkers were used to provide low energy ambulation in 11 boys with Duchenne muscular dystrophy in schools for the physically handicapped in South Glamorgan. Our preliminary experience suggests that these walkers improve the quality of life and provide a useful part of the physical treatment of the condition.

  5. Coaching Communication Partners: A Preliminary Investigation of Communication Intervention during Mealtime in Rett Syndrome

    Science.gov (United States)

    Bartolotta, Theresa E.; Remshifski, Patricia A.

    2013-01-01

    Rett syndrome (RTT) occurs primarily in females and is characterized by deficits in cognition, communication, hand use and ambulation. This quasi-experimental study explored the use of a coaching program to increase communicative interactions between girls with RTT and their communication partners. Communication coaching strategies were provided…

  6. Emergency Room Use Among Adults Aged 18-64

    Science.gov (United States)

    ... ambulance Lack of access to other providers Doctor's office not open No other place to go Emergency room is ... a hospital could help (54.5%), the doctor’s office was not open (48.0%), or there was no other place ...

  7. 49 CFR 571.10 - Designation of seating positions.

    Science.gov (United States)

    2010-10-01

    ... No. 208 (49 CFR 571.208), firefighting vehicles, ambulances, or motor homes. To determine the number of passenger seating positions in school buses, see S4.1 of Standard No. 222 (49 CFR 571.222). (b... 49 Transportation 6 2010-10-01 2010-10-01 false Designation of seating positions. 571.10...

  8. A Novel Human Autonomy Assessment System

    Directory of Open Access Journals (Sweden)

    Torsten Stevens

    2012-06-01

    Full Text Available This article presents a novel human autonomy assessment system for generating context and discovering the behaviors of older people who use ambulant services. Our goal is to assist caregivers in assessing possibly abnormal health conditions in their clients concerning their level of autonomy, thus enabling caregivers to take countermeasures as soon as possible.

  9. General anesthesia versus segmental thoracic or conventional lumbar spinal anesthesia for patients undergoing laparoscopic cholecystectomy

    OpenAIRE

    Yousef, Gamal T.; Lasheen, Ahmed E.

    2012-01-01

    Background: Laparoscopic cholecystectomy became the standard surgery for gallstone disease because of causing less postoperative pain, respiratory compromise and early ambulation. Objective: This study was designed to compare spinal anesthesia, (segmental thoracic or conventional lumbar) vs the gold standard general anesthesia as three anesthetic techniques for healthy patients scheduled for elective laparoscopic cholecystectomy, evaluating intraoperative parameters, postoperative recovery an...

  10. [Wound management].

    Science.gov (United States)

    Gresser, J; Bitz, K; Hegglin, J

    1992-07-01

    The following article is a check-list for wound care giving some practical hints. Special interest has been given to the themes of local anesthesia and prevention of infections. The indications and limits of the ambulant wound care are also discussed. Finally, a short explanation is given for the treatment of wounds situated at delicate regions of the body. PMID:1440441

  11. SU-SP3 Semesterprojekt 3

    DEFF Research Database (Denmark)

    Sørensen, John Aasted; Holst-Christensen, Bo; Munck-Fairwood, Roger;

    2010-01-01

    1. At planlægge videreførelsen af en prototype til et system, der hånd-terer patientkontakt før, mellem og efter indlæggelser samt ambulant behandling. 2. At planlægge og konstruere en Matlab baseret simulator til et patient monitoreringssystem for fysiologiske parametre. Simulatoren skal sætte e...

  12. Prednisone Therapy for Duchenne Dystrophy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-02-01

    Full Text Available The effects of prednisone on muscle function and the extent of steroid-related adverse effects were studied in 17 ambulant children with Duchenne muscular dystrophy (DMD at University Hospital, Groningen; Rehabilitation Centre, Utrecht; and Leiden University Medical Centre, the Netherlands.

  13. The influence of low dystrophin levels on disease pathology in mouse models for Duchenne Muscular Dystrophy

    NARCIS (Netherlands)

    Putten, Maaike van

    2013-01-01

    Duchenne muscular dystrophy (DMD) is the most prevalent neuromuscular disorder, caused by mutations in the DMD gene that prevent synthesis of dystrophin. Fibers that lack dystrophin are sensitive to exercise-induced damage, resulting in progressive muscle wasting, loss of ambulation and premature de

  14. Muscular Dystrophy: Hope Through Research

    Science.gov (United States)

    ... more severe and result in functional disability and loss of ambulation. Life expectancy often depends on the degree of muscle ... growth or mitigating damage due to inflammation Progressive loss of ... quality and length of life in MD. Drug treatment strategies designed to slow ...

  15. De verkeersonveiligheid van hulpverleningsvoertuigen. Consult ten behoeve van de Koninklijke Nederlandse Toeristenbond ANWB.

    NARCIS (Netherlands)

    Oei, H.-l.

    1986-01-01

    Drivers on emergency vehicles (ambulances, fire engines, police cars) which have to fulfil an urgent task and which make use of particular competencies, show often a driving behaviour with an increased risk. Each year more than hundred victims are killed or injured in accidents in which emergency ve

  16. Creación y planificación de un proyecto propio gastronómico ambulante

    OpenAIRE

    Recuerda Hernández, Núria

    2015-01-01

    Creació i planificació d'un projecte d'empresa de menjar ambulant amb la seva pròpia identitat corporativa, sorgit d'una idea personal. Introducció innovadora d'un producte clàssic d'una manera poc convencional.

  17. Periarticular regional analgesia in total knee arthroplasty: a review of the neuroanatomy and injection technique.

    Science.gov (United States)

    Guild, George N; Galindo, Rubin P; Marino, Joseph; Cushner, Fred D; Scuderi, Giles R

    2015-01-01

    Postoperative pain control after total knee arthroplasty may be insufficient, resulting in insomnia, antalgic ambulation, and difficulty with rehabilitation. Current strategies, including the use of femoral nerve catheters, may control pain but have been associated with falls, motor blockade, and quadriceps inhibition. Periarticular infiltration using the appropriate technique and knowledge of intraarticular knee anatomy may increase pain control and maximize rehabilitation. PMID:25435030

  18. The Right Son at the Right Time

    Institute of Scientific and Technical Information of China (English)

    崔礼山

    2004-01-01

    The story began on a downtown Brooklyn street corner.An elderly man had collapsed while crossing the street.and an ambulance rushed him to Kings County Hospital.There.when he came to now and again.the man repeatedly called for his son.

  19. Idling Reduction for Emergency and Other Service Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-05-07

    This is a fact sheet about reducing idling for emergency and service vehicles. Emergency vehicles, such as police cars, ambulances, and fire trucks, along with other service vehicles such as armored cars, are often exempt from laws that limit engine idling. However, these vehicles can save fuel and reduce emissions with technologies that allow them to perform vital services without idling.

  20. Case Study – Idling Reduction Technologies for Emergency Service Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Laughlin, Michael [Argonne National Lab. (ANL), Argonne, IL (United States); Owens, Russell J. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-01-01

    This case study explores the use of idle reduction technologies (IRTs) on emergency service vehicles in police, fire, and ambulance applications. Various commercially available IRT systems and approaches can decrease, or ultimately eliminate, engine idling. Fleets will thus save money on fuel, and will also decrease their criteria pollutant emissions, greenhouse gas emissions, and noise.

  1. Deficits in motor response to avoid sudden obstacles during gait in functional walkers poststroke

    NARCIS (Netherlands)

    Swigchem, R. van; Duijnhoven, H.J. van; Boer, J. den; Geurts, A.C.H.; Weerdesteijn, V.G.

    2013-01-01

    BACKGROUND: . Safe community ambulation requires the capacity to adapt gait to environmental changes on short notice. Reduced adaptability may contribute to an increased risk for falls. OBJECTIVE: . This study investigated gait adaptability in community-dwelling persons poststroke and sought to unde

  2. Systolic blood pressure and short-term mortality in the emergency department and prehospital setting

    DEFF Research Database (Denmark)

    Kristensen, Anders Kasper Bruun; Holler, Jon Gitz; Mikkelsen, Søren;

    2015-01-01

    retrospective, hospital-based cohort study was performed at Odense University Hospital which included all adult patients in the emergency department between 1995 and 2011, all patients transported to the emergency department in ambulances in the period 2012-2013, and all patients serviced by the physician...

  3. Quantitative magnetic resonance imaging in limb-girdle muscular dystrophy 2I

    DEFF Research Database (Denmark)

    Willis, Tracey A; Hollingsworth, Kieren G; Coombs, Anna;

    2014-01-01

    We conducted a prospective multinational study of muscle pathology using magnetic resonance imaging (MRI) in patients with limb-girdle muscular dystrophy 2I (LGMD2I). Thirty eight adult ambulant LGMD2I patients (19 male; 19 female) with genetically identical mutations (c.826C>A) in the fukutin...

  4. Prehospital Unassisted Assessment of Stroke Severity Using Telemedicine A Feasibility Study

    NARCIS (Netherlands)

    Van Hooff, Robbert-Jan; Cambron, Melissa; Van Dyck, Rita; De Smedt, Ann; Moens, Maarten; Espinoza, Alexis Valenzuela; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; De Keyser, Jacques; Brouns, Raf

    2013-01-01

    Background and Purpose We evaluated the feasibility and the reliability of remote stroke severity quantification in the prehospital setting using the Unassisted TeleStroke Scale (UTSS) via a telestroke ambulance system and a fourth-generation mobile network. Methods The technical feasibility and the

  5. 48 CFR 22.1003-5 - Some examples of contracts covered.

    Science.gov (United States)

    2010-10-01

    ... CFR 4.130 for additional examples): (a) Motor pool operation, parking, taxicab, and ambulance services... SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Service Contract Act of 1965, as..., stenographic reporting, or mortuary services. (j) Electronic equipment maintenance and operation...

  6. The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery.

    Science.gov (United States)

    McCaffrey, Ruth; Locsin, Rozzano

    2006-01-01

    The purpose of this study was to examine the effects of music listening in older adults following hip or knee surgery. Acute confusion and pain after surgery can increase length of stay and reduce function. Study results demonstrate a reduction in acute confusion and pain and improved ambulation and higher satisfaction scores in older adults who listened to music. PMID:16974175

  7. 77 FR 67628 - National Fire Codes: Request for Public Input for Revision of Codes and Standards

    Science.gov (United States)

    2012-11-13

    ... Fire Tests for Evaluating Room Fire Growth Contribution of Textile or Expanded Vinyl Wall Coverings on... Standard for 1/4/2013 Determination of Fire Loads for Use in Structural Fire Protection Design. NFPA 600... Standard for Automotive 7/8/2013 Ambulances. NFPA 1931--2010 Standard for 1/4/2013 Manufacturer's Design...

  8. Integration in stroke services: the challenges for primary and community care services

    OpenAIRE

    Baeza, Juan I; Fraser, Alec; Boaz, Dr Annette

    2012-01-01

    Objectives A number of evidence-based interventions are now available for stroke patients. Good quality stroke care involves a range of health professionals located across ambulance, hospital, community and primary care services. This study examined the perspectives of healthcare workers involved in stroke care in two different English case study sites on the integration challenges stroke care presents.

  9. Frostbite

    Science.gov (United States)

    ... the child walk on frostbitten feet. Get your child into dry clothing in a warm environment. If you cannot get to a hospital right away or must wait for an ambulance, give your child a warm drink and begin first-aid treatment: ...

  10. Ambulanceudrykning i København, Odense og Ringkøbing Amt. Resultater fra Sundhedsministeriets og Amtsrådsforeningens stikprøveundersøgelse 1990. 1. Epidemiologiske data

    DEFF Research Database (Denmark)

    Trier, H; Larsen, C F

    1992-01-01

    In 1990, The Danish Ministry of Health and the County Council Association undertook a spot test investigation of the activities in connection with 3,182 emergency ambulance services (AU) in the Municipality of Copenhagen (a city), the Odense district (a large provincial town) and the County of...

  11. When bystanders become bothersome: The negative consequences of bystander conflict and the moderating role of resilience

    NARCIS (Netherlands)

    Erp, van Kim J.P.M; Rispens, Sonja; Gevers, Josette M.P.; Demerouti, Evangelia

    2014-01-01

    Bystander conflict is a situation in which employees are hindered in their work by parties not involved in the primary process. Public service employees and emergency care workers, such as ambulance employees and firefighters, often encounter this kind of conflict with potentially far-reaching detri

  12. Development of a cosmetic knee disarticulation prosthesis : A single-patient case study

    NARCIS (Netherlands)

    de Laat, Fred A.; de Vos, Wouter; Geertzen, Jan; Roorda, Leo D.

    2015-01-01

    Background and aim: If a person does not become ambulant after an amputation, a knee disarticulation (KD) shouldbe considered and the person may then benefit from a cosmetic KD prosthesis. The features of a cosmetic KD prosthesis are, however, seldom described. The aim of this clinical note is to de

  13. Immediate Effects of Cane Use on Gait Symmetry in Individuals with Subacute Stroke

    OpenAIRE

    Beauchamp, Marla K.; Skrela, Martina; Southmayd, Degen; Trick, Jaime; Kessel, Meghan Van; Brunton, Karen; Inness, Elizabeth; McIlroy, William E

    2009-01-01

    Purpose: In stroke rehabilitation, there is a lack of consensus regarding the effects of cane use on gait symmetry. This study aimed to evaluate the immediate effects on gait symmetry of ambulating with a standard cane and a quad cane among individuals with subacute stroke.

  14. Muscular Dystrophy: Data and Statistics

    Science.gov (United States)

    ... duration and time to loss of ambulation. J Child Neurol. 2015 Sept;30(10):1275-80. Fox DJ, Kumar A, West N, DiRienzo AG, James KA, Oleszek J; Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STAR net ). Trends with corticosteroid use in males with ...

  15. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    Buuren, M. van; Kommer, G.J.; Mei, R.D. van der; Bhulai, S.

    2015-01-01

    In pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response time to the

  16. Indoor fire in a nursing home : evaluation of the medical response to a mass casualty incident based on a standardized protocol

    NARCIS (Netherlands)

    Koning, S. W.; Ellerbroek, P. M.; Leenen, L. P. H.

    2015-01-01

    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent res

  17. Experiential Learning in Pre-Hospital Emergency Care: A Qualitative Study.

    Science.gov (United States)

    Melby, Vidar

    2000-01-01

    Analysis of 141 nursing students' diaries and focus group interviews about their work with an ambulance service revealed the following: holistic nursing played a role; they developed appreciation for paramedics' skills; and experiential learning helped them understand the complete care process from the emergency call to patient discharge. (SK)

  18. DIAGNOSTIC SIGNIFICATION OF EXANTHEMA IN THE PREHOSPITAL CARE IN INFECTIOUS DISEASES

    Directory of Open Access Journals (Sweden)

    N. F. Plavunov

    2016-01-01

    Full Text Available Disease, with exanthema, pose a significant differential diagnostic difficulty for physicians multidisciplinary hospitals and require the consultation of an infectious disease physician. The article highlights the problem of early diagnostics of acute infectious diseases proceeding with exanthema. The analysis of quality of diagnostics of infectious disease on the outcomes of the consultative infectious ambulance team for 2013-2014.

  19. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

    OpenAIRE

    Staff Trine; Søvik Signe

    2011-01-01

    Abstract Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS) documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs). Methods Records from police, Emergency Medical Communication Centers (EMCC), ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS), respiratory rate (RR), and systolic...

  20. Heart rate and oxygen demand of powered exoskeleton–assisted walking in persons with paraplegia

    Directory of Open Access Journals (Sweden)

    Pierre Asselin, MS

    2015-06-01

    Full Text Available Historically, persons with paralysis have limited options for overground ambulation. Recently, powered exoskeletons, which are systems that translate the user’s body movements to activate motors that move the lower limbs through a predetermined gait pattern, have become available. As part of an ongoing clinical study (NCT01454570, eight nonambulatory persons with paraplegia were trained to ambulate with a powered exoskeleton. Measurements of oxygen uptake (VO2 and heart rate (HR were recorded for 6 min each during each maneuver while sitting, standing, and walking. The average value of VO2 during walking (11.2 +/– 1.7 mL/kg/min was significantly higher than for sitting and standing (3.5 +/– 0.4 and 4.3 +/– 0.9 mL/kg/min, respectively; p < 0.001. The HR response during walking was significantly greater than that of either sitting or standing (118 +/– 21 vs 70 +/– 10 and 81 +/– 12 beats per minute, respectively; p < 0.001. Persons with paraplegia were able to ambulate efficiently using the powered exoskeleton for overground ambulation, providing the potential for functional gain and improved fitness.

  1. Music as support and challenge

    DEFF Research Database (Denmark)

    Bonde, Lars Ole

    2010-01-01

    Første del af forskningsrapport om gruppemusikterapi med psykiatriske patienter i ambulant behandling. Metoden kaldes "Musiklytning og indre billeder" og der anvendes klassisk musik med såvel støttende som udfordrende elementer. Den artikel opridser den teoretiske baggrund for anvendelsen af denn...

  2. VehiHealth: An Emergency Routing Protocol for Vehicular Ad Hoc Network to Support Healthcare System.

    Science.gov (United States)

    Bhoi, S K; Khilar, P M

    2016-03-01

    Survival of a patient depends on effective data communication in healthcare system. In this paper, an emergency routing protocol for Vehicular Ad hoc Network (VANET) is proposed to quickly forward the current patient status information from the ambulance to the hospital to provide pre-medical treatment. As the ambulance takes time to reach the hospital, ambulance doctor can provide sudden treatment to the patient in emergency by sending patient status information to the hospital through the vehicles using vehicular communication. Secondly, the experienced doctors respond to the information by quickly sending a treatment information to the ambulance. In this protocol, data is forwarded through that path which has less link breakage problem between the vehicles. This is done by calculating an intersection value I v a l u e for the neighboring intersections by using the current traffic information. Then the data is forwarded through that intersection which has minimum I v a l u e . Simulation results show VehiHealth performs better than P-GEDIR, GyTAR, A-STAR and GSR routing protocols in terms of average end-to-end delay, number of link breakage, path length, and average response time. PMID:26696419

  3. Elastomeer-infuuspompen getest voor de praktijk

    NARCIS (Netherlands)

    Woerdenbag, Herman J.; Dillingh, Jan H.; Wanders, Jacquelien T. M.; Boer, E. Jildau; Frijlink, Henderik W.; Kosterink, Jos G. W.; Schellekens, Reinout C. A.

    2011-01-01

    OBJECTIVE: To test short-term and long-term elastomeric infusion pumps for applicability in hospital practice and for ambulant patients at home. DESIGN AND METHODS: Four short-term elastomeric infusion pumps (Accufuser C1000M, Easypump ST 100-1, Infusor Intermate SV-100, Surefuser Plus 100 ml) and f

  4. 42 CFR 422.112 - Access to services.

    Science.gov (United States)

    2010-10-01

    ... limited English proficiency or reading skills, and diverse cultural and ethnic backgrounds. (9) Ambulance... with community and social services generally available through contracting or noncontracting providers... may specify the networks of providers from whom enrollees may obtain services if the MA...

  5. Caring about the young

    NARCIS (Netherlands)

    John Stevens; Evert Pommer; Hetty van Kempen; Elke Zeijl; Isolde Woittiez; Klarita Sadiraj; Rob Gilsing; Saskia Keuzenkamp

    2009-01-01

    Original title: De jeugd een zorg. Youth care services are going through major changes. This has created a need for a better insight into the demand that is likely to be placed on these services in the future at both national and regional level. This report suggests that the use of ambulant care w

  6. The Rescue911 Emergency Response Information System (ERIS): A Systems Development Project Case

    Science.gov (United States)

    Cohen, Jason F.; Thiel, Franz H.

    2010-01-01

    This teaching case presents a systems development project useful for courses in object-oriented analysis and design. The case has a strong focus on the business, methodology, modeling and implementation aspects of systems development. The case is centered on a fictitious ambulance and emergency services company (Rescue911). The case describes that…

  7. Walking facilitates positive affect (even when expecting the opposite).

    Science.gov (United States)

    Miller, Jeffrey Conrath; Krizan, Zlatan

    2016-08-01

    Across 3 experiments, we rely on theoretical advancements that connect movement, embodiment, and reward-seeking behavior to test the proposal that walking incidental to routine activity (heretofore referred to as "incidental ambulation")-not specifically "exercise"-is a robust facilitator of positive affect. Experiment 1 reveals that ambulation facilitates positive affect even when participants are blind to the purpose of this activity. Experiment 2 further demonstrates the robustness of this effect of incidental ambulation by documenting its operation under conditions of low interest, as well as its power to override expectations of mood worsening. Experiment 3 replicates the main finding while eliminating the possibility that posture, ambient events, or experimenter bias account for the results. Taken together, the experiments demonstrate that incidental ambulation systematically promotes positive affect regardless of the focus on such movement, and that it can override the effects of other emotionally relevant events such as boredom and dread. The findings hold key implications for understanding the role of movement in shaping affect as well as for clarifying the embodied nature of emotion. (PsycINFO Database Record PMID:27100368

  8. Outcomes of acute exacerbations in COPD in relation to pre-hospital oxygen therapy

    DEFF Research Database (Denmark)

    Ringbaek, Thomas J; Terkelsen, Jakob; Lange, Peter

    2015-01-01

    . METHODS: In an audit of 405 consecutive patients with AECOPD arriving by ambulance to Hvidovre Hospital, details of transit time, oxygen administration, saturation, and arterial blood gases were registered. Outcomes were respiratory acidosis, need of supported ventilation, length of hospitalisation, and...

  9. Are they really refusing to travel? A qualitative study of prehospital records

    Directory of Open Access Journals (Sweden)

    Christopher Sarah

    2006-09-01

    Full Text Available Abstract Background Refusal by the patient to travel after calling an emergency ambulance may lead to a preventable waste of scarce resources if it can be shown that an alternative more appropriate response could be employed. A greater understanding is required of the reasons behind 'refusal to travel' (RTT in order to find appropriate solutions to address this issue. We sought to investigate the reasons why patients refuse to travel following emergency call-out in a rural county. Methods Written records made by ambulance crews for patients (n = 397 who were not transported to hospital following an emergency call-out during October 2004 were retrospectively analysed. Results Twelve main themes emerged for RTT which included non injury or minor injury, falls and recovery after treatment on scene; other themes included alternative supervision, follow-up and treatment arrangements or patients arranging their own transport. Importantly, only 8% of the sample was recorded by ambulance crews as truly refusing to travel against advice. Conclusion A system that facilitates standardised recording of RTT information including social reasons for non-transportation needs to be designed. 'Refused to travel' disclaimers need to reflect instances when crew and patient are satisfied that not going to hospital is the right outcome. These recommendations should be considered within the context of the plans for widening the role of ambulance services.

  10. 10 CFR 490.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ..., Pure Premium and Pure Cold Weather) as described by United States Patent number 5,697,987, dated... is required to save lives or property, such as a rescue vehicle, fire truck or ambulance. Fleet means... arrangement with a term of 120 days or more. Light Duty Motor Vehicle means a light duty truck or light...

  11. Førstehjælp ved observeret hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Lybecker, H; Andersen, C; Frandsen, F;

    1990-01-01

    In connection with participation of doctors in the emergency ambulance service in Odense, the number of cases of observed cardiac arrest outside hospital was registered during a period of six months. The object was to assess how often primary treatment for cardiac arrest was instituted by passers...

  12. Activity monitor accuracy in persons using canes

    Directory of Open Access Journals (Sweden)

    Deborah Michael Wendland, PT, DPT, CPed

    2012-12-01

    Full Text Available The StepWatch activity monitor has not been validated on multiple indoor and outdoor surfaces in a population using ambulation aids. The aims of this technical report are to report on strategies to configure the StepWatch activity monitor on subjects using a cane and to report the accuracy of both leg-mounted and cane-mounted StepWatch devices on people ambulating over different surfaces while using a cane. Sixteen subjects aged 67 to 85 yr (mean 75.6 who regularly use a cane for ambulation participated. StepWatch calibration was performed by adjusting sensitivity and cadence. Following calibration optimization, accuracy was tested on both the leg-mounted and cane-mounted devices on different surfaces, including linoleum, sidewalk, grass, ramp, and stairs. The leg-mounted device had an accuracy of 93.4% across all surfaces, while the cane-mounted device had an aggregate accuracy of 84.7% across all surfaces. Accuracy of the StepWatch on the stairs was significantly less accurate (p < 0.001 when comparing surfaces using repeated measures analysis of variance. When monitoring community mobility, placement of a StepWatch on a person and his/her ambulation aid can accurately document both activity and device use.

  13. Involvement in emergency situations by primary care doctors on-call in Norway - a prospective population-based observational study

    Directory of Open Access Journals (Sweden)

    Hunskaar Steinar

    2010-03-01

    Full Text Available Abstract Background Primary care doctors on-call in the emergency primary health care services in Norway are, together with the ambulances, the primary resources for handling emergencies outside hospitals. There is a lack of reliable data for Norway on how often the primary care doctors are alerted and on their responses in the most urgent emergency cases. The aim of this study was to investigate how doctors on-call are involved in red responses (highest priority, using three different emergency medical communication centres (EMCC as catchment area for a prospective population-based study. Methods In the period from October to December 2007 three dispatch centres covering approximately 816 000 inhabitants prospectively recorded all acute emergency cases. Ambulance records, air ambulance records and records from the doctors on-call were collected. NACA score was used to define the severity of the emergencies. Results 5 105 cases were classified as red responses during the period. We have complete basic recordings (AMIS forms from all and resaved ambulance records, air ambulance records and records from doctors on-call in 89% of the cases. Ambulances were alerted in 96% and doctors on-call in 47% of the cases, but there were large differences between the three EMCCs. Doctors on-call responded with call-out in 42% of the alerted cases. 28% of all patients were taken to a casualty clinic, 46% were admitted to hospital by a doctor and 24% were taken directly to hospital by ambulances. In total, primary care doctors on-call took active part in 42% of all red response cases, and together with GPs' daytime activity the primary health care services were involved in 50% of the cases. 29% of the cases were classified as life-threatening. Call-out by doctors on-call were found to be more frequent in life-threatening situations compared with not life-threatening situations. Conclusion Doctors on-call and GPs on daytime were involved in half of all red

  14. Human Performance in Simulated Reduced Gravity Environments

    Science.gov (United States)

    Cowley, Matthew; Harvill, Lauren; Rajulu, Sudhakar

    2014-01-01

    NASA is currently designing a new space suit capable of working in deep space and on Mars. Designing a suit is very difficult and often requires trade-offs between performance, cost, mass, and system complexity. Our current understanding of human performance in reduced gravity in a planetary environment (the moon or Mars) is limited to lunar observations, studies from the Apollo program, and recent suit tests conducted at JSC using reduced gravity simulators. This study will look at our most recent reduced gravity simulations performed on the new Active Response Gravity Offload System (ARGOS) compared to the C-9 reduced gravity plane. Methods: Subjects ambulated in reduced gravity analogs to obtain a baseline for human performance. Subjects were tested in lunar gravity (1.6 m/sq s) and Earth gravity (9.8 m/sq s) in shirt-sleeves. Subjects ambulated over ground at prescribed speeds on the ARGOS, but ambulated at a self-selected speed on the C-9 due to time limitations. Subjects on the ARGOS were given over 3 minutes to acclimate to the different conditions before data was collected. Nine healthy subjects were tested in the ARGOS (6 males, 3 females, 79.5 +/- 15.7 kg), while six subjects were tested on the C-9 (6 males, 78.8 +/- 11.2 kg). Data was collected with an optical motion capture system (Vicon, Oxford, UK) and was analyzed using customized analysis scripts in BodyBuilder (Vicon, Oxford, UK) and MATLAB (MathWorks, Natick, MA, USA). Results: In all offloaded conditions, variation between subjects increased compared to 1-g. Kinematics in the ARGOS at lunar gravity resembled earth gravity ambulation more closely than the C-9 ambulation. Toe-off occurred 10% earlier in both reduced gravity environments compared to earth gravity, shortening the stance phase. Likewise, ankle, knee, and hip angles remained consistently flexed and had reduced peaks compared to earth gravity. Ground reaction forces in lunar gravity (normalized to Earth body weight) were 0.4 +/- 0.2 on

  15. Assesment of Osteoporosis in Medulla Spinalis Injured Patients

    Directory of Open Access Journals (Sweden)

    Zuhal Bayırlı Karakoyun

    2011-12-01

    Full Text Available Aim: To investigate the relationship between osteoporosis and demographic features, clinical characteristics,risk factors in younger SCI patients. Materials and Methods: Between January-June 2009, all SCI patients admitted to our hospital evaluated and 58 patients who were younger than 50 years who had osteoporosis were enrolled.Patients age, gender, educational status, duration of injury, smoking, sunlight exposure and dietary habits were questioned. Neurological level, completeness, ambulation status and spasticity were assessed. Relationship between these findings with the severity of osteoporosis has been viewed. Results: There were 19 women. Mean age was 35,7 years. The mean time since injury were 117.7 months. 42 patients were paraplegia (17 complete, 16 were tetraplegia (4 complete.The most common osteoporotic site where the legs. There was no correlation between BMD values with age. In men, the legs and total body BMD were significantly lower.The effect of educational level on BMD was not found. No significant correlation was found between time since injury and BMD. In paraplegics, femoral neck and total femur Z-scores were significantly lower. In tetraplegics, Z scores of the arms were lower, but was not significant. Lumbar BMD values of complete patients were significantly lower than incompletes. Sunlight exposure and consumption of milk/milk products had not a significant positive effect on BMD. 8 patients had therapeutic ambulation, whereas 23 of them had community ambulation. Ambulation status of patients and the presence of spasticity was no effect on BMD. There was no significant correlation between BMD and the severity of spasticity. Smokers (n=19, bone density was lower in all regions except for femoral neck but were not significantly. Conclusion: Male gender, paraplegia, and incompleteness negatively effects the bone density. Age, time since injury, education level, spasticity, ambulation level, smoking, sunlight exposure and

  16. Cost-effectiveness of surgery plus radiotherapy versus radiotherapy alone for metastatic epidural spinal cord compression

    International Nuclear Information System (INIS)

    Purpose: A recent randomized clinical trial has demonstrated that direct decompressive surgery plus radiotherapy was superior to radiotherapy alone for the treatment of metastatic epidural spinal cord compression. The current study compared the cost-effectiveness of the two approaches. Methods and Materials: In the original clinical trial, clinical effectiveness was measured by ambulation and survival time until death. In this study, an incremental cost-effectiveness analysis was performed from a societal perspective. Costs related to treatment and posttreatment care were estimated and extended to the lifetime of the cohort. Weibull regression was applied to extrapolate outcomes in the presence of censored clinical effectiveness data. Results: From a societal perspective, the baseline incremental cost-effectiveness ratio (ICER) was found to be $60 per additional day of ambulation (all costs in 2003 Canadian dollars). Using probabilistic sensitivity analysis, 50% of all generated ICERs were lower than $57, and 95% were lower than $242 per additional day of ambulation. This analysis had a 95% CI of -$72.74 to 309.44, meaning that this intervention ranged from a financial savings of $72.74 to a cost of $309.44 per additional day of ambulation. Using survival as the measure of effectiveness resulted in an ICER of $30,940 per life-year gained. Conclusions: We found strong evidence that treatment of metastatic epidural spinal cord compression with surgery in addition to radiotherapy is cost-effective both in terms of cost per additional day of ambulation, and cost per life-year gained

  17. Prehospital Emergency Service for Internal Medicine Problems in Pediatrics; Causes, Time Indices and Outcomes

    Directory of Open Access Journals (Sweden)

    Hamid Reza Khoddami Vishteh

    Full Text Available Objective: Although pediatric pre-hospital emergency medical services (EMS are a main challenge of health care systems, few data exists over it. Current study of ambulance calls for medical causes relating to children in Tehran was conducted with the following aims: 1 assessment of the frequency of causes of EMS call, 2 assessment of time indices of service providing by EMS, and 3 to assess the correlation between outcomes and time indices.Material & Methods: In this retrospective study, all calls to Tehran EMS system (Dial 115 for medical causes of children =<15 years old in Tehran between December 2005 and May 2006 were extracted. Demographic variables, accident type, patient outcome before hospital arrival, and ambulance time indices (response time, scene time, total run time, total run time hospital, transport time, round trip time were registered.Findings: 1052 (15.5% calls were for children. From these, 717 (68% were due to problems of medic problems. The most frequent problem was epilepsy (26.8%, unconsciousness (18.1% and respiratory disorders (15.2%. 12 (5. 6% subjects died before ambulance arrival, but no one died between scene and hospital arrival. Mean (SD delay time, response time and scene time were 3.8 ± 1.8, 15.1 ± 6.9, and 23.5 ± 10.9, respectively. The pre-hospital mortality was not correlated with any of the time intervals. Conclusion: One of six ambulance calls in Tehran is related to pediatric patients, most of them with a medical cause. Epilepsy, unconsciousness and respiratory disorders as the most frequent causes for EMS calls for medical problems highlights the need for planning for training of the EMS personnel with these problems. There is still a need for further improvement in time intervals of EMS services, which may be possible by proper management and equipping by more ambulances.

  18. EMS adaptation for climate change

    Science.gov (United States)

    Pan, C.; Chang, Y.; Wen, J.; Tsai, M.

    2010-12-01

    The purpose of this study was to find an appropriate scenario of pre-hospital transportation of an emergency medical service (EMS) system for burdensome casualties resulting from extreme climate events. A case of natural catastrophic events in Taiwan, 88 wind-caused disasters, was reviewed and analyzed. A sequential-conveyance method was designed to shorten the casualty transportation time and to promote the efficiency of ambulance services. A proposed mobile emergency medical center was first constructed in a safe area, but nearby the disaster area. The Center consists of professional medical personnel who process the triage of incoming patients and take care of casualties with minor injuries. Ambulances in the Center were ready to sequentially convey the casualties with severer conditions to an assigned hospital that is distant from the disaster area for further treatment. The study suggests that if we could construct a spacious and well-equipped mobile emergency medical center, only a small portion of casualties would need to be transferred to distant hospitals. This would reduce the over-crowding problem in hospital ERs. First-line ambulances only reciprocated between the mobile emergency medical center and the disaster area, saving time and shortening the working distances. Second-line ambulances were highly regulated between the mobile emergency medical center and requested hospitals. The ambulance service of the sequential-conveyance method was found to be more efficient than the conventional method and was concluded to be more profitable and reasonable on paper in adapting to climate change. Therefore, additional practical work should be launched to collect more precise quantitative data.

  19. Pre-hospital treatment of acute poisonings in Oslo

    Directory of Open Access Journals (Sweden)

    Nore Anne K

    2008-11-01

    Full Text Available Abstract Background Poisoned patients are often treated in and discharged from pre-hospital health care settings. Studies of poisonings should therefore not only include hospitalized patients. Aims: To describe the acutely poisoned patients treated by ambulance personnel and in an outpatient clinic; compare patients transferred to a higher treatment level with those discharged without transfer; and study the one-week mortality after pre-hospital discharge. Methods A one-year multi-centre study with prospective inclusion of all acutely poisoned patients ≥ 16 years of age treated in ambulances, an outpatient clinic, and hospitals in Oslo. Results A total of 3757 health service contacts from 2997 poisoning episodes were recorded: 1860 were treated in ambulances, of which 15 died and 750 (40% were discharged without transfer; 956 were treated in outpatient clinic, of which 801 (84% were discharged without transfer; and 941 episodes were treated in hospitals. Patients discharged alive after ambulance treatment were mainly poisoned by opiates (70%, were frequently comatose (35%, had respiratory depression (37%, and many received naloxone (49%. The majority of the patients discharged from the outpatient clinic were poisoned by ethanol (55%, fewer were comatose (10%, and they rarely had respiratory depression (4%. Among the hospitalized, pharmaceutical poisonings were most common (58%, 23% were comatose, and 7% had respiratory depression. Male patients comprised 69% of the pre-hospital discharges, but only 46% of the hospitalized patients. Except for one patient, who died of a new heroin overdose two days following discharge from an ambulance, there were no deaths during the first week after the poisonings in the 90% of the pre-hospital discharged patients with known identity. Conclusion More than half of the poisoned patients treated in pre-hospital treatment settings were discharged without transfer to higher levels. These poisonings were more often

  20. Preoperative teaching and hysterectomy outcomes.

    Science.gov (United States)

    Oetker-Black, Sharon L; Jones, Susan; Estok, Patricia; Ryan, Marian; Gale, Nancy; Parker, Carla

    2003-06-01

    This study used a theoretical model to determine whether an efficacy-enhancing teaching protocol was effective in improving immediate postoperative behaviors and selected short- and long-term health outcomes in women who underwent abdominal hysterectomies. The model used was the self-efficacy theory of Albert Bandura, PhD. One hundred eight patients in a 486-bed teaching hospital in the Midwest who underwent hysterectomies participated. The participation rate was 85%, and the attrition rate was 17% during the six-month study. The major finding was that participants in the efficacy-enhancing teaching group ambulated significantly longer than participants in the usual care group. This is an important finding because the most prevalent postoperative complications after hysterectomy are atelectasis, pneumonia, paralytic ileus, and deep vein thrombosis, and postoperative ambulation has been shown to decrease or prevent all of these complications. This finding could affect the overall health status of women undergoing hysterectomies. PMID:12817743

  1.  MULTIMODAL ANALGESIA IN FAST TRACK HIP AND KNEE ARTHROPLASTY

    DEFF Research Database (Denmark)

    Holm, Bente; Bak, Mikkel; Kristensen, Billy Bjarne;

      PURPOSE: The purpose of this project was to study the length of the hospital stay (LOS) in relation to a new multimodal pain strategy for patients undergoing elective hip and knee arthroplasty. Usual discharge criteria were used: independence in ambulation and transfers, independence in toileting...... and dressing, and pain medication with only oral analgesics. RELEVANCE: Current efforts focus to shorten the LOS and improve pain management. However, a decreased LOS has to ensure restoration of functional ability to the same level achieved with traditional LOS. Accordingly a description of the...... medication. Patients started mobilisation on the day of the operation with further physiotherapy the following days, including transfer and ambulation training, and specific joint and muscle exercises. In connection with all activities, pain scores were assessed, using a Visual Analog Scale (VAS). All...

  2. Instrument for assessing the quality of mobile emergency pre-hospital care: content validation.

    Science.gov (United States)

    Dantas, Rodrigo Assis Neves; Torres, Gilson de Vasconcelos; Salvetti, Marina de Góes; Dantas, Daniele Vieira; Mendonça, Ana Elza Oliveira de

    2015-01-01

    OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K> 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services. PMID:26107697

  3. Methylbromide intoxication: a clinical case study.

    Science.gov (United States)

    Breeman, Wim

    2009-01-01

    The port of Rotterdam, The Netherlands, is the world's largest container port. In 2006, one of these containers caused a chemical incident. Methylbromide is used in some countries as a pesticide for the fumigation of maritime containers. Because of an insufficiently performed detoxification, this insecticide intoxicated several employees and some of the ambulance crew and Mobile Medical Team (MMT). The victims displayed symptoms of sore throat, irritated eyes, and hypersalivation. One of the victims suffered from multiple epileptic seizures. Two victims were admitted to the intensive care unit for respiratory support. Three other employees showed milder symptoms and received supportive care but were not admitted to the hospital. This complicated case shows that the safety of the ambulance crew and MMT must be guaranteed. It also demonstrates that healthcare providers cannot always oversee the accident scene and that there are some pitfalls that are almost impossible to prevent. PMID:20118865

  4. Faktorer af betydning for tidlig og sen indlaeggelse af patienter med apopleksi og transitorisk cerebral iskaemi

    DEFF Research Database (Denmark)

    Rasmussen, Berit H; Germer, Ulla; Kammersgaard, Lars Peter; Olsen, Tom Skyhøj

    2003-01-01

    TIA were entered; 49% were admitted by a GP, 38% by ambulance after calling emergency, 13% via other routes. Time from onset to hospital admission could be assessed reliably in 374 patients (67%) and was a median of 2.6 hours; 37% arrived within 0-3 hours, 55% within 0-6 hours. Patients calling an...... predictors of early admission. DISCUSSION: Patients with stroke or TIA in a Danish metropolitan area arrive at hospital a median of 2.6 hours after the stroke. Admission by ambulance after calling emergency was associated with the shortest onset to admission time. Udgivelsesdato: 2003-Jan-13......INTRODUCTION: Early admission after stroke and TIA is important in modern stroke treatment. We studied the time delay to admission and explored predictive factors of early/late admission. MATERIAL AND METHODS: The study was prospective and community-based comprising all patients with stroke or TIA...

  5. Analgesic effect of perioperative escitalopram in high pain catastrophizing patients after total knee arthroplasty

    DEFF Research Database (Denmark)

    Lunn, Troels H; Frokjaer, Vibe G; Hansen, Torben Bæk;

    2015-01-01

    has not previously been investigated. The authors hypothesized that perioperative escitalopram would reduce pain after TKA in high pain catastrophizing patients. METHODS: A total of 120 pain catastrophizing patients (selected using the pain catastrophizing scale as preoperative screening tool......) scheduled for TKA were randomized in a double-blind manner to either 10 mg escitalopram or placebo daily from preanesthesia to postoperative day 6 in addition to a standardized analgesic regime. The primary outcome was pain upon ambulation 24 h after surgery. Secondary outcomes were overall pain during well......-defined mobilizations and at rest from 2 to 48 h and from days 2 to 6, morphine equivalents, anxiety, depression, and side effects. RESULTS: Pain upon ambulation (mean [95% CI]) 24 h after surgery in the escitalopram versus placebo group was 58 (53 to 64) versus 64 (58 to 69), the mean difference being -5 (-13 to 3), P...

  6. Local infiltration analgesia in hip and knee arthroplasty: an emerging technique.

    Science.gov (United States)

    Dillon, John P; Brennan, Louise; Mitchell, David

    2012-04-01

    The optimal form of post-operative analgesia in hip and knee arthroplasty is still debated. Traditionally, patient-controlled analgesia and epidural anaesthesia were used. Potential side-effects such as nausea, confusion, urinary retention, hypotension and immobility have resulted in the emergence of newer techniques that limit opioid use. Peripheral nerve blockade provides excellent analgesia but limits patient ability to ambulate in the immediate post-operative period. Local infiltrative analgesia (LIA) is an emerging technique that has shown to provide superior analgesia, higher patient satisfaction and earlier discharge from hospital when compared to some of the more traditional methods. This review article highlights the advantages of LIA in hip and knee arthroplasty surgery. We describe the technique used, including additional measures that aid early ambulation and discharge from hospital in this cohort of patients. PMID:22696983

  7. Retirement Policies and Support for Emergency Service Personnel: The Transition to Retirement.

    Science.gov (United States)

    Bracken-Scally, Mairéad; McGilloway, Sinéad; Mitchell, Jeffrey T

    2016-06-01

    The aim of this study was to explore policies and procedures to support employees who retire from the emergency services. Interviews were conducted with participants who were familiar with existing policies and procedures in a large ambulance (n = 8) and fire (n = 6) service in Ireland. Four key themes were identified: (1) "I don't think it's a job at 65 to be running out on an emergency ambulance"; (2) "They do genuinely feel a wee bit isolated"; (3) improving the "cultural shock"; and (4) "I just keep going and hope for the best". Findings point towards retirement as a major life change and highlight a need for more structured, effective pre-retirement preparation. Factors unique to emergency service personnel include the physical and emotional stress involved in emergency service; a strong identification with the service; and a lack of clarity about rules and entitlements, requiring better information and preparation. PMID:27112913

  8. Fracture in Duchenne Muscular Dystrophy: Natural History and Vitamin D Deficiency.

    Science.gov (United States)

    Perera, Nadia; Sampaio, Hugo; Woodhead, Helen; Farrar, Michelle

    2016-08-01

    The present study examined the natural history of fracture and vitamin D levels in Duchenne muscular dystrophy patients, who are vulnerable to osteoporosis and fractures. Retrospective analysis of a cohort of 48 Duchenne muscular dystrophy patients revealed that 43% of patients experienced ≥1 fracture. Fracture probabilities at ages 6, 9, 12, and 15 years were 4%, 9%, 31%, and 60% respectively, accelerating around the time of ambulation loss (mean age 11.8 ± 2.7 years). Chronic corticosteroid therapy was utilized in 69% of patients and was associated with all vertebral fractures. A history of vitamin D deficiency occurred in 84%, and 35% were currently deficient. Despite chronic vitamin D supplementation, 38% remained deficient. These results demonstrate that osteoporosis and fracture remain major concerns in Duchenne muscular dystrophy. Bone health should be optimized well before loss of ambulation, however current levels of vitamin D supplementation may be inadequate given high levels of deficiency. PMID:27221372

  9. Magnetic resonance imaging to detect vesico-symphyseal fistula following robotic prostatectomy

    Directory of Open Access Journals (Sweden)

    Ryan C. Hutchinson

    2013-04-01

    Full Text Available Pubic complications following radical prostatectomy are rare. Osteitis pubis typically presents with symptoms related to irritation of the pubic rami including pain with ambulation and adduction of the leg. A 60-year-old male with prostatic adenocarcinoma underwent uneventful robotic assisted laparoscopic prostatectomy. The patient noted the onset of severe pubic pain exacerbated by ambulation approximately one month post-surgery. An abdominal/pelvic CT scan was negative for acute pathology. Due to continued discomfort, a multiplanar MRI of the pelvis was performed with and without intravenous contrast material (20 ml Omniscan. The MRI demonstrated irregularity of the bladder base and proximal urethra with a fistulous tract extending anteriorly in direct communication with the pubic symphysis joint space. Vague periarticular marrow edema-like signal and enhancement at the pubic symphysis was thought to represent osteitis pubis. The patient's symptoms resolved after one month of urethral catheter drainage, intravenous antibiotics, and anti-inflammatory therapy.

  10. International EMS Systems

    DEFF Research Database (Denmark)

    Langhelle, Audun; Lossius, Hans Morten; Silfvast, Tom;

    2004-01-01

    . Access to on-line medical advice of a physician is not available; (2) Finland: the autonomy of the individual municipalities and their responsibility to cover for primary and specialised health care, as well as the EMS, and the lack of supporting or demanding legislation regarding the EMS; (3) Iceland is...... the only country that has emergency medicine (EM) as a recognised speciality but there is a need for more fully trained specialists in EM; (4) Norway: the ordinary ground ambulance is pointed out as the weakest link in the EM chain and a health reform demands extensive co-operation between the new...... health enterprises to re-establish a nation-wide air ambulance service; (5) Sweden: to create evidence based medicine standards for treatment in emergency medicine, a better integration of all part of the chain of survival, a formalised education in EM and a nation wide physician staffed helicopter EMS...

  11. Bilateral Ankle and Subtalar Joint Fusion Secondary to Guillain Barré-Induced Foot Drop.

    Science.gov (United States)

    Seidel, Jay; Mathew, Bindu; Marks, Jeffrey

    2016-01-01

    Guillain-Barré syndrome is a serious disorder that occurs when the body's immune system mistakenly attacks the peripheral nervous system. This leads to nerve inflammation and damage that can cause muscle weakness and/or paralysis, including foot drop. Therapy ranges from supportive measures, such as physical therapy, to surgical intervention. It appears from the published data that these patients, generally, have been left to their own devices, because no known cure is available, necessitating reliance on others for their daily activities and ambulation. We present a unique surgical option, with a follow-up period of 24 months, in which bilateral subtalar and ankle fusion allowed unassisted ambulation to a patient who might otherwise have never walked again. PMID:25128306

  12. Time telling devices used in Danish health care are not synchronized

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Hosbond, Susanne; Petersen, Dan Brun;

    2012-01-01

    Many patients begin their encounter with the health-care services in an ambulance. In some critical patients, it is pivotal that the timing of treatment and events is registered correctly. When patients are transferred from one health care provider to another, there is a risk that the time tellin...... devices used are not synchronized. It has never been examined if this is a problem in Denmark. We performed the present study to examine if time telling devices used in the pre-hospital setting were synchronized with devices used in emergency departments.......Many patients begin their encounter with the health-care services in an ambulance. In some critical patients, it is pivotal that the timing of treatment and events is registered correctly. When patients are transferred from one health care provider to another, there is a risk that the time telling...

  13. Electronic registration of out-of-hospital cardiac arrests

    DEFF Research Database (Denmark)

    Nielsen, Niels Dalsgaard; Dahl, Michael; Gade, John;

    2007-01-01

    patients according to whether they received first aid, the identity of the first aid provider and the initial cardiac rhythm as diagnosed by the patient monitor.   Results: 18,666 patients where in contact with an emergency ambulance in the study period. Of those 296 (89/100,000/year) met the definition of...... cardiac arrest. 83 of those (28 %) received first aid. The first aid was provided by layman (68 %), physicians (11 %), nurses (11 %) and first-aiders (4 %). In 6 % the identity of the first aid provider was unknown. The majority of the patients (n = 177 (58 %)) had asystole upon ambulance arrival. 37 (12...... considerably higher incidence rate for OHCA, than documented by the analogue nationwide registry. Further we discovered a high rate of first aid to OHCA-patients. Finally our data showed a high occurence of asystolia in patients who met the official criteria for OHCA....

  14. Consequences of insecurity in emergency telephone consultations: an experimental study in medical students.

    OpenAIRE

    Barth, Jürgen; Ahrens, Regina; Schaufelberger, Mireille

    2014-01-01

    QUESTION UNDER STUDY Handling emergency telephone consultations (ETCs) is a challenging and very important task for doctors. The aims of the study were to document insecurity in medical students during ETCs and to identify the reasons for that insecurity. We hypothesised that insecurity is associated with advising more urgent action (e.g. advice to call for an ambulance) in ETCs. METHODS We used ETCs with simulated patients (SPs), with each student randomly allocated two of four p...

  15. Management of cardiac arrest in the community: a survey of resuscitation services.

    OpenAIRE

    Jones, R. H.

    1983-01-01

    A survey of the English health regions identified nine ambulance based resuscitation schemes. Their structure and function are heterogeneous and their impact on patient survival is often speculative. There is considerable medical, paramedical, and lay enthusiasm for resuscitation schemes but this cannot be harnessed until medicolegal uncertainties are removed and guidelines for development are set out. Better documentation of the benefits of existing schemes should be undertaken so that advan...

  16. An update on the management of chronic inflammatory demyelinating polyneuropathy

    OpenAIRE

    Gorson, Kenneth C.

    2012-01-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune mediated disorder of the peripheral nervous system with clinical features that include weakness, sensory loss, imbalance, pain and impaired ambulation which may lead to substantial disability. This review highlights current treatment strategies for CIDP, how best to utilize proven therapies such as intravenous immunoglobulin, oral prednisone, pulse dexamethasone, and plasma exchange, and when and how to use alternative immu...

  17. Equipment to prevent, diagnose, and treat hypothermia: a survey of Norwegian pre-hospital services

    OpenAIRE

    Karlsen, Anders M; Thomassen, Øyvind; Vikenes, Bjarne H.; Brattebø, Guttorm

    2013-01-01

    Introduction Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. Method In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air...

  18. Informationssystem Versorgungsdaten bei DIMDI nimmt Pilotbetrieb auf

    OpenAIRE

    Müller, W.

    2014-01-01

    Am 17. Februar 2014 nimmt das neue Informationssystem Versorgungsdaten (Datentransparenz) des DIMDI den Pilotbetrieb auf. Damit werden erstmals aggregierte Versorgungsdaten der gesetzlichen Krankenkassen für Analysen nutzbar. Das System eröffnet insbesondere der Versorgungsforschung neue Möglichkeiten: Zugänglich werden unter anderem ambulante und stationäre Diagnosen sowie Daten über ambulant verordnete und abgerechnete Arzneimittel. In dieser Vollständigkeit - über die verschiedenen gesetzl...

  19. Sonographische Diagnostik beim akuten Abdomen bei Kindern und Erwachsenen

    OpenAIRE

    Vauth, C; ENGLERT, H; Fischer, T.; Kulp, W; Greiner, W; Willich, SN; Stroever, B; Graf von der Schulenburg, JM

    2005-01-01

    Introduction The acute abdomen is the main term for an at first unclear emergency situation of the abdominal cavity. The acute abdomen belongs to the three most important reasons for the admission of patients into the emergency room. Further, this illness ranks 40% of all consultations in the ambulant care sector. The acute abdomen requires an early and direct diagnosis because of its potential of having a life threatening differential diagnosis. This HTA report aimed to assess the ultrasoun...

  20. "DETERMINANTS OF PREHOSPITAL DELAY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION"

    OpenAIRE

    Alidoosti, M

    2004-01-01

    Determination of pre-hospital delay time of patients with acute myocardial infarction and seeking ways of speeding up the time for reperfusion is an important factor to lower mortality in these patients. This is a cross-sectional study to determine pre-hospital delay time, its components, and related causes and conditions, obtained in 375 patients with prolonged chest pain referred to four hospitals of Tehran University of Medical Sciences. Means of transport to hospital, reasons of ambulance...

  1. The Myocardial Ischaemia National Audit Project (MINAP)

    OpenAIRE

    Herrett, Emily; Smeeth, Liam; Walker, Lynne; Weston, Clive; MINAP Academic Group; Fox, Keith

    2010-01-01

    AIMS OF MINAP: To audit the quality of care of patients with acute coronary syndrome and provide a resource for academic research. QUALITY OF CARE INTERVENTIONS: Feedback to hospitals, ambulance services and cardiac networks regarding benchmarking of performance against national standards and targets. SETTING: All 230 acute hospitals in England and Wales. Years: 2000-present. POPULATION: Consecutive patients, unconsented. Current number of records: 735 000. STARTPOINTS: Any acute coronary syn...

  2. Biochemical assessment of pancreatic disease in human immunodeficiency virus infected men.

    OpenAIRE

    Hancock, M R; N..A. Smith; Hawkins, D A; Gazzard, B; Ball, S G

    1997-01-01

    AIM: To determine the usefulness of measuring amylase activity as an indicator of pancreatic disease in human immunodeficiency virus (HIV) positive patients. METHODS: A prospective study of 129 ambulant HIV positive males. Total amylase, pancreatic amylase, and lipase activities were assayed using commercial test kits on an automated analyser. Samples with raised amylase were examined for the presence of macroamylasaemia using cellulose acetate electrophoresis. RESULTS: Thirty six (28%) of th...

  3. Surgical treatment of lymphedema of the penis and scrotum Tratamento cirúrgico do linfedema peno-escrotal

    OpenAIRE

    Miguel Modolin; Anuar Ibrahim Mitre; José Carlos Faes da Silva; Wilson Cintra; Ana Paula Quagliano; Sami Arap; Marcus Castro Ferreira

    2006-01-01

    PURPOSE: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by r...

  4. Effectiveness, Mediators, and Effect Predictors of Internet Interventions for Chronic Cancer-Related Fatigue : The Design and an Analysis Plan of a 3-Armed Randomized Controlled Trial

    OpenAIRE

    Wolvers, Marije DJ; Bruggeman-Everts, Fieke Z; van der Lee, Marije L; van de Schoot, Rens; Vollenbroek-Hutten, Miriam MR

    2015-01-01

    BACKGROUND: Internet interventions offer advantages that especially cancer survivors who suffer from fatigue could benefit from. Given the growing number of such patients, Internet interventions could supplement and strengthen currently available health care. OBJECTIVE: This paper describes the design and analysis plan that will be used to study 2 Internet interventions aimed at reducing severe fatigue in cancer survivors: a mobile ambulant activity feedback therapy supported through a weekly...

  5. Pre-hospital non-invasive ventilation for acute respiratory failure: a systematic review and cost-effectiveness evaluation.

    OpenAIRE

    Pandor, A; Thokala, P.; Goodacre, S; Poku, E.; Stevens, J.W.; Ren, S.; Cantrell, A.; Perkins, G.D.; Ward, M.; Penn-Ashman, J.

    2015-01-01

    BACKGROUND: Non-invasive ventilation (NIV), in the form of continuous positive airway pressure (CPAP) or bilevel inspiratory positive airway pressure (BiPAP), is used in hospital to treat patients with acute respiratory failure. Pre-hospital NIV may be more effective than in-hospital NIV but requires additional ambulance service resources. OBJECTIVES: We aimed to determine the clinical effectiveness and cost-effectiveness of pre-hospital NIV compared with usual care for adults presenting to t...

  6. Hospital Admissions from Nursing Homes: Rates and Reasons

    OpenAIRE

    Geir Egil Eide; Kristian Jansen; Anders Grimsmo; Kjell Krüger; Jonn Terje Geitung

    2011-01-01

    Hospital admissions from nursing homes have not previously been investigated in Norway. During 12 months all hospital admissions (acute and elective) from 32 nursing homes in Bergen were recorded via the Norwegian ambulance register. The principal diagnosis made during the stay, length of stay, and the ward were sourced from the hospital's data register and data were merged. Altogether 1,311 hospital admissions were recorded during the 12 months. Admissions from nursing homes made up 6.1% of ...

  7. Accuracy of StepWatch™ and ActiGraph Accelerometers for Measuring Steps Taken among Persons with Multiple Sclerosis

    OpenAIRE

    Brian M. Sandroff; Motl, Robert W.; Pilutti, Lara A.; Learmonth, Yvonne C.; Ipek Ensari; Deirdre Dlugonski; Klaren, Rachel E; Swathi Balantrapu; Barry J Riskin

    2014-01-01

    INTRODUCTION: There has been increased interest in the objective monitoring of free-living walking behavior using accelerometers in clinical research involving persons with multiple sclerosis (MS). The current investigation examined and compared the accuracy of the StepWatch activity monitor and ActiGraph model GT3X+ accelerometer for capturing steps taken during various speeds of prolonged, over-ground ambulation in persons with MS who had mild, moderate, and severe disability. METHODS: Sixt...

  8. Integrity of the Anterior Visual Pathway and Its Association with Ambulatory Performance in Multiple Sclerosis

    OpenAIRE

    Swathi Balantrapu; Brian M. Sandroff; Pula, John H.; Motl, Robert W.

    2013-01-01

    Background. Retinal nerve fiber layer thickness (RNFLT) and total macular volume (TMV) represent markers of neuroaxonal degeneration within the anterior visual pathway that might correlate with ambulation in persons with multiple sclerosis (MS). Objective. This study examined the associations between RNFLT and TMV with ambulatory parameters in MS. Methods. Fifty-eight MS patients underwent a neurological examination for generation of an expanded disability status scale (EDSS) score and measur...

  9. Prehospital quality improvement: past , present and future

    OpenAIRE

    Siriwardena, A Niroshan

    2015-01-01

    This keynote lecture describes developments in prehospital and ambulance quality improvement in the UK. Firstly it maps progress in the past decade focussing on the national structures for research and audit, the development of clinical indicators and the use of quality improvement methods to advance performance in key areas of clinical practice. Secondly, it discusses key areas of interest for current improvement studies. Finally it presents future research likely to affect quality of care a...

  10. Cardiovascular Responses Associated with Daily Walking in Subacute Stroke

    OpenAIRE

    Prajapati, Sanjay K.; Avril Mansfield; Gage, William H; Dina Brooks; McIlroy, William E.

    2013-01-01

    Despite the importance of regaining independent ambulation after stroke, the amount of daily walking completed during in-patient rehabilitation is low. The purpose of this study is to determine if (1) walking-related heart rate responses reached the minimum intensity necessary for therapeutic aerobic exercise (40%–60% heart rate reserve) or (2) heart rate responses during bouts of walking revealed excessive workload that may limit walking (>80% heart rate reserve). Eight individuals with suba...

  11. Results of a bone splint technique for the treatment of lower limb deformities in children with type I osteogenesis imperfecta

    OpenAIRE

    Dasheng Lin; Wenliang Zhai; Kejian Lian; Zhenqi Ding

    2013-01-01

    Background: Children with osteogenesis imperfecta (OI) can suffer from frequent fractures and limb deformities, resulting in impaired ambulation. Osteopenia and thin cortices complicate orthopedic treatment in this group. This study evaluates the clinical results of a bone splint technique for the treatment of lower limb deformities in children with type I OI. The technique consists of internal plating combined with cortical strut allograft fixation. Materials and Methods: We prospectivel...

  12. Psychometric evaluation of a functional walking test for children with cerebral palsy

    OpenAIRE

    Doyle, Aoife

    2009-01-01

    The aim of this study was to examine the psychometric properties of the Functional Walking Test (FWT) for a sample of ambulant children with Cerebral Palsy (CP). This included a review of the reliability, validity and sensitivity of the FWT. CP is a lifelong condition that challenges the individual child and their family. The majority of children with CP will walk either with or without the need for assistive mobility aids. These children will, however, all display some degree of pathologi...

  13. Why nursing care is missed?

    OpenAIRE

    Wiwanitkit V

    2014-01-01

    Nursing care is an important part for success of clinical therapeutics and diagnosis. The problem of nursing care can be seen elsewhere. An important consideration is on missed nursing care. The common elements of missed nursing care usually lie on these scopes: “ambulation, turning, delayed or missed feedings, patient teaching, discharge planning, emotional support, hygiene, intake and output documentation, and surveillance.”

  14. The use of out of hours health services: a cross sectional survey.

    OpenAIRE

    Brogan, C.; Pickard, D.; Gray, A; Fairman, S; Hill, A.

    1998-01-01

    OBJECTIVES: To determine the use and costs of the principal out of hours health services in Buckinghamshire. DESIGN: Prospective cross sectional survey and cost description of patient contacts with out of hours services. SETTING: Buckinghamshire during March and April 1995. SUBJECTS: General practices, accident and emergency departments, ambulance services, and community nursing services. MAIN OUTCOME MEASURE: Contacts with patients and cost of out of hours services. RESULTS: 438 patient cont...

  15. Ambulatory Blood Pressure Monitoring and Circadian Rhythm of Blood Pressure in Diabetes Mellitus

    OpenAIRE

    Elena Matteucci; Ottavio Giampietro

    2013-01-01

    Systolic and diastolic blood pressures display a circadian rhythmicity that can be assessed by 24-hour ambulatory blood pressure monitoring and analysed using the cosinor procedure. Altered characteristics to the circadian rhythm of blood pressure, which may result in adverse health outcomes, have been observed in both prediabetes and diabetes. We have investigated the circadian variability of blood pressure in patients with type 1 and type 2 diabetes. Chronobiologically interpreted ambulator...

  16. Search Engine Advertising: Channel Substitution when Pricing Ads to Context

    OpenAIRE

    Avi Goldfarb; Catherine Tucker

    2010-01-01

    We explore substitution patterns across advertising platforms. Using data on the advertising prices paid by lawyers for 139 Google search terms in 195 locations, we exploit a natural experiment in "ambulance-chaser" regulations across states. When lawyers cannot contact clients by mail, advertising prices per click for search engine advertisements are 5%-7% higher. Therefore, online advertising substitutes for offline advertising. This substitution toward online advertising is strongest in ma...

  17. Dentist’s drill allergy?

    OpenAIRE

    Sainsbury, David; Jaiganesh, Thiagarajan

    2010-01-01

    Subcutaneous emphysema of the face and neck can develop following restorative dentistry, particularly when air turbine drills are used. We present a case in which the dentist mistook the subcutaneous emphysema following such a procedure for an allergic/anaphylactic reaction and sent him to the emergency department in an ambulance. The differential diagnosis and the subsequent management, including the role of oxygen and techniques to prevent such complications, are discussed.

  18. Lymphoma of the Base of the Tongue: An Incidental Finding on the Preoperative Workup for a Spine Surgery

    OpenAIRE

    Walid, Mohammad Sami

    2009-01-01

    Lymphoma of the tongue is very rare and accounts for 1% of all malignant tumors of the oral cavity. We present a patient who presented with weakness and difficulties with ambulation who was a known cervical spine spondylosis and stenosis patient. During the preoperative workup for cervical spine surgery a tumor at the base of the tongue was discovered which was confirmed by pathology to be a lymphoma. Keywords Lymphoma; Tongue; Spine surgery; Preoperative workup

  19. Towards a molecular phylogeny of the Euglenozoa: analyses of ribosomal DNA sequences and deduced secondary structure elements

    OpenAIRE

    Pärschke, Stefan

    2016-01-01

    To shed light on the disputed molecular phylogeny of Euglenozoa, SSU rDNA sequences of an uncultured Peranema sp. (wild) and cultured Ploeotia edaphica (CCAP 1265/2) were isolated and a database was created containing a great many euglenozoan SSU rDNA sequences. Additionally, new LSU rDNA sequences were isolated from diplonemid Rhynchopus euleeides (ATCC 50226) and Diplonema ambulator (ATCC 50223) as well as of phagotrophic euglenids Entosiphon sulcatum (CCAP 1220/1B), Notosolenus ostium (wil...

  20. Overexpression of Latent TGFβ Binding Protein 4 in Muscle Ameliorates Muscular Dystrophy through Myostatin and TGFβ

    OpenAIRE

    Kay-Marie Lamar; Sasha Bogdanovich; Gardner, Brandon B.; Gao, Quan Q.; Tamari Miller; Earley, Judy U.; Michele Hadhazy; Vo, Andy H.; Lisa Wren; Molkentin, Jeffery D.; McNally, Elizabeth M.

    2016-01-01

    Latent TGFβ binding proteins (LTBPs) regulate the extracellular availability of latent TGFβ. LTBP4 was identified as a genetic modifier of muscular dystrophy in mice and humans. An in-frame insertion polymorphism in the murine Ltbp4 gene associates with partial protection against muscular dystrophy. In humans, nonsynonymous single nucleotide polymorphisms in LTBP4 associate with prolonged ambulation in Duchenne muscular dystrophy. To better understand LTBP4 and its role in modifying muscular ...

  1. Corticosteroid Treatment Impact on Spinal Deformity in Duchenne Muscular Dystrophy

    OpenAIRE

    Sanzarello, Ilaria; Merlini, Luciano; Traina, Francesco; Rosa, Michele Attilio; Faldini, Cesare

    2014-01-01

    Duchenne muscular dystrophy is a progressive disease with loss of ambulation at around 9-10 years of age, followed, if untreated, by development of scoliosis, respiratory insufficiency, and death in the second decade of life. This review highlights the natural history of the disease, in particular, with regard to the development of the spinal deformity and how this complication has been modified by surgical interventions and overall by corticosteroid treatment. The beneficial effect of cortic...

  2. The Canadian experience with long term deflazacort treatment in Duchenne muscular dystrophy

    OpenAIRE

    McADAM, LAURA C.; MAYO, AMANDA L.; Benjamin A Alman; Biggar, W. Douglas

    2012-01-01

    Deflazacort is the most commonly prescribed corticosteroid for the treatment of Duchenne muscular dystrophy in Canada. We review the long term experience with deflazacort treatment at two centers in Canada; Montreal and Toronto. Deflazacort has benefitted both cohorts by prolonged ambulation, preserved cardiac and respiratory function, less scoliosis and improved survival. Common side effects in both cohorts include weight gain, decreased height and cataract formation. The Canadian experience...

  3. Obstructive apnoeas in Duchenne muscular dystrophy.

    OpenAIRE

    Khan, Y.; Heckmatt, J Z

    1994-01-01

    BACKGROUND--In order to clarify the treatment of sleep hypoxaemias in Duchenne muscular dystrophy polysomnographic studies were performed on patients at home with the purpose of recruiting them into two clinical therapeutic trials. Observations concerning the nature of sleep hypoxaemia in these patients are presented. METHODS--Twenty one non-ambulant patients with Duchenne muscular dystrophy aged 13-23 years with no symptoms of sleep hypoventilation or apnoea were studied for two consecutive ...

  4. Taking a PAWS to Reflect on How the Work of a Therapy Dog Supports a Trauma-Informed Approach to Prisoner Health

    OpenAIRE

    Dell Colleen Anne; Poole, Nancy

    2015-01-01

    Canada’s Correctional Investigator has found that mental health disorders, alone or in combination with alcohol and drug abuse, challenge public health and safety. Trauma is a key contributor among Canada’s inmate population. Therapy dogs can assist in supporting individuals with mental health, addiction, and trauma concerns. This case report presents the work of a St. John Ambulance therapy dog in a trauma-informed approach to prisoner health. The Substance Abuse and Mental Health Services A...

  5. Implementation of a pre-hospital decision rule in general practice. Triage of patients with suspected myocardial infarction

    OpenAIRE

    Grijseels, Els; Deckers, Jaap; Hoes, Arno; Boersma, Eric; Hartman, J.A.M.; van der Does, Emiel; Simoons, Maarten

    1996-01-01

    textabstractOBJECTIVE: To improve pre-hospital triage of patients with suspected acute cardiac disease. DESIGN: Prospective study. SUBJECTS. Patients with symptoms suggestive of acute cardiac pathology, who were seen by a general practitioner, for whom acute admission into hospital was requested, and in whom a pre-hospital electrocardiogram was recorded by the ambulance service. METHODS: The study consisted of two phases. In the first phase, a decision rule was developed based on clinical cha...

  6. Zur Geschichte der Tierärztlichen Ambulanz Schwarzenbek (TAS) des Fachbereichs Veterinärmedizin an der Freien Universität Berlin 1979 bis 1997

    OpenAIRE

    Ribbat, Cosima

    2010-01-01

    By screening various sources, such as handouts, lectures, official and personal correspondence, and interviewing historical eyewitnesses, it was possible to reconstruct the history and document the importance of the Veterinary Ambulance and Diagnostic Services Schwarzenbek. Before 1989, when Germany was devided and Berlin in an insular situation separated from the Federal Republic, it seemed necessary to establish a field station of training for students studying at the Faculty of Veterina...

  7. Modelo hipercubo integrado a um algoritmo genético para análise de sistemas médicos emergenciais em rodovias The hypercube queuing model integrated to a genetic algorithm to analyze emergency medical systems on highways

    Directory of Open Access Journals (Sweden)

    Ana Paula Iannoni

    2006-04-01

    Full Text Available O modelo hipercubo, conhecido na literatura de problemas de localização de sistemas servidor para cliente, é um modelo baseado em teoria de filas espacialmente distribuídas e aproximações Markovianas. O modelo pode ser modificado para analisar os sistemas de atendimentos emergenciais (SAEs em rodovias, considerando as particularidades da política de despacho destes sistemas. Neste estudo, combinou-se o modelo hipercubo com um algoritmo genético para otimizar a configuração e operação de SAEs em rodovias. A abordagem é efetiva para apoiar decisões relacionadas ao planejamento e operação destes sistemas, por exemplo, em determinar o tamanho ideal para as áreas de cobertura de cada ambulância, de forma a minimizar o tempo médio de resposta aos usuários e o desbalanceamento das cargas de trabalho das ambulâncias. Os resultados computacionais desta abordagem foram analisados utilizando dados reais do sistema Anjos do Asfalto (rodovia Presidente Dutra.The hypercube model, well-known in the literature on problems of server-to-customer localization systems, is based on the spatially distributed queuing theory and Markovian analysis approximations. The model can be modified to analyze Emergency Medical Systems (EMSs on highways, considering the particularities of these systems' dispatching policies. In this study, we combine the hypercube model with a genetic algorithm to optimize the configuration and operation of EMSs on highways. This approach is effective to support planning and operation decisions, such as determining the ideal size of the area each ambulance should cover to minimize not only the average time of response to the user but also ambulance workload imbalances, as well as generating a Pareto efficient boundary between these measures. The computational results of this approach were analyzed using real data Anjos do Asfalto EMS (which covers the Presidente Dutra highway.

  8. Interdisciplinary Team Collaboration Within the Incident Command Post: A Case Study of Oslo and South-Eastern Norway

    OpenAIRE

    2012-01-01

    The Norwegian Emergency Response Service is built on collaboration between public, private and voluntary organizations, with the police, the fire and rescue service and the ambulance service outlining the primary response units. The emergency response work involves interdisciplinary team collaboration between different units and between the operational commanders within the Incident Command Post. A common language and shared understanding of the situation is essential for emergency response t...

  9. Bone marrow stem cells and their role in angiogenesis Células-tronco da medula óssea e seu papel na angiogênese

    OpenAIRE

    Paulo Eduardo Ocke Reis

    2005-01-01

    The degree of symptomatology of a patient with peripheral arterial disease dictates the kind of treatment. Despite the known therapies, some patients continue to have pain with ambulation, which affects their quality of life. The therapeutic implications of the angiogenic growth factors were identified by the pioneering studies of Folkman et al. 2 decades ago. Further investigations established the possibility of the use of formulations of recombinant angiogenic growth factors, with the objec...

  10. Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel

    OpenAIRE

    Alexander Wolkow; Sally Ferguson; Brad Aisbett; Luana Main

    2015-01-01

    Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel) that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextual...

  11. Establishing the Aus-ROC Australian and New Zealand out-of-hospital cardiac arrest Epistry

    OpenAIRE

    Beck, Ben; Bray, Janet; Smith, Karen; Walker, Tony; Grantham, Hugh; Hein, Cindy; Thorrowgood, Melanie; Smith, Anthony; Smith, Tony; Dicker, Bridget; Swain, Andy; Bailey, Mark; Bosley, Emma; Pemberton, Katherine; Cameron, Peter

    2016-01-01

    Introduction Out-of-hospital cardiac arrest (OHCA) is a global health problem with low survival. Regional variation in survival has heightened interest in combining cardiac arrest registries to understand and improve OHCA outcomes. While individual OHCA registries exist in Australian and New Zealand ambulance services, until recently these registries have not been combined. The aim of this protocol paper is to describe the rationale and methods of the Australian Resuscitation Outcomes Consort...

  12. A simple and safe technique for tibial lengthening.

    Science.gov (United States)

    Rezaian, S M; Abtahi, M

    1986-06-01

    This is a report of long-term results and complications in 62 patients. Closed tibial osteotomy, direct tibial distraction, and simultaneous indirect proximal fibular epiphyseal distraction are the essential features of this new technique. Fibular osteotomy and complications from tibiofibular synostosis are eliminated. Bone graft and plating procedures have been proven to be unnecessary. The patient is ambulated immediately. Hospitalization has been reduced to a few days. PMID:3720089

  13. Helicopter emergency medical services response times in Norway: Do they matter?

    OpenAIRE

    Zakariassen, Erik; Uleberg, Oddvar; Røislien, Jo

    2015-01-01

    Objective. The main objective of the Norwegian air ambulance service is to provide advanced emergency medicine to critically ill or severely injured patients. The government has defined a time frame of 45 minutes as the goal within which 90% of the population should be reached. The aims of this study were to document accurate flying times for rotor wing units to the scene and to determine the rates of acute primary missions in Norway. Methods. We analyzed operational data from every acute...

  14. Difficulties in Management of Occupational Exposure in Our Country: A Case Report

    OpenAIRE

    Yilmaz, Serkan; PEKDEMİR, Murat; Elif YAKA

    2012-01-01

    Occupational exposure to hazardous materials is a serious problem in developing countries. Unfortunately, the different presentations result in nonspecific clinical syndromes, making diagnosis difficult.We discuss lessons learned during the assessment and treatment of occupational exposure in two industrial workers. Two employees of a facility that manufactures plastic floor covering were admitted to the emergency department with complaints including inability to ambulate, lethargy and dizzin...

  15. Barriers and facilitators for people from minority ethnic groups accessing prehospital care: a systematic review

    OpenAIRE

    Phung, Viet-Hai; Windle, Karen; Ortega, Marishona; Essam, Nadya; Barot, Mukesh; Kai, Joe; Johnson, Mark; Siriwardena, Niro

    2015-01-01

    ABSTRACT Background Despite its increasing importance, equity remains an unrealised aspiration in healthcare. People from minority ethnic groups are proportionately less likely to access emergency and hospital services than the majority White population, despite higher levels of need. Our systematic literature review and narrative synthesis aimed to identify the barriers or facilitators to accessing ambulance and paramedic care for minority ethnic patients. In doing so, the review expl...

  16. 完形填空专项练习

    Institute of Scientific and Technical Information of China (English)

    王国军

    2010-01-01

    @@ An 1 woman died and several other passengers wore critically injured when a 2 Virgin express train crashed in Cumbria last night. A huge rescue operation involving BAF helicopters and 3 ambulances arrived after passengers were trapped in the train 4 mole than four hours because 5 power line poles made acceess for emergency workers difficult. Authorities reported 6 80 injuries.Thirteen people were taken to hospital in a "critical 7 serious condition".

  17. Nerve stimulator-guided thoracic paravertebral block for gynecomastia surgery

    OpenAIRE

    Ashok Jadon

    2012-01-01

    Thoracic paravertebral block (TPVB) is gaining popularity for female breast surgeries due to various advantages like less nausea and vomiting and better post-operative pain relief, which helps in early ambulation and discharge from the hospital. Use of nerve stimulator during this block has further enhanced its success and safety profile. Male breast surgery is usually done either under general anaesthesia or local infiltrative anaesthesia combining with intravenous sedation. We postulated th...

  18. Continuous epidural infusion of morphine versus single epidural injection of extended-release morphine for postoperative pain control after arthroplasty: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Stephanie Vanterpool

    2010-06-01

    Full Text Available Stephanie Vanterpool, Randall Coombs, Karamarie FechoDepartment of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USABackground: This study retrospectively compared the continuous epidural infusion of morphine with a single epidural injection of extended-release morphine for postoperative pain control after arthroplasty.Methods: Medical records were reviewed for subjects who had total knee or hip arthroplasty (THA under spinal anesthesia and received either a continuous epidural infusion of morphine (Group EPID; n = 101 or an extended-release epidural morphine (Group EREM; n = 109 for postoperative pain. Data were collected for three postoperative days (POD on: pain scores; supplemental opioids; medications for respiratory depression, nausea, and pruritus, and distance ambulated during physical therapy.Results: Pain scores were similar until subjects were transitioned to another analgesic approach on POD 2; after that time, pain scores increased in Group EPID, although they decreased in Group EREM. Supplemental opioids were used more on POD1 in Group EREM than in Group EPID, although time to first opioid and total daily morphine equivalents were similar. Naloxone and antiemetics, not antipruritics, were used more in Group EREM. Distance ambulated after THA was greater in Group EREM than in Group EPID.Conclusions: These results suggest that EREM is associated with better postoperative ambulation and analgesia during the transition to oral or intravenous analgesics, although a higher incidence of side-effects was evident.Keywords: continuous epidural morphine infusion, extended-release epidural morphine, lower extremity arthroplasty, ambulation, postoperative pain, side-effects

  19. Semesterprojekt 3

    DEFF Research Database (Denmark)

    Sørensen, John Aasted; Holst-Christensen, Bo; Tolstrup Jensen, Jytte;

    2011-01-01

    Projektet er opdelt i følgende to mål: 1.At planlægge videreførelsen af en prototype til et system, der hånd-terer patientkontakt før, mellem og efter indlæggelser samt ambulant behandling. 2.At planlægge og konstruere en Matlab baseret simulator til et patient monitoreringssystem for fysiologisk...

  20. Endpoint measures in the mdx mouse relevant for muscular dystrophy pre-clinical studies

    OpenAIRE

    Kobayashi, Yvonne M.; Rader, Erik P; Crawford, Robert W.; Campbell, Kevin P.

    2011-01-01

    Loss of mobility influences the quality of life for patients with neuromuscular diseases. Common measures of mobility and chronic muscle damage are the six-minute walk test and serum creatine kinase. Despite extensive pre-clinical studies of therapeutic approaches, characterization of these measures is incomplete. To address this, a six-minute ambulation assay, serum creatine kinase, and myoglobinuria were investigated for the mdx mouse, a dystrophinopathy mouse model commonly used in pre-cli...

  1. “The Forgotten Helpers? Life After the Emergency Services”

    OpenAIRE

    Bracken-Scally, Mairead

    2015-01-01

    Background: The impact of emergency service work on the health and well-being of personnel has been well documented in the literature. Despite this, however, very little is known about the experiences of emergency service retirees and their Quality of Life (QoL). Aims: The principal aim of this study was to assess the overall QoL and wellbeing of retired emergency services (ambulance and fire) personnel. The specific objectives of the study were to: (1) ascertain the possible l...

  2. Osteopenia in cerebral palsy.

    OpenAIRE

    Shaw, N J; White, C. P.; Fraser, W. D.; ROSENBLOOM, L.

    1994-01-01

    The bone mineral density of the lumbar spine was assessed in nine non-ambulant children with cerebral palsy combined with measurements of serum 25-hydroxyvitamin D, parathyroid hormone, and urinary calcium excretion. Three children with recurrent fractures received treatment with bisphosphonates for periods ranging from 12-18 months. All the children demonstrated a severe reduction in bone mineral density even when allowance was made for their body weight. There were no consistent abnormaliti...

  3. Bringing robustness to patient flow management through optimized patient transports in hospitals

    OpenAIRE

    Hanne, T.; Melo, T; Nickel, S

    2007-01-01

    Intra-hospital transports are often required for diagnostic or therapeutic reasons. Depending on the hospital layout, transportation between nursing wards and service units is either provided by ambulances or by trained personnel who accompany patients on foot. In many large German hospitals, the patient transport service is poorly managed and lacks workflow coordination. This contributes to higher hospital costs (e.g. when a patient is not delivered to the operating room on time) and to pati...

  4. Advances in patient-controlled analgesia: the role of fentanyl ITS

    OpenAIRE

    Ian Power; Jon G McCormack

    2009-01-01

    Ian Power, Jon G McCormackDepartment of Anaesthesia, Critical Care and Pain Medicine, The University of Edinburgh, Royal Infirmary, Edinburgh, UKAbstract: Effective pain relief is an essential component of a patient’s peri-operative care package. Good analgesia has been shown to reduce the incidence of cardiovascular, respiratory and thrombo-embolic complications following surgery. Satisfactory analgesia facilitates early patient ambulation following surgery, which may reduce in-pat...

  5. Messung der Leistungsfähigkeit mit der AGARD-STRES-Battery nach partiellem Schlafentzug im Vergleich zu Alkohol und Hypoxie

    OpenAIRE

    Gür, Okan

    2011-01-01

    The DLR Institute of Aerospace Medicine evaluated pilots’ sleep pattern on long-haul flights. Several field studies revealed a shortened sleep duration, which was one part, caused by crossing time zones and the consequent jet-lag the other by short and unfavorable layover times. Similar field studies were carried out on helicopter pilots occupied in air ambulance services. They showed significantly shorter sleep durations during the days of work than in leisure time. However short sleep dura...

  6. Effect of wearing a dorsiflexion assist orthosis on mobility, perceived fatigue and exertion during the six-minute walk test in people with multiple sclerosis: a randomised cross-over protocol

    OpenAIRE

    McLoughlin James; Barr Christopher; Sturnieks Daina; Lord Stephen; Crotty Maria

    2012-01-01

    Abstract Background Fatigue in combination with gait and balance impairments can severely limit daily activities in people with multiple sclerosis (PWMS). Generalised fatigue has a major impact on walking ability, with moderately disabled PWMS experiencing difficulty in walking extended distances. Localised motor fatigue in the ankle dorsiflexors can lead to foot drop, further reducing functional ambulation. The aim of this study is to evaluate the effect of a simple dynamic dorsiflexion assi...

  7. Ankle voluntary movement enhancement following robotic-assisted locomotor training in spinal cord injury

    OpenAIRE

    Varoqui, Deborah; Niu, Xun; Mirbagheri, Mehdi M

    2014-01-01

    Background In incomplete spinal cord injury (iSCI), sensorimotor impairments result in severe limitations to ambulation. To improve walking capacity, physical therapies using robotic-assisted locomotor devices, such as the Lokomat, have been developed. Following locomotor training, an improvement in gait capabilities—characterized by increases in the over-ground walking speed and endurance—is generally observed in patients. To better understand the mechanisms underlying these improvements, we...

  8. Changes in spatiotemporal gait variables over time during a test of functional capacity after stroke

    OpenAIRE

    Tang Ada; Sibley Kathryn M; Patterson Kara K; Brooks Dina; McIlroy William E

    2009-01-01

    Abstract Background Gait dysfunction and fatigue are common post-stroke, though it is unclear how extended walking activity, as would be performed during activities of daily living, may change over time. The purpose of this study was to examine if spatial and temporal gait variables deteriorate during an extended bout of walking in a test of functional capacity after stroke. Methods 24 community dwelling, independently ambulating individuals greater than 3 months after stroke performed the Si...

  9. Functional Stretching Exercise Submitted for Spastic Diplegic Children: A Randomized Control Study

    OpenAIRE

    Mohamed Ali Elshafey; Adel Abd-Elaziem; Rana Elmarzouki Gouda

    2014-01-01

    Objective. Studying the effect of the functional stretching exercise in diplegic children. Design. Children were randomly assigned into two matched groups. Setting. Outpatient Clinic of the Faculty of Physical Therapy, Cairo University. Participants. Thirty ambulant spastic diplegic children, ranging in age from five to eight years, participated in this study. Interventions. The control group received physical therapy program with traditional passive stretching exercises. The study group rece...

  10. Co-contraction patterns of trans-tibial amputee ankle and knee musculature during gait

    OpenAIRE

    Seyedali Mahyo; Czerniecki Joseph M; Morgenroth David C; Hahn Michael E

    2012-01-01

    Abstract Background Myoelectric control of upper extremity powered prostheses has been used clinically for many years, however this approach has not been fully developed for lower extremity prosthetic devices. With the advent of powered lower extremity prosthetic components, the potential role of myoelectric control systems is of increasing importance. An understanding of muscle activation patterns and their relationship to functional ambulation is a vital step in the future development of my...

  11. Improvements in gait characteristics after intensive resistance and functional training in people with dementia: a randomised controlled trial

    OpenAIRE

    Schwenk, Michael; Zieschang, Tania; Englert, Stefan; Grewal, Gurtej; Najafi, Bijan; Hauer, Klaus

    2014-01-01

    Background Preventing and rehabilitating gait disorders in people with dementia during early disease stage is of high importance for staying independent and ambulating safely. However, the evidence gathered in randomized controlled trials (RCTs) on the effectiveness of exercise training for improving spatio-temporal gait parameters in people with dementia is scarce. The aim of the present study was to determine whether a specific, standardized training regimen can improve gait characteristics...

  12. Spinal cord compression secondary to malignant disease (Superior sulcus tumour)

    International Nuclear Information System (INIS)

    Spinal cord compression from malignant disease is a complication of cancer. A high index of suspicion is required to make an early clinical diagnosis, which can be confirmed by appropriate radiological investigation. Quality of life particularly ambulation can be preserved with radiotherapy and in some situations surgery. In few instances paralysis can be reversed with treatment. This may delay as long as 15 months. (author)

  13. Balancing intrusive illness : the experiences of people with musculoskeletal problems

    OpenAIRE

    Wiitavaara, Birgitta

    2007-01-01

    The overall aim of the present thesis was to explore and describe the health experiences of men and women with musculoskeletal problems. The specific aims of the four papers were: (I) to explore the experience of illness and wellness among ambulance personnel with musculoskeletal symptoms; (II) to explore the experience of illness and wellness among female health care personnel with musculoskeletal symptoms; (III) to explore the experience of bodily illness among people with musculoskeletal p...

  14. Metastatic spinal cord compression: radiotherapy outcome and dose fractionation

    International Nuclear Information System (INIS)

    Background and purpose: No standard dose fractionation has been defined for metastatic spinal cord compression. This retrospective analysis was undertaken to explore the impact of hypo fractionated treatment compared to conventional multi fraction treatment. Materials and methods: One hundred and two consecutive patients referred to Mount Vernon Cancer Centre with metastatic spinal canal compression confirmed on MR scan in 95% with median age 68 years (range 32-90) and main primary tumour types breast (28%), prostate (28%) and lung (20%); 51% of patients were fully ambulant at diagnosis, 41% ambulant but with paraparesis and 9% had complete paraplegia. Spinal radiotherapy was given delivering a single dose in 32% and 20 Gy in five fractions in 64%. Results: The median survival was 3.5 months; survival was significantly related to primary site and motor function at presentation. Normal ambulation was achieved in 58% at 2 weeks and 71% up to 2 months after treatment. No patient who presented with paraplegia regained function. At presentation 59% of patients had severe pain, which fell to 8% at 2 weeks. Comparing those patients who received one or two dose treatments with those who received protracted fractionation, the two groups were matched for age, sex, primary site and site of compression. Relatively more patients treated with one or two doses had paraplegia; 19% vs. 3%. Despite this outcome in the two groups was equivalent for motor and sphincter function and pain control. Conclusions: Metastatic spinal canal compression carries a poor prognosis. Urgent treatment will maintain and improve motor function in patients presenting ambulant but those who have paraplegia at presentation do not improve and have a very short survival. In this series no difference in outcome was seen between patients treated with one or two radiation doses compared to multi fraction treatment; a randomised trial comparing fractionation schedules would be justified

  15. Gene Therapy for Muscular Dystrophy: Moving the Field Forward

    OpenAIRE

    Al-Zaidy, Samiah; Rodino-Klapac, Louise; Mendell, Jerry R.

    2014-01-01

    Gene therapy for the muscular dystrophies has evolved as a promising treatment for this progressive group of disorders. While corticosteroids and/or supportive treatments remain standard of care for Duchenne muscular dystrophy (DMD), loss of ambulation, respiratory failure and compromised cardiac function is the inevitable outcome. Recent developments in genetically mediated therapies have allowed for personalized treatments that strategically target individual muscular dystrophy subtypes bas...

  16. Využití psů v záchranářské kynologii

    OpenAIRE

    Nováková, Nikola

    2013-01-01

    This Bachelor´s dissertation is focused on different uses of dogs in rescue cynology, particular bodies of the Integrated Rescue System, and voluntary organizations dealing with training of rescue dogs. In the introduction of the dissertation, the history of rescue dogs as well as the use of ambulance dogs during the First World War and the Second World War, and the progression of rescue cynology is briefly summarized. The second part of the dissertation explores the public ...

  17. Questioning Accessibility of Disable People at Sea Front, Case Study: Kyrenia & Laguna Sea Fronts in North Cyprus

    OpenAIRE

    Nikoofam, Mojdeh

    2013-01-01

    ABSTRACT: In general, accessibility is one of the main problems that the ambulant disabled people face with especially in public open spaces. This problem has negative influence on the quality of their lives because they must have equal social right with the other people. Therefore, accessibility should be handled as a significant right for the disable people in public open spaces. Nowadays, the majority of world population is living in coastline settlements. All individuals desire to go to s...

  18. Metabolic Acidosis Without Clinical Signs of Dehydration in Young Calves

    OpenAIRE

    Kasari, T R; Naylor, J M

    1984-01-01

    Metabolic acidosis without clinical signs of dehydration was diagnosed in four calves between nine and 21 days of age. In each calf either coma or depression with weakness and ataxia was observed. Two calves had slow deep respirations. Treatment with intravenous administration of solutions of sodium bicarbonate was accompanied by a rise in blood pH and a return to normal demeanor, ambulation and appetites, allowing these calves to return to their respective herds.

  19. Disease severity and functional factors associated with walking performance in polyostotic fibrous dysplasia

    OpenAIRE

    Paul, Scott M.; Gabor, Lisa R.; Rudzinski, Scott; Giovanni, David; Boyce, Alison M.; Kelly, Marilyn R.N.; Collins, Michael T.

    2013-01-01

    The purpose of this study was to determine the association between measures of disease severity, impairment, and ambulation ability in persons with polyostotic fibrous dysplasia (PFD). A cross-sectional sample of 81 patients (ages 5–57) with polyostotic fibrous dysplasia was evaluated as part of an ongoing study. Subjects were scored on the Skeletal Disease Burden Score (SDBS), completed a 9-minute walk test (9MW), manual muscle testing (MMT), and measurements of range of motion (ROM). Correl...

  20. A meta-analysis of surgery versus conventional radiotherapy for the treatment of metastatic spinal epidural disease

    OpenAIRE

    Klimo, Paul; Thompson, Clinton J.; Kestle, John R. W.; Meic H. Schmidt

    2005-01-01

    Radiotherapy has been the primary therapy for managing metastatic spinal disease; however, surgery that decompresses the spinal cord circumferentially, followed by reconstruction and immediate stabilization, has also proven effective. We provide a quantitative comparison between the “new” surgery and radiotherapy, based on articles that report on ambulatory status before and after treatment, age, sex, primary neoplasm pathology, and spinal disease distribution. Ambulation was categorized as “...

  1. X-Ray or Computed Tomography Which Comes First?

    OpenAIRE

    Sancar Serbest

    2013-01-01

      The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 28-yearold man was brought to the emergency department by ambulance. At the time of admission he was suffering left shoulder pain. On local physical examination, there was severe pain on the proximal humerus. The left arm was in internal rotation in the adducted position. On local p...

  2. Persistent Left Superior Vena Cava, The View of a Rare Case

    OpenAIRE

    H.Volkan Kara

    2013-01-01

    The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 68-yearold woman was brought to the emergency department by ambulance  with shoulder pain following a fall from stairs. On local physical examination, there was severe pain on the left proximal humerus. The left arm was in internal rotation in the adducted position. Active and passive mo...

  3. Femoroacetabular impingement: A classic case of cam-type impingement in a 21-year-old soldier

    Directory of Open Access Journals (Sweden)

    Eric Royston, DO, MPH, CPT, MC

    2014-01-01

    Full Text Available We describe a case of femoroacetabular impingement (FAI in a 21-year-old male U.S. Army Private. Pre-operative radiographs demonstrated a dysplastic bump at the right head-neck junction. The patient underwent arthroscopy and resection of the bump, resulting in a improved contour of the femoral head-neck junction. After standard recovery, he is now able to ambulate and flex his right hip without pain and has returned to full duty.

  4. 救护车

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    5GHz W-LAN Trials for High Speed Mobile Applications - Trials on An Express Train and on An Ambulance Car, Active noise control for sound of siren using the DXHS algorithm with frequency and secondary path delay estimation, Analytical study of emergency medical service rescue time, Application of distributed traffic simulation to evaluate traffic signal controller algorithms,Enterprise modeling and decision-support for automating the business rules lifecycle。

  5. Clinical association between teeth malocclusions, wrong posture and ocular convergence disorders: an epidemiological investigation on primary school children

    OpenAIRE

    Silvestrini-Biavati Armando; Migliorati Marco; Demarziani Eleonora; Tecco Simona; Silvestrini-Biavati Piero; Polimeni Antonella; Saccucci Matteo

    2013-01-01

    Abstract Background As the various systems in the body are inter-connected to form a single structural unit, a pathological condition in one area can also affect other areas. There are many known correlations between the visual and motor system. The importance of visual function, particularly the paracentral peripheral field of view, in motor coordination, ambulation and the maintenance of balance has been amply demonstrated. In line with current medical principles, which are moving towards a...

  6. Support of Future Disaster Response Using Generalized Access Networks (GANs)

    OpenAIRE

    Karagiannis, Georgios; Jones, Val; Heemstra de Groot, Sonia

    2006-01-01

    Efficient communication and coordination are major challenges experienced by the emergency services (firebrigade, police, ambulance) during the first response to a major incident. A major incident can happen anywhere and at any time, hence support for emergency communications services should be ubiquitous and independent of communication technologies and infrastructure used. We present a vision of how ambient intelligent environments may be used in the future to support the emergency services...

  7. Ad hoc networking and ambient intelligence to support future disaster response

    OpenAIRE

    Jones, Val; Karagiannis, Georgios; Heemstra de Groot, Sonia

    2005-01-01

    We present a vision of how ambient intelligent environments may be used in future to support the emergency services during first response to a major incident. A futuristic scenario is presented where, for each of the emergency services, Ambient Intelligence (AmI) technologies are used to support communication amongst the members of a virtual team. AmI is further used to enable cross service communication and coordination, e.g., between police, firefighters and ambulance teams, which may inclu...

  8. Somatosensory inputs by application of KinesioTaping: effects on spasticity, balance, and gait in chronic spinal cord injury

    OpenAIRE

    Tamburella, Federica; Scivoletto, Giorgio; Molinari, Marco

    2014-01-01

    Introduction: Leg paralysis, spasticity, reduced interlimb coordination, and impaired balance are the chief limitations to overground ambulation in subjects with incomplete spinal cord injury (SCI). In recent years, the application of KinesioTaping (KT) has been proposed to enhance sensory inputs, decreasing spasticity by proprioception feedback and relieving abnormal muscle tension. Because no studies have examined KT-based techniques in SCI subjects, our goal was to analyze the effects of a...

  9. Stop Israel!

    OpenAIRE

    Reinhart, T.

    2006-01-01

    For a whole week now, The Israeli army has been terrorizing cities and villages in the West Bank. As in the darkest days at the beginning of the present Intifada, desperate voices and reports pour through the internet, telling of massive shelling, including schools, hospitals, the university and a maternity house in Bethlehem, of curfew, houses being seized or destroyed, water tanks ruined in refugee camps. In Beit Reema, the site of Israel's latest show of horror, ambulances were not allowed...

  10. PTSD is a better predictor of somatization in high trauma exposed than in community samples

    OpenAIRE

    Maia, Ângela

    2012-01-01

    Background: The relation between PTSD symptoms’ and health, including health complaints, have been the aim of recent research, but until now no research was done comparing the relation between these variables in high exposed subjects and community samples. Methods: 1573 subjects (790 from community and 774 with trauma exposure, e.g. veterans, ambulance personnel) filled out a PTSD scale and a somatization scale. Findings: 21% of total sample report PTSD. PTSD symptoms explain 22% of som...

  11. Dopravní nehodovost a její sociální dopady

    OpenAIRE

    VLÁSEK, Vladislav

    2007-01-01

    The thesis "Accident frequency and its social effects" focuses on traffic accidents caused by trespassing the law of speed limit and on social effects induced by accident frequency. Every year approximately one thousand people die on the Czech roads, other thousands of traffic accident victims face lifelong injury consequences. Apart from direct loss of lives, health and property, the traffic accidents carry a lot of other hardly denumerable costs starting at financing trip of ambulance, cont...

  12. Current and emerging treatment strategies for Duchenne muscular dystrophy

    OpenAIRE

    Mah JK

    2016-01-01

    Jean K Mah Department of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Abstract: Duchenne muscular dystrophy (DMD) is the most common form of muscular dystrophy in childhood. It is caused by mutations of the DMD gene, leading to progressive muscle weakness, loss of independent ambulation by early teens, and premature death due to cardiorespiratory complications. The diagnosis can usually be made after careful review of the...

  13. Deep Brain Stimulation and Dantrolene for Secondary Dystonia in X-Linked Adrenoleukodystrophy

    OpenAIRE

    Van Karnebeek, Clara; Horvath, Gabriella; Murphy, Tyler; Purtzki, Jacqueline; Bowden, Kristin; Sirrs, Sandra; Honey, Christopher R.; Stockler, Sylvia

    2014-01-01

    Deep brain stimulation (DBS) has been used to treat secondary dystonias caused by inborn errors of metabolism with varying degrees of effectiveness. Here we report for the first time the application of DBS as treatment for secondary dystonia in a 22-year-old male with X-linked adrenoleukodystrophy (X-ALD). The disease manifested at age 6 with ADHD, tics, and dystonic gait, and deteriorated to loss of ambulation by age 11, and speech difficulties, seizures, and characteristic adrenal insuffici...

  14. The Dark Side of Resilience and Burnout: A Moderation-Mediation Model

    OpenAIRE

    Treglown, Luke; Palaiou, Kat; Zarola, Anthony; Furnham, Adrian

    2016-01-01

    This study tested whether specific dark-side traits may be beneficial in manifesting and maintaining Resilience, whilst others are vulnerability factors for Burnout. Four hundred and fifty-one (50 female) ambulance personnel completed three questionnaires as a part of a selection and development assessment. The study utilised the Hogan Development survey as a measure of dark side personality, the Copenhagen Burnout Inventory to assess work-related burnout, and the Resilience Scale– 14 to meas...

  15. 美国提供急救设备等医疗设备

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@ 种类:急救设备(EMS),经修复的二手医疗设备(REFURBISHED),担架床(AMBULANCE COT),除纤颤器(DEFIBRILLATORS),麻醉设备(ANESTHETIC EQUIP-MENT),脉冲血氧计(PULSE OWIMETER).联系人:CHARLES STANFORD联系单位:STANFORD WORLDWIDE地址:UNITED STATES,FLORIDA电话:(00011)+305-992-0913传真:(00011)+407-699-1767HTTP://STANFORD-WORLDWIDE.COM/

  16. Development and evaluation of a novel, real time mobile telesonography system in management of patients with abdominal trauma: study protocol

    Directory of Open Access Journals (Sweden)

    Ogedegbe Chinwe

    2012-12-01

    Full Text Available Abstract Background Despite the use of e-FAST in management of patients with abdominal trauma, its utility in prehospital setting is not widely adopted. The goal of this study is to develop a novel portable telesonography (TS system and evaluate the comparability of the quality of images obtained via this system among healthy volunteers who undergo e-FAST abdominal examination in a moving ambulance and at the ED. We hypothesize that: (1 real-time ultrasound images of acute trauma patients in the pre-hospital setting can be obtained and transmitted to the ED via the novel TS system; and (2 Ultrasound images transmitted to the hospital from the real-time TS system will be comparable in quality to those obtained in the ED. Methods Study participants are three healthy volunteers (one each with normal, overweight and obese BMI category. The ultrasound images will be obtained by two ultrasound-trained physicians The TS is a portable sonogram (by Sonosite interfaced with a portable broadcast unit (by Live-U. Two UTPs will conduct e-FAST examinations on healthy volunteers in moving ambulances and transmit the images via cellular network to the hospital server, where they are stored. Upon arrival in the ED, the same UTPs will obtain another set of images from the volunteers, which are then compared to those obtained in the moving ambulances by another set of blinded UTPs (evaluators using a validated image quality scale, the Questionnaire for User Interaction Satisfaction (QUIS. Discussion Findings from this study will provide needed data on the validity of the novel TS in transmitting live images from moving ambulances to images obtained in the ED thus providing opportunity to facilitate medical care of a patient located in a remote or austere setting.

  17. IMPROVEMENTS IN LEFT-SIDED HEMIPARESIS IN AN ELDERLY FEMALE USING FUNCTIONAL NEUROLOGY TREATMENTS.

    OpenAIRE

    Chris Sass; Susan Elizabeth Esposito

    2015-01-01

    Background: A 71-year-old female presented to a functional neurology clinic with left-sided decorticate posturing caused by a stroke eight years prior. Her symptoms included imbalance, gait disturbances, and cervicalgia. She required the use of a cane for ambulation. Her left upper extremity was completely immobilized for volitional movement, save minor function of the shoulder joint. Methods: A complete physical and neurological exam including eye movement and vestibular testing was p...

  18. Emergency pre-hospital management of patients admitted with acute asthma

    OpenAIRE

    Simpson, A; Matusiewicz, S; Brown, P.; McCall, I; Innes, J; Greening, A.; Crompton, G

    2000-01-01

    BACKGROUND—Little is known about the management of acute asthma prior to hospital admission. Pre-hospital treatment of patients referred to hospital with acute asthma was therefore studied in 150 patients divided into three groups: those in the Edinburgh Emergency Asthma Admission Service (EEAAS) who can contact an ambulance and present directly to respiratory services when symptoms arise (n = 38), those under continuing supervision at a hospital respiratory outpatient cl...

  19. Why and when citizens call for emergency help: an observational study of 211,193 medical emergency calls

    OpenAIRE

    Møller, Thea Palsgaard; Ersbøll, Annette Kjær; Tolstrup, Janne Schurmann; Østergaard, Doris; Viereck, Søren; Overton, Jerry; Folke, Fredrik; Lippert, Freddy

    2015-01-01

    Background A medical emergency call is citizens’ access to pre-hospital emergency care and ambulance services. Emergency medical dispatchers are gatekeepers to provision of pre-hospital resources and possibly hospital admissions. We explored causes for access, emergency priority levels, and temporal variation within seasons, weekdays, and time of day for emergency calls to the emergency medical dispatch center in Copenhagen in a two-year study period (December 1st, 2011 to November 30th, 2013...

  20. Pre-hospital treatment of acute poisonings in Oslo

    OpenAIRE

    Nore Anne K; Bjornaas Mari A; Hovda Knut E; Heyerdahl Fridtjof; Figueiredo Jose CP; Ekeberg Oivind; Jacobsen Dag

    2008-01-01

    Background Poisoned patients are often treated in and discharged from pre-hospital health care settings. Studies of poisonings should therefore not only include hospitalized patients. Aims: To describe the acutely poisoned patients treated by ambulance personnel and in an outpatient clinic; compare patients transferred to a higher treatment level with those discharged without transfer; and study the one-week mortality after pre-hospital discharge. ...