Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

Science.gov (United States)

Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

2018-01-05

Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

Medical Emergencies in Goa

Science.gov (United States)

Saddichha, Sahoo; Saxena, Mukul Kumar

2010-01-01

Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa's roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs) were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%), which were mainly of the nature of accidents or assaults (17%) and fever related (17%). Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa. PMID:20606921

The difficult medical emergency call

DEFF Research Database (Denmark)

Møller, Thea Palsgaard; Kjærulff, Thora Majlund; Viereck, Søren

2017-01-01

BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the ......BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories...... and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data. Logistic regression analysis (N = 78,040 individuals) was used for identification...

L-027: EPR-First Responders: First Medical Response in a radiological emergency

International Nuclear Information System (INIS)

2011-01-01

The main topics covered in this conference are the tasks and the roles of medical emergency services and the local hospital such as firsts aid in a radiological emergency, protective measures, contamination level of the victims and lifesaving

Medical emergencies in dental practice.

LENUS (Irish Health Repository)

Wilson, M H

2009-06-01

Serious medical emergencies are fortunately a rare occurrence in the dental practice environment; however, if an emergency situation is encountered a delay in treatment may result in potentially avoidable consequences. The risk of mortality or serious morbidity can be reduced by ensuring that basic emergency equipment and medications are in place, and that the dental team is appropriately trained in basic life support measures. This article aims to provide an overview of the basic emergency medications and equipment that should be present in dental practices, and to discuss specific responses to some of the more common adverse medical events that can present while providing dental treatment.

First Response to Medical Emergency

International Nuclear Information System (INIS)

Manisah Saedon; Sarimah Mahat; Muhamad Nurfalah Karoji; Hasnul Nizam Osman

2015-01-01

Accident or medical emergencies, both minor and critical, occurs each day and can happen in any workplace. In any medical emergencies, time is a critical factor because the first person to arrive at the scene of an accident has a key role in the rescue of a victim. With the knowledge of some common medical procedures and emergency actions, this first responder can make a positive contribution to the welfare of the accident victim. In some cases, this contribution can make difference between life and death. Improper response to medical emergencies by an untrained person can result in worsen injuries or death. Therefore, first aids training are necessary to provide the information. (author)

Emergency Victim Care. A Textbook for Emergency Medical Personnel.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

This textbook for emergency medical personnel should be useful to fire departments, private ambulance companies, industrial emergency and rescue units, police departments, and nurses. The 30 illustrated chapters cover topics such as: (1) Emergency Medical Service Vehicles, (2) Safe Driving Practices, (3) Anatomy and Physiology, (4) Closed Chest…

Experimental comparison of 2D and 3D technology mediated paramedic-physician collaboration in remote emergency medical situations

DEFF Research Database (Denmark)

Sonnenwald, Diane H.; Maurin, Hanna; Cairns, Bruce

2006-01-01

techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. We conducted an experimental evaluation, simulating an emergency medical situation and examining the interaction between the attending paramedic...

Outcomes of medical emergencies on commercial airline flights.

Science.gov (United States)

Peterson, Drew C; Martin-Gill, Christian; Guyette, Francis X; Tobias, Adam Z; McCarthy, Catherine E; Harrington, Scott T; Delbridge, Theodore R; Yealy, Donald M

2013-05-30

Worldwide, 2.75 billion passengers fly on commercial airlines annually. When in-flight medical emergencies occur, access to care is limited. We describe in-flight medical emergencies and the outcomes of these events. We reviewed records of in-flight medical emergency calls from five domestic and international airlines to a physician-directed medical communications center from January 1, 2008, through October 31, 2010. We characterized the most common medical problems and the type of on-board assistance rendered. We determined the incidence of and factors associated with unscheduled aircraft diversion, transport to a hospital, and hospital admission, and we determined the incidence of death. There were 11,920 in-flight medical emergencies resulting in calls to the center (1 medical emergency per 604 flights). The most common problems were syncope or presyncope (37.4% of cases), respiratory symptoms (12.1%), and nausea or vomiting (9.5%). Physician passengers provided medical assistance in 48.1% of in-flight medical emergencies, and aircraft diversion occurred in 7.3%. Of 10,914 patients for whom postflight follow-up data were available, 25.8% were transported to a hospital by emergency-medical-service personnel, 8.6% were admitted, and 0.3% died. The most common triggers for admission were possible stroke (odds ratio, 3.36; 95% confidence interval [CI], 1.88 to 6.03), respiratory symptoms (odds ratio, 2.13; 95% CI, 1.48 to 3.06), and cardiac symptoms (odds ratio, 1.95; 95% CI, 1.37 to 2.77). Most in-flight medical emergencies were related to syncope, respiratory symptoms, or gastrointestinal symptoms, and a physician was frequently the responding medical volunteer. Few in-flight medical emergencies resulted in diversion of aircraft or death; one fourth of passengers who had an in-flight medical emergency underwent additional evaluation in a hospital. (Funded by the National Institutes of Health.).

Are You Ready for Emergency Medical Services in Your Oral and Maxillofacial Surgery Office?

Science.gov (United States)

Rayner, Clive; Ragan, Michael R

2018-05-01

Efficient responses to emergencies in the oral and maxillofacial surgery office require preparation, communication, and thorough documentation of the event and response. The concept of team anesthesia is showcased with these efforts. Emergency medical services training and response times vary greatly. The oral and maxillofacial surgery office should be prepared to manage the patient for at least 15 minutes after making the call to 911. Patient outcomes are optimized when providers work together to manage and transport the patient. Oral and maxillofacial surgery offices should develop and rehearse emergency plans and coordinate these protocols with local Emergency medical services teams. Copyright © 2018 Elsevier Inc. All rights reserved.

Training programmes and experiences of medical emergency preparedness for radiation accident in Japan

Energy Technology Data Exchange (ETDEWEB)

Suzuki-Yasumoto, M

1982-01-01

Our policy of training programmes for medical radiation emergency preparedness is described. We found it is necessary to have two approaches to the training of relevant personnel. The first approach was to conduct adequate basic training of nurses and health physics personnel in large nuclear installations for medical radiation emergency preparedness. We found it was necessary to have courses for basic knowledge of nuclear radiation and industrial activities, radiation monitoring procedures, radiation injuries, human counters and wound monitors, first aid practices, and radiation medical emergency procedures including practices. The second approach was to make a simple and introductory training program on the subject using lectures and visual presentations in the vicinity of big nuclear installations for personnel relating to the nuclear industrial activities and for concerned local personnel, including medical doctors and nurses. These two training courses and approaches were planned and have been conducted. 2 refs. (DT)

Pediatric сlinic of Odessa National Medical University: the quality of emergency medical care for children

Directory of Open Access Journals (Sweden)

E.A. Starets

2017-04-01

Full Text Available Background. The purpose of the article is to discuss the issue of improving the quality of emergency care for children with the most common diseases. Materials and methods. The quality of medical care includes 6 characteristics: 1 effectiveness — evidencebased health care results in improved health outcomes; 2 relevancy: health care is delivered in a manner that maximizes resource use and avoids wasting and provided in a setting where skills and resources are appropriate to medical need; 3 accessibility: health care is provided timely, reasonable and affordable; 4 acceptability/patient-centered: health care provided takes into account the preferences and aspirations of individual service users; 5 equity: health care provided does not vary in quality because of personal characteristics or socioeconomic status; 6 safety: health care provided minimizes risks and harm to service users and providers. Results. The Intensive Care Unit (ICU started working in the Pediatric Clinic of the Odessa National Medical University on February 1, 2017. The main task of ICU is the treatment of children with emergency conditions (who needs monitoring of breathing and cardiac activity, oxygen therapy, large-volume rehydration therapy, etc. The patients admit to the ICU according the results of triage. Triage is the process of rapidly screening of sick children soon after their addmission to hospital and in ICU, in order to identify those with emergency signs — obstruc-ted breathing or severe respiratory distress; central cyanosis; signs of shock; signs of severe dehydration; those with priority signs — very high temperature, severe pallor, respiratory distress etc. The local guidelines for the most common diseases in children have been developed in the Pediatric Clinic. These local guidelines are based on: 1 modern national guidelines; 2 WHO: Pocket book of hospital care for children: guidelines for the management of common childhood illnesses (2013; clinical

Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada

Science.gov (United States)

Curran, Jeffrey; Ritchie, Stephen D.; Beardy, Jackson; VanderBurgh, David; Born, Karen; Lewko, John; Orkin, Aaron M.

2018-01-01

(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training. (2) Methods: This study adhered to the principles of community-based participatory research and realist evaluation; it was an integrated component of the formative evaluation of the second Sachigo Lake Wilderness Emergency Response Education Initiative (SLWEREI) training course in 2012. Twelve members of Sachigo Lake First Nation participated in the training course, along with local nursing staff, police officers, community Elders, and course instructors (n = 24 total), who participated in interviews, focus groups, and a collaborative discussion of local health issues in the development of the SLWEREI. (3) Results: The qualitative results are organized into sections that describe the types of local health emergencies and the informal response system of community members in addressing these emergencies. Prominent themes of health adversity that emerged were an inability to manage chronic conditions and fears of exacerbations, the lack of capacity for addressing mental illness, and the high prevalence of injury for community members. (4) Discussion: A three-point framework of what constitutes local perceptions of an emergency emerged from the findings in this study: (1) a sense of isolation; (2) a condition with a potentially adverse outcome; and (3) a need for help. PMID:29401706

Magnetic resonance image examinations in emergency medical care

International Nuclear Information System (INIS)

Yamashiro, Takanobu; Yoshizumi, Tohru; Ogura, Akio; Hongou, Takaharu; Kikumoto, Rikiya

2006-01-01

There is a growing consensus in terms of the need for effective use of magnetic resonance imaging (MRI) diagnostic devices in emergency medical care. However, a thorough assessment of risk management in emergency medical care is required because of the high magnetic field in the MRI room. To understand the conditions required for the execution of emergency MRI examinations in individual medical facilities, and to prepare guidelines for emergency MRI examinations, we carried out a questionnaire survey concerning emergency MRI examinations. We obtained responses from 71% of 230 medical facilities and used this information in considering a system of emergency MRI examinations. Moreover, some difficulties were experienced in half of the facilities where emergency MRI examinations had been enacted, the main cause of which was the medics. Based on the results of the questionnaire, guidelines are necessary to maintain an urgent system for MRI examinations. Moreover, we were able to comprehend the current state of emergency MRI examinations in other medical facilities through this investigation, and we are preparing a system for the implementation of emergency MRI examinations. (author)

Exploring the potential of video technologies for collaboration in emergency medical care

DEFF Research Database (Denmark)

Söderholm, Hanna M.; Sonnenwald, Diane H.; Manning, James E.

2008-01-01

conferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The experimental design and results concerning information behavior are presented in the article "Exploring the Potential of Video...

[New possibilities in emergency medical transportation and emergency services of Polish Medical Air Rescue].

Science.gov (United States)

Gałazkowski, Robert

2010-01-01

In Poland, two types of medical services are accomplished by the Medical Air Rescue (MAR) operating all over the country: emergency transport from the incident scene to hospital and inter-hospital transport. Helicopters or planes are used for this purpose. In 2009, helicopters performed 4359 flights to incidents and 1537 inter-hospital transports whereas planes performed 589 inter-hospital ambulance and 196 rescue flights. MAR operates from 17 bases of the Helicopter Emergency Medical Service (HEMS) and one airbase. Helicopters are mainly used when medical transport is emergent, within the operational region of a given base whereas planes when the distance between the present and target airports exceeds 250 km. In 2008, new modern aircraft were introduced to HEMS-helicopters EC 135. They fulfil all requirements of air transport regulations and are adjusted to visual (VFR) and instrumental (IFR) flights rules, at day and night. The medical cabin of EC 135 is ergonomic and functional considering the majority of rescue activities under life-saving circumstances. It is equipped with ventilator, defibrillator, infusion pumps etc. Defibrillators have 12-lead ECG, E(T)CO2, SpO2, NIBP, and IBP modules. Transport ventilators can work in a variety of ventilation modes including CMV, SIMV, SVV, BILEVEL, PCV, ASB, PPV and CPAP. The purchase of helicopters with modern avionic and medical configuration ensures high quality services of MAR for many years to come.

Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.

Science.gov (United States)

Choi, Bryan Y; Blumberg, Charles; Williams, Kenneth

2016-03-01

Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs. Observations from existing program data suggest that these systems may prevent congestive heart failure readmissions, reduce EMS frequent-user transports, and reduce emergency department visits. Additional studies are needed to support the clinical and economic benefit of mobile integrated health care and community paramedicine. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Exploring the potential of video technologies for collaboration in emergency medical care

DEFF Research Database (Denmark)

Sonnenwald, Diane H.; Söderholm, Hanna M.; Manning, James E.

2008-01-01

videoconferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The 3D telepresence technology does not yet exist, and there is a need to understand its potential before resources are spent on its...

Medical emergency management among Iranian dentists.

Science.gov (United States)

Khami, Mohammad Reza; Yazdani, Reza; Afzalimoghaddam, Mohammad; Razeghi, Samaneh; Moscowchi, Anahita

2014-11-01

More than 18,000 patients need medical emergencies management in dental offices in Iran annually. The present study investigates medical emergencies management among Iranian dentists. From the list of the cell phone numbers of the dentists practicing in the city of Tehran, 210 dentists were selected randomly. A self-administered questionnaire was used as the data collection instrument. The questionnaire requested information on personal and professional characteristics of the dentists, as well as their knowledge and self-reported practice in the field of medical emergency management, and availability of required drugs and equipments to manage medical emergencies in their offices. Totally, 177 dentists (84%) completed the questionnaire. Less than 60% of the participants were knowledgeable about characteristics of hypoglycemic patient, chest pain with cardiac origin, and true cardiopulmonary resuscitation (CPR) practice. Regarding practice, less than one quarter of the respondents acquired acceptable scores. In regression models, higher practice scores were significantly associated with higher knowledge scores (p < 0.001). The results call for a need to further education on the subject for dentists. Continuing education and changing dental curriculum in the various forms seems to be useful in enhancement of the self-reported knowledge and practice of dentists. To successful control of medical emergencies in the dental office, dentists must be prepared to recognize and manage a variety of such conditions. In addition to dentist's knowledge and skill, availability of necessary equipments and trained staff is also of critical importance.

System of medical response to radiation emergency after a terror attack in China

International Nuclear Information System (INIS)

Liu, Y.; Wang, Z.

2005-01-01

Full text: Nuclear or radiological accident is an unintended or unexpected event occurring with a radiation source or during a practice involving ionizing radiation, which may result in significant human exposure and/or material damage. Recent events involving terrorist activities have focused attention on the radiological threats. The full spectrum of radiological threats from terrorist spans the deliberate dispersal of radioactive material to the detonation of a nuclear weapon. While the most likely threat is the dispersal of radioactive materials, the use of a crude nuclear weapon against a major city cannot be dismissed. Radiological incident response requires functions similar to non-radiological incident response. Radiation emergency system in China has been established for radiological emergency preparedness and response. National coordination committee of radiation emergency has been setup in 1994, which consist of 17 ministries. The ministry is responsible for the medical assistance for radiation emergency. Chinese Center for Medical Response to Radiation Emergency (CCMRRE) was established in 1992, based on the National Institute for Radiological Protection, China CDC (NIRP, China CDC). The CCMRRE has been as one liaison institutes of WHO/REMPAN and functions as a national and professional institute for medical assistance in radiation accidents and terrorist events involving radioactive material. Under Provincial Committee of Radiation Emergency, there are local organizations of medical assistance in radiation emergency. The organizations carry out the first aid, regional clinic treatment, radiation protection and radiation monitory in nuclear accidents and radiological accidents. (author)

[Emergency Medical Technician profile in Spain].

Science.gov (United States)

Martínez-Isasi, Santiago; Rodríguez-Lorenzo, María José; Vázquez-Santamariña, David; Abella-Lorenzo, Javier; Castro Dios, Diana Josefa; Fernández García, Daniel

2017-12-11

The emergency medical technician plays a fundamental role and is the most important figure quantitatively in pre-hospital emergencies. The aim was to asses the socio-demographic, work-related, health characteristics and technical skills of an Emergency Medical Technician in Spain. Cross-sectional descriptive study. An ad hoc questionnaire was managed using Google Docs® that was delivered between April-June 2014 via email and social networks. A total of 705 questionnaires were collected. Statistical analysis was performed with SPSS ® 20.0 Windows version. A significance level p≤0.05 was used for all analyzes. The data analyzed show that the profile of the Emergency Medical Technician in Spain is an 39 year-old man, married or living as a couple and has a child. The average BMI is 27 kg/m2, does regular exercise, does not smoke. His seniority in the company is 10 years and has the Medium Cycle of Emergency Medical Technician. The analysis for gender shows that men have an average of 40, an average BMI of 27, 5 kg/m2 and work in an advanced life support unit; while women have an average of 36,5 years, an average BMI of 24,7 kg/m2, mainly work in Basic Life Support Unit and her seniority in the company is 6,76 years. Emergency Medical Technician profile is a overweight men, who refer to practise regular exercise, his seniority in the company is 10 years and is in possession of CMTES; differences were observed according to gender in BMI, resource where they perform their work, seniority and age.

Emergency Medical Service (EMS): Rotorcraft Technology Workshop

Science.gov (United States)

Bauchspies, J. S.; Adams, R. J.

1981-01-01

A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

Emergency preparedness training for local communities

International Nuclear Information System (INIS)

Cooley, M.J.; Thompson, K.K.

1987-01-01

Detroit Edison, in cooperation with Monroe County, has developed a comprehensive training program for local emergency workers in the area surrounding the Fermi 2 Nuclear Power Plant. Using expertise from both organizations, a program consisting of two videotapes, two slide-tapes and nine narrated slide series was produced to address the worker-specific training needs of county emergency workers. In June of 185, the program was approved by Detroit Edison and the Monroe County Board of Commissioners. To date, Monroe County has trained more than 1000 emergency workers. This program has been so well received that the county staff has developed and presented a modified version of this program to the general public. The result of this cooperative effort is increased public confidence in emergency preparedness at the state, local and utility level and a renewed spirit of cooperation and trust between the utility and local units of government

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities

OpenAIRE

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed u...

Medical and radiological aspects of emergency preparedness and response at SevRAO facilities.

Science.gov (United States)

Savkin, M N; Sneve, M K; Grachev, M I; Frolov, G P; Shinkarev, S M; Jaworska, A

2008-12-01

response at SevRAO facilities is a priority task within the general system of emergency preparedness; (b) there is an effective and improving interaction between SevRAO and the local medical institutions of FMBA and other territorial medical units; (c) the infrastructure of emergency response at SevRAO facilities has been created and operates within the framework of Russian legal and normative requirements. Further proposals have been made aimed at increasing the effectiveness of the available system of emergency preparedness and response, and to promote interagency cooperation.

Local address and emergency contact details

CERN Multimedia

2013-01-01

The HR Department would like to remind members of the personnel that they are responsible for ensuring that their personal data concerning local address and preferred emergency contact details remains valid and up-to-date.   Both are easily accessible via the links below: Local address: https://edh.cern.ch/Document/Personnel/LocalAddressChange   Emergency contacts: https://edh.cern.ch/Document/Personnel/EC   Please take a few minutes to check your details and modify if necessary. Thank you in advance. HR Department Head Office

Emergency Medical Care Training and Adolescents.

Science.gov (United States)

Topham, Charles S.

1982-01-01

Describes an 11-week emergency medical care training program for adolescents focusing on: pretest results; factual emergency instruction and first aid; practical experience training; and assessment. (RC)

Development of a National Consensus for Tactical Emergency Medical Support (TEMS) Training Programs--Operators and Medical Providers.

Science.gov (United States)

Schwartz, Richard; Lerner, Brooke; Llwewllyn, Craig; Pennardt, Andre; Wedmore, Ian; Callaway, David; Wightman, John; Casillas, Raymond; Eastman, Alex; Gerold, Kevin; Giebner, Stephen; Davidson, Robert; Kamin, Richard; Piazza, Gina; Bollard, Glenn; Carmona, Phillip; Sonstrom, Ben; Seifarth, William; Nicely, Barbara; Croushorn, John; Carmona, Richard

2014-01-01

Tactical teams are at high risk of sustaining injuries. Caring for these casualties in the field involves unique requirements beyond what is provided by traditional civilian emergency medical services (EMS) systems. Despite this need, the training objectives and competencies are not uniformly agreed to or taught. An expert panel was convened that included members from the Departments of Defense, Homeland Security, Justice, and Health and Human Services, as well as federal, state, and local law-enforcement officers who were recruited through requests to stakeholder agencies and open invitations to individuals involved in Tactical Emergency Medical Services (TEMS) or its oversight. Two face-to-face meetings took place. Using a modified Delphi technique, previously published TEMS competencies were reviewed and updated. The original 17 competency domains were modified and the most significant changes were the addition of Tactical Emergency Casualty Care (TECC), Tactical Familiarization, Legal Aspects of TEMS, and Mass Casualty Triage to the competency domains. Additionally, enabling and terminal learning objectives were developed for each competency domain. This project has developed a minimum set of medical competencies and learning objectives for both tactical medical providers and operators. This work should serve as a platform for ensuring minimum knowledge among providers, which will serve enhance team interoperability and improve the health and safety of tactical teams and the public. 2014.

Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments.

Science.gov (United States)

Langabeer, James R; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

2016-11-01

Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system's capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

Air contamination analysis during emergency medical treatment

International Nuclear Information System (INIS)

Yamada, Y.; Fukutsu, K.; Yuuki, M.; Akashi, M.

2009-01-01

After radiological emergencies, patients contaminated with radioactivity are taken to radiation emergency hospitals for treatment. Numerical simulations using the computer software 'Flow Designer R were made in order to evaluate indoor air contamination caused by the breathing out of contaminated air. The National Inst. of Radiological Sciences facility was used for the numerical evaluation. Results indicate that the dispersion of contaminated air depends on the characteristics of the contaminants, and that the dispersion range was limited and localised. Only medical staff standing in a special position near the patient was exposed to almost un-diluted contaminated air. Highly contaminated air was evacuated with a local exhaust pump system. Room air quality was monitored using a continuous air sampling system, but it was found that the sampling point was not representative for the purpose of radiation protection. From the air-flow analysis, some problems that affect radiological safety were revealed and valuable information and measures for preventing secondary contamination were determined. (authors)

Planning of emergency medical treatment in nuclear power plant

International Nuclear Information System (INIS)

Kusama, Tomoko

1989-01-01

Medical staffs and health physicists have shown deep concerning at the emergency plans of nuclear power plants after the TMI nuclear accident. The most important and basic countermeasure for accidents was preparing appropriate and concrete organization and plans for treatment. We have planed emergency medical treatment for radiation workers in a nuclear power plant institute. The emergency medical treatment at institute consisted of two stages, that is on-site emergency treatment at facility medical service. In first step of planning in each stage, we selected and treatment at facility medical service. In first step of planning in each stage, we selected and analyzed all possible accidents in the institute and discussed on practical treatments for some possible accidents. The manuals of concrete procedure of emergency treatment for some accidents were prepared following discussion and facilities and equipment for medical treatment and decontamination were provided. All workers in the institute had periodical training and drilling of on-site emergency treatment and mastered technique of first aid. Decontamination and operation rooms were provided in the facillity medical service. The main functions at the facility medical service have been carried out by industrial nurses. Industrial nurses have been in close co-operation with radiation safety officers and medical doctors in regional hospital. (author)

Intelligent Medical Systems for Aerospace Emergency Medical Services

Science.gov (United States)

Epler, John; Zimmer, Gary

2004-01-01

The purpose of this project is to develop a portable, hands free device for emergency medical decision support to be used in remote or confined settings by non-physician providers. Phase I of the project will entail the development of a voice-activated device that will utilize an intelligent algorithm to provide guidance in establishing an airway in an emergency situation. The interactive, hands free software will process requests for assistance based on verbal prompts and algorithmic decision-making. The device will allow the CMO to attend to the patient while receiving verbal instruction. The software will also feature graphic representations where it is felt helpful in aiding in procedures. We will also develop a training program to orient users to the algorithmic approach, the use of the hardware and specific procedural considerations. We will validate the efficacy of this mode of technology application by testing in the Johns Hopkins Department of Emergency Medicine. Phase I of the project will focus on the validation of the proposed algorithm, testing and validation of the decision making tool and modifications of medical equipment. In Phase 11, we will produce the first generation software for hands-free, interactive medical decision making for use in acute care environments.

Strengthening patient safety in transitions of care: an emerging role for local medical centres in Norway.

Science.gov (United States)

Kongsvik, Trond; Halvorsen, Kristin; Osmundsen, Tonje; Gjøsund, Gudveig

2016-08-30

Patient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. LMCs represent a form of intermediate care organisation in Norway that is increasingly used as a strategy for integrated care policies. The analysis is based on institutional theory and general safety theories. A qualitative design was applied, involving 20 interviews of nursing home managers, managers at local medical centres and administrative personnel. The LMCs mediate important information between care levels, partly by means of workarounds, but also as a result of having access to the different information and communications technology (ICT) systems in use. Their knowledge of local conditions is found to be a key asset. LMCs are providers of competence and training for the local level, as well as serving as quality assurers. As a growing organisational form in Norway, LMCs have to legitimise their role in the health care system. They represent an asset to the local level in terms of information, competence and quality assurance. As they have overlapping competencies, tasks and responsibilities with other parts of the health care system, they add to organisational redundancy and strengthen patient safety.

Tactical emergency medical support programs: a comprehensive statewide survey.

Science.gov (United States)

Bozeman, William P; Morel, Benjamin M; Black, Timothy D; Winslow, James E

2012-01-01

Specially trained tactical emergency medical support (TEMS) personnel provide support to law enforcement special weapons and tactics (SWAT) teams. These programs benefit law enforcement agencies, officers, suspects, and citizens. TEMS programs are increasingly popular, but there are wide variations in their organization and operation and no recent data on their prevalence. We sought to measure the current prevalence and specific characteristics of TEMS programs in a comprehensive fashion in a single southeastern state. North Carolina emergency medical services (EMS) systems have county-based central EMS oversight; each system was surveyed by phone and e-mail. The presence and selected characteristics of TEMS programs were recorded. U.S. Census data were used to measure the population impact of the programs. All of the 101 EMS systems statewide were successfully contacted. Thirty-three counties (33%) have TEMS programs providing medical support to 56 local law enforcement agencies as well as state and federal agencies. TEMS programs tend to be located in more populated urban and suburban areas, serving a population base of 5.9 million people, or 64% of the state's population. Tactical medics in the majority of these programs (29/33; 88%) are not sworn law enforcement officers. Approximately one-third of county-based EMS systems in North Carolina have TEMS programs. These programs serve almost two-thirds of the state's population base, using primarily nonsworn tactical medics. Comparison with other regions of the country will be useful to demonstrate differences in prevalence and program characteristics. Serial surveillance will help track trends and measure the growth and impact of this growing subspecialty field.

The emergency patient's participation in medical decision-making.

Science.gov (United States)

Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh

2016-09-01

The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.

Identifying Local Hotspots of Pediatric Chronic Diseases Using Emergency Department Surveillance

Science.gov (United States)

Lee, David C.; Yi, Stella S.; Fong, Hiu-Fai; Athens, Jessica K.; Ravenell, Joseph E.; Sevick, Mary Ann; Wall, Stephen P.; Elbel, Brian

2016-01-01

Objective To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. Methods Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available. In addition, we used home addresses to map local variation in pediatric disease burden. Results We identified 549,547 New York City children who visited an emergency department at least once in 2009. Though our sample included more publicly insured and uninsured children, we found moderate to strong correlations of prevalence estimates when compared to health surveys and registry data at pre-specified geographic levels. Strongest correlations were found for asthma and mental health conditions by county among younger children (0.88, p=0.05 and 0.99, pdisease prevalence with higher geographic resolution. More studies are needed to investigate limitations of these methods and assess reliability of local disease estimates. What’s New This study demonstrated how emergency department surveillance may improve estimates of pediatric disease prevalence with higher geographic resolution. We identified 29% of New York City children with a single year of data and identified local hotspots of pediatric chronic diseases. PMID:28385326

IMPRESS: medical location-aware decision making during emergencies

Science.gov (United States)

Gkotsis, I.; Eftychidis, G.; Leventakis, G.; Mountzouris, M.; Diagourtas, D.; Kostaridis, A.; Hedel, R.; Olunczek, A.; Hahmann, S.

2017-09-01

Emergency situations and mass casualties involve several agencies and public authorities, which need to gather data from the incident scene and exchange geo-referenced information to provide fast and accurate first aid to the people in need. Tracking patients on their way to the hospitals can prove critical in taking lifesaving decisions. Increased and continuous flow of information combined by vital signs and geographic location of emergency victims can greatly reduce the response time of the medical emergency chain and improve the efficiency of disaster medicine activity. Recent advances in mobile positioning systems and telecommunications are providing the technology needed for the development of location-aware medical applications. IMPRESS is an advanced ICT platform based on adequate technologies for developing location-aware medical response during emergencies. The system incorporates mobile and fixed components that collect field data from diverse sources, support medical location and situation-based services and share information on the patient's transport from the field to the hospitals. In IMPRESS platform tracking of victims, ambulances and emergency services vehicles is integrated with medical, traffic and crisis management information into a common operational picture. The Incident Management component of the system manages operational resources together with patient tracking data that contain vital sign values and patient's status evolution. Thus, it can prioritize emergency transport decisions, based on medical and location-aware information. The solution combines positioning and information gathered and owned by various public services involved in MCIs or large-scale disasters. IMPRESS solution, were validated in field and table top exercises in cooperation with emergency services and hospitals.

24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

Science.gov (United States)

2010-04-01

... medical technicians. 291.530 Section 291.530 Housing and Urban Development Regulations Relating to Housing... medical technicians. A person qualifies as a firefighter/emergency medical technician for the purposes of... technician by a fire department or emergency medical services responder unit of the federal government, a...

Basic management of medical emergencies: recognizing a patient's distress.

Science.gov (United States)

Reed, Kenneth L

2010-05-01

Medical emergencies can happen in the dental office, possibly threatening a patient's life and hindering the delivery of dental care. Early recognition of medical emergencies begins at the first sign of symptoms. The basic algorithm for management of all medical emergencies is this: position (P), airway (A), breathing (B), circulation (C) and definitive treatment, differential diagnosis, drugs, defibrillation (D). The dentist places an unconscious patient in a supine position and comfortably positions a conscious patient. The dentist then assesses airway, breathing and circulation and, when necessary, supports the patient's vital functions. Drug therapy always is secondary to basic life support (that is, PABCD). Prompt recognition and efficient management of medical emergencies by a well-prepared dental team can increase the likelihood of a satisfactory outcome. The basic algorithm for managing medical emergencies is designed to ensure that the patient's brain receives a constant supply of blood containing oxygen.

Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education.

Science.gov (United States)

Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak

2015-01-01

There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.

Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

Directory of Open Access Journals (Sweden)

Sricharoen P

2015-02-01

Full Text Available Pungkava Sricharoen,1 Chaiyaporn Yuksen,1 Yuwares Sittichanbuncha,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, Khon Kaen University, Khon Kaen, Thailand Background: There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods: Fifth year medical students (academic year of 2010 at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results: During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74% were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001. The top three highest average satisfaction scores in the new EM curriculum group were trauma

American National Standard: for facilities and medical care for on-site nuclear-power-plant radiological emergencies

International Nuclear Information System (INIS)

Anon.

1979-01-01

This standard provides guidance for first aid during an emergency and for initial medical care of those persons on-site who are overexposed to penetrating radiation (irradiated). It also provides guidance for medical care of persons contaminated with radioactive material or radionuclides who may also be irradiated or injured as a result of an accident at a nuclear power plant. It provides recommendations for facilities, supplies, equipment, and the extent of care both on-site where first aid and initial care may be provided and off-site at a local hospital where further medical and surgical care may be provided. This initial care continues until either the patient is released or admitted, or referred to another, possibly distant, medical center for definitive care. Recommendations are also provided for the transportation of patients and the training of personnel. Recommendations for specialized care are considered to be beyond the scope of this standard on emergency medical care; however, since emergency and specialized care are related, a brief discussion of specialized care is provided in the Appendix

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

Science.gov (United States)

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

The appropriateness of emergency medical service responses in the ...

African Journals Online (AJOL)

The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa. PR Newton, R Naidoo, P Brysiewicz. Abstract. Introduction. Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high ...

Emergency Medical Rescue in a Radiation Environment

International Nuclear Information System (INIS)

Briesmeister, L.; Ellington, Y.; Hollis, R.; Kunzman, J.; McNaughton, M.; Ramsey, G.; Somers, B.; Turner, A.; Finn, J.

1999-01-01

Previous experience with emergency medical rescues in the presence of radiation or contamination indicates that the training provided to emergency responders is not always appropriate. A new course developed at Los Alamos includes specific procedures for emergency response in a variety of radiological conditions

Emergency Medicine for medical students world wide!

DEFF Research Database (Denmark)

Perinpam, Larshan; Thi Huynh, Anh-Nhi

2015-01-01

A guest blog from Larshan Perinpam (President of ISAEM) and Anh-Nhi Thi Huynh (Vice president of external affairs, ISAEM) - http://blogs.bmj.com/emj/2015/04/17/emergency-medicine-for-medical-students-world-wide/......A guest blog from Larshan Perinpam (President of ISAEM) and Anh-Nhi Thi Huynh (Vice president of external affairs, ISAEM) - http://blogs.bmj.com/emj/2015/04/17/emergency-medicine-for-medical-students-world-wide/...

National emergency medical assistance program for commercial nuclear power plants

International Nuclear Information System (INIS)

Linnemann, R.E.; Berger, M.E.

1987-01-01

Radiation Management Consultant's Emergency Medical Assistance Program (EMAP) for nuclear facilities provides a twenty-four hour emergency medical and health physics response capability, training of site and off-site personnel, and three levels of care for radiation accident victims: first air and rescue at an accident site, hospital emergency assessment and treatment, and definitive evaluation and treatment at a specialized medical center. These aspects of emergency preparedness and fifteen years of experience in dealing with medical personnel and patients with real or suspected radiation injury will be reviewed

Emergency medical treatment and 'do not resuscitate' orders: When ...

African Journals Online (AJOL)

Whether there is a conflict between these two requirements is answered by considering: (i) the meaning of emergency medical treatment; (ii) the relationship between emergency medical treatment and DNR orders; (iii) the meaning of futile medical treatment; (iv) the relationship between DNR orders and euthanasia; and (v) ...

Medical Emergency Workload of a Regional UK HEMS Service.

Science.gov (United States)

McQueen, Carl; Crombie, Nick; Cormack, Stef; Wheaton, Steve

2015-01-01

Regionalized trauma networks have been established in England to centralize specialist care at dedicated centers of excellence throughout the country. Helicopter emergency medical services (HEMS) in the West Midlands region have been redesigned to form an integrated component of such systems. The continued use of such valuable and scarce resources for medical emergencies requires evaluation. A retrospective review of mission data for a regional Air Ambulance Service in England over a two year period. Medical emergencies continue to contribute a large proportion of the overall workload of the service. Requirement for advanced interventions at the scene was rare, with less than 10% of patients attended by HEMS teams having care needs that fall beyond the scope of standard paramedic practice. Dynamic solutions are needed to ensure that HEMS support for cases of medical emergency are appropriately targeted to incidents in which clinical benefit is conferred to the patient. Intelligent tasking of appropriate resources has the potential to improve the HEMS response to medical emergencies while optimizing the availability of resources to respond to other incidents, most notably cases of major trauma. Copyright © 2015 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Medical intervention in radiological emergencies, formation and training

International Nuclear Information System (INIS)

Cardenas H, J.

2006-01-01

The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

Science.gov (United States)

Rockwell, Kimberly Lovett; Gilroy, Alexis

2018-03-12

Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

Explanation of procedure on site medical emergency response for nuclear accident

International Nuclear Information System (INIS)

Liu Yulong; Jiang Zhong

2012-01-01

National occupational health standard-Procedure on Site Medical Emergency Response for Nuclear Accident has been approved and issued by the Ministry of Health. This standard is formulated according to the Emergency Response Law of the People's Republic of China, Law of the People 's Republic of China on Prevention and Control of Occupational Diseases, Regulations on Emergency Measures for Nuclear Accidents at Nuclear Power Plants, and Health Emergency Plans for Nuclear and Radiological Accidents of Ministry of Health, supporting the use of On-site Medical Emergency Planning and Preparedness for Nuclear Accidents and Off-site Medical Emergency Planning and Preparedness for Nuclear Accidents. Nuclear accident on-site medical response procedure is a part of the on-site emergency plan. The standard specifies the basic content and requirements of the nuclear accident on-site medical emergency response procedures of nuclear facilities operating units to guide and regulate the work of nuclear accident on-site medical emergency response of nuclear facilities operating units. The criteria-related contents were interpreted in this article. (authors)

Emergency Medical Service (EMS) Stations

Data.gov (United States)

Kansas Data Access and Support Center — EMS Locations in Kansas The EMS stations dataset consists of any location where emergency medical services (EMS) personnel are stationed or based out of, or where...

Emergency radiology curriculum at Medical University - Plovdiv

International Nuclear Information System (INIS)

Velkova, K.; Hilendarov, A.; Cvetkova, S.; Stoeva, M.; Petrova, A.; Stefanov, P.; Simova, E.; Georgieva, V.; Sirakov, N.

2012-01-01

Full text: Introduction: Recent advances in contemporary radiology turn it into one of the major sources for patient information with improved emergency techniques. Emergency Radiology (EP) focuses on acute diagnosing conditions in ER patients. Objectives: The main objective of this paper is to present the ER curriculum at Medical Imaging Department, Medical University - Plovdiv, aiming to deliver knowledge about the indications, possibilities and diagnostic value of the contemporary imaging methods in ER cases. Material and methods: The curriculum covers various aspects of ER Radiology - diagnostic imaging methods, contrast enhanced examinations, imaging topography, traumatic and acute conditions, physical and technical aspects. It includes 6 lectures and 12 practical classes. Results and discussion: The educational course in Emergency Radiology is available for medical students in their 8-th and 9-th semester. Therapeutic methods under imaging control are also covered by the course. Conclusion: Being one of the most advanced areas of radiology, ER improves the quality of care and treatment of patients and of the emergency medicine as a whole

Local emergency arrangements for radiation accidents

International Nuclear Information System (INIS)

Jones, A.

1989-01-01

This paper describes the local and national framework for public protection during peacetime emergencies with particular reference to major accidents or events with radiological consequences. The basis for the development of emergency plans will be described together with the inter-relationship between the responsibilities of individual organisations. (author)

Updated posters to help manage medical emergencies in the dental practice.

Science.gov (United States)

Jevon, P

2015-09-11

Medical emergencies can occur in the dental practice. Medical Emergencies in the Dental Practice and Emergency Drugs in the Dental Practice posters have been designed to help dental practitioners to respond effectively and safely to a medical emergency. These posters, endorsed by the British Dental Association, are included with this issue of the British Dental Journal. Further copies can be downloaded from: https://www.walsallhealthcare.nhs.uk/medical-education.aspx.

Radiation emergency medical preparedness and assistance network in Korea

International Nuclear Information System (INIS)

Kim, E. S.; Kong, H. J.; Noh, J. H.; Lim, Y. K.; Kim, C. S.

2003-01-01

Nationwide Medical Preparedness for Nuclear Accidents as an integral part of nuclear safety system has been discussed for several years and Radiation Health Research Institute (RHRI) of Korea Hydro and Nuclear Power Co. was established on July, 1999. The National Radiation Emergency Medical Center (NREMC) of Korea Cancer Center Hospital was also founded on September, 2002. Two organizations have established Radiation Emergency Medical Preparedness and Assistance Network in Korea to cope with accidental situations in nuclear power plants and also in handling sites of radionuclides. In order to construct an effective Nationwide Emergency Medical Network System they maintain good cooperation among regional hospitals. RHRI is going to make three types of medical groups, that is to say, the collaboration of the regional (primary appointed) hospital group around the nuclear power plants, the regional core (secondary appointed) hospital group and the central core hospital (RHRI). NREMC is also playing a central role in collaboration with 10 regional hospitals. Two cores are working key role for the maintenance of the network. Firstly, They maintain a radiological emergency response team consisting of physicians, nurses, health physicists, coordinators, and necessary support personnel to provide first-line responders with consultative or direct medical and radiological assistance at their facility or at the accident site. Secondly, they serves educational programs for the emergency personnel of collaborating hospitals not only as a treatment facility but also as a central training and demonstration unit. Regularly scheduled courses for the physician and nurse, and health/medical physicists are conducted. Therefore, to activate Nationwide Emergency Medical Network System and to maintain it for a long time, well-trained specialists and budgetary supports are indispensable

Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

Directory of Open Access Journals (Sweden)

Abbasali Ebrahimian

2014-01-01

Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

A Review of Medical Emergencies in Dental Practice | Uyamadu ...

African Journals Online (AJOL)

A Review of Medical Emergencies in Dental Practice. ... are those adverse medical events that may present in the course of dental treatment. ... be available in a dental clinic, outline the prevention and management of such emergencies, ...

Emergency medical assistance programs for nuclear power reactors

International Nuclear Information System (INIS)

Linnemann, R.E.; Mettler, F.A. Jr.

1977-01-01

This paper deals with a simple but practical medical support of geographically distributed nuclear reactors in isolated areas. A staff of experts at a centre devote their full attention to accident prevention and preparedness at reactor sites. They establish and maintain emergency medical programs at reactor sites and nearby support hospitals. The emphasis is on first aid and emergency treatment by medical attendants who are not and cannot be experts in radiation but do know how to treat patients. (author)

High-Fidelity Simulation: Preparing Dental Hygiene Students for Managing Medical Emergencies.

Science.gov (United States)

Bilich, Lisa A; Jackson, Sarah C; Bray, Brenda S; Willson, Megan N

2015-09-01

Medical emergencies can occur at any time in the dental office, so being prepared to properly manage the situation can be the difference between life and death. The entire dental team must be properly trained regarding all aspects of emergency management in the dental clinic. The aim of this study was to evaluate a new educational approach using a high-fidelity simulator to prepare dental hygiene students for medical emergencies. This study utilized high-fidelity simulation (HFS) to evaluate the abilities of junior dental hygiene students at Eastern Washington University to handle a medical emergency in the dental hygiene clinic. Students were given a medical emergency scenario requiring them to assess the emergency and implement life-saving protocols in a simulated "real-life" situation using a high-fidelity manikin. Retrospective data were collected for four years from the classes of 2010 through 2013 (N=114). The results indicated that learning with simulation was effective in helping the students identify the medical emergency in a timely manner, implement emergency procedures correctly, locate and correctly utilize contents of the emergency kit, administer appropriate intervention/treatment for a specific patient, and provide the patient with appropriate follow-up instructions. For dental hygiene programs seeking to enhance their curricula in the area of medical emergencies, this study suggests that HFS is an effective tool to prepare students to appropriately handle medical emergencies. Faculty calibration is essential to standardize simulation.

Medical response in the initial phase of a radiological or nuclear emergency

International Nuclear Information System (INIS)

Vazquez, M.; Perez, M.R.; Dubner, D.; Michelin, S.; Malvicini, M.

2006-01-01

The frequency of radiological and nuclear accidents is low with relationship to another type of have an accident, but the use of radioactive sources has been increased in the finish decades. Additionally, a growing world concern exists by the eventual use of radioactive material with malevolent ends. These facts put in relevance the necessity to have an appropriate preparation for the medical answer in this type of emergencies. The medical answer consists of different phases: Initial: pre-hospital and in local general hospitals; Intermediate: in local general hospitals and central reference hospitals. Late: in central reference hospitals and the pursuit to long term. The presence of conventional injuries (radio combined injuries) modifies in substantial form the assignment in the priority of the attention, the prediction and the evolution. The establishment of an appropriate triage is outstanding in the initial phase. The present communication approaches the early medical answer, sustained in the anamnesis, the chronology and severity of the symptoms and prodromal signs besides the laboratory results and complementary exams arisen during the first ones 24 to 72 hours. (Author)

Ethics curriculum for emergency medicine graduate medical education.

Science.gov (United States)

Marco, Catherine A; Lu, Dave W; Stettner, Edward; Sokolove, Peter E; Ufberg, Jacob W; Noeller, Thomas P

2011-05-01

Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. Copyright © 2011 Elsevier Inc. All rights reserved.

Helicopter Emergency Medical Services: effects, costs and benefits

NARCIS (Netherlands)

A.N. Ringburg (Akkie)

2009-01-01

textabstractAdvanced prehospital medical care with air transport was introduced in the Netherlands in May 1995. The fi rst helicopter Mobile Medical Team, also called Helicopter Emergency Medical Service (HEMS) was a joint venture initiative of the VU Medical Center in Amsterdam and the Algemene

Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

Directory of Open Access Journals (Sweden)

James Robert Langabeer

2016-11-01

Full Text Available Introduction Emergency medical services (EMS agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED, affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001. EMS productivity (median time from EMS notification to unit back in service was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median. There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

Emergency situation in a medical cyclotron facility

International Nuclear Information System (INIS)

Kumar, Rajeev; Bhat, M.K.; Singh, D.K.; Pthania, B.S.; Pandit, A.G.; Jacob, M.J.

2010-01-01

Full text: Medical cyclotron is a particle accelerator used in producing short lived radioisotopes such as 18 F, 11 C, 15 O, 13 N, 18 F-2 gas etc. Positron Emission Tomography (PET) is a nuclear imaging modality that has rapidly gained favour. 18 F-FDG is the most widely used radiopharmaceutical with a half-life of 109.8 min. Having more than five years experience in this field we face lots of emergency conditions in the medical cyclotron facility. On the basis of harm we have divided in to three categories i.e. Harm of (a) working personnel, (b) Equipment and (c) environment. Radioactive gas leak and Target foil rupture is considered as the major emergency situations during medical cyclotron operations because there is a potential of over exposure to the working personnel. Radiation protection survey of a self-shielded medical cyclotron installation was carried out during normal and emergency conditions. It is found that the induced activity in the target foil increases with its successive usages. Recommendations have also been made to reduce personal exposure while handling the radioactive gas leak and target foil rupture conditions

Refusal of Emergency Medical Treatment: Case Studies and Ethical Foundations.

Science.gov (United States)

Marco, Catherine A; Brenner, Jay M; Kraus, Chadd K; McGrath, Norine A; Derse, Arthur R

2017-11-01

Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

[Discussion of the implementation of MIMIC database in emergency medical study].

Science.gov (United States)

Li, Kaiyuan; Feng, Cong; Jia, Lijing; Chen, Li; Pan, Fei; Li, Tanshi

2018-05-01

To introduce Medical Information Mart for Intensive Care (MIMIC) database and elaborate the approach of critically emergent research with big data based on the feature of MIMIC and updated studies both domestic and overseas, we put forward the feasibility and necessity of introducing medical big data to research in emergency. Then we discuss the role of MIMIC database in emergency clinical study, as well as the principles and key notes of experimental design and implementation under the medical big data circumstance. The implementation of MIMIC database in emergency medical research provides a brand new field for the early diagnosis, risk warning and prognosis of critical illness, however there are also limitations. To meet the era of big data, emergency medical database which is in accordance with our national condition is needed, which will provide new energy to the development of emergency medicine.

The evolving story of medical emergency teams in quality improvement.

Science.gov (United States)

Amaral, André Carlos Kajdacsy-Balla; Shojania, Kaveh G

2009-01-01

Adverse events affect approximately 3% to 12% of hospitalized patients. At least a third, but as many as half, of such events are considered preventable. Detection of these events requires investments of time and money. A report in a recent issue of Critical Care used the medical emergency team activation as a trigger to perform a prospective standardized evaluation of charts. The authors observed that roughly one fourth of calls were related to a preventable adverse event, which is comparable to the previous literature. However, while previous studies relied on retrospective chart reviews, this study introduced the novel element of real-time characterization of events by the team at the moment of consultation. This methodology captures important opportunities for improvements in local care at a rate far higher than routine incident-reporting systems, but without requiring substantial investments of additional resources. Academic centers are increasingly recognizing engagement in quality improvement as a distinct career pathway. Involving such physicians in medical emergency teams will likely facilitate the dual roles of these as a clinical outreach arm of the intensive care unit and in identifying problems in care and leading to strategies to reduce them.

The appropriateness of emergency medical service responses in the ...

African Journals Online (AJOL)

2015-10-10

Oct 10, 2015 ... P R Newton,1 MTech (Emergency Medical Care); R Naidoo,1 MSc (Cardiology); P Brysiewicz,2 PhD (Health Science). 1 Department of Emergency Medical Care and Rescue, Faculty of Health Sciences, Durban University of Technology, South Africa ..... tation, may include a straightforward refusal.

Noise exposure during prehospital emergency physicians work on Mobile Emergency Care Units and Helicopter Emergency Medical Services

DEFF Research Database (Denmark)

Hansen, Mads Christian Tofte; Schmidt, Jesper Hvass; Brøchner, Anne C

2017-01-01

BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS)....... initiatives. Although no hearing loss was demonstrated in the personnel of the ground-based units, a reduced function of the outer sensory hair cells was found in the HEMS group following missions.......BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS......). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet. All recorded sounds were analysed...

Medical dispatchers recognise substantial amount of acute stroke during emergency calls

DEFF Research Database (Denmark)

Viereck, Søren; Møller, Thea Palsgaard; Iversen, Helle Klingenberg

2016-01-01

without an inappropriate amount of false positive cases. CONCLUSIONS: We report an overall high recognition of stroke by medical dispatchers. A final diagnosis of TIA, compared to ICH, was positively associated with recognition of acute stroke. Emergency medical dispatchers serve as the essential first...... stroke are therefore critical in organising emergency stroke care. We aimed to describe the sensitivity and positive predictive value of medical dispatchers' ability to recognise acute stroke during emergency calls, and to identify factors associated with recognition. METHODS: This was an observational...... study of 2653 consecutive unselected patients with a final diagnosis of stroke or transient ischemic attack (TIA). All admitted through the Emergency Medical Services Copenhagen, during a 2-year study period (2012-2014). Final diagnoses were matched with dispatch codes from the Emergency Medical...

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service.

NARCIS (Netherlands)

Gerritse, B.M.; Schalkwijk, A.; Pelzer, B.J.; Scheffer, G.J.; Draaisma, J.M.T.

2010-01-01

BACKGROUND: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures

30 CFR 75.1713 - Emergency medical assistance; first-aid.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Emergency medical assistance; first-aid. 75... Emergency medical assistance; first-aid. [Statutory Provisions] Each operator shall make arrangements in... trained in first-aid and first-aid training shall be made available to all miners. Each coal mine shall...

The "prudent layperson" definition of an emergency medical condition.

Science.gov (United States)

Li, James; Galvin, Hannah K; Johnson, Sandra C

2002-01-01

The study objectives, based on federal and state legislative language, were to objectively define symptoms and signs commonly agreed on by "prudent laypersons" as "emergency medical conditions." After comprehensive tabulation of symptom classifications from the International Classification of Diseases (ICD-9), we performed a survey of nonmedical laypersons. Data analysis included descriptive statistics, proportional calculations, and 95% confidence intervals. A minority of symptoms and signs (25/87, 29%) were considered emergency medical conditions by more than half of nonmedical survey respondents who were self-defined as prudent laypersons. The leading conditions deemed emergencies were loss of consciousness, seizure, no recognition of one side of the body, paralysis, shock, gangrene, coughing blood, trouble breathing, chest pain, and choking. Pain, except for renal colic or chest pain, was not considered an emergency. No symptoms or signs specifically related to gynecologic disorders were considered emergencies. Most symptoms and signs tabulated in the diagnostic coding manual, ICD-9, are not considered emergency medical conditions by self-designated prudent laypersons. These include many conditions that are commonly investigated and treated in the emergency department setting. Use of the prudent layperson standard for reimbursable emergency health services may not reflect the actual scope of symptoms necessitating emergency care.

Bystander Intervention Prior to The Arrival of Emergency Medical Services: Comparing Assistance across Types of Medical Emergencies.

Science.gov (United States)

Faul, Mark; Aikman, Shelley N; Sasser, Scott M

2016-01-01

To determine the situational circumstances associated with bystander interventions to render aid during a medical emergency. This study examined 16.2 million Emergency Medical Service (EMS) events contained within the National Emergency Medical Services Information System. The records of patients following a 9-1-1 call for emergency medical assistance were analyzed using logistic regression to determine what factors influenced bystander interventions. The dependent variable of the model was whether or not a bystander intervened. EMS providers recorded bystander assistance 11% of the time. The logistic regression model correctly predicted bystander intervention occurrence 71.4% of the time. Bystanders were more likely to intervene when the patient was male (aOR = 1.12, 95% CI = 1.12-1.3) and if the patient was older (progressive aOR = 1.10, 1.46 age group 20-29 through age group 60-99). Bystanders were less likely to intervene in rural areas compared to urban areas (aOR = 0.58, 95% CI = 0.58-0.59). The highest likelihood of bystander intervention occurred in a residential institution (aOR = 1.86, 95% CI = 1.85-1.86) and the lowest occurred on a street or a highway (aOR = 0.96, 95% CI = 0.95-0.96). Using death as a reference group, bystanders were most likely to intervene when the patient had cardiac distress/chest pain (aOR = 11.38, 95% CI = 10.93-11.86), followed by allergic reaction (aOR = 7.63, 95% CI = 7.30-7.99), smoke inhalation (aOR = 6.65, 95% CI = 5.98-7.39), and respiration arrest/distress (aOR = 6.43, 95% CI = 6.17-6.70). A traumatic injury was the most commonly recorded known event, and it was also associated with a relatively high level of bystander intervention (aOR = 5.81, 95% CI = 5.58-6.05). The type of injury/illness that prompted the lowest likelihood of bystander assistance was Sexual Assault/Rape (aOR = 1.57, 95% CI = 1.32-1.84) followed by behavioral/psychiatric disorder (aOR = 1.64, 95% CI = 1.57-1.71). Bystander intervention varies greatly on

Asthma Medication Ratio Predicts Emergency Depart...

Data.gov (United States)

U.S. Department of Health & Human Services — According to findings reported in Asthma Medication Ratio Predicts Emergency Department Visits and Hospitalizations in Children with Asthma, published in Volume 3,...

Medical Emergency Education in Dental Hygiene Programs.

Science.gov (United States)

Stach, Donna J.; And Others

1995-01-01

A survey of 169 dental hygiene training programs investigated the curriculum content and instruction concerning medical emergency treatment, related clinical practice, and program policy. Several trends are noted: increased curriculum hours devoted to emergency care; shift in course content to more than life-support care; and increased emergency…

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

Directory of Open Access Journals (Sweden)

Scheffer Gert J

2010-03-01

Full Text Available Abstract Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS and a Helicopter Emergency Medical Service (HEMS for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

Improving the non-technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™).

Science.gov (United States)

Cant, Robyn P; Porter, Joanne E; Cooper, Simon J; Roberts, Kate; Wilson, Ian; Gartside, Christopher

2016-12-01

This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Radiation emergency planning for medical organizations

International Nuclear Information System (INIS)

Jerez Vergueria, Sergio F.; Jerez Vergueria, Pablo F.

1997-01-01

The possible occurrence of accidents involving sources of ionizing radiation demands response plans to mitigate the consequences of radiological accidents. This paper offers orientations in order to elaborate emergency planning for institutions with medical applications of ionizing radiation. Taking into account that the prevention of accidents is of prime importance in dealing with radioactive materials and others sources of ionizing radiation, such as X-rays, it is recommended that one include in emergency instructions and procedures several aspects relative to causes which originate these radiological events. Topics such as identification of radiological events in these practices and their consequences, protective measures, planning for and emergency response and maintenance of emergency capacity, are considered in this article. (author)

Local Emergency Planning Committee (LEPC) Data

Data.gov (United States)

U.S. Environmental Protection Agency — The LEPC data set contains over 3000 listings, as of 2008, for name and location data identifying Local Emergency Planning Committees (LEPCs). LEPCs are people...

Medical Journalism and Emergency Medicine

Directory of Open Access Journals (Sweden)

Saeed Safari

2015-07-01

Full Text Available Nowadays, many researches in the field of medicine are conducting all around the world and medical journalism is a way to share the results. In fact, dissemination of the related manuscripts can prevent the repetitive research or may even lead to conducting a better survey. Therefore high quality medical journals are considered as up-to-date resources for further investigations. Medical journals are propagating their papers in various media including television programs, newspapers, internet websites and different social media. So they can influence the government policy makers, health-care professionals and even public. Moreover, most researchers hear about medical discoveries for the first time through medical journals and their related social media. So as well a high quality journal can help to improve medical science, a journal of poor quality can be damaging and distorting. Indeed, popular journals have the power of inventing a “communication storm” to draw attention to a certain topic. Thus they have to respect the accepted international principles to prevent spreading inaccurate and misleading data. This paper aims to review the previous and current situation of medical journalism by focus on field of emergency medicine.

Medical treatment of radiation damages and medical emergency planning in case of nuclear power plant incidents and accidents

International Nuclear Information System (INIS)

Ohlenschlaeger, L.

1981-03-01

Medical measures in case of radiation damages are discussed on the basis of five potential categories of radiation incidents and accidents, respectively, viz. contaminations, incorporations, external local and general radiation over-exposures, contaminated wounds, and combinations of radiation damages and conventional injuries. Considerations are made for diagnostic and therapeutic initial measures especially in case of minor and moderate radiation accidents. The medical emergency planning is reviewed by means of definations used in the practical handling of incidents or accidents. The parameters are: extent of the incident or accident, number of persons involved, severity of radiation damage. Based on guiding symptoms the criteria for the classification into minor, moderate or severe radiation accidents are discussed. Reference is made to the Medical Radiation Protection Centers existing in the Federal Republic of Germany and the possibility of getting advices in case of radiation incidents and accidents. (orig.) [de

Preclinical diagnosis and emergency medical care in case of radiation accidents

International Nuclear Information System (INIS)

Ohlenschlaeger, L.

1990-01-01

Reference is made to preclinical diagnosis and emergency medical care at the site of a potential radiation accident. Possibilities and limits, respectively, of the medical measures are shown. Cooperation between the experts of the technical and medical rescue services is described. Exposition to radiation for the emergency medical staff resulting from the medical care of contaminated persons, is negligible if the personal precautions are observed. (orig.) [de

Rural emergency medical technician pre-hospital electrocardiogram transmission.

Science.gov (United States)

Powell, A M; Halon, J M; Nelson, J

2014-01-01

Emergent care of the acute heart attack patient continues to be at the forefront of quality and cost reduction strategies throughout the healthcare industry. Although the average cardiac door-to-balloon (D2B) times have decreased substantially over the past few years, there are still vast disparities found in D2B times in populations that reside in rural areas. Such disparities are mostly related to prolonged travel time and subsequent delays in cardiac catherization lab team activation. Urban ambulance companies that are routinely staffed with paramedic level providers have been successful in the implementation of pre-hospital 12-lead electrocardiogram (ECG) protocols as a strategy to reduce D2B times. The authors sought to evaluate the evidence related to the risk and benefits associated with the replication of an ECG transmission protocol in a small rural emergency medical service. The latter is staffed with emergency medical technician-basics (EMT-B), emergency medical technician-advanced (EMT-A), and emergency medical technician-intermediate (EMT-I) level. The evidence reviewed was limited to studies with relevant data regarding the challenges and complexities of the ECG transmission process, the difficulties associated with ECG transmission in rural settings, and ECG transmission outcomes by provider level. The evidence supports additional research to further evaluate the feasibility of ECG transmission at the non-paramedic level. Multiple variables must be investigated including equipment cost, utilization, and rural transmission capabilities. Clearly, pre-hospital ECG transmission and early activation of the cardiac catheterization laboratory are critical components to successfully decreasing D2B times.

Emerging Pathogens Initiative (EPI)

Data.gov (United States)

Department of Veterans Affairs — The Emerging Pathogens Initiative (EPI) database contains emerging pathogens information from the local Veterans Affairs Medical Centers (VAMCs). The EPI software...

Developing an active emergency medical service system based on WiMAX technology.

Science.gov (United States)

Li, Shing-Han; Cheng, Kai-An; Lu, Wen-Hui; Lin, Te-Chang

2012-10-01

The population structure has changed with the aging of population. In the present, elders account for 10.63% of the domestic population and the percentage is still gradually climbing. In other words, the demand for emergency services among elders in home environment is expected to grow in the future. In order to improve the efficiency and quality of emergency care, information technology should be effectively utilized to integrate medical systems and facilities, strengthen human-centered operation designs, and maximize the overall performance. The improvement in the quality and survival rate of emergency care is an important basis for better life and health of all people. Through integrated application of medical information systems and information communication technology, this study proposes a WiMAX-based emergency care system addressing the public demands for convenience, speed, safety, and human-centered operation of emergency care. This system consists of a healthcare service center, emergency medical service hospitals, and emergency ambulances. Using the wireless transmission capability of WiMAX, patients' physiological data can be transmitted from medical measurement facilities to the emergency room and emergency room doctors can provide immediate online instructions on emergency treatment via video and audio transmission. WiMAX technology enables the establishment of active emergency medical services.

Emergency medical technician education and training.

Science.gov (United States)

Lauro, Joseph; Sullivan, Francis; Williams, Kenneth A

2013-12-03

Emergency Medical Services (EMS) training and education are vital and vibrant aspects of a young and evolving profession. This article provides a perspective on this effort in the United States and reviews current activity in Rhode Island.

Facilities and medical care for on-site nuclear power plant radiological emergencies

International Nuclear Information System (INIS)

Anon.

1979-01-01

The operation of a nuclear power plant introduces risks of injury or accidents that could also result in the exposure of personnel to radiation or radioactive materials. It is important in such an event to have adequate first aid and medical facilities, supplies, equipment, transportation capabilities and trained personnel available to provide necessary care. This standard provides guidance for first aid during an emergency and for initial medical care of those overexposed to penetrating radiation or contaminated with radioactive material or radionuclides. Recommendations cover facilities, supplies, equipment and the extent of care on-site, where first aid and initial care may be provided, and off-site at a local hospital, where further medical and surgical care may be provided. Additional recommendations are also provided for the transportation of patients and the training of personnel. A brief discussion of specialized care is provided in an appendix

'REACTS'. A pragmatic approach for providing medical care and physician education for radiation emergencies

International Nuclear Information System (INIS)

Lushbaugh, C.C.; Andrews, G.A.; Huebner, K.F.; Cloutier, R.J.; Beck, W.L.; Berger, J.D.

1976-01-01

Because serious radiation incidents have been rare, few medical personnel (notably only some in France, Russia, Belgium, Canada, Yugoslavia, Japan, Great Britain and the United States) have first-hand experience in radiation-accident management. The generation of physicians who participated in those accidents now needs to pass on the bits of knowledge that were gleaned from them. These case histories are difficult for the local, non-radiology physician to obtain when he is called upon to help formulate the medical-emergency response plan required everywhere for licensing power reactors. The Radiation Emergency Assistance Center and Training Site (REACTS) in Oak Ridge, Tennessee, supported by the US Energy Research and Development Administration, is designed to meet these medical and educational needs. REACTS, located in the Oak Ridge Hospital of the Methodist Church, is not involved in the hospital's daily community functions except insofar as REACTS is the radiation emergency arm of the area's major disaster plan. Its dual mission is training physicians, nurses, and paramedical emergency personnel in radiation-accident management, and treating irradiated and contaminated persons. Its training activities are carried out by the Special Training Division of Oak Ridge Associated Universities. Formal courses in radiation medicine and health physics and practical laboratory experience are now conducted twice a year for physicians. They will be expanded in the future to include training of paramedical personnel. Follow-up studies of radiation-accident survivors are carried out in REACTS to ensure the preservation of valuable human data and radiation-accident experiences. This unique facility and its staff are dedicated to meet the needs of the far-flung public and private medical domains in the United States for nuclear-production energy

Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries

DEFF Research Database (Denmark)

Møller, Thea Palsgaard; Andréll, Cecilia; Viereck, Søren

2016-01-01

in two steps; registry data were merged with electronically registered emergency call data from the emergency medical dispatch centres in the two regions. Cases with missing or non-OHCA dispatch codes were analysed further by auditing emergency call recordings using a uniform data collection template......INTRODUCTION: Survival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching...... of the emergency medical services. AIM: To analyse and compare the accuracy of OHCA recognition by medical dispatchers in two countries. METHOD: An observational register-based study collecting data from national cardiac arrest registers in Denmark and Sweden during a six-month period in 2013. Data were analysed...

Medical rescue for nuclear or radiologic emergencies

International Nuclear Information System (INIS)

Chen Xiaohua; Nie Suifeng

2011-01-01

Nuclear or radiologic emergencies are defined as incidents that are caused by radioactive substance or by other sources of radiation and can pose a serious hazard to public health. In case of nuclear or radiologic emergencies, radioactive rays will damage the human body and bring about psychological and mental stress, resulting in a series of social psychological effects. The key to medical rescue for nuclear or radiologic emergencies is to take effective measures which can minimize the body harm resulting from nuclear or radiologic emergencies and maintain social stability. This article reviews the personnel protection, on-the-spot salvage, treatments of various harm, and prevention of public psychological effect following nuclear or radiologic emergencies. (authors)

Emergency motorcycle: has it a place in a medical emergency system?

Science.gov (United States)

Soares-Oliveira, Miguel; Egipto, Paula; Costa, Isabel; Cunha-Ribeiro, Luis Manuel

2007-07-01

In an emergency medical service system, response time is an important factor in determining the prognosis of a victim. There are well-documented increases in response time in urban areas, mainly during rush hour. Because prehospital emergency care is required to be efficient and swift, alternative measures to achieve this goal should be addressed. We report our experience with a medical emergency motorcycle (MEM) and propose major criteria for dispatching it. This work presents a prospective analysis of the data relating to MEM calls from July 2004 to December 2005. The analyzed parameters were age, sex, reason for call, action, and need for subsequent transport. A comparison was made of the need to activate more means and, if so, whether the MEM was the first to arrive. There were 1972 calls. The average time of arrival at destination was 4.4 +/- 2.5 minutes. The main action consisted of administration of oxygen (n = 626), immobilization (n = 118), and control of hemorrhage (n = 101). In 63% of cases, MEM arrived before other emergency vehicles. In 355 cases (18%), there was no need for transport. The MEM can intervene in a wide variety of clinical situations and a quick response is guaranteed. Moreover, in specific situations, MEM safely and efficiently permits better management of emergency vehicles. We propose that it should be dispatched mainly in the following situations: true life-threatening cases and uncertain need for an ambulance.

Integration of foreign and local medical staff in a disaster area: the Honduras and El Salvador experiences.

Science.gov (United States)

Waisman, Yehezkel

2003-06-01

International medical aid after natural disasters may take various forms, ranging from self-sufficient military forces to single experts or specialists who function primarily as advisers. A model integrating foreign and local medical staff has not previously been reported. In response to the call for international aid by the Honduran and El Salvadorian governments in the wake of Hurricane Mitch in November 1998 and the San Salvador earthquake in January 2001, Israel sent medical supplies and 10 member teams of medical professionals to each country. The aim of the present paper is to describe the unique Israeli approach to providing healthcare in disaster areas by integrating foreign and local medical staff, and to discuss its advantages and disadvantages. The paper focuses on the experience of the two emergency medicine physicians on the team who were assigned to the Atlantida General Hospital in La Ceiba, Honduras. The same team in San Salvador subsequently applied the same approach.

The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): The First 10 Years and a Look at Public Perception of Emergency Medical Services (EMS).

Science.gov (United States)

Crowe, Remle P; Bentley, Melissa A; Levine, Roger

2016-12-01

Crowe RP , Bentley MA , Levine R . The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): the first 10 years and a look at public perception of Emergency Medical Services (EMS). Prehosp Disaster Med. 2016;31(Suppl. 1):s1-s6.

In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment

Directory of Open Access Journals (Sweden)

Hinkelbein J

2017-02-01

Full Text Available Jochen Hinkelbein,1,2 Christopher Neuhaus,2,3 Lennert Böhm,1 Steffen Kalina,1 Stefan Braunecker1,2 1Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, 2Working group “Emergency Medicine and Air Rescue”, German Society for Aviation and Space Medicine (DGLRM, Munich, 3Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany Background: Data on the incidence of in-flight medical emergencies on-board civil aircraft are uncommon and rarely published. Such data could provide information regarding required medical equipment on-board aircraft and requisite training for cabin crew. The aim of the present study was to gather data on the incidences, nature, and medical equipment for in-flight medical emergencies by way of a survey of physician members of a German aerospace medical society.Materials and methods: Using unipark.de (QuestBack GmbH, Cologne, Germany, an online survey was developed and used to gather specific information. Members of the German Society for Aviation and Space Medicine (Deutsche Gesellschaft für Luft- und Raumfahrtmedizin e.V.; DGLRM were invited to participate in the survey during a 4-week period (21 March 2015 to 20 April 2015. Chi-square test was used for statistical analysis (p<0.05 was considered significant.Results: Altogether, 121 members of the society responded to the survey (n=335 sent out. Of the 121 respondents, n=54 (44.6% of the participants (89.9% male and 10.1% female; mean age, 54.1 years; n=121 were involved in at least one in-flight medical emergency. Demographic parameters in this survey were in concordance with the society members’ demographics. The mean duration of flights was 5.7 hours and the respondents performed 7.1 airline flights per year (median. Cardiovascular (40.0% and neurological disorders (17.8% were the most frequent diagnoses. The medical equipment (78.7% provided was sufficient. An emergency diversion was

78 FR 59623 - Emergency Medical Equipment

Science.gov (United States)

2013-09-27

... accordance with the FAA master minimum equipment list does not adversely affect aviation safety. This action... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Parts 121 and 135 [Docket No... inoperative Emergency Medical Kit (EMK) or automated external defibrillator (AED). A copy of Master Minimum...

Prudent layperson definition of an emergent pediatric medical condition.

Science.gov (United States)

Huang, Craig J; Poirier, Michael P; Cantwell, John R; Ermis, Peter R; Isaacman, Daniel J

2006-03-01

This study was designed to assess how well parents rated pediatric medical conditions based on their perceived degree of urgency so as to determine if the "Prudent Layperson Standard'' is reasonable. A self-administered, supervised survey was given to a convenience sample of 340 caregivers in the emergency department of an urban children's hospital. Respondents were asked to rank the urgency of 15 scenarios. A caregiver response within 1 point of the physician score was considered concordant with medical opinion. A 2-week-old infant with a rectal temperature of 103.7 degrees F was the only emergent scenario underestimated by caregivers. A 1 1/2-yr-old child with an upper respiratory tract infection, a 7-year-old child with ringworm, an 8-month-old infant with a simple forehead contusion, and a 4-year-old child with conjunctivitis were the non-urgent scenarios overestimated by caregivers. Laypeople are able to identify cases constructed to represent obvious pediatric medical emergencies. Several patient subgroups frequently overestimate medical urgency.

Who killed Rambhor?: The state of emergency medical services in India

Directory of Open Access Journals (Sweden)

Rajesh H Garg

2012-01-01

Full Text Available In India, the healthcare delivery system starts up from the sub-center at the village level and reaches up to super specialty medical centers providing state of the art emergency medical services (EMS. These highest centers, located in big cities, are considered the last referral points for the patients from nearby cities and states. As the incidents of rail and road accidents have increased in recent years, the role of EMS becomes critical in saving precious lives. But when the facilities and management of these emergency centers succumbs before the patient, then the question arises regarding the adequate availability and quality of EMS. The death of an unknown common man, Rambhor, for want of EMS in three big hospitals in the national capital of India put a big question on the "health" of the emergency health services in India. The emergency services infrastructure seems inadequate and quality and timely provision of EMS to critical patients appears unsatisfactory. There is lack of emergency medicine (EM specialists in India and also the postgraduation courses in EM have not gained foot in our medical education system. Creation of a Centralized Medical Emergency Body, implementation of management techniques, modification of medical curriculum, and fixing accountability are some of the few steps which are required to improve the EMS in India.

Patients crash more than airlines: a medical emergency at 35,000 ft

Directory of Open Access Journals (Sweden)

Talha Bashir

2014-07-01

Full Text Available An estimated 1 in 600 commercial flights will have an onboard medical emergency and approximately half of the time a passenger physician will provide medical assistance. A medical emergency on an aircraft can be a daunting task for even the most seasoned physician. This article is a narrative case report from a physician passenger who found himself in the midst of such an emergency on a 15-hour international flight.

A Model Curriculum for an Emergency Medical Services (EMS Rotation for Emergency Medicine Residents

Directory of Open Access Journals (Sweden)

Michael Mancera

2018-01-01

Full Text Available Audience: This EMS curriculum is designed for Emergency Medicine residents at all levels of training. Introduction: Emergency Medicine (EM physicians have routine interaction with Emergency Medical Services (EMS in their clinical practice. Additionally, the American College of Graduate Medical Education (ACGME mandates that all Emergency Medicine resident physicians receive specific training in the area of EMS.1 Historically, EMS training for EM residents has been conducted in the absence of a standardized didactic curriculum. Despite advancements in the area of prehospital training, there remains wide inconsistency in EMS training experiences among EM residency training programs.2 To our knowledge a standardized and reproducible EMS curriculum for EM residents does not exist. Objectives: The aim of this curriculum is to provide a robust learning experience for EM residents around prehospital care and EMS that fulfills the ACGME requirements and which can be easily replicated and implemented in a variety of EM residency training programs. Method: The educational strategies used in this curriculum include didactics, asynchronous learning through online modules and a focused reading list, experiential learning through ride-alongs, structured small group discussion, supervised medical command shifts, and mentored practice in organizing and delivering didactics to EMS providers.

Multidisciplinary collaboration for meeting radiation emergencies

International Nuclear Information System (INIS)

Jankowski, C.B.

1986-01-01

Radiation emergencies preparedness depend on the participation of many kinds of professionals in a concerted effort to meet whatever unforeseen situation may arise. This is true even for an injury involving only a single individual, the most common kind of radiation emergency. Each local hospital supporting a nuclear power facility performs at least one medical drill annually to review its ability to manage radiation casualties. Admitting even one injured and contaminated plant employee to the emergency room requires the involvement of many hospital departments, including the nursing, medical, security, housekeeping, radiology, clinical laboratories, and administration groups. The triage of several injured victims to regional hospitals would demand even more personnel and coordination of their efforts. In an extreme situation, the need for health care personnel could be enormous. Planning for large-scale radiation emergencies should involve physicians, but there must also be advice from and coordination with nurses, health physicists, emergency management specialists, emergency medical technicians, and state and local police and fire officials

Brazilian dentists' attitudes about medical emergencies during dental treatment.

Science.gov (United States)

Arsati, Franco; Montalli, Victor Angelo; Flório, Flavia Martão; Ramacciato, Juliana Cama; da Cunha, Fernanda Lopes; Cecanho, Rodrigo; de Andrade, Eduardo Dias; Motta, Rogério Heládio Lopes

2010-06-01

The main objective of this study was to evaluate the prevalence of emergencies in dental practices and the prepared-ness and the training experience in cardiopulmonary resuscitation (CPR) of Brazilian dentists in dealing with emergencies. The volunteer participants in the study were 498 Brazilian dentists who were present at the 27th International Congress of Dentistry in São Paulo. The most prevalent emergency was presyncope (reported by 54.20 percent of respondents), followed by orthostatic hypotension (44.37 percent), moderate allergic reactions (16.86 percent), hypertensive crisis (15.06 percent), asthma (15.06 percent), syncope (12.65 percent), angina (6.82 percent), convulsion (6.22 percent), hypoglycemia (5.62 percent), hyperventilation crisis (5.22 percent), choking (2.20 percent), and cerebrovascular accident (0.8 percent). Anaphylaxis, myocardial infarction, and cardiac arrest were the rarest emergencies, reported by only 0.4, 0.2, and 0.2 percent of dentists, respectively. Only 41 percent of the dentists judged themselves capable to diagnose the cause of an emergency during a dental visit. The majority responded that they would be capable of performing initial treatment of presyncope, syncope, orthostatic hypotension, convulsion, and choking. However, most of them felt unable to treat anaphylaxis, myocardial infarction, or cardiac arrest. Further, the majority felt unable to perform CPR or undertake an intravenous injection. It was concluded that the most prevalent medical emergencies in dental practice of Brazilian dentists are presyncope and orthostatic hypotension. The occurrence of life-threatening medical emergencies like anaphylaxis, myocardial infarction, cardiac arrest, and cerebrovascular accident is rare. Brazilian dentists are not fully prepared to manage medical emergencies and have insufficient experience training in CPR.

14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

Initial operations in local nuclear emergency response headquarter

International Nuclear Information System (INIS)

2012-06-01

As a result of the Fukushima nuclear accident due to the Great East Japan Earthquake and the tsunami that occurred thereafter, local nuclear emergency response headquarters (local headquarters) was set up at off-site center (OFC). However, several obstacles such as the collapse of means of communication resulting from severed communication lines, food and fuel shortage resulting from stagnant physical distribution, and increasing radiation dose around the center significantly restricted originally intended operation of local headquarters. In such severe situation, the personnel gathered at the OFC from the government, local public bodies and electric companies from March 11 to 15 acted without sufficient food, sleep or rest and did all they could against successively occurring unexpected challenges by using limited means of communication. However, issues requiring further consideration were activities of each functional group, location of OFC and the functions of equipment, machines and materials and reflecting the consideration results into future protective measures and revision of the manual for nuclear emergency response were greatly important. This report described investigated results on initial operations in local headquarters such as situation of activities conducted by local headquarters and operations at functional groups. (T. Tanaka)

Implementing a nationwide criteria-based emergency medical dispatch system

DEFF Research Database (Denmark)

Andersen, Mikkel S; Johnsen, Søren Paaske; Sørensen, Jan Nørtved

2013-01-01

A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks.......A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks....

Current status on educational program for radiation emergency medical preparedness in Korea

International Nuclear Information System (INIS)

Kim, E. S.; Kong, H. J.; Noh, J. H.; Kim, C. S.

2002-01-01

There are several educational programs in worldwide for the user of radiation, radioisotopes, and nuclear power plant. REAC/TS is one of the most famous centers for radiation emergency personnel. REMPAN, one of the World Health Organization is also to promote the medical preparedness for radiation accident and provide advice and assistance in the case of radiation accident and radiological emergency. There are a variety of educational programs of radiation emergency, but not many programs of medical preparedness in Korea. Therefore, it is introduced here Korean current environment and future direction of educational programs for the radiation emergency medical preparedness

Communicating one's local address and emergency contact details

CERN Multimedia

Information Technology Department, AIS (Administrative Information Services) Group; Human Resources Department, SPS (Services, Procedures and Social) Group

2007-01-01

As part of the ongoing simplification of procedures and rationalisation of administrative processes, the IT, PH (Users Office) and HR Departments have developed two new EDH forms for communicating or updating one's local address and emergency contact details. This is the first time that the forms relating to an official HR procedure can be accessed on a self-service basis and directly updated by the members of personnel themselves. The information recorded remains confidential and may only be accessed by the authorised administrative services and the emergency services. Local address: Members of the personnel must declare any change in their local address (Art. R V 1.38 of the Staff Regulations). This declaration is henceforth made by directly filling out the EDH document indicated below, and without requiring any other spontaneous formality vis-à-vis the department secretariat or the Users Office. It is also possible for any member of the personnel to check whether the local address in the Organizati...

Can public health registry data improve Emergency Medical Dispatch?

DEFF Research Database (Denmark)

Andersen, M S; Christensen, E F; Jepsen, S B

2016-01-01

BACKGROUND: Emergency Medical Dispatchers make decisions based on limited information. We aimed to investigate if adding demographic and hospitalization history information to the dispatch process improved precision. METHODS: This 30-day follow-up study evaluated time-critical emergencies...

Development of Rural Emergency Medical System (REMS) with Geospatial Technology in Malaysia

Science.gov (United States)

Ooi, W. H.; Shahrizal, I. M.; Noordin, A.; Nurulain, M. I.; Norhan, M. Y.

2014-02-01

Emergency medical services are dedicated services in providing out-of-hospital transport to definitive care or patients with illnesses and injuries. In this service the response time and the preparedness of medical services is of prime importance. The application of space and geospatial technology such as satellite navigation system and Geographical Information System (GIS) was proven to improve the emergency operation in many developed countries. In collaboration with a medical service NGO, the National Space Agency (ANGKASA) has developed a prototype Rural Emergency Medical System (REMS), focusing on providing medical services to rural areas and incorporating satellite based tracking module integrated with GIS and patience database to improve the response time of the paramedic team during emergency. With the aim to benefit the grassroots community by exploiting space technology, the project was able to prove the system concept which will be addressed in this paper.

Study on the action guidelines for medical support team for nuclear and radiological emergency

International Nuclear Information System (INIS)

Liu Chang'an; Liu Ying; Geng Xiusheng

2006-01-01

Objective: To study the action guidelines for medical support team for nuclear and radiological emergency. Methods: It is based on the experience and lessons learned in the course of meeting the emergencies preparedness and response of nuclear and radiological emergencies in China and abroad with the reference of the relevant reports of International Atomic Energy Agency. Results: Essential requirements and practical recommendations for the roles, responsibilities, emergency preparedness, principles and procedures of medical assistance at the scene, as well as the radiological protection of medical support team were provided. Conclusion: The document mentioned above can be applied to direct the establishment, effective medical preparedness and response of the medical support team for nuclear and radiological emergency. (authors)

Reconstruction of the Radiation Emergency Medical System From the Acute to the Sub-acute Phases After the Fukushima Nuclear Power Plant Crisis.

Science.gov (United States)

Ojino, Mayo; Ishii, Masami

2014-02-01

The radiation emergency medical system in Japan ceased to function as a result of the accident at the Fukushima Daiichi Nuclear Power Plant, which has commonly become known as the "Fukushima Accident." In this paper, we review the reconstruction processes of the radiation emergency medical system in order of events and examine the ongoing challenges to overcoming deficiencies and reinforcing the system by reviewing relevant literature, including the official documents of the investigation committees of the National Diet of Japan, the Japanese government, and the Tokyo Electric Power Company, as well as technical papers written by the doctors involved in radiation emergency medical activities in Fukushima. Our review has revealed that the reconstruction was achieved in 6 stages from March 11 to July 1, 2011: (1) Re-establishment of an off-site center (March 13), (2) Re-establishment of a secondary radiation emergency hospital (March 14), (3) Reconstruction of the initial response system for radiation emergency care (April 2), (4) Reinforcement of the off-site center and stationing of disaster medical advisors at the off-site center (April 4), (5) Reinforcement of the medical care system and an increase in the number of hospitals for non-contaminated patients (From April 2 to June 23), and (6) Enhancement of the medical care system in the Fukushima Nuclear Power Plant and the construction of a new medical care system, involving both industrial medicine and emergency medicine (July 1). Medical resources such as voluntary efforts, academic societies, a local community medical system and university hospitals involved in medical care activities on 6 stages originally had not planned. In the future, radiation emergency medical systems should be evaluated with these 6 stages as a basis, in order to reinforce and enrich both the existing and backup systems so that minimal harm will come to nuclear power plant workers or evacuees and that they will receive proper care. This

The preparedness of private dental offices and polyclinics for medical emergencies

Science.gov (United States)

Al-Sebaei, Maisa O.; Alkayyal, Moayyad A.; Alsulimani, Abdulelah H.; Alsulaimani, Othman S.; Habib, Weam T.

2015-01-01

Objectives: To assess preparedness for medical emergencies in private dental offices in Jeddah, Kingdom of Saudi Arabia (KSA). Methods: In this cross-sectional study, a survey was distributed to 70 dental offices and polyclinics in Jeddah, Saudi Arabia between October 2013 and January 2014. The questionnaire gathered information on the prevention of medical emergencies, the preparedness of the office personnel, and availability of emergency drugs and equipment. Results: For prevention, 92% (n=65) of the offices reported that they obtain a thorough medical history prior to treatment; however, only 11% (n=8) obtain vital signs for each visit. Using a preparedness percent score (0 to 100), the mean level of preparedness of the office personnel in all surveyed dental offices was 55.2±20. The availability of emergency drugs was 35±35, and equipment was 19±22. Conclusion: We found a deficiency in personnel training, availability of drugs, and emergency equipment in the surveyed dental clinics. More stringent rules and regulations for emergency preparedness must be reinforced to avoid disasters in these clinics. PMID:25737177

The relationship betweenmanagers’ leadership styles and emergency medical technicians’ job satisfaction

Directory of Open Access Journals (Sweden)

Azimeh Ghorbanian

2012-01-01

Full Text Available Background/AimsLeadership plays a crucial role in many professions, especially in challenging positions such as emergency medical service jobs. The purpose of this study was to explore the relationship between managers’ leadership styles and emergency medical technicians’ job satisfaction.MethodThis is a descriptive and cross-sectional study that was carried out in 2010. The research population included 21 managers and 87 emergency medical technicians working in 23 stations in Isfahan city, Iran. The main tools used for data accumulation were the Multiple Leadership Questionnaire for evaluating leadership styles and the Job Descriptive Index for measuring job satisfaction levels. Also, the Pearson correlation analysis test was used to evaluate the relationship between leadership style and job satisfaction.ResultsAmong both managers and technicians, the highest mean score related to the transformational management style, whereas the lowest mean score related to the laissez-faire management style. Moreover, a significant relationship (P<0.01 was found between the transformational and transactional leadership styles and job satisfaction. However, no significant relationship was observed between the laissez-faire management style and job satisfaction.ConclusionConsidering the importance of job satisfaction in medical emergencies, it is recommended that health sector policy makers should provide the groundwork for implementing the transformational leadership style to enhance job satisfaction of the medical emergency staff.

Highlights in emergency medicine medical education research: 2008.

Science.gov (United States)

Farrell, Susan E; Coates, Wendy C; Khun, Gloria J; Fisher, Jonathan; Shayne, Philip; Lin, Michelle

2009-12-01

The purpose of this article is to highlight medical education research studies published in 2008 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine. Through a PubMed search of the English language literature in 2008, 30 medical education research studies were independently identified as hypothesis-testing investigations and measurements of educational interventions. Six reviewers independently rated and scored all articles based on eight anchors, four of which related to methodologic criteria. Articles were ranked according to their total rating score. A ranking agreement among the reviewers of 83% was established a priori as a minimum for highlighting articles in this review. Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Four of these employed experimental or quasi-experimental methodology. Although technology was not a component of the structured literature search employed to identify the candidate articles for this review, 14 of the articles identified, including four of the five highlighted articles, employed or studied technology as a focus of the educational research. Overall, 36% of the reviewed studies were supported by funding; three of the highlighted articles were funded studies. This review highlights quality medical education research studies published in 2008, with outcomes of relevance to teaching and education in emergency medicine. It focuses on research methodology, notes current trends in the use of technology for learning in emergency medicine, and suggests future avenues for continued rigorous study in education.

Medical emergency planning in case of severe nuclear power plant accidents

International Nuclear Information System (INIS)

Ohlenschlaeger, L.

1980-01-01

This paper is an attempt to discuss a three-step-plan on medical emergency planning in case of severe accidents at nuclear power plants on the basis of own experiences in the regional area as well as on the basis of recommendations of the Federal Minister of the Interior. The medical considerations take account of the severity and extension of an accident whereby the current definitions used in nuclear engineering for accident situations are taken as basis. A comparison between obligatory and actual state is made on the possibilities of medical emergency planning, taking all capacities of staff, facilities, and equipment available in the Federal Republic of Germany into account. To assure a useful and quick utilization of the existing infra-structure as well as nation-wide uniform training of physicians and medical assistants in the field of medical emergency in case of a nuclear catastrophe, a federal law for health protection is regarded urgently necessary. (orig.) [de

American Association for Emergency Psychiatry Task Force on Medical Clearance of Adults

Directory of Open Access Journals (Sweden)

Eric L. Anderson

2017-02-01

Full Text Available Introduction: In the United States, the number of patients presenting to the emergency department (ED for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs. Methods: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED (Part I and then combined this with expert consensus (Part II. Results: In Part I, we discuss terminological issues and existing evidence on medical exams and laboratory studies of psychiatric patients in the ED. Conclusion: Emergency physicians should work cooperatively with psychiatric receiving facilities to decrease unnecessary testing while increasing the quality of medical screening exams for psychiatric patients who present to EDs. [West J Emerg Med. 2017;18(2235-242.

Covert medication in psychiatric emergencies: is it ever ethically permissible?

Science.gov (United States)

Hung, Erick K; McNiel, Dale E; Binder, Renée L

2012-01-01

Covert administration of medications to patients, defined as the administration of medication to patients without their knowledge, is a practice surrounded by clinical, legal, ethics-related, and cultural controversy. Many psychiatrists would be likely to advocate that the practice of covert medication in emergency psychiatry is not clinically, ethically, or legally acceptable. This article explores whether there may be exceptions to this stance that would be ethical. We first review the standard of emergency psychiatric care. Although we could identify no published empirical studies of covert administration of medicine in emergency departments, we review the prevalence of this practice in other clinical settings. While the courts have not ruled with respect to covert medication, we discuss the evolving legal landscape of informed consent, competency, and the right to refuse treatment. We discuss dilemmas regarding the ethics involved in this practice, including the tensions among autonomy, beneficence, and duty to protect. We explore how differences between cultures regarding the value placed on individual versus family autonomy may affect perspectives with regard to this practice. We investigate how consumers view this practice and their treatment preferences during a psychiatric emergency. Finally, we discuss psychiatric advance directives and explore how these contracts may affect the debate over the practice.

Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre.

Science.gov (United States)

Ek, Bosse; Svedlund, Marianne

2015-04-01

To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses. A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame

Psychiatry and emergency medicine: medical student and physician attitudes toward homeless persons.

Science.gov (United States)

Morrison, Ann; Roman, Brenda; Borges, Nicole

2012-05-01

The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden curriculum" in medical education, in which values are communicated from teacher to student outside of the formal instruction. A group of 79 students on Psychiatry and 66 on Emergency Medicine clerkships were surveyed at the beginning and end of their rotation regarding their attitudes toward homeless persons by use of the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI). The HPATHI was also administered to 31 Psychiatry residents and faculty and 41 Emergency Medicine residents and faculty one time during the course of this study. For Psychiatry clerks, t-tests showed significant differences pre- and post-clerkship experiences on 2 of the 23 items on the HPATHI. No statistically significant differences were noted for the Emergency Medicine students. An analysis of variance revealed statistically significant differences on 7 out of the 23 survey questions for residents and faculty in Psychiatry, as compared with those in Emergency Medicine. Results suggest that medical students showed small differences in their attitudes toward homeless people following clerkships in Psychiatry but not in Emergency Medicine. Regarding resident and faculty results, significant differences between specialties were noted, with Psychiatry residents and faculty exhibiting more favorable attitudes toward homeless persons than residents and faculty in Emergency Medicine. Given that medical student competencies should be addressing the broader social issues of homelessness, medical schools need to first understand the attitudes of medical students to such issues, and then develop curricula to overcome inaccurate or stigmatizing beliefs.

[The nurse within emergency medical-psychological units].

Science.gov (United States)

Darbon, Rémy; Dalphin, Catherine; Prieto, Nathalie; Cheucle, Éric

2017-04-01

The growing recognition of post-traumatic stress disorders and the need to intervene early justifies the creation of emergency medical-psychological units. The nurse has a major role to play within these teams. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Influence of awareness and availability of medical alternatives on parents seeking paediatric emergency care.

Science.gov (United States)

Ellbrant, Julia A; Åkeson, S Jonas; Karlsland Åkeson, Pia M

2018-06-01

Direct seeking of care at paediatric emergency departments may result from an inadequate awareness or a short supply of medical alternatives. We therefore evaluated the care-seeking patterns, availability of medical options and initial medical assessments - with overall reference to socioeconomic status - of parents at an urban paediatric emergency department in a Scandinavian country providing free paediatric healthcare. The parents of children assessed by paediatric emergency department physicians at a Swedish university hospital over a 25-day winter period completed a questionnaire on recent medical contacts and their reasons for attendance. Additional information was obtained from ledgers, patient records and population demographics. In total, 657 of 713 eligible patients (92%) were included. Seventy-nine per cent of their parents either failed to or managed to establish medical contact before the emergency department visit, whereas 21% sought care with no attempt at recent medical contact. Visits with a failed telephone or primary care contact (18%) were more common outside office hours ( p=0.014) and were scored as less urgent ( p=0.014). A perceived emergency was the main reason for no attempt at medical contact before the visit. Direct emergency department care-seeking was more common from the city district with the lowest socioeconomic status ( p=0.027). Although most parents in this Swedish study tried to seek medical advice before attending a paediatric emergency department, perceived emergency, a short supply of telephone health line or primary care facilities and lower socioeconomic status contributed to direct care-seeking by almost 40% of parents. Pre-hospital awareness and the availability of medical alternatives with an emphasis on major differences in socioeconomic status should therefore be considered to further optimize care-seeking in paediatric emergency departments.

Just-In-Time eTraining Applied To Emergency Medical Services

OpenAIRE

Vico Vela, Francisco José; Sánchez Canteli, Vicente; Lobo Fernández, Daniel; Fernández Rodríguez, Jose David; Bandera, César; Rivas, Ramón; Rosen, M.; Schlegel, M.

2013-01-01

While the applications of just-in-time training are more and more spread, the ubiquitous mobile technology has not found practical uses of this training strategy. As an original example of services for healthcare, we present in this work an application of eTraining that makes use of mobile telephones to transmit medical and on-site information content to emergency medical personnel that attend and emergency. The state-of-the-art in related technologies, overall architectu...

Energy network dispatch optimization under emergency of local energy shortage

International Nuclear Information System (INIS)

Cai, Tianxing; Zhao, Chuanyu; Xu, Qiang

2012-01-01

The consequence of short-time energy shortage under extreme conditions, such as earthquake, tsunami, and hurricane, may cause local areas to suffer from delayed rescues, widespread power outages, tremendous economic losses, and even public safety threats. In such urgent events of local energy shortage, agile energy dispatching through an effective energy transportation network, targeting the minimum energy recovery time, should be a top priority. In this paper, a novel methodology is developed for energy network dispatch optimization under emergency of local energy shortage, which includes four stages of work. First, emergency-area-centered energy network needs to be characterized, where the capacity, quantity, and availability of various energy sources are determined. Second, the energy initial situation under emergency conditions needs to be identified. Then, the energy dispatch optimization is conducted based on a developed MILP (mixed-integer linear programming) model in the third stage. Finally, the sensitivity of the minimum dispatch time with respect to uncertainty parameters is characterized by partitioning the entire space of uncertainty parameters into multiple subspaces. The efficacy of the developed methodology is demonstrated via a case study with in-depth discussions. -- Highlights: ► Address the energy network dispatch problem under emergency of local energy shortage. ► Minimize the energy restoration time for the entire energy network under emergency events. ► Develop a new MILP model and a sensitivity analysis method with respect to uncertainties.

The relationship between managers' leadership styles and emergency medical technicians' job satisfaction.

Science.gov (United States)

Ghorbanian, Azimeh; Bahadori, Mohammadkarim; Nejati, Mostafa

2012-01-01

Leadership plays a crucial role in many professions, especially in challenging positions such as emergency medical service jobs. The purpose of this study was to explore the relationship between managers' leadership styles and emergency medical technicians' job satisfaction. This is a descriptive and cross-sectional study that was carried out in 2010. The research population included 21 managers and 87 emergency medical technicians working in 23 stations in Isfahan city, Iran. The main tools used for data accumulation were the Multiple Leadership Questionnaire for evaluating leadership styles and the Job Descriptive Index for measuring job satisfaction levels. Also, the Pearson correlation analysis test was used to evaluate the relationship between leadership style and job satisfaction. Among both managers and technicians, the highest mean score related to the transformational management style, whereas the lowest mean score related to the laissez-faire management style. Moreover, a significant relationship (Pleadership styles and job satisfaction. However, no significant relationship was observed between the laissez-faire management style and job satisfaction. Considering the importance of job satisfaction in medical emergencies, it is recommended that health sector policy makers should provide the groundwork for implementing the transformational leadership style to enhance job satisfaction of the medical emergency staff.

A Systematic Literature Review: Workplace Violence Against Emergency Medical Services Personnel

OpenAIRE

Pourshaikhian, Majid; Abolghasem Gorji, Hassan; Aryankhesal, Aidin; Khorasani-Zavareh, Davood; Barati, Ahmad

2016-01-01

Context In spite of the high prevalence and consequences of much workplace violence against emergency medical services personnel, this phenomenon has been given insufficient attention. A systematic review can aid the development of guidelines to reduce violence. Objectives The research question addressed by this paper is, “What are the characteristics and findings of studies on workplace violence against emergency medical services...

Longitudinal Emergency Medical Technician Attributes and Demographic Study (LEADS) Design and Methodology.

Science.gov (United States)

Levine, Roger

2016-12-01

The objective of this study is to describe the Longitudinal Emergency Medical Technician (EMT) Attributes and Demographic Study (LEADS) design, instrument development, pilot testing, sampling procedures, and data collection methodology. Response rates are provided, along with results of follow-up surveys of non-responders (NRs) and a special survey of Emergency Medical Services (EMS) professionals who were not nationally certified. Annual surveys from 1999 to 2008 were mailed out to a random, stratified sample of nationally registered EMT-Basics and Paramedics. Survey weights were developed to reflect each respondent's probability of selection. A special survey of NRs was mailed out to individuals who did not respond to the annual survey to estimate the probable extent and direction of response bias. Individuals who indicated they were no longer in the profession were mailed a special exit survey to determine their reasons for leaving EMS. Given the large number of comparisons between NR and regular (annual) survey respondents, it is not surprising that some statistically significant differences were found. In general, there were few differences. However, NRs tended to report higher annual EMS incomes, were younger, healthier, more physically fit, and were more likely to report that they were not practicing EMS. Comparisons of the nationally certified EMS professionals with EMS professionals who were not nationally certified indicated that nationally certified EMS providers were younger, had less EMS experiences, earned less, were more likely to be female and work for private EMS services, and less likely to work for fire-based services. These differences may reflect state and local policy and practice, since many states and local agencies do not require maintenance of national certification as a requirement to practice. When these differences were controlled for statistically, there were few systematic differences between non-nationally certified and nationally

Commercial Airline In-Flight Emergency: Medical Student Response and Review of Medicolegal Issues.

Science.gov (United States)

Bukowski, Josh H; Richards, John R

2016-01-01

As the prevalence of air travel increases, in-flight medical emergencies occur more frequently. A significant percentage of these emergencies occur when there is no certified physician, nurse, or paramedic onboard. During these situations, flight crews might enlist the help of noncertified passengers, such as medical students, dentists, or emergency medical technicians in training. Although Good Samaritan laws exist, many health care providers are unfamiliar with the limited legal protections and resources provided to them after responding to an in-flight emergency. A 78-year-old woman lost consciousness and became pulseless onboard a commercial aircraft. No physician was available. A medical student responded and coordinated care with the flight crew, ground support physician, and other passengers. After receiving a packet (4 g) of sublingual sucrose and 1 L i.v. crystalloid, the patient regained pulses and consciousness. The medical student made the decision not to divert the aircraft based on the patient's initial response to therapy and, 45 min later, the patient had normal vital signs. Upon landing, she was met and taken by paramedics to the nearest emergency department for evaluation of her collapse. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians are the most qualified to assist in-flight emergencies, but they might not be aware of the medicolegal risks involved with in-flight care, the resources available, and the role of the flight crew in liability and decision making. This case, which involved a medical student who was not given explicit protection under Good Samaritan laws, illustrates the authority of the flight crew during these events and highlights areas of uncertainty in the legislation for volunteer medical professionals. Copyright © 2016 Elsevier Inc. All rights reserved.

Training for the medical response in radiological emergency experiences and results

International Nuclear Information System (INIS)

Cardenas Herrera, J.; Lopez Forteza, Y.

2003-01-01

The use of the nuclear techniques int he social practice confers a special imporatnce to the relative aspects to the safety of the practices and radiationsources, for what the implementation of efficient programs of radiation protection constitutes a priority. However in spite of the will before expressed, regrettably radiological situations happen accidental assocaited to multiple causes taht suggest the creation of response capacities to intervention before these fortuitous facts. The experiences accumulated in the last decades related with accidental exposures have evidenced the convenience of having properly qualified human resources for the Medical Response in Radiological Emergencies. The training in the medical aspects of the radiological emergencies acquires a singular character. In such a sense when valuing the national situation put onof manifest deficiences as for the training in medical aspects of the radiological emergencies that advised the development of training programs in such aspects for the different response groups linked to the topic. After identified the training necessities and the scope of the same ones, the contents of the training program were elaborated. The program has as general purpose the invigoration of the capacity of the medical response in front of accidental radiological situations, by means of actions that they bear to prepare groups of medical response in the handling of people accident victims and to the identification of potentials,accidental scenarios, as well as of the necessary resources to confront them. The program content approaches theoretical and paractical aspects to the medical aspect to radiological emergencies. The program include the different topics about fundamental of physical biological to radiation protection, radiation protection during exposure of radiological accidents, medical care for overexposed or contaminated persons, drill, exercises and concludes with designation of a strategy as preparation and

Usage of emergency contraception between medical related and non-medical related students.

LENUS (Irish Health Repository)

Khalid, A K

2009-04-01

Teenagers and young adultshave the most risk of unplanned pregnancy, due to lack of awareness to see a family planning provider after unprotected sexual intercourse. In addition, nearly one in five physicians is reluctant to provide information regarding Emergency Contraception (EC) to women and this may contribute to their lack of awareness. This study was conducted to assess the knowledge, attitudes and practices regarding the use of EC between medical related students compared to non-medical related students. Data collection was done using questionnaires distributed among students in University College Cork (UCC). 93% of medically related students were aware of EC compared to only 73.5% of non-medically related students. Medical related students also were more aware about the mechanism of action and detailed knowledge of EC compared to the non-medical students. This study has proven that medically related students have more detailed knowledge regarding EC compared to non-medical related students. However, there was no significant difference noted regarding the attitude and practice between the two groups.

Smart City Governance: A Local Emergent Perspective

NARCIS (Netherlands)

Meijer, Albert

2016-01-01

This chapter presents a local emergent perspective on smart city governance. Smart city governance is about using new technologies to develop innovative governance arrangements. Cities all around the world are struggling to find smart solutions to wicked problems and they hope to learn from

Medical care at mass gatherings: emergency medical services at large-scale rave events.

Science.gov (United States)

Krul, Jan; Sanou, Björn; Swart, Eleonara L; Girbes, Armand R J

2012-02-01

The objective of this study was to develop comprehensive guidelines for medical care during mass gatherings based on the experience of providing medical support during rave parties. Study design was a prospective, observational study of self-referred patients who reported to First Aid Stations (FASs) during Dutch rave parties. All users of medical care were registered on an existing standard questionnaire. Health problems were categorized as medical, trauma, psychological, or miscellaneous. Severity was assessed based on the Emergency Severity Index. Qualified nurses, paramedics, and doctors conducted the study after training in the use of the study questionnaire. Total number of visitors was reported by type of event. During the 2006-2010 study period, 7,089 persons presented to FASs for medical aid during rave parties. Most of the problems (91.1%) were categorized as medical or trauma, and classified as mild. The most common medical complaints were general unwell-being, nausea, dizziness, and vomiting. Contusions, strains and sprains, wounds, lacerations, and blisters were the most common traumas. A small portion (2.4%) of the emergency aid was classified as moderate (professional medical care required), including two cases (0.03%) that were considered life-threatening. Hospital admission occurred in 2.2% of the patients. Fewer than half of all patients presenting for aid were transported by ambulance. More than a quarter of all cases (27.4%) were related to recreational drugs. During a five-year field research period at rave dance parties, most presentations on-site for medical evaluation were for mild conditions. A medical team of six healthcare workers for every 10,000 rave party visitors is recommended. On-site medical staff should consist primarily of first aid providers, along with nurses who have event-specific training on advanced life support, event-specific injuries and incidents, health education related to self-care deficits, interventions for

Social Factors Determine the Emergency Medical Admission Workload

Directory of Open Access Journals (Sweden)

Seán Cournane

2017-06-01

Full Text Available We related social factors with the annual rate of emergency medical admissions using census small area statistics. All emergency medical admissions (70,543 episodes in 33,343 patients within the catchment area of St. James’s Hospital, Dublin, were examined between 2002 and 2016. Deprivation Index, Single-Parent status, Educational level and Unemployment rates were regressed against admission rates. High deprivation areas had an approximately fourfold (Incidence Rate Ratio (IRR 4.0 (3.96, 4.12 increase in annual admission rate incidence/1000 population from Quintile 1(Q1, from 9.2/1000 (95% Confidence Interval (CI: 9.0, 9.4 to Q5 37.3 (37.0, 37.5. Single-Parent families comprised 40.6% of households (95% CI: 32.4, 49.7; small areas with more Single Parents had a higher admission rate-IRR (Q1 vs. for Q5 of 2.92 (95% CI: 2.83, 3.01. The admission incidence rate was higher for Single-Parent status (IRR 1.50 (95% CI: 1.46, 1.52 where the educational completion level was limited to primary level (Incidence Rate Ratio 1.45 (95% CI: 1.43, 1.47. Small areas with higher educational quintiles predicted lower Admission Rates (IRR 0.85 (95% CI: 0.84, 0.86. Social factors strongly predict the annual incidence rate of emergency medical admissions.

[Cirurgia Taurina--emergency medical treatment of bullfighters in Spain].

Science.gov (United States)

Lehmann, V; Lehmann, J

2003-08-01

A considerable risk of life-threatening injury is inherent to bullfighting. Thus, a unique form of emergency treatment has evolved over recent decades of organized bull-fighting. Today bullfight arenas in larger cities are equipped with emergency facilities including fully furnished operating rooms. During a fiesta these facilities are run by a medical team consisting of three surgeons, one intensive care specialist, and one anesthesiologist with their supporting medical personnel. In smaller arenas or villages immediate care units consist of emergency vehicles, and a mobile container equipped with a fully functional operating room. Of all toreros the matadores including the novilleros are most often injured in 56 % of cases. This rate decreases for banderillos (30 %), and for picadores (14 %). Parts of the body that are most frequently affected are thighs, and the inguinal region (54 %). Head and neck injuries are seen in 19 %, and 12 % of cases present with open abdominal wounds including liver or gastrointestinal tract traumas. 10 % of injuries affect the thorax, and 4 % the pelvic floor. The particular form of organised medical treatment for bullfighters in Spain has only developed since the nineteen-thirties. In 1972 a scientific society for bullfight surgery was founded in Spain by specialized surgeons, and immediate care specialists holding a first convention that year. The society is continuously striving to improve technical and logistical aspects of immediate medical care for injured bullfighters.

Emergency medical consequence planning and management for national special security events after September 11: Boston 2004.

Science.gov (United States)

Kade, Kristy A; Brinsfield, Kathryn H; Serino, Richard A; Savoia, Elena; Koh, Howard K

2008-10-01

The post-September 11 era has prompted unprecedented attention to medical preparations for national special security events (NSSE), requiring extraordinary planning and coordination among federal, state, and local agencies. For an NSSE, the US Secret Service (USSS) serves as the lead agency for all security operations and coordinates with relevant partners to provide for the safety and welfare of participants. For the 2004 Democratic National Convention (DNC), designated an NSSE, the USSS tasked the Boston Emergency Medical Services (BEMS) of the Boston Public Health Commission with the design and implementation of health services related to the Convention. In this article, we describe the planning and development of BEMS' robust 2004 DNC Medical Consequence Management Plan, addressing the following activities: public health surveillance, on-site medical care, surge capacity in the event of a mass casualty incident, and management of federal response assets. Lessons learned from enhanced medical planning for the 2004 DNC may serve as an effective model for future mass gathering events.

Medical emergencies in the imaging department of a university hospital: event and imaging characteristics.

Science.gov (United States)

van Tonder, F C; Sutherland, T; Smith, R J; Chock, J M E; Santamaria, J D

2013-01-01

We aimed to describe the characteristics of medical emergencies that occurred in the medical imaging department (MID) of a university hospital in Melbourne, Australia. A database of 'Respond Medical Emergency Team (MET)' and 'Respond Blue' calls was retrospectively examined for the period June 2003 to November 2010 in relation to events that occurred in the MID. The hospital medical imaging database was also examined in relation to these events and, where necessary, patients' notes were reviewed. Ethics approval was granted by the hospital ethics review board. There were 124 medical emergency calls in the MID during the study period, 28% Respond Blue and 72% Respond MET. Of these 124 calls, 26% occurred outside of usual work hours and 12% involved cardiac arrest. The most common reasons for the emergency calls were seizures (14%) and altered conscious state (13%). Contrast anaphylaxis precipitated the emergency in 4% of cases. In 83% of cases the emergency calls were for patients attending the MID for diagnostic imaging, the remainder being for a procedure. Of the scheduled imaging techniques, 45% were for computed tomography. The scheduled imaging was abandoned due to the emergency in 12% of cases. When performed, imaging informed patient management in 34% of cases in diagnostic imaging and in all cases in the context of image-guided procedures. Medical emergency calls in the MID often occurred outside usual work hours and were attributed to a range of medical problems. The emergencies occurred in relation to all imaging techniques and imaging informed patient management in many cases. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Developing an electronic system to manage and track emergency medications.

Science.gov (United States)

Hamm, Mark W; Calabrese, Samuel V; Knoer, Scott J; Duty, Ashley M

2018-03-01

The development of a Web-based program to track and manage emergency medications with radio frequency identification (RFID) is described. At the Cleveland Clinic, medication kit restocking records and dispense locations were historically documented using a paper record-keeping system. The Cleveland Clinic investigated options to replace the paper-based tracking logs with a Web-based program that could track the real-time location and inventory of emergency medication kits. Vendor collaboration with a board of pharmacy (BOP) compliance inspector and pharmacy personnel resulted in the creation of a dual barcoding system using medication and pocket labels. The Web-based program was integrated with a Cleveland Clinic-developed asset tracking system using active RFID tags to give the real-time location of the medication kit. The Web-based program and the asset tracking system allowed identification of kits nearing expiration or containing recalled medications. Conversion from a paper-based system to a Web-based program began in October 2013. After 119 days, data were evaluated to assess the success of the conversion. Pharmacists spent an average of 27 minutes per day approving medication kits during the postimplementation period versus 102 minutes daily using the paper-based system, representing a 74% decrease in pharmacist time spent on this task. Prospective reports are generated monthly to allow the manager to assess the expected workload and adjust staffing for the next month. Implementation of a BOP-approved Web-based system for managing and tracking emergency medications with RFID integration decreased pharmacist review time, minimized compliance risk, and increased access to real-time data. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

[The characteristics of medical technologies in emergency medical care hospital].

Science.gov (United States)

Murakhovskiĭ, A G; Babenko, A I; Bravve, Iu I; Tataurova, E A

2013-01-01

The article analyzes the implementation of major 12 diagnostic and 17 treatment technologies applied during medical care of patients with 12 key nosology forms of diseases in departments of the emergency medical care hospital No 2 of Omsk. It is established that key groups of technologies in the implementation of diagnostic process are the laboratory clinical diagnostic analyses and common diagnostic activities at reception into hospital and corresponding departments. The percentage of this kind of activities is about 78.3% of all diagnostic technologies. During the realization of treatment process the priority technologies are common curative and rehabilitation activities, intensive therapy activities and clinical diagnostic monitoring activities. All of them consist 80.1% of all curative technologies.

The FIFA medical emergency bag and FIFA 11 steps to prevent sudden cardiac death: setting a global standard and promoting consistent football field emergency care.

Science.gov (United States)

Dvorak, Jiri; Kramer, Efraim B; Schmied, Christian M; Drezner, Jonathan A; Zideman, David; Patricios, Jon; Correia, Luis; Pedrinelli, André; Mandelbaum, Bert

2013-12-01

Life-threatening medical emergencies are an infrequent but regular occurrence on the football field. Proper prevention strategies, emergency medical planning and timely access to emergency equipment are required to prevent catastrophic outcomes. In a continuing commitment to player safety during football, this paper presents the FIFA Medical Emergency Bag and FIFA 11 Steps to prevent sudden cardiac death. These recommendations are intended to create a global standard for emergency preparedness and the medical response to serious or catastrophic on-field injuries in football.

Controlling disasters: Local emergency management perceptions about Federal Emergency Management and Homeland Security actions after September 11, 2001.

Science.gov (United States)

Hildebrand, Sean

This article examines local emergency manager's beliefs regarding control over tasks during various stages of the hazard cycle since federal policies went into effect following the September 11 attacks. The study considers whether a disparity exists between the actions of local officials during each phase of the "hazard cycle" and the policy expectations of the federal government, which call for greater federal control over activities in emergency management and homeland security. To do so, hypothesis testing investigates the jurisdiction's use of comprehensive emergency management (CEM) practices, the perceived "clarity" of the federal policy demands, and if the local actors feel coerced to comply with federal policy demands so that grant funding is not compromised. Using a model developed from "third-generation" policy implementation research, the results show that the odds of local officials citing federal control over these actions have very limited statistical significance. This signals that the perceived lack of local input into the development of these federal policies and the policies' limited use of traditional CEM measures may not be in concert with what local actors perform in the field. Simply put, the respondents claim to understand the federal policy demands, support the concept of federal control as the policies describe, yet follow their own plans or traditional CEM principles, even if such actions do not support the federal policy demands. These results align with pre-existing research in the emergency management field that show issues with efforts to centralize policies under the Department of Homeland Security and Federal Emergency Management Agency.

The health and safety implications of local medical support for land seismic crews in remote locations in southeast Asia

International Nuclear Information System (INIS)

Win, P.M.; Suter, P.C.

1991-01-01

The paper attempts to detail the benefits and drawbacks of hiring local doctors to support the medical services needed for land seismic acquisition crews in remote locations in South East Asia. The actual conditions prevailing among such seismic operations will be presented highlighting the problems and risks involved. The management of these problems will be outlined in terms of prevention and actual diagnosis and treatment of disease and injuries including emergency stabilization and evacuation of critically ill patients. The results and lessons learned will be evaluated and discussed including the economics of setting up a reasonably reliable medical facility. The paper will conclude that local knowledge, high levels of training and low costs make this type of medical support beneficial for such operations and may well be applicable for similar operations in other parts of the world

Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management.

Science.gov (United States)

Malamed, Stanley F

2015-12-01

Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment. Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations. Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.

Medical Identity Theft in the Emergency Department: Awareness is Crucial

Directory of Open Access Journals (Sweden)

Michelino Mancini

2014-11-01

Full Text Available Medical Identity theft in the emergency department (ED can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient’s identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior. [West J Emerg Med. 2014;15(7:–0.

Factors associated with emergency medical services scope of practice for acute cardiovascular events.

Science.gov (United States)

Williams, Ishmael; Valderrama, Amy L; Bolton, Patricia; Greek, April; Greer, Sophia; Patterson, Davis G; Zhang, Zefeng

2012-01-01

To examine prehospital emergency medical services (EMS) scope of practice for acute cardiovascular events and characteristics that may affect scope of practice; and to describe variations in EMS scope of practice for these events and the characteristics associated with that variability. In 2008, we conducted a telephone survey of 1,939 eligible EMS providers in nine states to measure EMS agency characteristics, medical director involvement, and 18 interventions authorized for prehospital care of acute cardiovascular events by three levels of emergency medical technician (EMT) personnel. A total of 1,292 providers responded to the survey, for a response rate of 67%. EMS scope of practice interventions varied by EMT personnel level, with the proportion of authorized interventions increasing as expected from EMT-Basic to EMT-Paramedic. Seven of eight statistically significant associations indicated that EMS agencies in urban settings were less likely to authorize interventions (odds ratios department-based EMS agencies were two to three times more likely to authorize interventions for EMT-Intermediate personnel. Volunteer EMS agencies were more than twice as likely as nonvolunteer agencies to authorize interventions for EMT-Basic and EMT-Intermediate personnel but were less likely to authorize any one of the 11 interventions for EMT-Paramedics. Greater medical director involvement was associated with greater likelihood of authorization of seven of the 18 interventions for EMT-Basic and EMT-Paramedic personnel but had no association with EMT-Intermediate personnel. We noted statistically significant variations in scope of practice by rural vs. urban setting, medical director involvement, and type of EMS service (fire department-based/non-fire department-based; volunteer/paid). These variations highlight local differences in the composition and capacity of EMS providers and offer important information for the transition towards the implementation of a national scope of

Achievements in emergency medical rescue service, North-West ...

African Journals Online (AJOL)

2006-08-28

Aug 28, 2006 ... In North-West province this process of provincialisation took place in ... Emergency Medical Rescue Service, Department of Health, North-West. Victor R .... recovery after CPR treatment should be started as soon as possible ...

Emerging medical informatics research trends detection based on MeSH terms.

Science.gov (United States)

Lyu, Peng-Hui; Yao, Qiang; Mao, Jin; Zhang, Shi-Jing

2015-01-01

The aim of this study is to analyze the research trends of medical informatics over the last 12 years. A new method based on MeSH terms was proposed to identify emerging topics and trends of medical informatics research. Informetric methods and visualization technologies were applied to investigate research trends of medical informatics. The metric of perspective factor (PF) embedding MeSH terms was appropriately employed to assess the perspective quality for journals. The emerging MeSH terms have changed dramatically over the last 12 years, identifying two stages of medical informatics: the "medical imaging stage" and the "medical informatics stage". The focus of medical informatics has shifted from acquisition and storage of healthcare data by integrating computational, informational, cognitive and organizational sciences to semantic analysis for problem solving and clinical decision-making. About 30 core journals were determined by Bradford's Law in the last 3 years in this area. These journals, with high PF values, have relative high perspective quality and lead the trend of medical informatics.

Local-regional anesthesia in the management of stingray stings: Experience of the Bouffard medical-surgical hospital in Djibouti.

Science.gov (United States)

Vanoye, C; Lacroix, G; Le Gonidec, E; Couret, A; Benois, A; Peigne, V

2017-02-01

Stingray injuries are very painful. Systemic analgesics are ineffective, and the use of local-regional anesthesia has been reported. This retrospective descriptive study reviewed all cases of stingray injuries seen at the emergency department of the Bouffard Hospital (Djbouti, Africa) between 2011 and 2014. The study included 35 patients. Most of the injuries (n= 31, 89%) concerned the lower limbs. Median pain intensity was 6 [5-8] on a visual analog scale of 0 (no pain) to 10. The following systemic medications were administered: acetaminophen to 13 (27%) patients, morphine to 8 (23%), and tramadol to 6 (17%). In all, 25 (71%) patients received local-regional anesthesia, 15 (60%) by injections at the ankle. All procedures were successful, and no adverse event was reported. This study reports clinical data about stingray injuries in the Red Sea area and highlights the interest of local-regional anesthesia in their management. Most of the procedures were distal and could be performed by trained emergency physicians.

An intelligent IoT emergency vehicle warning system using RFID and Wi-Fi technologies for emergency medical services.

Science.gov (United States)

Lai, Yeong-Lin; Chou, Yung-Hua; Chang, Li-Chih

2018-01-01

Collisions between emergency vehicles for emergency medical services (EMS) and public road users have been a serious problem, impacting on the safety of road users, emergency medical technicians (EMTs), and the patients on board. The aim of this study is to develop a novel intelligent emergency vehicle warning system for EMS applications. The intelligent emergency vehicle warning system is developed by Internet of Things (IoT), radio-frequency identification (RFID), and Wi-Fi technologies. The system consists of three major parts: a system trigger tag, an RFID system in an emergency vehicle, and an RFID system at an intersection. The RFID system either in an emergency vehicle or at an intersection contains a controller, an ultrahigh-frequency (UHF) RFID reader module, a Wi-Fi module, and a 2.4-GHz antenna. In addition, a UHF ID antenna is especially designed for the RFID system in an emergency vehicle. The IoT system provides real-time visual warning at an intersection and siren warning from an emergency vehicle in order to effectively inform road users about an emergency vehicle approaching. The developed intelligent IoT emergency vehicle warning system demonstrates the capabilities of real-time visual and siren warnings for EMS safety.

Examining Career Success of Minority and Women Emergency Medical Technicians (EMTs): A LEADS Project

Science.gov (United States)

Russ-Eft, Darlene F.; Dickison, Philip D.; Levine, Roger

2008-01-01

Emergency medical technicians (EMTs) are a critical segment in prehospital medical care. This study examined EMT-paramedic career success focused on minorities and women, as part of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). The LEADS data come from a representative sampling of EMTs throughout the…

Interprofessional education of medical students and paramedics in emergency medicine.

Science.gov (United States)

Hallikainen, J; Väisänen, O; Rosenberg, P H; Silfvast, T; Niemi-Murola, L

2007-03-01

Emergency medicine is team work from the field to the hospital and therefore it is also important for physicians to understand the work of paramedics, and vice versa. Interprofessional emergency medicine education for medical and paramedic students in Helsinki was started in 2001. It consisted of a 15 European credit transfer system (ECTS) credits programme combining 22 students in 2001. In 2005, the number of students had increased to 25. The programme consisted of three parts: acute illness in childhood and adults (AI), advanced life support (ALS) and trauma life support (TLS). In this paper, we describe the concept of interprofessional education of medical students and paramedics in emergency medicine. After finishing the programmes in 2001 and in 2005, the students' opinions regarding the education were collected using a standardized questionnaire. There were good ratings for the courses in AI (2001 vs. 2005, whole group; 4.3 +/- 0.7 vs. 4.2 +/- 0.4, P = 0.44) ALS (4.7 +/- 0.5 vs. 4.4 +/- 0.5, P = 0.06) and TLS (3.9 +/- 0.7 vs. 4.4 +/- 0.5, P = 0.01) in both years. Most of the medical students considered that this kind of co-education should be arranged for all medical students (2001 vs. 2005; 4.8 +/- 0.6 vs. 4.4 +/- 0.5, P = 0.02) and should be obligatory (3.5 +/- 1.5 vs. 3.1 +/- 1.3, P = 0.35). Co-education was well received and determined by the students as an effective way of improving their knowledge of emergency medicine and medical skills. The programme was rated as very useful and it should be included in the educational curriculum of both student groups.

An insight into the emerging role of regional medical advisor in the pharmaceutical industry

Directory of Open Access Journals (Sweden)

Sandeep Kumar Gupta

2013-01-01

Full Text Available The position of regional medical advisor (RMA is relatively new in the pharmaceutical industry and its roles and responsibility are still evolving. The RMA is a field based position whose main mission is to foster collaborative relationships with the key opinion leaders (KOLs and to facilitate the exchange of unbiased scientific information between the medical community and the company. Field-based medical liaison teams are expanding world-wide as part of the pharmaceutical industry′s increased focus on global operations including emerging markets. Now, the position of the RMA has evolved into comprehensive, complex, highly interactive, targeted, highly strategic, innovative, and independent role since its inception by the Upjohn Company in 1967. The major objective of the RMA is to develop the professional relationships with the health-care community, particularly KOLs, through peer-to-peer contact. The RMA can facilitate investigator-initiated clinical research proposals from approval until completion, presentation, and publication. It is possible for a RMA to have valuable access to KOLs through his expertise in the clinical research. The RMA can assist in the development, review, and follow-up of the clinical studies initiated within the relevant therapeutic area at the regional/local level. The RMA can lead regional/local clinical projects to ensure that all clinical trials are conducted in compliance with the International Conference of Harmonisation Good Clinical Practice (ICH GCP guidelines.

Emergency medical personnel training: I. An historical perspective.

Science.gov (United States)

Sytkowski, P A; Jacobs, L M; Meany, M

1983-01-01

The status of Emergency Medical Technicians has evolved from an undefined role with few rules, regulations, or standards to an established health care profession and a nationally administered program. The evolution of this profession received major impetus from the 1966 report by the National Academy of Science/National Research Council that provided recommended training standards. Development of a training course curriculum for basic life support (BLS) followed. The need for coordinated training of Emergency Medical Technical Technicians was recognized, and funds became available to aid in the national standardization of education, examination, certification, and recertification procedures for EMTs. Concomitant with the attempt to standardize BLS training, advanced life support (ALS) programs grew in number. By 1977 the National Standard Training Curriculum became available and was soon followed by a national certification exam. As states have the option to accept or reject the federal standards embodied in the national training course, there remains variation among programs offered by each state. Because of the difference in need for specific emergency services among the states at a time of increased professional mobility, arguments still exist regarding the desirability of federally mandated training and certification programs.

Utilization of emergency medical transports and hospital admissions among persons with behavioral health conditions.

Science.gov (United States)

Cuddeback, Gary; Patterson, P Daniel; Moore, Charity Galena; Brice, Jane H

2010-04-01

Emergency medical services transport and emergency department misuse among persons with behavioral health conditions is a concern. Administrative data were used to examine medical transports and hospital admissions among persons with behavioral health conditions. Data on 70,126 medical transports to emergency departments in three southeastern counties were analyzed. Compared with general medical transports, fewer behavioral health transports resulted in a hospital admission. Among behavioral health transports, persons with schizophrenia were 2.62 times more likely than those with substance use disorders to be admitted, and persons with mood disorders were 4.36 times more likely than those with substance use disorders to be admitted. Also, among behavioral health transports, rural transports were less likely than more urban transports to result in a hospital admission. More training of emergency medical services personnel and more behavioral health crisis resources, especially targeting rural areas and substance use disorders, are needed.

Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

Directory of Open Access Journals (Sweden)

Stoneking LR

2016-08-01

Full Text Available LR Stoneking,1 AL Waterbrook,1 J Garst Orozco,2 D Johnston,1 A Bellafiore,1 C Davies,3 T Nuño,1 J Fatás-Cabeza,4 O Beita,5 V Ng,1 KH Grall,6 W Adamas-Rappaport7 1Department of Emergency Medicine, University of Arizona, Tucson, AZ, 2Department of Emergency Medicine, Sinai Health System, Chicago, IL, 3Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, 4Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, 5Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 6Department of Emergency Medicine, Regions Hospital, St Paul, MN, 7Department of Surgery, University of Arizona, Tucson, AZ, USA Background: After emergency department (ED discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit.Objectives: To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency.Methods: Our ED has two Emergency Medicine Residency Programs, University Campus (UC and South Campus (SC. SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions.Results: Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study

Local responses to French medical imperialism in late nineteenth-century Algeria.

Science.gov (United States)

Gallois, William

2007-08-01

This article offers the first account of the lives of Algerian-born doctors working in the French colonial medical service between 1870 and 1900. Their stories reveal the manner in which the idea of medical imperialism had collapsed in Algeria, as a result of maladministration, racial policies, competition between civil and military authorities, budgetary constraints and the rise of the colons. The article also indicates the way in which medicine became a locus of opposition to French rule. It shows how the first decades of the Third Republic were critical in terms of a shift from the earlier idea of medicine serving as an emblem of the mission civilisatrice to the ideological potential of medicine being seen in much more nuanced terms by both French settlers and Algerian locals. It is argued that the notion of cultural resistance to imperialism through medicine emerges in the 1870s and 1880s, thereby prefiguring the work of Fanon and the Front de Liberation Nationale's later analysis of the 'sickness' of colonial Algerian society.

A Pilot Project Demonstrating that Combat Medics Can Safely Administer Parenteral Medications in the Emergency Department.

Science.gov (United States)

Schauer, Steven G; Cunningham, Cord W; Fisher, Andrew D; DeLorenzo, Robert A

2017-12-01

Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration. Project Design This was a quality assurance project that monitored training of combat medics to administer parenteral medications and to ensure patient safety. Combat medics were provided training that included direct supervision during medication administration. Once proficiency was demonstrated, combat medics would prepare the medications under direct supervision, followed by indirect supervision during administration. As part of the quality assurance and safety processes, combat medics were required to document all medication administrations, supervising provider, and unexpected adverse events. Additional quality assurance follow-up occurred via complete chart review by the project lead. Data During the project period, the combat medics administered the following medications: ketamine (n=13), morphine (n=8), ketorolac (n=7), fentanyl (n=5), ondansetron (n=4), and other (n=6). No adverse events or patient safety events were reported by the combat medics or discovered during the quality assurance process. In this limited case series, combat medics safely administered parenteral medications under indirect provider supervision. Future research is needed to further develop this training model for both the military and civilian setting. Schauer SG , Cunningham C W, Fisher AD , DeLorenzo RA . A pilot project demonstrating that combat medics can safely administer parenteral medications in the emergency department. Prehosp Disaster Med. 2017;32(6):679-681.

Recurrent Local Tetanus: A Case Report | Talabi | Nigerian Medical ...

African Journals Online (AJOL)

This case report is on the recurrence of tetanus localized over the (R) upper limb within a seventeen-month period. Recurrent localized tetanus has not been reported in our local medical literature just as there is paucity of reported localized tetanus. The patient in this case sustained a piercing broomstick injury to the medial ...

Wireless local network architecture for Naval medical treatment facilities

OpenAIRE

Deason, Russell C.

2004-01-01

Approved for public release; distribution is unlimited In today's Navy Medicine, an approach towards wireless networks is coming into view. The idea of developing and deploying workable Wireless Local Area Networks (WLAN) throughout Naval hospitals is but just a few years down the road. Currently Naval Medical Treatment Facilities (MTF) are using wired Local Area Networks (LANs) throughout the infrastructure of each facility. Civilian hospitals and other medical treatment facilities have b...

Emergency ultrasound and echocardiography in patients with infarct-related cardiogenic shock : A survey among members of the German Society of Medical Intensive Care and Emergency Medicine.

Science.gov (United States)

Michels, G; Hempel, D; Pfister, R; Janssens, U

2018-04-09

Current international and national guidelines promote the use of emergency echocardiography in patients with cardiogenic shock. We assessed whether these recommendations are followed in clinical practice of infarct-related cardiogenic shock patients. For this purpose we conducted a web-based survey among all members of the German Society of Medical Intensive Care and Emergency Medicine (DGIIN); 40% of the DGIIN members completed the survey. Participants reported that in their department emergency echocardiography/ultrasound is performed on most patients in infarct-related cardiogenic shock presenting to the emergency department/chest pain unit or intensive care unit (58.6% versus 81.4%). Only 33% stated that on patients admitted directly to the catheterization laboratory emergency ultrasound/echocardiography is applied in their institution. Local availability of a standardized algorithm was lacking in the majority of departments (77.2%). A great proportion (38.3%) of participants stated that they personally had no formal training in emergency ultrasound. In order to meet the demands of the current guidelines, in addition to integration of ultrasound examinations into diagnostic algorithms, a structured training of all emergency and intensive care physicians is necessary.

Emergency medical service in the stroke chain of survival.

Science.gov (United States)

Chenaitia, Hichem; Lefevre, Oriane; Ho, Vanessa; Squarcioni, Christian; Pradel, Vincent; Fournier, Marc; Toesca, Richard; Michelet, Pierre; Auffray, Jean Pierre

2013-02-01

The Emergency Medical Services (EMS) play a primordial role in the early management of adults with acute ischaemic stroke (AIS). The aim of this study was to evaluate the role and effectiveness of the EMS in the stroke chain of survival in Marseille. A retrospective observational study was conducted in patients treated for AIS or transient ischaemic attack in three emergency departments and at the Marseille stroke centre over a period of 12 months. In 2009, of 1034 patients ultimately presenting a diagnosis of AIS or transient ischaemic attack, 74% benefited from EMS activation. Dispatchers correctly diagnosed 57% of stroke patients. The symptoms most frequently reported included limb weakness, speech problems and facial paresis. Elements resulting in misdiagnosis by dispatchers were general discomfort, chest pain, dyspnoea, fall or vertigo. Stroke patients not diagnosed by emergency medical dispatchers but calling within 3 h of symptom onset accounted for 20% of cases. Our study demonstrates that public intervention programmes must stress the urgency of recognizing stroke symptoms and the importance of calling EMS through free telephone numbers. Further efforts are necessary to disseminate guidelines for healthcare providers concerning stroke recognition and the new therapeutic possibilities in order to increase the likelihood of acute stroke patients presenting to a stroke team early enough to be eligible for acute treatment. In addition, EMS dispatchers should receive further training about atypical stroke symptoms, and 'Face Arm Speech Test' tests must be included in the routine questionnaires used in emergency medical calls concerning elderly persons.

Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations

CERN Document Server

2014-01-01

Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations

Knowledge and Preparedness of Dental Practitioners on Management of Medical Emergencies in Jazan Province

Directory of Open Access Journals (Sweden)

Ghassan M. Al-Irany

2018-02-01

Full Text Available Medical emergencies are one of the most stressful situations the staff in a dental practice might encounter. The duty of care toward the attending patients obligates suitable preparedness to provide the necessary care if such emergencies ensue. Unfortunately, we found that 22% of the investigated dental clinics had no emergency kit available. Only 38% of the interviewed dentists felt confident to perform CPR, and 18% had no confidence to manage any medical emergency. An MCQ test of 20 questions examining the dentists’ knowledge in medical emergencies was distributed, and the level of knowledge was found to be suboptimal. The average score of the interviewed dentists was 10.87 out of 20. Experience and specialty training had a negligible effect on the level of knowledge.

Mammalian synthetic biology: emerging medical applications.

Science.gov (United States)

Kis, Zoltán; Pereira, Hugo Sant'Ana; Homma, Takayuki; Pedrigi, Ryan M; Krams, Rob

2015-05-06

In this review, we discuss new emerging medical applications of the rapidly evolving field of mammalian synthetic biology. We start with simple mammalian synthetic biological components and move towards more complex and therapy-oriented gene circuits. A comprehensive list of ON-OFF switches, categorized into transcriptional, post-transcriptional, translational and post-translational, is presented in the first sections. Subsequently, Boolean logic gates, synthetic mammalian oscillators and toggle switches will be described. Several synthetic gene networks are further reviewed in the medical applications section, including cancer therapy gene circuits, immuno-regulatory networks, among others. The final sections focus on the applicability of synthetic gene networks to drug discovery, drug delivery, receptor-activating gene circuits and mammalian biomanufacturing processes. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Frequency of Burnout, Sleepiness and Depression in Emergency Medicine Residents with Medical Errors in the Emergency Department

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Alireza Aala

2014-07-01

Full Text Available Aims: Medical error is a great concern of the patients and physicians. It usually occurs due to physicians’ exhaustion, distress and fatigue. In this study, we aimed to evaluate frequency of distress and fatigue among emergency medicine residents reporting a medical error. Materials and Methods: The study population consisted of emergency medicine residents who completed an emailed questionnaire including self-assessment of medical errors, the Epworth Sleepiness Scale (ESS score, the Maslach Burnout Inventory, and PRIME-MD validated depression screening tool.   Results: In this survey, 100 medical errors were reported including diagnostic errors in 53, therapeutic errors in 24 and following errors in 23 subjects. Most errors were reported by males and third year residents. Residents had no signs of depression, but all had some degrees of sleepiness and burnout. There were significant differences between errors subtypes and age, residency year, depression, sleepiness and burnout scores (p<0.0001.   Conclusion: In conclusion, residents committing a medical error usually experience burnout and have some grades of sleepiness that makes them less motivated increasing the probability of medical errors. However, as none of the residents had depression, it could be concluded that depression has no significant role in medical error occurrence and perhaps it is a possible consequence of medical error.    Keywords: Residents; Medical error; Burnout; Sleepiness; Depression

Simulation in Medical School Education: Review for Emergency Medicine

Directory of Open Access Journals (Sweden)

Shahram Lotfipour

2011-05-01

Full Text Available Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM. The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.

Examination of image diagnosis system at high level emergency medical service

International Nuclear Information System (INIS)

Hirose, Masaharu; Endo, Toshio; Aoki, Tomio

1983-01-01

This is a report of the basic idea on imaging system focussing on a necessary X-ray system for high-level emergencies which was worked out due to the establishment of the independent emergency medical institute specialized in the tertiary lifesaving and emergency, and of examinations on satisfactory results we gained for about three years of usage. (author)

NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory

Data.gov (United States)

Federal Laboratory Consortium — The NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory is a 2005 Wheeled Coach Type III ambulance mounted on a Ford E-450 cut-away van chassis....

Evaluation of preparedness for medical emergencies among dental practitioners in Khammam town: A cross-sectional study

Directory of Open Access Journals (Sweden)

L Surya Chandra Varma

2015-01-01

Full Text Available Introduction: Medical emergencies can occur frequently in the dental setting. Effective management of an emergency situation in the dental office is ultimately the dentist responsibility. The assessment of preparedness of dental practitioners would help to bring about required changes in the teaching aspects of dental institutions, which would ultimately help dental graduates to improve knowledge regarding management of medical emergencies. This would also make dental offices available with required emergency drugs. Aim: To evaluate the preparedness for medical emergencies among the dental practitioners in Khammam town. Materials and Methods: A cross-sectional questionnaire-based study with a sample of 301 was conducted among dental clinicians at Khammam to evaluate their knowledge regarding medical emergencies. The questionnaire consisted of nineteen questions. First nine questions are objective questions, requiring a simple yes or no reply. Next ten questions are multiple choice questions regarding Emergency Medical Services and basic life support. Chi-square test was used to analyze the data. A P < 0.05 is considered significant. Results: The results of this study showed that almost all the participants (94.02% enquired about medical and drug history, but only 67.11% of them obtained a complete health history proforma of the patient. About 83.06% record vital signs, 74.09% of members report about attending workshops on emergency training and management, and 50.5% of members were either not sure or not in a position to handle the emergency condition. Conclusion: The results of this study reflect an alarming situation of the capability of dentists to deal with medical emergencies at dental offices and make available all the emergency drugs at their offices.

A comparison of two emergency medical dispatch protocols with respect to accuracy.

Science.gov (United States)

Torlén, Klara; Kurland, Lisa; Castrén, Maaret; Olanders, Knut; Bohm, Katarina

2017-12-29

Emergency medical dispatching should be as accurate as possible in order to ensure patient safety and optimize the use of ambulance resources. This study aimed to compare the accuracy, measured as priority level, between two Swedish dispatch protocols - the three-graded priority protocol Medical Index and a newly developed prototype, the four-graded priority protocol, RETTS-A. A simulation study was carried out at the Emergency Medical Communication Centre (EMCC) in Stockholm, Sweden, between October and March 2016. Fifty-three voluntary telecommunicators working at SOS Alarm were recruited nationally. Each telecommunicator handled 26 emergency medical calls, simulated by experienced standard patients. Manuscripts for the scenarios were based on recorded real-life calls, representing the six most common complaints. A cross-over design with 13 + 13 calls was used. Priority level and medical condition for each scenario was set through expert consensus and used as gold standard in the study. A total of 1293 calls were included in the analysis. For priority level, n = 349 (54.0%) of the calls were assessed correctly with Medical Index and n = 309 (48.0%) with RETTS-A (p = 0.012). Sensitivity for the highest priority level was 82.6% (95% confidence interval: 76.6-87.3%) in the Medical Index and 54.0% (44.3-63.4%) in RETTS-A. Overtriage was 37.9% (34.2-41.7%) in the Medical Index and 28.6% (25.2-32.2%) in RETTS-A. The corresponding proportion of undertriage was 6.3% (4.7-8.5%) and 23.4% (20.3-26.9%) respectively. In this simulation study we demonstrate that Medical Index had a higher accuracy for priority level and less undertriage than the new prototype RETTS-A. The overall accuracy of both protocols is to be considered as low. Overtriage challenges resource utilization while undertriage threatens patient safety. The results suggest that in order to improve patient safety both protocols need revisions in order to guarantee safe emergency medical

Occupational injury rates in personnel of emergency medical services

Directory of Open Access Journals (Sweden)

Robert Gałązkowski

2015-12-01

Full Text Available [i][/i][b]Introduction and objectives. [/b]The system of emergency medical services (EMS in Poland was established in 2006. The risk of occupational injuries to EMS personnel is very high, irrespective of the country where they operate, as they face many hazards in their everyday work. The aim of this study is to describe the type, incidence and consequences of occupational accidents among the personnel of the National Emergency Medical Services in Poland (NEMS – land and air ambulance crews in 2008–2012. [b]Material and methods:[/b] The study reviewed all occupational accidents among the EMS personnel reported to the National Labour Inspectorate in 2008–2012. [b]Results[/b]: In the period reported, the number of accidents decreased from 32 in 2008 to just 6 in 2012. Traffic accidents predominated and most of the victims were male paramedics under 30 years of age. The most common injuries included multiple organ injuries and injuries of the cervical spine, chest and trunk. [b]Conclusions:[/b] The growing professional experience of the EMS personnel has a beneficial effect on occupational injury rates as they tend to decrease with longer employment. Occupational accidents are definitely more common among ambulance crews than in the personnel of other organizational units of the National Emergency Medical Services.

EXAMINATION OF THE EMERGENCY MEDICAL RESPONSE SYSTEM IN KOREA AND SUGGESTIONS FOR IMPROVEMENTS RELATING TO TRANSPORT

Directory of Open Access Journals (Sweden)

Sei-Chang OH, Ph.D.

2004-01-01

This research focuses on the examination of current emergency medical response system related to the transport of emergency vehicles and suggests some transport-related ideas to improve the system in Korea. The study aimed to investigate the present emergency medical response system and identify problems, questionnaire survey and literature review were carried. The ideas include the improvement of emergency information flow and the development of preferential treatment methods for emergency vehicles. To improve the emergency information flow, this research studied the bridge between emergency medical information center and traffic information center and proposed the efficient utilization of traffic information for the better treatment of an emergency. When it comes to the movement of emergency vehicles, various preferential treatment methods were suggested.

75 FR 27917 - Emergency Medical Services Week, 2010

Science.gov (United States)

2010-05-18

... enhancing our country's preparedness and resilience. During Emergency Medical Services Week, we recommit to... physicians. From rural regions of our Nation to our busiest urban centers, EMS teams provide access to... to arrive at the scene of a crisis. These heroic professionals, volunteers, and citizens form a...

Benchmarking online dispatch algorithms for Emergency Medical Services

NARCIS (Netherlands)

Jagtenberg, C.J.; Berg, P.L.; van der Mei, R.D.

2016-01-01

Providers of Emergency Medical Services (EMS) face the online ambulance dispatch problem, in which they decide which ambulance to send to an incoming incident. Their objective is to minimize the fraction of arrivals later than a target time. Today, the gap between existing solutions and the optimum

76 FR 29131 - Emergency Medical Services Week, 2011

Science.gov (United States)

2011-05-19

... public and private sector partners across the United States to make certain that all children... often make the difference between life and death. Emergency medical technicians (EMTs), paramedics, and first responders serve on the front lines of our health care and public health system. Working with them...

A forgotten life-threatening medical emergency: myxedema coma

Directory of Open Access Journals (Sweden)

Elisa Pizzolato

2016-08-01

Full Text Available Nowadays myxedema coma is a rare medical emergency but, sometimes, it still remains a fatal condition even if appropriate therapy is soon administered. Although physical presentation is very non-specific and diversified, physicians should pay attention when patients present with low body temperature and alteration of neurological status; the presence of precipitating events in past medical history can help in making a diagnosis. Here we discuss one such case: an 83-year-old female presented with abdominal pain since few days. Laboratory tests and abdomen computed tomography scan demonstrated alithiasic cholecystitis; she was properly treated but, during the Emergency Department stay she experienced a cardiac arrest. Physicians immediately started advance cardiovascular life support algorithm and she survived. Later on, she was admitted to the Intensive Care Unit where doctors discovered she was affected by severe hypothyroidism. Straightway they started the right therapy but, unfortunately, the patient died in a few hours.

Emerging Security Mechanisms for Medical Cyber Physical Systems.

Science.gov (United States)

Kocabas, Ovunc; Soyata, Tolga; Aktas, Mehmet K

2016-01-01

The following decade will witness a surge in remote health-monitoring systems that are based on body-worn monitoring devices. These Medical Cyber Physical Systems (MCPS) will be capable of transmitting the acquired data to a private or public cloud for storage and processing. Machine learning algorithms running in the cloud and processing this data can provide decision support to healthcare professionals. There is no doubt that the security and privacy of the medical data is one of the most important concerns in designing an MCPS. In this paper, we depict the general architecture of an MCPS consisting of four layers: data acquisition, data aggregation, cloud processing, and action. Due to the differences in hardware and communication capabilities of each layer, different encryption schemes must be used to guarantee data privacy within that layer. We survey conventional and emerging encryption schemes based on their ability to provide secure storage, data sharing, and secure computation. Our detailed experimental evaluation of each scheme shows that while the emerging encryption schemes enable exciting new features such as secure sharing and secure computation, they introduce several orders-of-magnitude computational and storage overhead. We conclude our paper by outlining future research directions to improve the usability of the emerging encryption schemes in an MCPS.

[Current Situation and Prospects of Emergency Medical Equipment in Our Country].

Science.gov (United States)

Qi, Lijing; Cheng, Feng

2016-03-01

This article analyzes the new demand of emergency medical equipment in the current development trend based on the analysis of the development and current situation of emergency medicine in our country. At the same time it introduces the current industrial characteristics of our country. Finally it analyzes the development trend of this kind of equipment in the new emergency medicine field.

Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority.

Science.gov (United States)

Debenham, Sierra; Fuller, Matthew; Stewart, Matthew; Price, Raymond R

2017-12-01

By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks. Debenham S , Fuller M , Stewart M , Price RR . Where there is no EMS: lay providers in Emergency Medical Services care - EMS as a public health priority. Prehosp Disaster Med. 2017;32(6):593-595.

Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

Directory of Open Access Journals (Sweden)

Bui, Quan M.

2015-05-01

Full Text Available We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. [West J Emerg Med. 2015;16(3:414–417.

American Association for Emergency Psychiatry Task Force on Medical Clearance of Adult Psychiatric Patients. Part II: Controversies over Medical Assessment, and Consensus Recommendations.

Science.gov (United States)

Wilson, Michael P; Nordstrom, Kimberly; Anderson, Eric L; Ng, Anthony T; Zun, Leslie S; Peltzer-Jones, Jennifer M; Allen, Michael H

2017-06-01

The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus. Consensus was achieved by group discussion as well as iterative revisions of the written document. The document was reviewed and approved by the AAEP Board of Directors. Eight recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term "medical clearance," and the need for better science in this area. The evidence indicates that a thorough history and physical examination, including vital signs and mental status examination, are the minimum necessary elements in the evaluation of psychiatric patients. With respect to laboratory testing, the picture is less clear and much more controversial.

[Medical globalization and local culture.

Science.gov (United States)

Paci, Eugenio

2017-03-01

Biomedical globalization is a reality in the presence of local worlds with growing human sufferance and inequalities. In this structural and cultural context, characterised by the new communication by Internet and social media, polarisation of medical and scientific debate is enhancing. Based on episodes related to public health issues like vaccines, the quest for better access of Italian professionals and public opinion to an open scientific debate on health research and practice is discussed.

Impact of Vehicular Networks on Emergency Medical Services in Urban Areas

Directory of Open Access Journals (Sweden)

Chun-Liang Lee

2014-10-01

Full Text Available The speed with which emergency personnel can provide emergency treatment is crucial to reducing death and disability among acute and critically ill patients. Unfortunately, the rapid development of cities and increased numbers of vehicles are preventing emergency vehicles from easily reaching locations where they are needed. A significant number of researchers are experimenting with vehicular networks to address this issue, but in most studies the focus has been on communication technologies and protocols, with few efforts to assess how network applications actually support emergency medical care. Our motivation was to search the literature for suggested methods for assisting emergency vehicles, and to use simulations to evaluate them. Our results and evidence-based studies were cross-referenced to assess each method in terms of cumulative survival ratio (CSR gains for acute and critically ill patients. Simulation results indicate that traffic light preemption resulted in significant CSR increases of between 32.4% and 90.2%. Route guidance was found to increase CSRs from 14.1% to 57.8%, while path clearing increased CSRs by 15.5% or less. It is our hope that this data will support the efforts of emergency medical technicians, traffic managers, and policy makers.

Impact of vehicular networks on emergency medical services in urban areas.

Science.gov (United States)

Lee, Chun-Liang; Huang, Chung-Yuan; Hsiao, Tzu-Chien; Wu, Chun-Yen; Chen, Yaw-Chung; Wang, I-Cheng

2014-10-31

The speed with which emergency personnel can provide emergency treatment is crucial to reducing death and disability among acute and critically ill patients. Unfortunately, the rapid development of cities and increased numbers of vehicles are preventing emergency vehicles from easily reaching locations where they are needed. A significant number of researchers are experimenting with vehicular networks to address this issue, but in most studies the focus has been on communication technologies and protocols, with few efforts to assess how network applications actually support emergency medical care. Our motivation was to search the literature for suggested methods for assisting emergency vehicles, and to use simulations to evaluate them. Our results and evidence-based studies were cross-referenced to assess each method in terms of cumulative survival ratio (CSR) gains for acute and critically ill patients. Simulation results indicate that traffic light preemption resulted in significant CSR increases of between 32.4% and 90.2%. Route guidance was found to increase CSRs from 14.1% to 57.8%, while path clearing increased CSRs by 15.5% or less. It is our hope that this data will support the efforts of emergency medical technicians, traffic managers, and policy makers.

Local Helioseismology of Emerging Active Regions: A Case Study

Science.gov (United States)

Kosovichev, Alexander G.; Zhao, Junwei; Ilonidis, Stathis

2018-04-01

Local helioseismology provides a unique opportunity to investigate the subsurface structure and dynamics of active regions and their effect on the large-scale flows and global circulation of the Sun. We use measurements of plasma flows in the upper convection zone, provided by the Time-Distance Helioseismology Pipeline developed for analysis of solar oscillation data obtained by Helioseismic and Magnetic Imager (HMI) on Solar Dynamics Observatory (SDO), to investigate the subsurface dynamics of emerging active region NOAA 11726. The active region emergence was detected in deep layers of the convection zone about 12 hours before the first bipolar magnetic structure appeared on the surface, and 2 days before the emergence of most of the magnetic flux. The speed of emergence determined by tracking the flow divergence with depth is about 1.4 km/s, very close to the emergence speed in the deep layers. As the emerging magnetic flux becomes concentrated in sunspots local converging flows are observed beneath the forming sunspots. These flows are most prominent in the depth range 1-3 Mm, and remain converging after the formation process is completed. On the larger scale converging flows around active region appear as a diversion of the zonal shearing flows towards the active region, accompanied by formation of a large-scale vortex structure. This process occurs when a substantial amount of the magnetic flux emerged on the surface, and the converging flow pattern remains stable during the following evolution of the active region. The Carrington synoptic flow maps show that the large-scale subsurface inflows are typical for active regions. In the deeper layers (10-13 Mm) the flows become diverging, and surprisingly strong beneath some active regions. In addition, the synoptic maps reveal a complex evolving pattern of large-scale flows on the scale much larger than supergranulation

78 FR 30727 - Emergency Medical Services Week, 2013

Science.gov (United States)

2013-05-22

.... During Emergency Medical Services Week, we pause to offer our gratitude to these remarkable men and women, whose dedication is fundamental to our society's well-being. In recent weeks, we have again seen the... thousand thirteen, and of the Independence of the United States of America the two hundred and thirty...

The State of Emergency Medical Services (EMS) Systems in Africa.

Science.gov (United States)

Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A

2017-06-01

Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet. The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each). Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (<9.0%) of Africans have coverage by an EMS system. Most systems were predominantly BLS, government operated, and fee-for-service. Mould-Millman NK , Dixon JM , Sefa N , Yancey A , Hollong BG , Hagahmed M , Ginde AA , Wallis LA . The state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

The appropriateness of emergency medical service responses in the ...

African Journals Online (AJOL)

2015-10-10

Oct 10, 2015 ... in the eThekwini district of KwaZulu-Natal, South Africa ... Rescue, Faculty of Health Sciences, Durban University of Technology, South Africa ... Emergency medical services (EMS) are sometimes required to respond to cases ...

Snow shovel-related injuries and medical emergencies treated in US EDs, 1990 to 2006.

Science.gov (United States)

Watson, Daniel S; Shields, Brenda J; Smith, Gary A

2011-01-01

Injuries and medical emergencies associated with snow shovel use are common in the United States. This is a retrospective analysis of data from the National Electronic Injury Surveillance System. This study analyzes the epidemiologic features of snow shovel-related injuries and medical emergencies treated in US emergency departments (EDs) from 1990 to 2006. An estimated 195 100 individuals (95% confidence interval, 140 400-249 800) were treated in US EDs for snow shovel-related incidents during the 17-year study period, averaging 11 500 individuals annually (SD, 5300). The average annual rate of snow shovel-related injuries and medical emergencies was 4.15 per 100 000 population. Approximately two thirds (67.5%) of these incidents occurred among males. Children younger than 18 years comprised 15.3% of the cases, whereas older adults (55 years and older) accounted for 21.8%. The most common diagnosis was soft tissue injury (54.7%). Injuries to the lower back accounted for 34.3% of the cases. The most common mechanism of injury/nature of medical emergency was acute musculoskeletal exertion (53.9%) followed by slips and falls (20.0%) and being struck by a snow shovel (15.0%). Cardiac-related ED visits accounted for 6.7% of the cases, including all of the 1647 deaths in the study. Patients required hospitalization in 5.8% of the cases. Most snow shovel-related incidents (95.6%) occurred in and around the home. This is the first study to comprehensively examine snow shovel-related injuries and medical emergencies in the United States using a nationally representative sample. There are an estimated 11 500 snow shovel-related injuries and medical emergencies treated annually in US EDs. Copyright © 2011 Elsevier Inc. All rights reserved.

Emergency Physician Awareness of Prehospital Procedures and Medications

Directory of Open Access Journals (Sweden)

Rachel Waldron

2014-07-01

Full Text Available Introduction: Maintaining patient safety during transition from prehospital to emergency department (ED care depends on effective handoff communication between providers. We sought to determine emergency physicians’ (EP knowledge of the care provided by paramedics in terms of both procedures and medications, and whether the use of a verbal report improved physician accuracy. Methods: We conducted a 2-phase observational survey of a convenience sample of EPs in an urban, academic ED. In this large ED paramedics have no direct contact with physicians for non-critical patients, giving their report instead to the triage nurse. In Phase 1, paramedics gave verbal report to the triage nurse only. In Phase 2, a research assistant (RA stationed in triage listened to this report and then repeated it back verbatim to the EPs caring for the patient. The RA then queried the EPs 90 minutes later regarding their patients’ prehospital procedures and medications. We compared the accuracy of these 2 reporting methods. Results: There were 163 surveys completed in Phase 1 and 116 in Phase 2. The oral report had no effect on EP awareness that the patient had been brought in by ambulance (86% in Phase 1 and 85% in Phase 2. The oral report did improve EP awareness of prehospital procedures, from 16% in Phase 1 to 45% in Phase 2, OR=4.28 (2.5-7.5. EPs were able to correctly identify all oral medications in 18% of Phase 1 cases and 47% of Phase 2 cases, and all IV medications in 42% of Phase 1 cases and 50% of Phase 2 cases. The verbal report led to a mild improvement in physician awareness of oral medications given, OR=4.0 (1.09-14.5, and no improvement in physician awareness of IV medications given, OR=1.33 (0.15-11.35. Using a composite score of procedures plus oral plus IV medications, physicians had all three categories correct in 15% of Phase 1 and 39% of Phase 2 cases (p<0.0001. Conclusion: EPs in our ED were unaware of many prehospital procedures and

Emergency medical support for a manned stratospheric balloon test program.

Science.gov (United States)

Blue, Rebecca S; Norton, Sean C; Law, Jennifer; Pattarini, James M; Antonsen, Erik L; Garbino, Alejandro; Clark, Jonathan B; Turney, Matthew W

2014-10-01

Red Bull Stratos was a commercial program that brought a test parachutist, protected by a full-pressure suit, in a stratospheric balloon with pressurized capsule to over 127,582 ft (38,969 m), from which he free fell and subsequently parachuted to the ground. Given that the major risks to the parachutist included ebullism, negative Gz (toe-to-head) acceleration exposure from an uncontrolled flat spin, and trauma, a comprehensive plan was developed to recover the parachutist under nominal conditions and to respond to any medical contingencies that might have arisen. In this report, the project medical team describes the experience of providing emergency medical support and crew recovery for the manned balloon flights of the program. The phases of flight, associated risks, and available resources were systematically evaluated. Six distinct phases of flight from an Emergency Medical Services (EMS) standpoint were identified. A Medical Support Plan was developed to address the risks associated with each phase, encompassing personnel, equipment, procedures, and communications. Despite geographical, communications, and resource limitations, the medical team was able to implement the Medical Support Plan, enabling multiple successful manned balloon flights to 71,615 ft (21,828 m), 97,221 ft (29,610 m), and 127,582 ft (38,969 m). The experience allowed refinement of the EMS and crew recovery procedures for each successive flight and could be applied to other high altitude or commercial space ventures.

Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries.

Science.gov (United States)

Hoysted, Claire; Babl, Franz E; Kassam-Adams, Nancy; Landolt, Markus A; Jobson, Laura; Van Der Westhuizen, Claire; Curtis, Sarah; Kharbanda, Anupam B; Lyttle, Mark D; Parri, Niccolò; Stanley, Rachel; Alisic, Eva

2018-01-01

Background : Provision of psychosocial care, in particular trauma-informed care, in the immediate aftermath of paediatric injury is a recommended strategy to minimize the risk of paediatric medical traumatic stress. Objective : To examine the knowledge of paediatric medical traumatic stress and perspectives on providing trauma-informed care among emergency staff working in low- and middle-income countries (LMICs). Method : Training status, knowledge of paediatric medical traumatic stress, attitudes towards incorporating psychosocial care and barriers experienced were assessed using an online self-report questionnaire. Respondents included 320 emergency staff from 58 LMICs. Data analyses included descriptive statistics, t -tests and multiple regression. Results : Participating emergency staff working in LMICs had a low level of knowledge of paediatric medical traumatic stress. Ninety-one percent of respondents had not received any training or education in paediatric medical traumatic stress, or trauma-informed care for injured children, while 94% of respondents indicated they wanted training in this area. Conclusions : There appears to be a need for training and education of emergency staff in LMICs regarding paediatric medical traumatic stress and trauma-informed care, in particular among staff working in comparatively lower income countries.

Offshore industry: medical emergency response in the offshore oil and gas industry.

Science.gov (United States)

Ponsonby, Will; Mika, Frano; Irons, Greg

2009-08-01

The hunt for oil and gas has taken workers into new more distant locations including those offshore. The remoteness of the offshore platforms and vessels coupled with the potential risk of being cut off by bad weather presents particular challenges for medical emergency response (MER). Firstly to define the challenges for MER in terms of locations, population and epidemiology of injuries and illnesses in the offshore environment. Secondly to give examples of legal requirements and industry standards to manage MER. Thirdly to look at existing and emerging practice to manage these challenges. A review of published literature was supplemented with a summary of current practice in the industry. Medical professionals (medics) working offshore on installations and vessels are primarily responsible for the medical care of the workers. The medics have clinics with suitable medical equipment for managing emergencies as well as providing limited primary care. Some countries have legislation that stipulate minimum requirements. Where there is no national legislation, industry and company guidance is used to define the MER standards. Supervision of the offshore medics is often provided by doctors on shore via radio and phone links. These methods of communication are now being augmented with more sophisticated telemedicine solutions such as the Internet and live video links. These newer solutions allow for prompt high-quality care and provide the scope for a variety of new treatment options to be available for the offshore workforce.

Family emergency plan and preparedness among medical practitioners in Zaria, Nigeria.

Science.gov (United States)

Makama, Jerry Godfrey; Joshua, Istifanus Anekoson; Makama, Elizabeth Jerry

There has been an increase in the incidence of disasters in many parts of the world. Similarly, Nigeria has witnessed a recent increase of man-made disaster events such as plane crash, fire incidents, flood, and building collapse, including bomb blast orchestrated by terrorists that often create emergency situations. Therefore, the aim of the study was to evaluate family emergency plan and preparedness among medical practitioners in Zaria. This was a cross-sectional descriptive study (May-July, 2013) of medical practitioners in Zaria, Nigeria. The structured questionnaire sought the socio-demographic features of the respondents, the availability of emergency gate(s) in the house, education of safety measures within and outside the house, well-known located shut-off devices for gases, electricity, and water in the house, and written document/policy in the event of disaster. Also, planned orientations/drills/sensitizations, whether there is contact information of family members and supporting agencies. Majority of the respondents were male 56 (80.0 percent) and fall within the age group of 46-50 years (20.0 percent). Only 8.6 percent admitted having an unwritten policy on emergency management in their houses. Similarly, only 8.6 percent do create time to teach their family members on emergency management. Only 27 (38.6 percent) had emergency supplies kits and among this group, water appears to be the most essential component that the respondents had paid attention to, leaving out special items. The communication plans of respondents to likely supportive services/agencies during disaster showed that majority had contact address or have affirmative plans for hospital and ambulance services than for radio and television stations. Family emergency plans and preparedness among medical practitioners in Zaria are extremely low. There is a gap between knowledge of what need to be done to enhance preparedness and internalizing preparedness recommendations in the study area.

Compensation of Emergency Medical Technician (EMT)-Basics and Paramedics.

Science.gov (United States)

Studnek, Jonathan R

2016-12-01

The objective of this paper is to identify factors associated with compensation for Emergency Medical Technician (EMT)-Basics and Paramedics and assess whether these associations have changed over the period 1999-2008. Data obtained from the Longitudinal EMT Attributes and Demographic Study (LEADS) surveys, a mail survey of a random, stratified sample of nationally certified EMT-Basics and Paramedics, were analyzed. For the 1999-2003 period, analyses included all respondents providing Emergency Medical Services (EMS). With the addition of a survey in 2004 about volunteers, it was possible to exclude volunteers from these analyses. Over 60% of EMT-Basics reported being either compensated or noncompensated volunteers in the 2004-2008 period. This was substantially and significantly greater than the proportion of EMT-Paramedic volunteers (Technician (EMT)-Basics and Paramedics. Prehosp Disaster Med. 2016;31(Suppl. 1):s87-s95.

American Association for Emergency Psychiatry Task Force on Medical Clearance of Adult Psychiatric Patients. Part II: Controversies over Medical Assessment, and Consensus Recommendations

Directory of Open Access Journals (Sweden)

Michael P. Wilson

2017-05-01

Full Text Available Introduction: The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED, usually termed “medical clearance,” often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP, consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. Methods: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus. Consensus was achieved by group discussion as well as iterative revisions of the written document. The document was reviewed and approved by the AAEP Board of Directors. Results: Eight recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term “medical clearance,” and the need for better science in this area. Conclusion: The evidence indicates that a thorough history and physical examination, including vital signs and mental status examination, are the minimum necessary elements in the evaluation of psychiatric patients. With respect to laboratory testing, the picture is less clear and much more controversial.

Helicopter emergency medical service patient transport safe at night?

NARCIS (Netherlands)

Peters, J.H.; Wageningen, B. van; Hoogerwerf, N.; Biert, J.

2014-01-01

OBJECTIVE: Dutch helicopter emergency medical services are available 24/7. Working without daylight brings additional challenges, both in patient care and in-flight operation. We retrospectively evaluated the safety of this nighttime helicopter transportation of patients. METHODS: Our helicopter

A Secure Cloud-Assisted Wireless Body Area Network in Mobile Emergency Medical Care System.

Science.gov (United States)

Li, Chun-Ta; Lee, Cheng-Chi; Weng, Chi-Yao

2016-05-01

Recent advances in medical treatment and emergency applications, the need of integrating wireless body area network (WBAN) with cloud computing can be motivated by providing useful and real time information about patients' health state to the doctors and emergency staffs. WBAN is a set of body sensors carried by the patient to collect and transmit numerous health items to medical clouds via wireless and public communication channels. Therefore, a cloud-assisted WBAN facilitates response in case of emergency which can save patients' lives. Since the patient's data is sensitive and private, it is important to provide strong security and protection on the patient's medical data over public and insecure communication channels. In this paper, we address the challenge of participant authentication in mobile emergency medical care systems for patients supervision and propose a secure cloud-assisted architecture for accessing and monitoring health items collected by WBAN. For ensuring a high level of security and providing a mutual authentication property, chaotic maps based authentication and key agreement mechanisms are designed according to the concept of Diffie-Hellman key exchange, which depends on the CMBDLP and CMBDHP problems. Security and performance analyses show how the proposed system guaranteed the patient privacy and the system confidentiality of sensitive medical data while preserving the low computation property in medical treatment and remote medical monitoring.

Ethical issues associated with in-hospital emergency from the Medical Emergency Team's perspective: a national survey.

Science.gov (United States)

Cabrini, Luca; Giannini, Alberto; Pintaudi, Margherita; Semeraro, Federico; Radeschi, Giulio; Borga, Sara; Landoni, Giovanni; Troiano, Herbert; Luchetti, Marco; Pellis, Thomas; Ristagno, Giuseppe; Minoja, Giulio; Mazzon, Davide; Alampi, Daniela

2016-01-01

Medical Emergency Teams (METs) are frequently involved in ethical issues associated to in-hospital emergencies, like decisions about end-of-life care and intensive care unit (ICU) admission. MET involvement offers both advantages and disadvantages, especially when an immediate decision must be made. We performed a survey among Italian intensivists/anesthesiologists evaluating MET's perspective on the most relevant ethical aspects faced in daily practice. A questionnaire was developed on behalf of the Italian scientific society of anesthesia and intensive care (SIAARTI) and administered to its members. Decision making criteria applied by respondents when dealing with ethical aspects, the estimated incidence of conflicts due to ethical issues and the impact on the respondents' emotional and moral distress were explored. The questionnaire was completed by 327 intensivists/anesthesiologists. Patient life-expectancy, wishes, and the quality of life were the factors most considered for decisions. Conflicts with ward physicians were reported by most respondents; disagreement on appropriateness of ICU admission and family unpreparedness to the imminent patient death were the most frequent reasons. Half of respondents considered that in case of conflicts the final decision should be made by the MET. Conflicts were generally recognized as causing increased and moral distress within the MET members. Few respondents reported that dedicated protocols or training were locally available. Italian intensivists/anesthesiologists reported that ethical issues associated with in-hospital emergencies are occurring commonly and are having a significant negative impact on MET well-being. Conflicts with ward physicians happen frequently. They also conveyed that hospitals don't offer ethics training and have no protocols in place to address ethical issues.

The emergence of medical specialization in the nineteenth century.

Science.gov (United States)

Weisz, George

2003-01-01

This essay reexamines the nineteenth-century origins of medical specialization. It suggests that by the 1880s, specialization had become perceived as a necessity of medical science as a result of the realization of two preconditions: First, a new collective desire to expand medical knowledge prompted clinical researchers to specialize; only specialization, it was believed, permitted the rigorous observation of many cases. Second, administrative rationality suggested that one could best manage large populations through proper classification, gathering together individuals belonging to the same class and separating those belonging to different categories. Both of these conditions emerged first and most powerfully in early nineteenth-century Paris. They were, in contrast, uniquely underdeveloped in the fragmented medical community of London during this period.

Emerging localized food networks in Denmark

DEFF Research Database (Denmark)

Hansen, Mette Weinreich; Kristensen, Niels Heine

2012-01-01

, together with an analysis of how this has evolved and expanded. The challenges this rapid expansion puts on the internal network and organisation, and on the local food supplieres - the organic farmers - are elaborated in this paper. Also – from a rural sociology perspective – the interaction......One of the fastest growing food related social movements are citizen driven food networks. The Danish initiatives emerged in Copenhagen from an open culinary, social, environmental and organic oriented network. The theories and strategies of the original initiative is presented in this paper...

Emergency Physicians as Good Samaritans: Survey of Frequency, Locations, Supplies and Medications

Directory of Open Access Journals (Sweden)

Taylor W. Burkholder, MD, MPH

2016-01-01

Full Text Available Introduction: Little is known about the frequency and locations in which emergency physicians (EPs are bystanders to an accident or emergency; equally uncertain is which contents of an “emergency kit” may be useful during such events. The aim of this study was to describe the frequency and locations of Good Samaritan acts by EPs and also determine which emergency kit supplies and medications were most commonly used by Good Samaritans. Methods: We conducted an electronic survey among a convenience sample of EPs in Colorado. Results: Respondents reported a median frequency of 2.0 Good Samaritan acts per five years of practice, with the most common locations being sports and entertainment events (25%, road traffic accidents (21%, and wilderness settings (19%. Of those who had acted as Good Samaritans, 86% reported that at least one supply would have been useful during the most recent event, and 66% reported at least one medication would have been useful. The most useful supplies were gloves (54%, dressings (34%, and a stethoscope (20%, while the most useful medications were oxygen (19%, intravenous fluids (17%, and epinephrine (14%. Conclusion: The majority of EPs can expect to provide Good Samaritan care during their careers and would be better prepared by carrying a kit with common supplies and medications where they are most likely to use them.

Retrospective on the construction and practice of a state-level emergency medical rescue team.

Science.gov (United States)

Lei, Zhang; Haitao, Guo; Xin, Wang; Yundou, Wang

2014-10-01

For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.

A seamless ubiquitous emergency medical service for crisis situations.

Science.gov (United States)

Lin, Bor-Shing

2016-04-01

In crisis situations, a seamless ubiquitous communication is necessary to provide emergency medical service to save people's lives. An excellent prehospital emergency medicine provides immediate medical care to increase the survival rate of patients. On their way to the hospital, ambulance personnel must transmit real-time and uninterrupted patient information to the hospital to apprise the physician of the situation and provide options to the ambulance personnel. In emergency and crisis situations, many communication channels can be unserviceable because of damage to equipment or loss of power. Thus, data transmission over wireless communication to achieve uninterrupted network services is a major obstacle. This study proposes a mobile middleware for cognitive radio (CR) for improving the wireless communication link. CRs can sense their operating environment and optimize the spectrum usage so that the mobile middleware can integrate the existing wireless communication systems with a seamless communication service in heterogeneous network environments. Eventually, the proposed seamless mobile communication middleware was ported into an embedded system, which is compatible with the actual network environment without the need for changing the original system architecture. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Severe hypoglycaemia requiring the assistance of emergency medical services - frequency, causes and symptoms

Czech Academy of Sciences Publication Activity Database

Krnačová, V.; Kuběna, Aleš Antonín; Macek, K.; Bezděk, M.; Šmahelová, A.; Vlček, J.

2012-01-01

Roč. 156, č. 3 (2012), s. 271-277 ISSN 1213-8118 Grant - others:GA UK(CZ) SVV-2010-261-004 Keywords : regression trees * causes * symptoms * incidence * emergency medical service * severe hypoglycaemia Subject RIV: EI - Biotechnology ; Bionics Impact factor: 0.990, year: 2012 http://library.utia.cas.cz/separaty/2013/E/kubena-severe hypoglycaemia requiring the assistance of emergency medical services - frequency causes and symptoms.pdf

Medical emergency and first aid for radiation accident

International Nuclear Information System (INIS)

Suzuki-Yasumoto, Masashi

1980-01-01

The thinkings concerning the injuries to human beings in nuclear accidents differ somewhat between Japan and the U.S.A. and other European countries. In accordance with the historical evolution of nuclear power and the characteristics of medical system in respective countries, there are more or less modified measures in the scheme of three phases; i.e. first aid stations on the sites of nuclear facilities, support hospitals, and radiation injury centers, in order. So far, easy reliance on such as the National Institute of Radiological Sciences was large, but with the Three Mile Island nuclear plant accident as the turning point, the emergency and first aid systems are being studied intensively both in the Government and private nuclear power enterprises. The following matters are described: the differences in thinkings between Japan and other countries; fundamentals in the medical emergency scheme in radiation accidents; the systems in U.S.A., U.K., France and West Germany; and the problems and measures in the scheme of Japan. (J.P.N.)

Establishment of exposure dose assessment laboratory in National Radiation Emergency Medical Center (NREMC)

Energy Technology Data Exchange (ETDEWEB)

Yoo, Jae Ryong; Ha, Wi Ho; Yoon, Seok Won; Han, Eun Ae; Lee, Seung Sook [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

2011-10-15

As unclear industry grown, 432 of the nuclear power plants are operating and 52 of NPPs are under construction currently. Increasing use of radiation or radioisotopes in the field of industry, medical purpose and research such as non-destructive examination, computed tomography and x-ray, etc. constantly. With use of nuclear or radiation has incidence possibility for example the Fukushima NPP incident, the Goiania accident and the Chernobyl Nuclear accident. Also the risk of terror by radioactive material such as Radiological Dispersal Device(RDD) etc. In Korea, since the 'Law on protection of nuclear facilities and countermeasure for radioactive preparedness was enacted in 2003, the Korean institute of Radiological and Medical Sciences(KIRAMS) was established for the radiation emergency medical response in radiological disaster due to nuclear accident, radioactive terror and so on. Especially National Radiation Emergency Medical Center(NREMC) has the duty that is protect citizens from nuclear, radiological accidents or radiological terrors through the emergency medical preparedness. The NREMC was established by the 39-article law on physical protection of nuclear material and facilities and measures for radiological emergencies. Dose assessment or contamination survey should be performed which provide the radiological information for medical response. For this reason, the NREMC establish and re-organized dose assessment system based on the existing dose assessment system of the NREMC recently. The exposure dose could be measured by physical and biological method. With these two methods, we can have conservative dose assessment result. Therefore the NREMC established the exposure dose assessment laboratory which was re-organized laboratory space and introduced specialized equipment for dose assessment. This paper will report the establishment and operation of exposure dose assessment laboratory for radiological emergency response and discuss how to enhance

Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals.

LENUS (Irish Health Repository)

Gorman, J

2010-06-01

Unplanned readmissions of medical hospital patients have been increasing in recent years. We examined the frequency and associates of emergency medical readmissions to Galway University Hospitals (GUH).

Development of new core competencies for Taiwanese Emergency Medical Technicians

Directory of Open Access Journals (Sweden)

Chang YT

2018-03-01

Full Text Available Yu-Tung Chang,1,2 Kuang-Chau Tsai,2 Brett Williams1,3 1Department of Community Emergency Health and Paramedic Practice, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia; 2Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; 3Division of Paramedicine, University of Tasmania, Hobart, TAS, Australia Objectives: Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. Methods: A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents’ perspectives of the Taiwanese EMT training and education system. Results: The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS education system are the attitude of authorities, the licensure system, and legislation. Conclusion: The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of

75 FR 80762 - Medicare Program; Emergency Medical Treatment and Labor Act: Applicability to Hospital and...

Science.gov (United States)

2010-12-23

... [CMS-1350-ANPRM] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act... Emergency Medical Treatment and Labor Act (EMTALA). Specifically, this document serves as a request for... available to persons without Federal government identification, commenters are encouraged to leave their...

77 FR 5213 - Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA): Applicability to Hospital...

Science.gov (United States)

2012-02-02

... [CMS-1350-NC] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA... the applicability of the Emergency Medical Treatment and Labor Act (EMTALA) to hospital inpatients... available to persons without Federal government identification, commenters are encouraged to leave their...

Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers. Student Study Guide.

Science.gov (United States)

National Highway Traffic Safety Administration (DOT), Washington, DC.

To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this student guide provides a standardized approach for first responders to traffic accidents to learn emergency medical care. Training is provided in all aspects of emergency medical care required at the scene of a traffic accident.…

Emergency Medical Services Capacity for Prehospital Stroke Care

Centers for Disease Control (CDC) Podcasts

2013-09-05

In this audio podcast, lead author and Preventing Chronic Disease’s 2013 Student Research Contest Winner, Mehul D. Patel, talks about his article on stroke care and emergency medical services.  Created: 9/5/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/5/2013.

Use of telehealth in the management of non-critical emergencies in rural or remote emergency departments: a systematic review.

Science.gov (United States)

du Toit, Marie; Malau-Aduli, Bunmi; Vangaveti, Venkat; Sabesan, Sabe; Ray, Robin A

2017-01-01

Background Telehealth has been used extensively in emergency departments to improve healthcare provision. However, its impact on the management of non-critical emergency presentations within rural and remote emergency department settings has not been adequately explored. The objective of this systematic review is to identify how telehealth has been used to assist in the management of non-critical presentations in rural and remote emergency departments and the outcomes. Methods Articles were identified through database searches of CINAHL, Cochrane, MEDLINE (OVID), Informit and SCOPUS, as well as the screening of relevant article reference and citation lists. To determine how telehealth can assist in the management of non-critical emergencies, information was extracted relating to telehealth programme model, the scope of service and participating health professionals. The outcomes of telehealth programmes were determined by analysing the uptake and usage of telehealth, the impact on altering a diagnosis or management plan as well as patient disposition including patient transfer, discharge, local hospital admission and rates of discharge against medical advice. Results Of the 2532 identified records, 15 were found to match the eligibility criteria and were included in the review. Uptake and usage increased for telehealth programmes predominantly utilised by nursing staff with limited local medical support. Teleconsultation conservatively altered patient diagnosis or management in 18-66% of consultations. Although teleconsultation was associated with increased patient transfer rates, unnecessary transfers were reduced. Simultaneously, an increase in local hospital admission was noted and fewer patients were discharged home. Discharge against medical advice rates were low at 0.9-1.1%. Conclusion The most widely implemented hub-and-spoke telehealth model could be incorporated into existing referral frameworks. Telehealth programmes may assist in reducing unnecessary

Medical emergencies facing general practitioners: Drugs for the doctor's bag

OpenAIRE

Janković Slobodan

2014-01-01

General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever), morphine (for severe pain), naloxone (for heroin poisoning), ceftriaxone (for meningococcal ...

Attitude of interns towards implementation and contribution of undergraduate Emergency Medicine training: Experience of an Ethiopian Medical School

Directory of Open Access Journals (Sweden)

Temesgen Beyene

2017-09-01

Conclusion: An Emergency Medicine rotation during the final year of medical school provides opportunities to learn about undifferentiated medical emergencies and it should be included for other medical schools in the country. Participants suggest that leadership aspects of Emergency Medicine need more emphasis as the curriculum is further developed in the future.

Paramedic versus emergency physician emergency medical service: role of the anaesthesiologist and the European versus the Anglo-American concept

NARCIS (Netherlands)

Timmermann, Arnd; Russo, Sebastian G.; Hollmann, Markus W.

2008-01-01

Purpose of review Much controversy exists about who can provide the best medical care for critically ill patients in the prehospital setting. The Anglo-American concept is on the whole to provide well trained paramedics to fulfil this task, whereas in some European countries emergency medical

Three Types of Memory in Emergency Medical Services Communication

Science.gov (United States)

Angeli, Elizabeth L.

2015-01-01

This article examines memory and distributed cognition involved in the writing practices of emergency medical services (EMS) professionals. Results from a 16-month study indicate that EMS professionals rely on distributed cognition and three kinds of memory: individual, collaborative, and professional. Distributed cognition and the three types of…

A local adaptive algorithm for emerging scale-free hierarchical networks

International Nuclear Information System (INIS)

Gomez Portillo, I J; Gleiser, P M

2010-01-01

In this work we study a growing network model with chaotic dynamical units that evolves using a local adaptive rewiring algorithm. Using numerical simulations we show that the model allows for the emergence of hierarchical networks. First, we show that the networks that emerge with the algorithm present a wide degree distribution that can be fitted by a power law function, and thus are scale-free networks. Using the LaNet-vi visualization tool we present a graphical representation that reveals a central core formed only by hubs, and also show the presence of a preferential attachment mechanism. In order to present a quantitative analysis of the hierarchical structure we analyze the clustering coefficient. In particular, we show that as the network grows the clustering becomes independent of system size, and also presents a power law decay as a function of the degree. Finally, we compare our results with a similar version of the model that has continuous non-linear phase oscillators as dynamical units. The results show that local interactions play a fundamental role in the emergence of hierarchical networks.

Does plant species richness guarantee the resilience of local medical systems? A perspective from utilitarian redundancy.

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Flávia Rosa Santoro

Full Text Available Resilience is related to the ability of a system to adjust to disturbances. The Utilitarian Redundancy Model has emerged as a tool for investigating the resilience of local medical systems. The model determines the use of species richness for the same therapeutic function as a facilitator of the maintenance of these systems. However, predictions generated from this model have not yet been tested, and a lack of variables exists for deeper analyses of resilience. This study aims to address gaps in the Utilitarian Redundancy Model and to investigate the resilience of two medical systems in the Brazilian semi-arid zone. As a local illness is not always perceived in the same way that biomedicine recognizes, the term "therapeutic targets" is used for perceived illnesses. Semi-structured interviews with local experts were conducted using the free-listing technique to collect data on known medicinal plants, usage preferences, use of redundant species, characteristics of therapeutic targets, and the perceived severity for each target. Additionally, participatory workshops were conducted to determine the frequency of targets. The medical systems showed high species richness but low levels of species redundancy. However, if redundancy was present, it was the primary factor responsible for the maintenance of system functions. Species richness was positively associated with therapeutic target frequencies and negatively related to target severity. Moreover, information about redundant species seems to be largely idiosyncratic; this finding raises questions about the importance of redundancy for resilience. We stress the Utilitarian Redundancy Model as an interesting tool to be used in studies of resilience, but we emphasize that it must consider the distribution of redundancy in terms of the treatment of important illnesses and the sharing of information. This study has identified aspects of the higher and lower vulnerabilities of medical systems, adding

A model for emergency medicine education in post-conflict Liberia

Directory of Open Access Journals (Sweden)

Braden Hexom

2012-12-01

This article describes a unique paradigm for addressing the deficit in human capacity for emergency health care in the Republic of Liberia. This system was designed and supported by a consortium of academic medical centres in the United States working in conjunction with a local non-governmental organisation, Health Education and Relief Through Teaching (HEARTT. Since 2007, the consortium has delivered virtually uninterrupted emergency medical care and medical education at the largest teaching hospital in Liberia. The Liberian programme objectives included supervising and directing emergency medical care, providing a model for curriculum development, building capacity for medical education, and improving systems-based EM practice. The collaboration of multiple academic institutions in bringing emergency medical services and academic EM teaching to a post-conflict setting remains a unique model for introducing the development of acute care in a developing country.

Medical identity theft in the emergency department: awareness is crucial.

Science.gov (United States)

Mancini, Michelino

2014-11-01

Medical identity theft in the emergency department (ED) can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient's identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior.

Medical Identity Theft in the Emergency Department: Awareness is Crucial

Science.gov (United States)

Mancini, Michelino

2014-01-01

Medical Identity theft in the emergency department (ED) can harm numerous individuals, and many frontline healthcare providers are unaware of this growing concern. The two cases described began as typical ED encounters until red flags were discovered upon validating the patient’s identity. Educating all healthcare personnel within and outside the ED regarding the subtle signs of medical identity theft and implementing institutional policies to identify these criminals will discourage further fraudulent behavior. PMID:25493150

An effective support system of emergency medical services with tablet computers.

Science.gov (United States)

Yamada, Kosuke C; Inoue, Satoshi; Sakamoto, Yuichiro

2015-02-27

There were over 5,000,000 ambulance dispatches during 2010 in Japan, and the time for transportation has been increasing, it took over 37 minutes from dispatch to the hospitals. A way to reduce transportation time by ambulance is to shorten the time of searching for an appropriate facility/hospital during the prehospital phase. Although the information system of medical institutions and emergency medical service (EMS) was established in 2003 in Saga Prefecture, Japan, it has not been utilized efficiently. The Saga Prefectural Government renewed the previous system in an effort to make it the real-time support system that can efficiently manage emergency demand and acceptance for the first time in Japan in April 2011. The objective of this study was to evaluate if the new system promotes efficient emergency transportation for critically ill patients and provides valuable epidemiological data. The new system has provided both emergency personnel in the ambulance, or at the scene, and the medical staff in each hospital to be able to share up-to-date information about available hospitals by means of cloud computing. All 55 ambulances in Saga are equipped with tablet computers through third generation/long term evolution networks. When the emergency personnel arrive on the scene and discern the type of patient's illness, they can search for an appropriate facility/hospital with their tablet computer based on the patient's symptoms and available medical specialists. Data were collected prospectively over a three-year period from April 1, 2011 to March 31, 2013. The transportation time by ambulance in Saga was shortened for the first time since the statistics were first kept in 1999; the mean time was 34.3 minutes in 2010 (based on administrative statistics) and 33.9 minutes (95% CI 33.6-34.1) in 2011. The ratio of transportation to the tertiary care facilities in Saga has decreased by 3.12% from the year before, 32.7% in 2010 (regional average) and 29.58% (9085

IMPORTANT REMINDER - In a Medical Emergency Call 74444

CERN Multimedia

2005-01-01

What happened? A CERN employee, complaining of pains that might indicate a serious heart problem, went to building 57 for medical assistance1). He went to the first floor and found the reception desk temporarily unoccupied. He then went to the CERN Fire Station. The firemen and the CERN medical team took care of him and requested helicopter transport to the Geneva cantonal hospital, where he responded well to medical treatment. What do we learn from this event? Although in this case the patient is doing well, precious time was lost. In the event of serious and acute illness, you must call the CERN internal number 74444 and avoid going in person, even accompanied by someone else. This number is available for all types of emergency. The firemen can provide professional assistance at all times as required: first aid on the spot, ambulance transport and medical assistance as necessary. The CERN Fire Station is located in building 65, on ‘Route Einstein', the first road on your right when you enter CERN Ent...

Medical Geology: a globally emerging discipline

Energy Technology Data Exchange (ETDEWEB)

Bunnell, J.E.; Finkelman, R.B.; Centeno, J.A.; Selinus, O. [Armed Forces Institute of Pathology, Washington, DC (United States)

2007-07-01

Medical Geology, the study of the impacts of geologic materials and processes on animal and human health, is a dynamic emerging discipline bringing together the geoscience, biomedical, and public health communities to solve a wide range of environmental health problems. Among the Medical Geology described in this review are examples of both deficiency and toxicity of trace element exposure. Goiter is a widespread and potentially serious health problem caused by deficiency of iodine. In many locations the deficiency is attributable to low concentrations of iodine in the bedrock. Similarly, deficiency of selenium in the soil has been cited as the principal cause of juvenile cardiomyopathy and muscular abnormalities. Overexposure to arsenic is one of the most widespread Medical Geology problems affecting more than one hundred million people in Bangladesh, India, China, Europe, Africa and North and South America. The arsenic exposure is primarily due to naturally high levels in groundwater but combustion of mineralized coal has also caused arsenic poisoning. Dental and skeletal fluorosis also impacts the health of millions of people around the world and, like arsenic, is due to naturally high concentrations in drinking water and, to a lesser extent, coal combustion. Other Medical Geology issues described include geophagia, the deliberate ingestion of soil, exposure to radon, and ingestion of high concentrations of organic compounds in drinking water. Geoscience and biomedical/public health researchers are teaming to help mitigate these health problems as well as various non-traditional issues for geoscientists such as vector-borne diseases.

On the Alert: Preparing for Medical Emergencies in Schools

Science.gov (United States)

Mahoney, Dan

2012-01-01

Medical emergencies can happen in any school at any time. They can be the result of preexisting health problems, accidents, violence, unintentional actions, natural disasters, and toxins. Premature deaths in schools from sudden cardiac arrest, blunt trauma to the chest, firearm injuries, asthma, head injuries, drug overdose, allergic reactions,…

Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

Science.gov (United States)

Morrison, Ann; Roman, Brenda; Borges, Nicole

2012-01-01

Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

Utility and assessment of non-technical skills for rapid response systems and medical emergency teams.

Science.gov (United States)

Chalwin, R P; Flabouris, A

2013-09-01

Efforts are ongoing to improve outcomes from cardiac arrest and medical emergencies. A promising quality improvement modality is use of non-technical skills (NTS) that aim to address human factors through improvements in performance of leadership, communication, situational awareness and decision-making. Originating in the airline industry, NTS training has been successfully introduced into anaesthesia, surgery, emergency medicine and other acute medical specialities. Some aspects of NTS have already achieved acceptance for cardiac arrest teams. Leadership skills are emphasised in advanced life support training and have shown favourable results when employed in simulated and clinical resuscitation scenarios. The application of NTS in medical emergency teams as part of a rapid response system attending medical emergencies is less certain; however, observations of simulations have also shown promise. This review highlights the potential benefits of NTS competency for cardiac arrest teams and, more importantly, medical emergency teams because of the diversity of clinical scenarios encountered. Discussion covers methods to assess and refine NTS and NTS training to optimise performance in the clinical environment. Increasing attention should be applied to yielding meaningful patient and organisational outcomes from use of NTS. Similarly, implementation of any training course should receive appropriate scrutiny to refine team and institutional performance. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Emerging applications of fluorescence spectroscopy in medical microbiology field.

Science.gov (United States)

Shahzad, Aamir; Köhler, Gottfried; Knapp, Martin; Gaubitzer, Erwin; Puchinger, Martin; Edetsberger, Michael

2009-11-26

There are many diagnostic techniques and methods available for diagnosis of medically important microorganisms like bacteria, viruses, fungi and parasites. But, almost all these techniques and methods have some limitations or inconvenience. Most of these techniques are laborious, time consuming and with chances of false positive or false negative results. It warrants the need of a diagnostic technique which can overcome these limitations and problems. At present, there is emerging trend to use Fluorescence spectroscopy as a diagnostic as well as research tool in many fields of medical sciences. Here, we will critically discuss research studies which propose that Fluorescence spectroscopy may be an excellent diagnostic as well as excellent research tool in medical microbiology field with high sensitivity and specificity.

Emerging applications of fluorescence spectroscopy in medical microbiology field

Directory of Open Access Journals (Sweden)

Gaubitzer Erwin

2009-11-01

Full Text Available Abstract There are many diagnostic techniques and methods available for diagnosis of medically important microorganisms like bacteria, viruses, fungi and parasites. But, almost all these techniques and methods have some limitations or inconvenience. Most of these techniques are laborious, time consuming and with chances of false positive or false negative results. It warrants the need of a diagnostic technique which can overcome these limitations and problems. At present, there is emerging trend to use Fluorescence spectroscopy as a diagnostic as well as research tool in many fields of medical sciences. Here, we will critically discuss research studies which propose that Fluorescence spectroscopy may be an excellent diagnostic as well as excellent research tool in medical microbiology field with high sensitivity and specificity.

A "Neurological Emergency Trolley" reduces turnaround time for high-risk medications in a general intensive care unit.

Science.gov (United States)

Ajzenberg, Henry; Newman, Paula; Harris, Gail-Anne; Cranston, Marnie; Boyd, J Gordon

2018-02-01

To reduce medication turnaround times during neurological emergencies, a multidisciplinary team developed a neurological emergency crash trolley in our intensive care unit. This trolley includes phenytoin, hypertonic saline and mannitol, as well as other equipment. The aim of this study was to assess whether the cart reduced turnaround times for these medications. In this retrospective cohort study, medication delivery times for two year epochs before and after its implementation were compared. Eligible patients were identified from our intensive care unit screening log. Adults who required emergent use of phenytoin, hypertonic saline or mannitol while in the intensive care unit were included. Groups were compared with nonparametric analyses. 33-bed general medical-surgical intensive care unit in an academic teaching hospital. Time to medication administration. In the pre-intervention group, there were 43 patients with 66 events. In the post-intervention group, there were 45 patients with 80 events. The median medication turnaround time was significantly reduced after implementation of the neurological emergency trolley (25 vs. 10minutes, p=0.003). There was no statistically significant difference in intensive care or 30-day survival between the two cohorts. The implementation of a novel neurological emergency crash trolley in our intensive care unit reduced medication turnaround times. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Independent Human Factors Analysis and Evaluation of the Emergency Medical Protocol Checklist for the International Space Station

Science.gov (United States)

Marshburn, Thomas; Whitmore, Mihriban; Ortiz, Rosie; Segal, Michele; Smart, Kieran; Hughes, Catherine

2003-01-01

Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS

Assessment of emergency medical services in the Ashanti region of ...

African Journals Online (AJOL)

Deficient areas in need of development are governance, reliable revenue, public access, community integration, clinical care guidelines, research and quality assurance processes. Conclusions: The Ashanti Region has a growing and thriving emergency medical services system. Although many essential areas for ...

[Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units].

Science.gov (United States)

Dick, W

1994-01-01

clinical pictures. Cost effectiveness is clearly in favor of emergency medicine. Future developments will be characterized by the consequences of new health care legislation and by effects of financial stringencies on the emergency medical services.

The Use of Emergency Medication Kits in Community Palliative Care: An Exploratory Survey of Views of Current Practice in Australian Home-Based Palliative Care Services.

Science.gov (United States)

Bullen, Tracey; Rosenberg, John P; Smith, Bradley; Maher, Kate

2015-09-01

Improving symptom management for palliative care patients has obvious benefits for patients and advantages for the clinicians, as workload demands and work-related stress can be reduced when the emergent symptoms of patients are managed in a timely manner. The use of emergency medication kits (EMKs) can provide such timely symptom relief. The purpose of this study was to conduct a survey of a local service to examine views on medication management before and after the implementation of an EMK and to conduct a nationwide prevalence survey examining the use of EMKs in Australia. Most respondents from community palliative care services indicated that EMKs were not being supplied to palliative care patients but believed such an intervention could improve patient care. © The Author(s) 2014.

State of emergency medicine in Azerbaijan.

Science.gov (United States)

Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

2008-04-01

There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the "specialty" model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. The Emergency Medicine Development Initiative (EMDI) of the International Medical Corps (IMC) was designed to improve the quality of emergency care in four pilot regional centers in Azerbaijan. The objective of this study was to assess the baseline emergency medical capacity of these four centers. EMDI staff conducted a four-part baseline survey in April 2006 to assess emergency care in Ganja (the second largest city in Azerbaijan), Kurdamir, Shamkir and Yevlakh. Data collection involved interviews with relevant personnel and a retrospective records review in each city. Pre-hospital: The number of ambulance teams per 10,000 inhabitants is below the number required by local regulations. On average, 45% of 27 medications and 37% of 17 pieces of critical equipment were available. Of the emergency procedures, 21% could be performed in the pre-hospital setting. In-hospital: Admission rates were near 100% for the admissions department-an area that is supposed to function as an emergency department would. On average 57% of 40 medications and 42% of 22 pieces of critical equipment were available. Of the emergency procedures, 62% could be performed in the in-hospital setting. The emergency medical system surveyed in Azerbaijan is inefficiently organized, under-financed, poorly equipped and lacks adequately trained staff. Reforms need to be directed towards achieving international standards, while adapting new models for service delivery into the existing framework and improving system capacity as highlighted by this baseline

Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study.

Science.gov (United States)

Aftyka, Anna; Rybojad, Beata; Rudnicka-Drozak, Ewa

2014-10-01

To compare interventions of medical emergency teams in urban and rural areas with particular emphasis on response time and on-site medical rescue activities. A retrospective analysis of ambulance call reports from two emergency medical service substations: one in the city and the other in a rural area. Two emergency medical service substations: one in the city and the other in a rural area. Medical emergency teams. Interventions in the city were associated with a substantially shorter response time in comparison to rural areas. In the city, the distances were generally less than 10 km. In the rural area, however, such short distances accounted for only 7.2% of events, while 33.8% were over 30 km. Medical emergency teams more often acted exclusively on-site or ceased any interventions in rural areas. Compared with the city, actions in the rural setting were associated with significantly increased use of cervical collars and decreased use of intravenous access. The presence of a physician in the team raised the probability of pharmacotherapy. The relationship between medical emergency teams activities and the location of intervention shows the real diversity of the functioning of emergency medical service within a city and rural areas. Further research should aim to improve the generalisability of these findings. © 2014 National Rural Health Alliance Inc.

Effect of acute and chronic job demands on effective individual teamwork behaviour in medical emergencies.

Science.gov (United States)

Gevers, Josette; van Erven, Pierre; de Jonge, Jan; Maas, Maaike; de Jong, Jos

2010-07-01

This paper is a report of a study conducted to determine the combined effect of acute and chronic job demands on acute job strains experienced during medical emergencies, and its consequences for individual teamwork behaviour. Medical emergency personnel have to cope with high job demands, which may cause considerable work stress (i.e. job strains), particularly when both acute and chronic job demands are experienced to be high. This may interfere with effective individual teamwork behaviour. A cross-sectional survey study was conducted in 2008, involving 48 members (doctors and nurses) of medical emergency teams working in the emergency department of a Dutch general hospital. Data were analyzed by means of hierarchical regression analyses. High acute job demands impeded effective teamwork behaviour, but only when they resulted in acute job strain. Acute emotional demands were more likely to result in acute job strain when chronic emotional job demands were also experienced as high. Although acute cognitive and physical strains were also detrimental, effective teamwork behaviour was particularly impeded by acute emotional strain. Acute job strains impair effective individual teamwork behaviour during medical emergencies, and there is urgent need to prevent or reduce a build-up of job strain from high acute and chronic demands, particularly of the emotional kind.

Integration of Tactical Emergency Casualty Care Into the National Tactical Emergency Medical Support Competency Domains.

Science.gov (United States)

Pennardt, Andre; Callaway, David W; Kamin, Rich; Llewellyn, Craig; Shapiro, Geoff; Carmona, Philip A; Schwartz, Richard B

2016-01-01

Tactical emergency medical support (TEMS) is a critical component of the out-of-hospital response to domestic high-threat incidents such as hostage scenarios, warrant service, active shooter or violent incidents, terrorist attacks, and other intentional mass casualty-producing acts. From its grass-roots inception in the form of medical support of select law enforcement special weapons and tactics (SWAT) units in the 1980s, the TEMS subspecialty of prehospital care has rapidly grown and evolved over the past 40 years. The National TEMS Initiative and Council (NTIC) competencies and training objectives are the only published recommendations of their kind and offer the opportunity for national standardization of TEMS training programs and a future accreditation process. Building on the previous work of the NTIC and the creation of acknowledged competency domains for TEMS and the acknowledged civilian translation of TCCC by the Committee for Tactical Emergency Casualty Care (C-TECC), the Joint Review Committee (JRC) has created an opportunity to bring forward the work in a form that could be operationally useful in an all-hazards and whole of community format. 2016.

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 5. CPR, Oxygen Therapy. Revised.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the fifth in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains two sections covering the following course content; cardiopulmonary resuscitation (CPR) (including artificial ventilation, foreign body obstructions, adjunctive equipment and special techniques, artificial…

78 FR 801 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

Science.gov (United States)

2013-01-04

...The NHTSA announces a meeting of NEMSAC to be held in the Metropolitan Washington, DC, area. This notice announces the date, time, and location of the meeting, which will be open to the public. The purpose of NEMSAC, a nationally recognized council of emergency medical services representatives and consumers, is to provide advice and recommendations regarding Emergency Medical Services (EMS) to DOT's NHTSA and to the Federal Interagency Committee on EMS (FICEMS).

Medical response guide for the initial phase of a radiological emergency; Guia para la respuesta medica en la fase inicial de una emergencia radiologica

Energy Technology Data Exchange (ETDEWEB)

Vazquez, Marina A; Perez, Maria del R

2007-07-01

In case of a sanitary emergency, the local community and its health care system are the first aid providers. Therefore, preparedness through education and training programs would allow emergency systems to provide an appropriate first medical response. The main objective of this guide is to give basic guidelines for the medical response management after situations involving radioactive materials, in an easy and simple way. The information contained in this guide is addressed to health care personnel of any local assistance center. (author) [Spanish] Las emergencias que afecten a un numero importante de personas y que tengan como protagonistas agentes 'no convencionales' como lo son las radiaciones ionizantes, deben ser abordadas mediante la implementacion de programas sanitarios especiales. En una situacion de emergencia, generalmente los primeros en proporcionar la ayuda, son la comunidad local y su sistema de salud. Por ello la preparacion previa local, a traves de la capacitacion y el entrenamiento permitira brindar una respuesta inicial adecuada que se articule con un sistema de respuesta en emergencias escalonado y de complejidad creciente. Esto requiere la participacion de las autoridades de salud en cada uno de los niveles de atencion, asi como apoyo de otros sectores para desarrollar sus planes de preparacion y respuesta. La presente guia, como instrumento de capacitacion, tiene como objetivo primario brindar las herramientas basicas para el manejo de la respuesta medica en una situacion de emergencia que involucre material radiactivo, en un lenguaje claro y sencillo, dirigida al personal de salud de todos los centros asistenciales locales. (autor)

Perceived Facilitators and Barriers to Local Health Department Workers' Participation in Infectious Disease Emergency Responses.

Science.gov (United States)

Rutkow, Lainie; Paul, Amy; Taylor, Holly A; Barnett, Daniel J

Local health departments play a key role in emergency preparedness and respond to a wide range of threats including infectious diseases such as seasonal influenza, tuberculosis, H1N1, Ebola virus disease, and Zika virus disease. To successfully respond to an infectious disease outbreak, local health departments depend upon the participation of their workforce; yet, studies indicate that sizable numbers of workers would not participate in such a response. The reasons why local health department workers participate, or fail to participate, in infectious disease responses are not well understood. To understand why local health department workers are willing, or not willing, to report to work during an infectious disease response. From April 2015 to January 2016, we conducted 28 semistructured interviews with local health department directors, preparedness staff, and nonpreparedness staff. Interviews were conducted with individuals throughout the United States. We interviewed 28 individuals across 3 groups: local health department directors (n = 8), preparedness staff (n = 10), and nonpreparedness staff (n = 10). Individuals' descriptions of why local health department workers are willing, or not willing, to report to work during an infectious disease response. Factors that facilitate willingness to respond to an infectious disease emergency included availability of vaccines and personal protective equipment; flexible work schedule and childcare arrangements; information sharing via local health department trainings; and perceived commitments to one's job and community. Factors that hinder willingness to respond to an infectious disease emergency included potential disease exposure for oneself and one's family; logistical considerations for care of children, the elderly, and pets; and perceptions about one's role during an infectious disease response. Our findings highlight opportunities for local health departments to revisit their internal policies and engage in

Smartphones and Medical Apps in the Practice of Emergency Medicine in Iran

Directory of Open Access Journals (Sweden)

Amirhosein Jahanshir

2017-01-01

Full Text Available Introduction: Medical applications help physicians to make more rapid and evidence based decisions that may provide better patient care. This study aimed to determine the extent to which smart phones and medical applications are integrated in the emergency department daily practice.Method: In a cross sectional study, a modified standard questionnaire (Payne et al. consisting of demographic data and information regarding quality and quantity of smartphone and medical app utilization was sent to emergency-medicine residents and interns twice (two weeks apart, in January 2015. The questionnaire was put online using open access "Web-form Module" and the address of the web page was e-mailed along with a cover letter explaining the survey. Finally, responses were analyzed using descriptive statistics and SPSS 22 software.Results: 65 cases participated (response rate 86%. The mean age of interns and residents were 25.03 ± 1.13 and 30.27 ± 4.68 years, respectively (p < 0.001. There was no significant difference between interns and residents in owning a smartphone (p = 0.5. Android was more popular than IOS (67.7% against 25.8% and the most popular medical apps were Medscape and UpToDate, respectively. 38 (61.3% of the respondents were using their apps more than once a day and mostly for drug information. English (83.9%, Persian (12.9%, and other languages (3.2% were preferred languages for designing a medical software among the participants, respectively.Conclusion: The findings of present study showed that smartphones are very popular among Iranian interns and residents in emergency department and a substantial number of them own a smartphone and are using medical apps regularly in their clinical practice. 

Eliciting comprehensive medication histories in the emergency department: the role of the pharmacist.

Directory of Open Access Journals (Sweden)

Crook M

2007-06-01

Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to hospital. Accurate medication histories are vital in optimising health outcomes and have been shown to reduce mortality rates. This study aimed to examine the accuracy of medication histories taken in the Emergency Department of the Royal Adelaide Hospital. Medication histories recorded by medical staff were compared to those elicited by a pharmacy researcher. The study, conducted over a six-week period, included 100 patients over the age of 70, who took five or more regular medications, had three or more clinical co-morbidities and/or had been discharged from hospital in three months prior to the study. Following patient interviews, the researcher contacted the patient’s pharmacist and GP for confirmation and completion of the medication history. Out of the 1152 medications recorded as being used by the 100 patients, discrepancies were found for 966 medications (83.9%. There were 563 (48.9% complete omissions of medications. The most common discrepancies were incomplete or omitted dosage and frequency information. Discrepancies were mostly medications that treated dermatological and ear, nose and throat disorders but approximately 29% were used to treat cardiovascular disorders. This study provides support for the presence of an Emergency Department pharmacist who can compile a comprehensive and accurate medication history to enhance medication management along the continuum of care. It is recommended that the patient’s community pharmacy and GP be contacted for clarification and confirmation of the medication history.

Medical assistance in the management of nuclear power plant accidents. Guide for: medical personnel of emergency preparedness services, doctors of emergency departments, doctors for out-patient or in-patient treatment. 2. rev. ed.

International Nuclear Information System (INIS)

Gumprecht, D.; Haehnel, S.

1995-01-01

The guide explains the medical tasks and activities in the context of the emergency preparedness programmes and provisions established by the Laender. The medical expert for radiation injuries is a particularly important function in the radiologial accident management services. The provisions for medical care have been determined on the basis of knowledge drawn among other sources from the German Nuclear Power Plant Risk Study, Phase B. In addition, the guide's provisions are based on international knowledge about the consequences of enhanced radiation exposure, and the medical tasks and the required organisational infrastructure have been determined accordingly. A further source of reference for planning the activities are the data accumulated during emergency preparedness training activities in the various Laender. (orig./MG). 3 figs., 5 tabs [de

Emergency contraception: Knowledge and attitude toward its use among medical students of a medical college in North-West India

Directory of Open Access Journals (Sweden)

Rajiv Kumar Gupta

2016-01-01

Full Text Available Context: Emergency contraception (EC is use of drug or device to prevent pregnancy after unprotected sexual intercourse. Unlike other regular methods of contraception which are taken prior to the sexual act, EC is used after the unprotected sex. Aim: To assess the knowledge and attitude toward use of emergency contraceptives among medical students. Setting and Design: A cross-sectional questionnaire based study was conducted among all the medical students in the Government Medical College in North-West India. Subjects and Methods: A questionnaire seeking information on knowledge and attitude of undergraduate medical students was administered over a period of 4 weeks in the month of February and March 2014. Statistical Analysis: The data were entered in MS excel and expressed using percentages. Chi-square test was used as a test of statistical significance. Results: About 61.6% (247/401 of the participants were aware about the timing of use of EC. Audio visual media (76.6%; 307/401 was the most common source of information for of these medical students. Conclusions: The lack of appropriate in-depth knowledge of EC among future health care professional should alarm the medical teaching system as EC is the only method that can be used to prevent pregnancy after unprotected sex or contraceptive accident.

Working styles of medicine professionals in emergency medical service

Directory of Open Access Journals (Sweden)

Lazarević Marija

2015-01-01

Full Text Available Introduction: Transactional analysis is a personality and communication theory established by psychiatrist Eric Berne, at the end of the fifties. Counter script is the way of life in accordance with parental imperative. The person with a counter-script has a compulsion to fulfill the required task in order to avoid the disaster of ban. There are five drivers that are considered essential, and these are: 'Be perfect!', 'Be strong!', 'Hurry up!', 'Please others!' and 'Work hard!' Objective: a Determination of the most dominant driver in this medical service. b Because of the specifics of this job which requires speed and humanity, the emphasis will be on doublet: 'Hurry up!' and 'Please others!' Method: The study was conducted on a group of subjects employed in a general service with medical emergency. The instrument used in the study was Julie Hay's questionnaire for diagnosing the working styles. Results: Statistical research was conducted on a sample of 30 subjects employed in the emergency medical service. Availability of all afore mentioned drivers was tested. The research hypotheses were formulated as follows: H0: The driver is not present among the employees in this service; H1: The driver is present among the employees in this service. Calculated value of the t-statistics for the driver 'Hurry up!' is 1.398; for the driver 'Be perfect!' 3.616; for the driver 'Please others!' 11.693; for the driver 'Work hard!' -0.673; and for the driver 'Be strong!' 3.880. Since the realizable value of the t-statistics for the drivers: 'Be perfect!' and 'Please others!' and 'Be strong!' is bigger than the critical value 1.699, and p<0.05 we reject the null hypothesis and we accept the alternative hypothesis on the significance level of 95%. For the drivers 'Hurry up!' and 'Work hard!' the values of t-statistics are lower than the critical value 1.699 for significance level of 95%, so the alternative hypothesis are not acceptable. Conclusion: The results of

Medical intervention in radiological emergencies, formation and training; Intervencion medica en emergencias radiologicas, formacion y adiestramiento

Energy Technology Data Exchange (ETDEWEB)

Cardenas H, J. [CPHR, Calle 20 No. 4113, e/41 y 47 Playa, CP 11300, La Habana (Cuba)]. e-mail: cardenas@cphr.edu.cu

2006-07-01

The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

Patient prioritization in medical emergencies: an ethical analysis.

Science.gov (United States)

Fortes, Paulo Antônio de Carvalho; Pereira, Patricia Cristina Andrade

2012-01-01

To identify and analyze, in the light of ethical considerations, the choices and justifications of public health professionals in hypothetical situations of patient prioritization in circumstances of limited resources during emergency medical care. Qualitative and quantitative study, carried out through interviews with 80 public health professionals, graduate students (MSc and PhD students) in public health who were faced with hypothetical situations involving the criteria of gender, age, and responsibility, asked to choose between alternatives that referred to the existence of people, equally submitted to life-threatening situations, who needed care in an emergency department. The choices prioritized children, young individuals, women, and married women, with decision-making invoking the ethical principles of vulnerability, social utility, and equity. The study shows a clear tendency to justify the choices that were made, guided by utilitarian ethics.

Emergency medical service providers' experiences with traffic congestion.

Science.gov (United States)

Griffin, Russell; McGwin, Gerald

2013-02-01

The population's migration from urban to suburban areas has resulted in a more dispersed population and has increased traffic flow, possibly resulting in longer emergency response times. Although studies have examined the effect of response times on time to definitive care and survival, no study has addressed the possible causes of slowed response time from the point of view of emergency medical services (EMS) first responders. To assess the variables most commonly associated with increased emergency response time as described by the opinions and views of EMS first responders. A total of 500 surveys were sent to randomly selected individuals registered as first responders with the Alabama Department of Public Health, and 112 surveys were returned completed. The survey included questions regarding roadway design, response to emergency calls, in-vehicle technology aimed at decreasing travel time, and public education regarding emergency response. Respondents reported traveling on city streets most often during emergency calls, and encountering traffic more often on interstates and national highways. Traffic congestion, on average, resulted in nearly 10min extra response time. Most agreed that the most effective in-vehicle technology for reducing response time was a pre-emptive green light device; however, very few reported availability of this device in their emergency vehicles. Public education regarding how to react to approaching emergency vehicles was stated as having the greatest potential impact on reducing emergency response time. The results of the survey suggest that the best methods for reducing emergency response times are those that are easy to implement (e.g., public education). Copyright © 2013 Elsevier Inc. All rights reserved.

Nip, tuck and click: medical tourism and the emergence of web-based health information.

Science.gov (United States)

Lunt, Neil; Hardey, Mariann; Mannion, Russell

2010-02-12

An emerging trend is what has become commonly known as 'Medical Tourism' where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions.This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making.This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework.

Nip, Tuck and Click: Medical Tourism and the Emergence of Web-Based Health Information

Science.gov (United States)

Lunt, Neil; Hardey, Mariann; Mannion, Russell

2010-01-01

An emerging trend is what has become commonly known as ‘Medical Tourism’ where patients travel to overseas destinations for specialised surgical treatments and other forms of medical care. With the rise of more affordable cross-border travel and rapid technological developments these movements are becoming more commonplace. A key driver is the platform provided by the internet for gaining access to healthcare information and advertising. There has been relatively little attention given to the role and impact of web-based information to inform Medical Tourism decisions. This article provides a brief overview of the most recent development in Medical Tourism and examines how this is linked to the emergence of specialized internet web sites. It produces a summary of the functionality of medical tourist sites, and situates Medical Tourism informatics within the broader literatures relating to information search, information quality and decision-making. This paper is both a call to strengthen the empirical evidence in this area, and also to advocate integrating Medical Tourism research within a broader conceptual framework. PMID:20517465

Plain abdominal radiographs in acute medical emergencies: an abused investigation?

Science.gov (United States)

Feyler, S; Williamson, V; King, D

2002-02-01

Plain abdominal radiographs are commonly requested for acute medical emergencies on patients with non-specific abdominal symptoms and signs. In this study 131 plain abdominal radiographs performed on the day of admission were prospectively analysed. In only 16 cases (12%) the reasons for requests conformed to the recommended guidelines by the Royal College of Radiologists. The reason for the request was stated in the case notes in only three cases. In 62 cases (47%), there was no comment made on the film by the requesting clinician. There was a discrepancy in the interpretation of the radiograph between the clinician and the radiologist in 31 cases (24%). The clinical management was influenced by plain abdominal radiographs in only nine cases (7%). The majority of plain abdominal radiographs requested on acute medical emergencies is inappropriate. There is a need to ensure guidelines are followed to prevent unnecessary exposure of patients to radiation as well as preventing expenditure on irrelevant investigations.

Deprivation index and dependency ratio are key determinants of emergency medical admission rates.

Science.gov (United States)

Conway, Richard; Byrne, Declan; O'Riordan, Deirdre; Cournane, Seán; Coveney, Seamus; Silke, Bernard

2015-11-01

Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission; there has been debate as to the extent to which deprivation and population structure influences hospital admission rate. All emergency medical admissions to an Irish hospital over a 12-year period (2002-2013) categorized by quintile of Deprivation Index and Dependency Ratio (proportion of population Dependency Ratio was an independent predictor of the admission rate with adjusted predicted rates of Q1 20.8 (95%CI 20.5 to 21.1), Q2 19.2 (95%CI 19.0 to 19.4), Q3 27.6 (95%CI 27.3 to 27.9), Q4 43.9 (95%CI 43.5 to 44.4) and Q5 34.4 (95%CI 34.1 to 34.7). A high concurrent Deprivation Index and Dependency Ratio were associated with very high admission rates. Deprivation Index and population Dependency Ratio are key determinants of the rate of emergency medical admissions. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Medical emergencies facing general practitioners: Drugs for the doctor's bag

Directory of Open Access Journals (Sweden)

Janković Slobodan

2014-01-01

Full Text Available General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever, morphine (for severe pain, naloxone (for heroin poisoning, ceftriaxone (for meningococcal meningitis, albuterol (for bronchial asthma attack, hydrocortisone (for bronchial asthma attack, glucagon (for severe hypoglycemia, dextrose (for mild to moderate hypoglycemia, diazepam (for febrile convulsions or epileptic status, epinephrine (for anaphylaxis and cardiac arrest, atropine (for symptomatic bradicardia, chloropyramine (for acute allergy, aspirin (for acute myocardial infarction, nitroglycerine (for acute coronary syndrome, metoclopramide (for nausea and vomiting, haloperidol (for delirium, methylergometrine (for control of bleeding after delivery or abortion, furosemide (for acute pulmonary edema and flumazenil (for benzodiazepine poisoning. For each of the listed drugs a physician should well know the recommended doses, indications, contraindications and warnings. All of the listed drugs are either registered in Serbia or available through special import, so general practitioners may fill their bags with all necessary drugs and effectively and safely treat medical emergencies.

Knowledge and Practices of Medical And Traditional Emergency Contraception among Married Women in Odemis

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Zeynep Daşıkan

2013-06-01

Full Text Available Objectives: The present study was designed to determine medical and traditional knowledge and practices of emergency contraception among married women after unprotected sexual intercourse.\tMaterials and Methods: The present study was carried out as a descriptive study on 367 married women registered to Primary Health Center number one in Odemis County of Izmir City between the dates 12.05.2005 and 20.06.2005. The data were collected through a questionnaire consisting of characteristic desciriptive, reproductive data and knowledge and use of medical and traditional emergency contraception. For collecting data, face-to-face interview technique was used. Data were evaluated by as number, percentage and chi-square tests on the SPSS version 12.0.\tResults: It was found that 25.1% of the women knew medical methods of emergency contraception and 1.4% of them (n = 5 used morning after pills. It was also found that 50.1% of the women knew at least one traditional practice for contraception and 19.3% of them used traditional practice at least for one time, and the most frequently used traditional practice was vaginal douche with rate of 75.7%. Conclusions: It was concluded that rate of having knowledge on and using medical emergency contraceptive methods was lower for contraception from unintended pregnancies whereas rate of having knowledge on and using traditional contraceptive practice was higher among married women in Odemis. The women should be informed on emergency contraceptive methods and they should be given counselling.

Systematic Review Methodology for the Fatigue in Emergency Medical Services Project

Science.gov (United States)

2018-01-11

Background: Guidance for managing fatigue in the Emergency Medical Services (EMS) setting is limited. The Fatigue in EMS Project sought to complete multiple systematic reviews guided by seven explicit research questions, assemble the best available e...

Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies.

Science.gov (United States)

Waterbrook, Anna L; Spear Ellinwood, Karen C; Pritchard, T Gail; Bertels, Karen; Johnson, Ariel C; Min, Alice; Stoneking, Lisa R

2018-01-01

Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones. Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable. Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process.

Barriers to recognition of out-of-hospital cardiac arrest during emergency medical calls

DEFF Research Database (Denmark)

Alfsen, David; Møller, Thea Palsgaard; Egerod, Ingrid

2015-01-01

the dispatchers' recognition of OHCA, focusing on the communication during the emergency call. The purpose of this study is to identify factors affecting medical dispatchers' recognition of OHCA during emergency calls in a qualitative analysis of calls. METHODS: An investigator triangulated inductive thematic...... to an automated external defibrillator should be initiated. Previous studies have investigated barriers to recognition of OHCA, and found the caller's description of sign of life, the type of caller, caller's emotional state, an inadequate dialogue during the emergency call, and patient's agonal breathing...... as influential factors. Though many of these factors are included in the algorithms used by medical dispatchers, many OHCA still remain not recognised. Qualitative studies investigating the communication between the caller and dispatcher are very scarce. There is a lack of knowledge about what influences...

Local contexts as activation mechanisms of market development: contemporary art in emerging markets

NARCIS (Netherlands)

Komarova, N.; Velthuis, O.

2018-01-01

The paper studies how local contexts contribute to the emergence of markets. In particular, it explains how potential entrepreneurs are motivated to become active in establishing new markets. Empirically, the focus is on contemporary art markets in two emerging countries: India and Russia. The paper

41 CFR 102-36.460 - Do we report excess medical shelf-life items held for national emergency purposes?

Science.gov (United States)

2010-07-01

... medical shelf-life items held for national emergency purposes? 102-36.460 Section 102-36.460 Public... Disposal Requires Special Handling Shelf-Life Items § 102-36.460 Do we report excess medical shelf-life items held for national emergency purposes? When the remaining shelf life of any medical materials or...

Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies

Directory of Open Access Journals (Sweden)

Waterbrook AL

2018-05-01

Full Text Available Anna L Waterbrook,1 Karen C Spear Ellinwood,2 T Gail Pritchard,3 Karen Bertels,1 Ariel C Johnson,4 Alice Min,1 Lisa R Stoneking1 1Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA; 2Department of Obstetrics and Gynecology, The University of Arizona College of Medicine, Tucson, AZ, USA; 3Department of Pediatrics, The University of Arizona College of Medicine, Tucson, AZ, USA; 4College of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management are challenging for a supervising emergency medicine (EM physician to evaluate in real-time on shift while also managing a busy emergency department (ED. This study examines residents’ perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills.Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones.Results: Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2. Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received

The emergency medical programs of japan and foreign countries for radiation accidents in nuclear power stations

International Nuclear Information System (INIS)

Aoki, Yoshiro

1994-01-01

In our country, the medical emergency programs for the people living near nuclear power stations are well organized, however, preparation of medical staffs who are well trained is considered to be not sufficient. In the USA, on call 24 hours response to a radiological emergency is provided and funded by Department of Energy(DOE) or electric companies. Especially, REAC/TS is a part of DOE response network, in which there are provided well-trained physicians, nurses, health physicists, coordinators and support personnels. In United Kingdom, National Radiological Protection Board(NRPB) is responsible to a radiological emergency program. Each nuclear power station has its own emergency program consisting of a team of physicians, nurses and health physicists. In France, French Atomic Energy Commission (CEA) is a responsible agency for a radiological emergency program. On call 24 hours response to a radiological emergency is provided in Fontenay-aux Roses Institute and Curie Institute. Curie Institute also responds to radiological emergencies in other countries at the request of WHO. In Germany(West Germany), compulsory assurance system covers a radiological emergency program and a radiological protection. There are seven centers in West Germany, in which well-trained medical staffs are provided against radiological injuries. In this report, I tried to propose a new concept about emergency medical programs for nuclear power station accidents in Japan. I think it is a very urgent theme to provide on call 24 hours radiological emergency program, in which patients suffered from acute radiation sickness with internal contamination or contaminated radiation burns will be treated without any trouble. We have to make our best efforts to complete basic or clinical research about radiation injuries including bone marrow transplantation, radioprotectors, chelating agents and radiation burns etc. (J.P.N.)

Medical History of Elderly Patients in the Emergency Setting: Not an Easy Point-of-Care Diagnostic Marker

Directory of Open Access Journals (Sweden)

Tobias Lindner

2015-01-01

Full Text Available Background. Medical histories are a crucially important diagnostic tool. Elderly patients represent a large and increasing group of emergency patients. Due to cognitive deficits, taking a reliable medical history in this patient group can be difficult. We sought to evaluate the medical history-taking in emergency patients above 75 years of age with respect to duration and completeness. Methods. Anonymous data of consecutive patients were recorded. Times for the defined basic medical history-taking were documented, as were the availability of other sources and times to assess these. Results. Data of 104 patients were included in the analysis. In a quarter of patients (25%, n=26 no complete basic medical history could be obtained. In the group of patients where complete data could be gathered, only 16 patients were able to provide all necessary information on their own. Including other sources like relatives or GPs prolonged the time until complete medical history from 7.3 minutes (patient only to 26.4 (+relatives and 56.3 (+GP minutes. Conclusions. Medical histories are important diagnostic tools in the emergency setting and are prolonged in the elderly, especially if additional documentation and third parties need to be involved. New technologies like emergency medical cards might help to improve the availability of important patient data but implementation of these technologies is costly and faces data protection issues.

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 3--Anatomy and Physiology. Revised.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the third in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains one section covering the following topics: general anatomical terms, the body cavities and contents, the integumentary system, the skeletal system, the muscular system, the nervous system, the respiratory…

Using the MDRD value as an outcome predictor in emergency medical admissions.

LENUS (Irish Health Repository)

Chin, Jun Liong

2011-10-01

Both physiological- and laboratory-derived variables, alone or in combination, have been used to predict mortality among acute medical admissions. Using the Modification of Diet in Renal Disease (MDRD) not as an estimate of glomerular filtration rate but as an outcome predictor for hospital mortality, we examined the relationship between the MDRD value and in-hospital death during an emergency medical admission.

Absence and Need for Fatigue Risk Management in Emergency Medical Services

Science.gov (United States)

2018-01-11

Fatigue in the Emergency Medical Services (EMS) workplace is widespread. Reports of fatigue-related events that involve ambulance crashes, personnel injury, patient death, and other negative outcomes are on the rise (1-7). There is growing evidence t...

Simulation training for medical emergencies in the dental setting using an inexpensive software application.

Science.gov (United States)

Kishimoto, N; Mukai, N; Honda, Y; Hirata, Y; Tanaka, M; Momota, Y

2017-11-09

Every dental provider needs to be educated about medical emergencies to provide safe dental care. Simulation training is available with simulators such as advanced life support manikins and robot patients. However, the purchase and development costs of these simulators are high. We have developed a simulation training course on medical emergencies using an inexpensive software application. The purpose of this study was to evaluate the educational effectiveness of this course. Fifty-one dental providers participated in this study from December 2014 to March 2015. Medical simulation software was used to simulate a patient's vital signs. We evaluated participants' ability to diagnose and treat vasovagal syncope or anaphylaxis with an evaluation sheet and conducted a questionnaire before and after the scenario-based simulation training. The median evaluation sheet score for vasovagal syncope increased significantly from 7/9 before to 9/9 after simulation training. The median score for anaphylaxis also increased significantly from 8/12 to 12/12 (P simulation training. This simulation course improved participants' ability to diagnose and treat medical emergencies and improved their confidence. This course can be offered inexpensively using a software application. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Selection and construction of nuclear and radiation emergency medical center in a region

International Nuclear Information System (INIS)

Wang Guojun; He Xu; Liao Li; Gao Dong

2014-01-01

Three level of first-class comprehensive hospital is an important force of nuclear and radiation accident rescue, has a very rich experience in response to nuclear and radiation accidents and deal with large quantities of the sick and wounded. With the foundation and the ability of the construction and operation of medical emergency rescue center. This paper according to the median model location theory of emergency center, combined with the specific situation of the nuclear and radiation accident in Hunan Province, reference location, rescue experience, emergency allocation of resources, teaching and research capacity, establish regional medical emergency center of nuclear and radiation accidents based on three level of first-class comprehensive hospital, break the traditional concept that the center must be provincial capital,form a multi-level, three-dimensional, network of emergency hospital rescue system. The main duties of the center are accident emergency response, on-site treatment and technical guidance of accident, psychological grooming. The author propose building measures according to the duties of the center: increase national and provincial financial investment, carry out training, drills and first aid knowledge missionaries regularly, innovative materials management, speed up the construction of information platform, establish and improve the hospital rescue system, improve organization institution and system of plans, reengineering rescue process. (authors)

Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services

Science.gov (United States)

2018-01-11

Background: Administrators of Emergency Medical Services (EMS) operations lack guidance on how to mitigate workplace fatigue, which affects greater than half of all EMS personnel. The primary objective of the Fatigue in EMS Project was to create an e...

Reporting Helicopter Emergency Medical Services in Major Incidents

DEFF Research Database (Denmark)

Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

2016-01-01

OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...... variables were determined by consensus. These variables were formatted in a template with 4 main categories: HEMS background information, the major incident characteristics relevant to HEMS, the HEMS response to the major incident, and the key lessons learned. CONCLUSION: Based on opinions from European...

Medical emergencies in a dental office: inhalation and ingestion of orthodontic objects.

Science.gov (United States)

Bilder, Leon; Hazan-Molina, Hagai; Aizenbud, Dror

2011-01-01

The authors reviewed the literature regarding inhalation and ingestion of orthodontic appliances and suggest ways to manage and prevent these events. The authors conducted literature searches of free text and Medical Subject Headings terms by using PubMed and Embase databases and selected appropriate studies. They analyzed retrieved articles according to several parameters: inhalation or ingestion event, number of cases, patient's sex and age, type of orthodontic appliance, in-office event or out-of-office event, and medical treatment. The authors found a total of 2,279 articles in their preliminary search. Eighteen reports of 24 cases from this search met all of the search criteria (that is, clinical studies, case reports or reviews limited to English, Hebrew or Arabic on any form of aspiration or inhalation of orthodontic appliances). Most cases (67 percent) involved ingested objects, and of those cases, the majority (57 percent) occurred in female patients. Most cases (85 percent) occurred outside the orthodontist's office. Seventeen patients (71 percent) had been treated with a fixed orthodontic appliance. In 60 percent of cases, the maxilla was involved. With one exception, no severe complications were reported (only seven patients were examined in a hospital emergency department), and patients were discharged uneventfully from the orthodontic office or emergency department. Orthodontists and team members should participate in medical emergency management courses that emphasize the use of guidelines in cases of inhalation or ingestion of orthodontic objects. Each orthodontist's office should develop written emergency protocols for out-of-office events and present them to patients and their parents at the start of treatment.

Build-up forces at Military Institute of Medical Radiology and Oncology for emergency medical response to some eventualities of radiological accidents - some suggestions

International Nuclear Information System (INIS)

Ho Van Cu; Nguyen Huu Nghia

2011-01-01

Nowadays, the use of various nuclear sources in some fields of the life has brought many practical advantages in general; especially in the next several years, our country will begin construction of the first nuclear plant. However, if there were user carelessness or objective disadvantageous factors (earthquake, tsunami, etc.), that disadvantages could lead to a radiation accident or nuclear accident which causes damages not only for economy but also for public health. Therefore, the emergency response to radiation accident, especially the emergency medical response that has a great important position. To satisfy this real demand, in 1996, Vietnam Ministry of Defence made the decision to establish Center for Nuclear Medicine and Radiation Protecting (now becomes Military Institute of Medical Radiology and Oncology) with the main missions are research, applying radiation protecting methods and organizing treatments to radiation injured victims. To fulfill above main missions, with the help of Vietnam Atomic Energy Institute (VAEI), Vietnam Agency for Radiation and Nuclear Safety (VARANS), the doctors and staffs of our Institute have been participated in the international training courses and workshops that organized in Vietnam or in regional countries about emergency medical response to radiation accidents, they get valuable information, knowledge and documents from these courses and workshops. Depending on the principles of radiation emergency medical response to nuclear/ radiation accidents that International Atomic Energy Agency (IAEA) guided, and with the experience learned from other countries in Asia region, our Institute have been gradually improving on organization and curing processes for the radiation victims and also setting the preparedness for emergency medical response to radiation accidents if maybe they could occur. (author)

Incidence of emergency contacts (red responses to Norwegian emergency primary healthcare services in 2007 – a prospective observational study

Directory of Open Access Journals (Sweden)

Hansen Elisabeth

2009-07-01

Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics

Physiological scoring: an aid to emergency medical services transport decisions?

Science.gov (United States)

Challen, Kirsty; Walter, Darren

2010-01-01

Attendance at UK emergency departments is rising steadily despite the proliferation of alternative unscheduled care providers. Evidence is mixed on the willingness of emergency medical services (EMS) providers to decline to transport patients and the safety of incorporating such an option into EMS provision. Physiologically based Early Warning Scores are in use in many hospitals and emergency departments, but not yet have been proven to be of benefit in the prehospital arena. The use of a physiological-social scoring system could safely identify patients calling EMS who might be diverted from the emergency department to an alternative, unscheduled, care provider. This was a retrospective, cohort study of patients with a presenting complaint of "shortness of breath" or "difficulty breathing" transported to the emergency department by EMS. Retrospective calculation of a physiological social score (PMEWS) based on first recorded data from EMS records was performed. Outcome measures of hospital admission and need for physiologically stabilizing treatment in the emergency department also were performed. A total of 215 records were analyzed. One hundred thirty-nine (65%) patients were admitted from the emergency department or received physiologically stabilizing treatment in the emergency department. Area Under the Receiver Operating Characteristic Curve (AUROC) for hospital admission was 0.697 and for admission or physiologically stabilizing treatment was 0.710. No patient scoringemergency department to alternative, unscheduled, care providers.

[The set of wearable medical equipment for medical and nursing teams].

Science.gov (United States)

Efimenko, N a; Valevskii, V V; Lyutov, V V; Makhnovskii, A I; Sorokin, S I; Blinda, I V

2015-06-01

The kit is designed in accordance with the list of the first medical aid procedures and syndromic standards of emergency medical care providing. The kit contains modern local hemostatic agents, vent tubes, cricothyrotomy, needles to eliminate pneumothorax, portable oxygen machine, sets for intravenous and intraosseous infusion therapy, collapsible plastic tires, anti-shock pelvic girdle, and other medical products and pharmaceuticals. As containers used backpack and trolley bag on wheels camouflage colours. For the convenience and safety of the personnel of the vest is designed discharge to be converted in the body armour.

Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ?

Science.gov (United States)

Hobgood, Cherri; Weiner, Bryan; Tamayo-Sarver, Joshua H

2006-04-01

To determine if the three types of emergency medicine providers--physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs])--differ in their identification, disclosure, and reporting of medical error. A convenience sample of providers in an academic emergency department evaluated ten case vignettes that represented two error types (medication and cognitive) and three severity levels. For each vignette, providers were asked the following: 1) Is this an error? 2) Would you tell the patient? 3) Would you report this to a hospital committee? To assess differences in identification, disclosure, and reporting by provider type, error type, and error severity, the authors constructed three-way tables with the nonparametric Somers' D clustered on participant. To assess the contribution of disclosure instruction and environmental variables, fixed-effects regression stratified by provider type was used. Of the 116 providers who were eligible, 103 (40 physicians, 26 nurses, and 35 EMTs) had complete data. Physicians were more likely to classify an event as an error (78%) than nurses (71%; p = 0.04) or EMTs (68%; p error to the patient (59%) than physicians (71%; p = 0.04). Physicians were the least likely to report the error (54%) compared with nurses (68%; p = 0.02) or EMTs (78%; p error types, identification, disclosure, and reporting increased with increasing severity. Improving patient safety hinges on the ability of health care providers to accurately identify, disclose, and report medical errors. Interventions must account for differences in error identification, disclosure, and reporting by provider type.

Emergency Medical Services Public Health Implications and Interim Guidance for the Ebola Virus in the United States

Directory of Open Access Journals (Sweden)

Christopher E. McCoy

2014-11-01

Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.

Organization of accident medical service in emergency situations in the system of Federal administration board for medical-biological and emergency problems at the Ministry of public health and medical industry of Russia

International Nuclear Information System (INIS)

Parfenova, L.N.

1995-01-01

Federal Administration Board for medical-biological problems at the Ministry of Public Health and Medical Industry of Russia, in accordance with the entrusted functions, provides medical-sanitary service for the workers of the branches of industry with especially dangerous labour conditions. For these purpose, there is functioning in its system a network of therapeutic-prophylactic, sanitary, scientific-research, educational and other establishments. A high degree of accident danger of the attended industrial plants determines the state policy of organizations and administrations as well as scientific-practical establishments of the Federal Administration Board in respect of elaboration and introduction of a complex of measures which would enable to guarantee the safe functioning of the plants. All sub-administration establishments have the necessary structures, settle the questions of liquidation of medical-sanitary after-effects of accidents at the attended plants, and are regarded to be the organizations of specialized emergency medical aid of the Federal Administration Board

Development of new core competencies for Taiwanese Emergency Medical Technicians.

Science.gov (United States)

Chang, Yu-Tung; Tsai, Kuang-Chau; Williams, Brett

2018-01-01

Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT) and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents' perspectives of the Taiwanese EMT training and education system. The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS) education system are the attitude of authorities, the licensure system, and legislation. The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of incorporating competency standards in the current skills-based curriculum. Moreover, the core-competencies gap that exists between Taiwanese EMT-1s, EMT-2s, and EMT-Paramedics and internationally recognized core competencies needs to be addressed. By identifying the key factors that potentially impact the development of the EMS education system, such as the attitude of authorities, the licensure system, and legislation, these findings will inform

Competing with giants. Survival strategies for local companies in emerging markets.

Science.gov (United States)

Dawar, N; Frost, T

1999-01-01

The arrival of a multinational corporation often looks like a death sentence to local companies in an emerging market. After all, how can they compete in the face of the vast financial and technological resources, the seasoned management, and the powerful brands of, say, a Compaq or a Johnson & Johnson? But local companies often have more options than they might think, say the authors. Those options vary, depending on the strength of globalization pressures in an industry and the nature of a company's competitive assets. In the worst case, when globalization pressures are strong and a company has no competitive assets that it can transfer to other countries, it needs to retreat to a locally oriented link within the value chain. But if globalization pressures are weak, the company may be able to defend its market share by leveraging the advantages it enjoys in its home market. Many companies in emerging markets have assets that can work well in other countries. Those that operate in industries where the pressures to globalize are weak may be able to extend their success to a limited number of other markets that are similar to their home base. And those operating in global markets may be able to contend head-on with multinational rivals. By better understanding the relationship between their company's assets and the industry they operate in, executives from emerging markets can gain a clearer picture of the options they really have when multinationals come to stay.

Driving improvements in emerging disease surveillance through locally relevant capacity strengthening.

Science.gov (United States)

Halliday, Jo E B; Hampson, Katie; Hanley, Nick; Lembo, Tiziana; Sharp, Joanne P; Haydon, Daniel T; Cleaveland, Sarah

2017-07-14

Emerging infectious diseases (EIDs) threaten the health of people, animals, and crops globally, but our ability to predict their occurrence is limited. Current public health capacity and ability to detect and respond to EIDs is typically weakest in low- and middle-income countries (LMICs). Many known drivers of EID emergence also converge in LMICs. Strengthening capacity for surveillance of diseases of relevance to local populations can provide a mechanism for building the cross-cutting and flexible capacities needed to tackle both the burden of existing diseases and EID threats. A focus on locally relevant diseases in LMICs and the economic, social, and cultural contexts of surveillance can help address existing inequalities in health systems, improve the capacity to detect and contain EIDs, and contribute to broader global goals for development. Copyright © 2017, American Association for the Advancement of Science.

[Medical care for the burnt in modern local military conflicts].

Science.gov (United States)

Sidel'nikov, V O; Paramonov, B A; Tatarin, S N

2002-07-01

The article is devoted to the experience of treatment of the servicemen who burned during the hostilities in Afghanistan (1979-1989), Tadjikistan (1992-1994) and in Republic of Chechnya (1994-2996). Medical care rendered in 18,921 cases of burns and combined trauma (the burn prevailed) is analyzed: 1201--in Afghanistan, 205--in Tadjikistan and 415--in Republic of Chechnya. In the structure of sanitary losses of surgical character the burned persons constituted 2.5% in Afghanistan, 7.0%--in Tadjikistan and 3.9%--in Republic of Chechnya. The most effective was the medical-evacuation system in Afghanistan. The optimal medical-evacuation system during the local armed conflicts and wars is the evacuation consisted of two stages: first medical aid--specialized medical care.

Further studies into the emergency medical care of radiation accidents

International Nuclear Information System (INIS)

Nakao, Isamu

1989-01-01

The emergency medical care of radiation accidents constitute a peculier characteristics of radiation protection including the works of the administrative management, environmental radiological monitoring and health physics around the clinical medicine. It is thought to be an interdisciplinary medical field which is designated as a comprehensive medicine for radiation hazard. Moreover, it will be thought that the radiological medicine is not only the medical science which deals with the use of radiant energy in the diagnosis and treatment of disease, but also the art and science of maintenance of health and cure for radiation injuries, just as the two wheels of a cart. It should reward the needs of today. We would like to expect that this symposium will be a clue to the theoretical systematization of the comprehensive medicine of radiation accidents. (author)

Assessment of Iranian nurses and emergency medical personnel in terms of cardiopulmonary resuscitation knowledge based on the 2010 guideline

Directory of Open Access Journals (Sweden)

Reza Pourmirza Kalhori

2017-01-01

Full Text Available Background: The aim of this study was to compare the cardiopulmonary resuscitation (CPR knowledge of hospital nurses and emergency medical personnel in Kermanshah, Iran. Materials and Methods: This descriptive cross-sectional study was conducted on 330 hospital nurses and 159 emergency medical personnel working in educational hospitals and emergency medical centers in Kermanshah. Data were collected using a validated and reliable (r = 0.74 researcher-made questionnaire consisting of a demographic characteristics questionnaire and the 2010 CPR knowledge questionnaire. Results: Based on the most recent CPR guidelines, the knowledge of 19.5%, 78.6%, and 1.9% of the emergency medical staff was excellent, good, and moderate, respectively. None of the participants had poor knowledge. In addition, the knowledge of 20.2%, 65.4%, 14%, and 0.4% of the nurses in this study was excellent, good, moderate, and poor, respectively. There was no significant difference in CPR knowledge between hospital nurses and emergency medical staff. Moreover, no significant association was found between CPR knowledge and gender, age, work experience, field of study, previous occupation, and advanced resuscitation courses. However, CPR knowledge of individuals with training in basic CPR courses was higher than participants without training in these courses (P < 0.05. Conclusions: Based on the findings of this study, CPR knowledge among Iranian nurses and emergency medical personnel was in an acceptable range. Nevertheless, it is strongly recommended that nurses and emergency staff receive training according to the most recent CPR guidelines.

An anthropological analysis on the casuistry of the emergency medical service

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Baciu Adina

2014-01-01

Full Text Available The objective of this study is to observe the contribution of the current distribution of diseases in a group of patients from the urban area, considering their sex and age, contribution which is visible in the emergency medical service and the importance of the computed-tomography in the process of diagnosing. This cross-sectional study was taken during two months in the emergency medical service of Bucharest, studying a group of 600 patients (236 women, 364 men, 1-92 years of age, based on the diagnostics agreed when the subjects concerned had been hospitalized and the computed-tomography had already completed. The results were processed using statistical methods. 27.12% of women involved were diagnosed with tumor conditions and 20.60% of the men involved were diagnosed with CCT. 27.78% of men above 80 years of age usually need emergency medical services because of intracranial expansive processes and cerebral vascular accidents (strokes. The percentage of women (55.17% having tumors is higher than that of men included in the study (44.83%, the difference being statistically significant (p<0.05. This study reveals that men under the age of 60 and women under the age of 40 are affected by traumas, in comparison with the people of both sexes over this age, for whom the most frequent diseases visible are tumors. Consequently, we consider that it is necessary to promote the primary prevention method, to fight the risk factors, so that such severe conditions are avoided.

Skylab IMSS checklist application study for emergency medical care. [emergency medical care operations involving the use and operation of the portable ambulance module

Science.gov (United States)

Carl, J. G.; Furukawa, S.

1975-01-01

A manual is presented that provides basic technical documentation to support the operation and utilization of the Portable Ambulance Module (PAM) in the field. The PAM is designed to be used for emergency resuscitation and victim monitoring. The functions of all the controls, displays, and stowed equipment of the unit are defined. Supportive medical and physiological data in those areas directly related to the uses of the PAM unit are presented.

[Local impact of antiseptic medical textile on tissues of organism].

Science.gov (United States)

Nazarchuk, O A; Vernyhorods'kyĭ, S V; Paliĭ, V H; Nazarchuk, H H; Paliĭ, D V; Honchar, O O; Zadereĭ, N V

2013-07-01

Morphological investigation for studying of a local impact on the tissues, localized in the antiseptic textile implantation zone, was conducted. The textile was impregnated by composition of decametoxine with modified polysaccharides. Basing on the investigation result there was established the absence of a toxic impact of antiseptic medical textile on the macroorganism tissues, the regenerative processes course, the wounds epithelization, antioedematous and anti-inflammatory effects.

Design and Development of Virtual Reality Simulation for Teaching High-Risk Low-Volume Problem-Prone Office-Based Medical Emergencies

Science.gov (United States)

Lemheney, Alexander J.

2014-01-01

Physicians' offices are not the usual place where emergencies occur; thus how staff remains prepared and current regarding medical emergencies presents an ongoing challenge for private practitioners. The very nature of low-volume, high-risk, and problem-prone medical emergencies is that they occur with such infrequency it is difficult for staff to…

Identification of factors which affect the tendency towards and attitudes of emergency unit nurses to make medical errors.

Science.gov (United States)

Kiymaz, Dilek; Koç, Zeliha

2018-03-01

To determine individual and professional factors affecting the tendency of emergency unit nurses to make medical errors and their attitudes towards these errors in Turkey. Compared with other units, the emergency unit is an environment where there is an increased tendency for making medical errors due to its intensive and rapid pace, noise and complex and dynamic structure. A descriptive cross-sectional study. The study was carried out from 25 July 2014-16 September 2015 with the participation of 284 nurses who volunteered to take part in the study. Data were gathered using the data collection survey for nurses, the Medical Error Tendency Scale and the Medical Error Attitude Scale. It was determined that 40.1% of the nurses previously witnessed medical errors, 19.4% made a medical error in the last year, 17.6% of medical errors were caused by medication errors where the wrong medication was administered in the wrong dose, and none of the nurses filled out a case report form about the medical errors they made. Regarding the factors that caused medical errors in the emergency unit, 91.2% of the nurses stated excessive workload as a cause; 85.1% stated an insufficient number of nurses; and 75.4% stated fatigue, exhaustion and burnout. The study showed that nurses who loved their job were satisfied with their unit and who always worked during day shifts had a lower medical error tendency. It is suggested to consider the following actions: increase awareness about medical errors, organise training to reduce errors in medication administration, develop procedures and protocols specific to the emergency unit health care and create an environment which is not punitive wherein nurses can safely report medical errors. © 2017 John Wiley & Sons Ltd.

Composition of emergency medical services teams and the problem of specialisation of emergency medical services physicians in the opinions of occupationally active paramedics

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Dorota Rębak

2015-01-01

Full Text Available Introduction: Emergency medicine includes prevention, prehospital care, specialised treatment, rehabilitation, and education. Aim of the research: The objective of the analysis was to determine the opinions of paramedics concerning the problem of the composition of emergency medical services (EMS teams and specialisation of EMS system physicians according to their education level and sense of coherence. Material and methods: The study was conducted among 336 occupationally active paramedics working in EMS teams delivering prehospital care in selected units in Poland. The study was conducted at Ambulance Stations and in Hospital Emergency Departments, which within their structure had an out-of-hospital EMS team. The study was conducted by the method of a diagnostic survey, and the research instrument was the Orientation to Life Questionnaire SOC-29 and a questionnaire designed by the author. Results: The respondents who had licentiate education relatively more frequently indicated paramedics with licentiate education level as persons most suitable to undertake medical actions (26.32% rather than physicians (21.05%. Paramedics with 2-year post-secondary school education relatively more often mentioned physicians (33.07% than those with licentiate education (17.32%. As many as 89.58% of the paramedics reported the need for a physician in the composition of the EMS team delivering prehospital care, while only 10.42% of them expressed an opinion that there should be teams composed of paramedics only. According to 30.65% of respondents, EMS team delivering prehospital care should include a physician with the specialty in emergency medicine, whereas 8.04% of respondents reported the need for a physician, irrespective of specialisation. However, 42.56% of the paramedics expressed an opinion that a physician is needed only in a specialist team with a specialisation in emergency medicine. The opinions of the paramedics concerning the need for a

Determining Chronic Disease Prevalence in Local Populations Using Emergency Department Surveillance.

Science.gov (United States)

Lee, David C; Long, Judith A; Wall, Stephen P; Carr, Brendan G; Satchell, Samantha N; Braithwaite, R Scott; Elbel, Brian

2015-09-01

We sought to improve public health surveillance by using a geographic analysis of emergency department (ED) visits to determine local chronic disease prevalence. Using an all-payer administrative database, we determined the proportion of unique ED patients with diabetes, hypertension, or asthma. We compared these rates to those determined by the New York City Community Health Survey. For diabetes prevalence, we also analyzed the fidelity of longitudinal estimates using logistic regression and determined disease burden within census tracts using geocoded addresses. We identified 4.4 million unique New York City adults visiting an ED between 2009 and 2012. When we compared our emergency sample to survey data, rates of neighborhood diabetes, hypertension, and asthma prevalence were similar (correlation coefficient = 0.86, 0.88, and 0.77, respectively). In addition, our method demonstrated less year-to-year scatter and identified significant variation of disease burden within neighborhoods among census tracts. Our method for determining chronic disease prevalence correlates with a validated health survey and may have higher reliability over time and greater granularity at a local level. Our findings can improve public health surveillance by identifying local variation of disease prevalence.

Management of non-traumatic chest pain by the French Emergency Medical System: Insights from the DOLORES registry.

Science.gov (United States)

Manzo-Silberman, Stéphane; Assez, Nathalie; Vivien, Benoît; Tazarourte, Karim; Mokni, Tarak; Bounes, Vincent; Greffet, Agnès; Bataille, Vincent; Mulak, Geneviève; Goldstein, Patrick; Ducassé, Jean Louis; Spaulding, Christian; Charpentier, Sandrine

2015-03-01

The early recognition of acute coronary syndromes is a priority in health care systems, to reduce revascularization delays. In France, patients are encouraged to call emergency numbers (15, 112), which are routed to a Medical Dispatch Centre where physicians conduct an interview and decide on the appropriate response. However, the effectiveness of this system has not yet been assessed. To describe and analyse the response of emergency physicians receiving calls for chest pain in the French Emergency Medical System. From 16 November to 13 December 2009, calls to the Medical Dispatch Centre for non-traumatic chest pain were included prospectively in a multicentre observational study. Clinical characteristics and triage decisions were collected. A total of 1647 patients were included in the study. An interview was conducted with the patient in only 30.5% of cases, and with relatives, bystanders or physicians in the other cases. A Mobile Intensive Care Unit was dispatched to 854 patients (51.9%) presenting with typical angina chest pains and a high risk of cardiovascular disease. Paramedics were sent to 516 patients (31.3%) and a general practitioner was sent to 169 patients (10.3%). Patients were given medical advice only by telephone in 108 cases (6.6%). Emergency physicians in the Medical Dispatch Centre sent an effecter to the majority of patients who called the Emergency Medical System for chest pain. The response level was based on the characteristics of the chest pain and the patient's risk profile. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Antimicrobial Activity of Sabulun Salo a Local Traditional Medicated ...

African Journals Online (AJOL)

The antimicrobial activity of Sabulun salo; a local traditional medicated soap widely used by different tribes in Nigeria such as Hausa, Yoruba and Nupe against skin infections was examined against some clinical isolates of pathogenic microorganisms (Staphylococcus aureus, Escherichia coli and Candida albicans) using ...

Emergency preparedness: medical management of nuclear accidents involving large groups of victims

International Nuclear Information System (INIS)

Parmentier, N.; Nenot, J.C.

1988-01-01

The treatment of overexposed individuals implies hospitalisation in a specialized unit applying hematological intense care. If the accident results in a small number of casualties, the medical management does not raise major problems in most of the countries, where specialized units exist, as roughly 7% of the beds are available at any time. But an accident which would involved tens or hundreds of people raises much more problems for hospitalization. Such problems are also completely different and will involve steps in the medical handling, mainly triage, (combined injuries), determination of whole body dose levels, transient hospitalization. In this case, preplanning is necessary, adapted to the system of medical care in case of a catastrophic event in the given Country, with the main basic principles : emergency concerns essentially the classical injuries (burns and trauma) - and contamination problems in some cases - treatment of radiation syndrome is not an emergency during the first days but some essential actions have to be taken such as early blood sampling for biological dosimetry and for HLa typing

Guidance for organizing a local radiation protection program in medical care

International Nuclear Information System (INIS)

Sarby, B.; Jorulf, H.

2000-12-01

The following report is intended to be a guidance of how to organize a local radiation protection program and how it can be incorporated into daily medical care. The report is based on knowledge derived from participation and observations from inspections and the experience from hospitals who for a long time have been working in a well documented organisation. The organisation is described in local. The aim with these documents is to achieve a clear distribution of duties and responsibilities between the licence holder and directors concerned. Furthermore, a basic thought is to establish an efficient form of collaboration between the diverse staff categories and to achieve continuity in the embodiment of new laws and regulations. At that it is important to organise 'the local radiation committee' to operate in close collaboration with the dally medical care

Medical response in the initial phase of a radiological or nuclear emergency; Respuesta medica en la fase inicial de una emergencia radiologica o nuclear

Energy Technology Data Exchange (ETDEWEB)

Vazquez, M; Perez, M R; Dubner, D; Michelin, S; Malvicini, M [Autoridad Regulatoria Nuclear, Av. Del Libertador 8250, Gobierno Autonomo de la Ciudad de Buenos Aires (Argentina)

2006-07-01

The frequency of radiological and nuclear accidents is low with relationship to another type of have an accident, but the use of radioactive sources has been increased in the finish decades. Additionally, a growing world concern exists by the eventual use of radioactive material with malevolent ends. These facts put in relevance the necessity to have an appropriate preparation for the medical answer in this type of emergencies. The medical answer consists of different phases: Initial: pre-hospital and in local general hospitals; Intermediate: in local general hospitals and central reference hospitals. Late: in central reference hospitals and the pursuit to long term. The presence of conventional injuries (radio combined injuries) modifies in substantial form the assignment in the priority of the attention, the prediction and the evolution. The establishment of an appropriate triage is outstanding in the initial phase. The present communication approaches the early medical answer, sustained in the anamnesis, the chronology and severity of the symptoms and prodromal signs besides the laboratory results and complementary exams arisen during the first ones 24 to 72 hours. (Author)

Recovery and well-being among Helicopter Emergency Medical Service (HEMS) pilots

NARCIS (Netherlands)

Radstaak, M.; Geurts, S.A.E.; Beckers, D.G.J.; Brosschot, J.F.; Kompier, M.A.J.

2014-01-01

This study investigated the effects of a compressed working week with high cognitive and emotional work demands within the population of Dutch Helicopter Emergency Medical Service (HEMS) pilots. Work stressors were measured and levels of well-being were examined before, during and after a series of

Emergency Medical Technician Training During Medical School: Benefits for the Hidden Curriculum.

Science.gov (United States)

Russ-Sellers, Rebecca; Blackwell, Thomas H

2017-07-01

Medical schools are encouraged to introduce students to clinical experiences early, to integrate biomedical and clinical sciences, and to expose students to interprofessional health providers and teams. One important goal is for students to gain a better understanding of the patients they will care for in the future and how their social and behavioral characteristics may affect care delivery. To promote early clinical exposure and biomedical integration, in 2012 the University of South Carolina School of Medicine Greenville incorporated emergency medical technician (EMT) training into the curriculum. This report describes the program; outlines changes (made after year 1) to improve biomedical integration; and provides a brief analysis and categorization of comments from student reflections to determine whether particular themes, especially related to the hidden curriculum, appeared. Medical students wrote frequently about EMT-related experiences: 29% of reflections in the charter year (1.2 per student) and 38% of reflections in the second year (1.5 per student) focused on EMT-related experiences. Reflections related to patient care, professionalism, systems-based practice, and communication/interpersonal skills. The frequency of themes in student reflections may provide insight into a medical program's hidden curriculum. This information may serve to inform curricula that focus on biosocial elements such as professionalism and communication with the goal of enhancing future physicians' tolerance, empathy, and patient-centeredness. The authors plan to conduct further qualitative analysis of student reflections to iteratively revise curricula to address gaps both in learning and in the differences between the explicit curriculum and actual experiences.

Ebola Virus Disease: Ethics and Emergency Medical Response Policy.

Science.gov (United States)

Jecker, Nancy S; Dudzinski, Denise M; Diekema, Douglas S; Tonelli, Mark

2015-09-01

Caring for patients affected with Ebola virus disease (EVD) while simultaneously preventing EVD transmission represents a central ethical challenge of the EVD epidemic. To address this challenge, we propose a model policy for resuscitation and emergent procedure policy of patients with EVD and set forth ethical principles that lend support to this policy. The policy and principles we propose bear relevance beyond the EVD epidemic, offering guidance for the care of patients with other highly contagious, virulent, and lethal diseases. The policy establishes (1) a limited code status for patients with confirmed or suspected EVD. Limited code status means that a code blue will not be called for patients with confirmed or suspected EVD at any stage of the disease; however, properly protected providers (those already in full protective equipment) may initiate resuscitative efforts if, in their clinical assessment, these efforts are likely to benefit the patient. The policy also requires that (2) resuscitation not be attempted for patients with advanced EVD, as resuscitation would be medically futile; (3) providers caring for or having contact with patients with confirmed or suspected EVD be properly protected and trained; (4) the treating team identify and treat in advance likely causes of cardiac and respiratory arrest to minimize the need for emergency response; (5) patients with EVD and their proxies be involved in care discussions; and (6) care team and provider discretion guide the care of patients with EVD. We discuss ethical issues involving medical futility and the duty to avoid harm and propose a utilitarian-based principle of triage to address resource scarcity in the emergency setting.

Flight diversions due to onboard medical emergencies on an international commercial airline.

Science.gov (United States)

Valani, Rahim; Cornacchia, Marisa; Kube, Douglas

2010-11-01

Each year, close to 2 billion passengers travel on commercial airlines. In-flight medical events result in suboptimal care due to a variety of factors. Flight diversions due to medical emergencies carry a significant financial and legal cost. The purpose of this study was to determine the causes of in-flight medical diversions from Air Canada. This was a review of in-flight medical emergencies from 2004-2008. Both telemedicine and Air Canada databases were crossreferenced to capture all incidents. Presenting complaints were categorized by systems. Descriptive statistics were used to analyze the data. Over the 5 yr, there were 220 diversions, of which 91 (41.4%) of the decisions were made by pilots or onboard medical personnel. During this period there were 5386 telemedicine contacts with ground support providers, who on average recommended 2.4 diversions per 100 calls. The rate for diversions almost doubled from 2006 to 2007, with a sharp drop in telemedicine contacts during the same period. The four most common categories resulting in diversions were cardiac (58 diversions, 26.4%), neurological (43 diversions, 19.5%), gastrointestinal (GI) (25 diversions, 11.4%), and syncope (22 diversions, 10.0%). Only 6.8% of all diversions were due to cardiac arrest. Medical conditions most commonly leading to diversions were cardiac, neurological, gastrointestinal, and syncope. Our study showed that a decrease in telemedicine contact during this period was accompanied by an increase in diversions, while increased pre-screening of passengers did not prove effective in decreasing diversion rates.

The validation of the Utrecht work engagement scale for emergency medical technicians in Gauteng

Directory of Open Access Journals (Sweden)

JLP Naudé

2004-04-01

Full Text Available The objectives of this study were to validate the Utrecht Work Engagement Scale (UWES for emergency medical technicians in the Gauteng Province of South Africa and to determine its construct equivalence and bias for different language groups. A cross-sectional survey design was used with a convenient sample (N = 318 of emergency medical technicians in Gauteng. The UWES and a biographical questionnaire were administered. A two-factor model of work engagement, consisting of Vigour/Dedication and Absorption was found. Exploratory factor analysis with target rotations confirmed the construct equivalence of the work engagement construct for white and black employees.

A qualitative study about experiences and emotions of emergency medical technicians and out-of-hospital emergency nurses after performing cardiopulmonary resuscitation resulting in death.

Science.gov (United States)

Fernández-Aedo, I; Pérez-Urdiales, I; Unanue-Arza, S; García-Azpiazu, Z; Ballesteros-Peña, S

To explore the experiences, emotions and coping skills among emergency medical technicians and emergency nurses after performing out-of-hospital cardiopulmonary resuscitation manoeuvres resulting in death. An exploratory qualitative research was performed. Seven emergency medical technicians and six emergency nurses were selected by non-probability sampling among emergency medical system workers. The meetings took place up to information saturation, achieved after six individual interviews and a focal group. The meetings were then transcribed and a manual and inductive analysis of the contents performed. After a failed resuscitation several short and long-term reactions appear. They can be negatives, such as sadness or uncertainty, or positives, such as the feeling of having done everything possible to save the patient's life. Emotional stress increases when ambulance staff have to talk with the deceased's family or when the patient is a child. The workers don't know of a coping strategy other than talking about their emotions with their colleagues. Death after a failed resuscitation can be viewed as a traumatic experience for rescuers. Being in contact with the suffering of others is an emotional, stress-generating factor with direct repercussions on the working and personal lives of emergency staff. Nevertheless, structured coping techniques are not common among those professionals. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

Effect of training problem-solving skill on decision-making and critical thinking of personnel at medical emergencies

Science.gov (United States)

Heidari, Mohammad; Shahbazi, Sara

2016-01-01

Background: The aim of this study was to determine the effect of problem-solving training on decision-making skill and critical thinking in emergency medical personnel. Materials and Methods: This study is an experimental study that performed in 95 emergency medical personnel in two groups of control (48) and experimental (47). Then, a short problem-solving course based on 8 sessions of 2 h during the term, was performed for the experimental group. Of data gathering was used demographic and researcher made decision-making and California critical thinking skills questionnaires. Data were analyzed using SPSS software. Results: The finding revealed that decision-making and critical thinking score in emergency medical personnel are low and problem-solving course, positively affected the personnel’ decision-making skill and critical thinking after the educational program (P problem-solving in various emergency medicine domains such as education, research, and management, is recommended. PMID:28149823

Ground and Helicopter Emergency Medical Services Time Tradeoffs Assessed with Geographic Information.

Science.gov (United States)

Widener, Michael J; Ginsberg, Zac; Schleith, Daniel; Floccare, Douglas J; Hirshon, Jon Mark; Galvagno, Samuel

2015-07-01

We describe how geographic information systems (GIS) can be used to assess and compare estimated transport time for helicopter and ground emergency medical services. Recent research shows that while the odds of a trauma patient's survival increase with helicopter emergency medical services (HEMS), they may not increase to the extent necessary to make HEMS cost effective. This study offers an analytic tool to objectively quantify the patient travel time advantage that HEMS offers compared to ground emergency medical services (GEMS). Using helicopter dispatch data from the Maryland State Police from 2000-2011, we computed transport time estimates for HEMS and GEMS, compare these results to a reference transport time of 60 min, and use geospatial interpolation to extrapolate the total response times for each mode across the study region. Mapping the region's trauma incidents and modeling response times, our findings indicate the GIS framework for calculating transportation time tradeoffs is useful in identifying which areas can be better served by HEMS or GEMS. The use of GIS and the analytical methodology described in this study present a method to compare transportation by air and ground in the prehospital setting that accounts for how mode, distance, and road infrastructure impact total transport time. Whether used to generate regional maps in advance or applied real-time, the presented framework provides a tool to identify earlier incident locations that favor HEMS over GEMS transport modes.

Exposure management systems in emergencies as comprehensive medical care

International Nuclear Information System (INIS)

Shinohara, Teruhiko

2000-01-01

The emergency management of nuclear hazards relies on a comprehensive medical care system that includes accident prevention administration, environmental monitoring, a health physics organization, and a medical institution. In this paper, the care organization involved in the criticality accident at Tokai-mura is described, and the problems that need to be examined are pointed out. In that incident, even the expert was initially utterly confused and was unable to take appropriate measures. The author concluded that the members of the care organization were all untrained for dealing with nuclear hazards and radiation accidents. The education and training of personnel at the job site are important, and they are even more so for the leaders. Revisions of the regional disaster prevention plans and care manual are needed. (K.H.)

Dedication increases productivity: an analysis of the implementation of a dedicated medical team in the emergency department.

Science.gov (United States)

Ramos, Pedro; Paiva, José Artur

2017-12-01

In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED. Our study assesses the effect of an intervention in a large academic hospital ED in Portugal in 2002, and it is the first to test the hypothesis that implementing a dedicated team of doctors with EM expertise increases the productivity and reduces costs in the ED, maintaining the quality of care provided to patients. A pre-post design was used for comparing the change on the organisational model of delivering care in our medical ED. All emergency medical admissions were tracked in 2002 (classic model with 12-h shift in the ED) and 2005/2006 (dedicated team with full-time EM physicians), and productivity, costs with medical human resources and quality of care measures were compared. We found that medical productivity (number of patients treated per hour of medical work) increased dramatically after the creation of the dedicated team (X 2 KW = 31.135; N = 36; p work reduced both in regular hours and overtime. Moreover, hospitalisation rates decreased and the length of stay in the ED increased significantly after the creation of the dedicated team. Implementing a dedicated team of doctors increased the medical productivity and reduced costs in our ED. Our findings have straightforward implication for Portuguese policymakers aiming at reducing hospital costs while coping with increased ED demand.

Prognosis and risk factors for deterioration in patients admitted to a medical emergency department

DEFF Research Database (Denmark)

Henriksen, Daniel Pilsgaard; Brabrand, Mikkel; Lassen, Annmarie Touborg

2014-01-01

vital signs at arrival to a medical emergency department (MED). DESIGN AND SETTING: Single-centre, retrospective cohort study of all patients admitted to the MED from September 2010-August 2011. SUBJECTS: Patients were included when their vital signs (systolic blood pressure, pulse rate, respiratory.......2-3.0%) among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38-7.10). CONCLUSIONS: Among acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open...... general ED. Thirty-day mortality among patients with deterioration was four times higher than among non-deteriorating patients. Further research is needed to determine whether intensified monitoring of vital signs can help to prevent deterioration or mortality among medical emergency patients....

Emergence of global preferential attachment from local interaction

International Nuclear Information System (INIS)

Li Menghui; Fan Ying; Wu Jinshan; Di Zengru; Gao Liang

2010-01-01

Global degree/strength-based preferential attachment is widely used as an evolution mechanism of networks. But it is hard to believe that any individual can get global information and shape the network architecture based on it. In this paper, it is found that the global preferential attachment emerges from the local interaction models, including the distance-dependent preferential attachment (DDPA) evolving model of weighted networks (Li et al 2006 New J. Phys. 8 72), the acquaintance network model (Davidsen et al 2002 Phys. Rev. Lett. 88 128701) and the connecting nearest-neighbor (CNN) model (Vazquez 2003 Phys. Rev. E 67 056104). For the DDPA model and the CNN model, the attachment rate depends linearly on the degree or vertex strength, whereas for the acquaintance network model, the dependence follows a sublinear power law. It implies that for the evolution of social networks, local contact could be more fundamental than the presumed global preferential attachment.

Physician medical direction and clinical performance at an established emergency medical services system.

Science.gov (United States)

Munk, Marc-David; White, Shaun D; Perry, Malcolm L; Platt, Thomas E; Hardan, Mohammed S; Stoy, Walt A

2009-01-01

Few developed emergency medical services (EMS) systems operate without dedicated medical direction. We describe the experience of Hamad Medical Corporation (HMC) EMS, which in 2007 first engaged an EMS medical director to develop and implement medical direction and quality assurance programs. We report subsequent changes to system performance over time. Over one year, changes to the service's clinical infrastructure were made: Policies were revised, paramedic scopes of practice were adjusted, evidence-based clinical protocols were developed, and skills maintenance and education programs were implemented. Credentialing, physician chart auditing, clinical remediation, and online medical command/hospital notification systems were introduced. Following these interventions, we report associated improvements to key indicators: Chart reviews revealed significant improvements in clinical quality. A comparison of pre- and post-intervention audited charts reveals a decrease in cases requiring remediation (11% to 5%, odds ratio [OR] 0.43 [95% confidence interval (CI) 0.20-0.85], p = 0.01). The proportion of charts rated as clinically acceptable rose from 48% to 84% (OR 6 [95% CI 3.9-9.1], p < 0.001). The proportion of misplaced endotracheal tubes fell (3.8% baseline to 0.6%, OR 0.16 [95% CI 0.004-1.06], (exact) p = 0.05), corresponding to improved adherence to an airway placement policy mandating use of airway confirmation devices and securing devices (0.7% compliance to 98%, OR 714 [95% CI 64-29,334], (exact) p < 0.001). Intravenous catheter insertion in unstable cases increased from 67% of cases to 92% (OR 1.31 [95% CI 1.09-1.71], p = 0.004). EMS administration of aspirin to patients with suspected ischemic chest pain improved from 2% to 77% (OR 178 [95% CI 35-1,604], p < 0.001). We suggest that implementation of a physician medical direction is associated with improved clinical indicators and overall quality of care at an established EMS system.

Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers. Instructor's Lesson Plans.

Science.gov (United States)

National Highway Traffic Safety Administration (DOT), Washington, DC.

To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this instructor's guide provides a standardized approach for providing training in emergency medical care for first responders to traffic accidents. The objective of the course is to provide training in all aspects of emergency medical…

Medical admissions through the emergency department: Who, how and how long?

DEFF Research Database (Denmark)

Arvidsen, Pernille; Pressel, Eckart

Objectives: The study aims to describe the clinical characteristics of elderly patients admitted to medical wards through the emergency department (ED).Methods: In a first part, we described demographic changes in the uptake area and ED visits of older patients in a 900 bed university hospital...... in Central Copenhagen from 2004-2014.In a second descriptive-retrospective part we studied clinical characteristics of patients >65 years admitted to the medical wards through the ED in January 2014 (n=132). We collected data on medication, comorbidities and admission rates to stationary wards .Results......: The number of ED visits of persons >65 years increased by 28.3% during the study period whereas the number of persons aged ≥65 years in the uptake area remained stable. 21.1 % of the patients admitted to the medical wardswere transferred to the geriatric department. Conclusion: •The growing number of older...

Radiological emergency assessment of local decision support system

International Nuclear Information System (INIS)

Breznik, B.; Kusar, A.; Boznar, M.Z.; Mlakar, P.

2003-01-01

Local decision support system has been developed based on the needs of Krsko Nuclear Power Plant for quick dose projection and it is one of important features required for proposal of intervention before actual release may occur. Radiological emergency assessment in the case of nuclear accident is based on plant status analysis, radiation monitoring data and on prediction of release of radioactive sources to the environment. There are possibilities to use automatic features to predict release source term and manual options for selection of release parameters. Advanced environmental modelling is used for assessment of atmospheric dispersion of radioactive contamination in the environment. (author)

A study on the improvement of nuclear emergency countermeasure technology for local government

International Nuclear Information System (INIS)

Khang, Byung Oui; Lee, J. T.; Lee, G. Y.

2005-01-01

There were necessities of the establishment of the regional nuclear emergency plan on the nuclear disaster of nuclear facilities according to the 'nuclear facilities physical protection and emergency preparedness act' and the strengthening of the regional nuclear disaster management system to get confidence on the related national policy from the public and the defining and improving the relationship between local government and other organizations on responsibilities, authorities, duties and support. So, the project was started, the Results of the project are the establishment of Regional Nuclear Emergency Plan (Draft) connected to the national safety management basic plan and national radiological emergency plan which contains the description of the emergency preparedness to respond nuclear disaster and the duty description of related organizations to respond a nuclear disaster and several description of nuclear emergency preparedness. And this report describes the regional nuclear disaster countermeasure technology improvement and the emergency training, drill, exercise methodology

Emergency Medical Service (EMS) Utilization by Syrian Refugees Residing in Ankara, Turkey.

Science.gov (United States)

Altıner, Ali Osman; Yeşil, Sıdıka Tekeli

2018-04-01

Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Ankara. Study Objective This study investigated Emergency Medical Service (EMS) utilization among Syrian refugees residing in Ankara. This study was a descriptive, cross-sectional database analysis using data obtained from the Department of EMS of the Ankara Provincial Health Directorate. Five stations in the Altındağ region of Ankara responded to 42% of all calls from Syrian refugees. Prehospital EMS in Ankara have been used mostly by Syrian refugees younger than 18-years-old. Study findings also suggest that medical staff in regions where Syrian refugees are likely to be treated should be supported and provided with the ability to overcome language barriers and cultural differences. Altıner AO , Tekeli Yeşil S . Emergency Medical Service (EMS) utilization by Syrian refugees residing in Ankara, Turkey. Prehosp Disaster Med. 2018;33(2):160-164.

Team Regulation in a Simulated Medical Emergency: An In-Depth Analysis of Cognitive, Metacognitive, and Affective Processes

Science.gov (United States)

Duffy, Melissa C.; Azevedo, Roger; Sun, Ning-Zi; Griscom, Sophia E.; Stead, Victoria; Crelinsten, Linda; Wiseman, Jeffrey; Maniatis, Thomas; Lachapelle, Kevin

2015-01-01

This study examined the nature of cognitive, metacognitive, and affective processes among a medical team experiencing difficulty managing a challenging simulated medical emergency case by conducting in-depth analysis of process data. Medical residents participated in a simulation exercise designed to help trainees to develop medical expertise,…

A continuous quality improvement project to reduce medication error in the emergency department.

Science.gov (United States)

Lee, Sara Bc; Lee, Larry Ly; Yeung, Richard Sd; Chan, Jimmy Ts

2013-01-01

Medication errors are a common source of adverse healthcare incidents particularly in the emergency department (ED) that has a number of factors that make it prone to medication errors. This project aims to reduce medication errors and improve the health and economic outcomes of clinical care in Hong Kong ED. In 2009, a task group was formed to identify problems that potentially endanger medication safety and developed strategies to eliminate these problems. Responsible officers were assigned to look after seven error-prone areas. Strategies were proposed, discussed, endorsed and promulgated to eliminate the problems identified. A reduction of medication incidents (MI) from 16 to 6 was achieved before and after the improvement work. This project successfully established a concrete organizational structure to safeguard error-prone areas of medication safety in a sustainable manner.

Evaluating the success of an emergency response medical information system.

Science.gov (United States)

Petter, Stacie; Fruhling, Ann

2011-07-01

STATPack™ is an information system used to aid in the diagnosis of pathogens in hospitals and state public health laboratories. STATPack™ is used as a communication and telemedicine diagnosis tool during emergencies. This paper explores the success of this emergency response medical information system (ERMIS) using a well-known framework of information systems success developed by DeLone and McLean. Using an online survey, the entire population of STATPack™ users evaluated the success of the information system by considering system quality, information quality, system use, intention to use, user satisfaction, individual impact, and organizational impact. The results indicate that the overall quality of this ERMIS (i.e., system quality, information quality, and service quality) has a positive impact on both user satisfaction and intention to use the system. However, given the nature of ERMIS, overall quality does not necessarily predict use of the system. Moreover, the user's satisfaction with the information system positively affected the intention to use the system. User satisfaction, intention to use, and system use had a positive influence on the system's impact on the individual. Finally, the organizational impacts of the system were positively influenced by use of the system and the system's individual impact on the user. The results of the study demonstrate how to evaluate the success of an ERMIS as well as introduce potential changes in how one applies the DeLone and McLean success model in an emergency response medical information system context. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Understanding the value of mixed methods research: the Children’s Safety Initiative-Emergency Medical Services

Science.gov (United States)

Hansen, Matthew; O’Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

2016-01-01

Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children’s Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. PMID:26949970

A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study.

Science.gov (United States)

April, Michael D; Schauer, Steven G; Brown Rd, Calvin A; Ng, Patrick C; Fernandez, Jessie; Fantegrossi, Andrea E; Maddry, Joseph K; Summers, Shane; Sessions, Daniel J; Barnwell, Robert M; Antonacci, Mark

2017-01-01

Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition. We cross-referenced these forms against the numbers of intubation events reported in the ED nursing daily reports to ensure capture of all intubations. Providers completed forms for every intubation within 6 weeks of the procedure. We analyzed data from March 28, 2016, to March 27, 2017. During the study period, providers performed 259 intubations in the BAMC ED. Reasons for intubation were related to trauma for 184 patients (71.0%) and medical conditions for 75 patients (29.0%). Overall, first-attempt success was 83.0%. Emergency medicine residents performed a majority of first attempts (95.0%). Most common devices chosen on first attempt were a video laryngoscope for 143 patients (55.2%) and a direct laryngoscope for 115 patients (44.4%). One patient underwent cricothyrotomy. The 2 most common induction agents were ketamine (59.8%; 95% CI, 55.2%-67.4%) and etomidate (19.3%; 95% CI, 14.7%-24.7%). The most common neuromuscular blocking agents were rocuronium (62.9%; 95% CI, 56.7%-68.8%) and succinylcholine (18.9%; 95% CI, 14.3%-24.2%). In the BAMC ED, emergency intubation most commonly occurred for trauma indications using video laryngoscopy with a high first-pass success.

Recruitment and Retention of New Emergency Medical Technician (EMT)-Basics and Paramedics.

Science.gov (United States)

Chapman, Susan A; Crowe, Remle P; Bentley, Melissa A

2016-12-01

The purpose of this paper is to describe factors important for the recruitment and retention of Emergency Medical Technician (EMT)-Basics and EMT-Paramedics new to the Emergency Medical Services (EMS) field (defined as two years or less of EMS employment) through an analysis of 10 years of Longitudinal EMT Attributes and Demographic Study (LEADS) data. Data were obtained from 10 years of LEADS surveys (1999-2008). Individuals new to the profession were identified through responses to a survey item. Their responses were analyzed using weights reflecting each individual's probability of selection. Means, proportions, and 95% confidence intervals (CIs) were determined and used to identify statistically significant differences. There were few changes in the demographic characteristics of new EMT-Basics and Paramedics across survey years. New EMT-Basics tended to be older and less likely to have a college degree than new EMT-Paramedics. More new EMT-Basics than EMT-Paramedics worked in rural areas and small towns and reported that they were working as a volunteer. There were differences between new EMT-Basics and EMT-Paramedics in several of the reasons for entering the profession and in facets of job satisfaction. The findings provide guidance for recruiters, educators, employers, and governmental EMS policy organizations and will provide better insight into how to attract and retain new entrants to the field. Chapman SA , Crowe RP , Bentley MA . Recruitment and retention of new Emergency Medical Technician (EMT)-Basics and Paramedics. Prehosp Disaster Med. 2016;31(Suppl. 1):s70-s86.

The 2017 International Joint Working Group White Paper by INDUSEM, the Emergency Medicine Association and the Academic College of Emergency Experts on Establishing Standardized Regulations, Operational Mechanisms, and Accreditation Pathways for Education and Care Provided by the Prehospital Emergency Medical Service Systems in India.

Science.gov (United States)

Sikka, Veronica; Gautam, V; Galwankar, Sagar; Guleria, Randeep; Stawicki, Stanislaw P; Paladino, Lorenzo; Chauhan, Vivek; Menon, Geetha; Shah, Vijay; Srivastava, R P; Rana, B K; Batra, Bipin; Kalra, O P; Aggarwal, P; Bhoi, Sanjeev; Krishnan, S Vimal

2017-01-01

The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India.

Expanded access to naloxone among firefighters, police officers, and emergency medical technicians in Massachusetts.

Science.gov (United States)

Davis, Corey S; Ruiz, Sarah; Glynn, Patrick; Picariello, Gerald; Walley, Alexander Y

2014-08-01

Naloxone is a medication that reverses respiratory depression from opioid overdose if given in time. Paramedics routinely administer naloxone to opioid overdose victims in the prehospital setting, and many states are moving to increase access to the medication. Several jurisdictions have expanded naloxone administration authority to nonparamedic first responders, and others are considering that step. We report here on policy change in Massachusetts, where several communities have equipped emergency medical technicians, law enforcement officers, and firefighters with naloxone.

Social Media: Portrait of an Emerging Tool in Medical Education.

Science.gov (United States)

Roy, Durga; Taylor, Jacob; Cheston, Christine C; Flickinger, Tabor E; Chisolm, Margaret S

2016-02-01

The authors compare the prevalence of challenges and opportunities in commentaries and descriptive accounts versus evaluative studies of social media use in medical education. A previously published report of social media use in medical education provided an in-depth discussion of 14 evaluative studies, a small subset of the total number of 99 articles on this topic. This study used the full set of articles identified by that review, including the 58 commentaries and 27 descriptive accounts which had not been previously reported, to provide a glimpse into how emerging tools in medical education are initially perceived. Each commentary, descriptive account, and evaluative study was identified and compared on various characteristics, including discussion themes regarding the challenges and opportunities of social media use in medical education. Themes related to the challenges of social media use in medical education were more prevalent in commentaries and descriptive accounts than in evaluative studies. The potential of social media to affect medical professionalism adversely was the most commonly discussed challenge in the commentaries (53%) and descriptive accounts (63%) in comparison to technical issues related to implementation in the evaluative studies (50%). Results suggest that the early body of literature on social media use in medical education-like that of previous innovative education tools-comprises primarily commentaries and descriptive accounts that focus more on the challenges of social media than on potential opportunities. These results place social media tools in historical context and lay the groundwork for expanding on this novel approach to medical education.

Genetics: A New Landscape for Medical Geography

Science.gov (United States)

Carrel, Margaret; Emch, Michael

2014-01-01

The emergence and re-emergence of human pathogens resistant to medical treatment will present a challenge to the international public health community in the coming decades. Geography is uniquely positioned to examine the progressive evolution of pathogens across space and through time, and to link molecular change to interactions between population and environmental drivers. Landscape as an organizing principle for the integration of natural and cultural forces has a long history in geography, and, more specifically, in medical geography. Here, we explore the role of landscape in medical geography, the emergent field of landscape genetics, and the great potential that exists in the combination of these two disciplines. We argue that landscape genetics can enhance medical geographic studies of local-level disease environments with quantitative tests of how human-environment interactions influence pathogenic characteristics. In turn, such analyses can expand theories of disease diffusion to the molecular scale and distinguish the important factors in ecologies of disease that drive genetic change of pathogens. PMID:24558292

Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities.

Science.gov (United States)

Timpka, Toomas; Schyllander, Jan; Stark Ekman, Diana; Ekman, Robert; Dahlström, Örjan; Hägglund, Martin; Kristenson, Karolina; Jacobsson, Jenny

2018-02-01

Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries. One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Medical Evaluation and Triage of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Medical Evaluation Workgroup

Directory of Open Access Journals (Sweden)

Kimberly Nordstrom

2012-04-01

Full Text Available Numerous medical and psychiatric conditions can cause agitation, some of these causes are life threatening. It is important to be able to differentiate between medical and non-medical causes of agitation so that patients can receive appropriate and timely treatment. This article aims to educate all clinicians in non-medical settings, such as mental health clinics, and medical settings on the differing levels of severity in agitation, basic triage, use of de-escalation, and factors, symptoms, and signs in determining whether a medical etiology is likely. Lastly, this article focuses on the medical workup of agitation when a medical etiology is suspected or when etiology is unclear. [West J Emerg Med. 2012;13(1:3–10.

The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study.

Science.gov (United States)

Leggio, William Joseph

2014-10-01

This study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia. A phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings. Emergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training. Emergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.

Emergency Medical Technician Training for Medical Students: A Two-Year Experience.

Science.gov (United States)

Blackwell, Thomas H; Halsey, R Maglin; Reinovsky, Jennifer H

2016-01-01

New medical school educational curriculum encourages early clinical experiences along with clinical and biomedical integration. The University of South Carolina School of Medicine Greenville, one of the new expansion schools, was established in 2011 with the first class matriculating in 2012. To promote clinical skills early in the curriculum, emergency medical technician (EMT) training was included and begins in the first semester. Along with the early clinical exposure, the program introduces interprofessional health and teams and provides the opportunity for students to personally see and appreciate the wide variety of environments from which their future patients emanate. This report describes the EMT program and changes that were made after the first class that were designed to integrate EMT training with the biomedical sciences and to assess the value of these integrative changes using objective criteria. A two-year retrospective study was conducted that involved the first two classes of medical students. Baseline student data and pass rates from the psychomotor skill and written components of the State examination were used to determine if students performed better in the integrated, prolonged course. There were 53 students in the first class and 54 in the second. Of the 51 students in the first class and 53 students in the second class completing the state psychomotor and written examination, 20 (39%) in the first class and 17 (32%) in the second passed on the initial psychomotor skill attempt; however, more students passed in the first three attempts in the second class than the first class, 51 (96%) versus 45 (88%) , respectively. All students passed by 5 attempts. For the written examination, 50 (98%) students in the first class and 51 (96%) in the second class passed on the first attempt. All students passed by the third attempt. Pass rates on both components of the State examination were not significantly different between classes. Medical students who

Emergency medical readmission: long-term trends and impact on mortality.

LENUS (Irish Health Repository)

Glynn, Nigel

2011-04-01

There is increasing emphasis on prevention of emergency medical readmissions. The broad pattern of acute medical readmissions was studied over a seven-year period and the impact of any readmission on 30-day mortality was recorded. Significant predictors of outcome, including co-morbidity and illness severity score, were entered into a multivariate regression model, adjusting the univariate estimates of the readmission status on mortality. In total, 23,114 consecutive acute medical patients were admitted between 2002-8; the overall readmission rate was 27%. Readmission independently predicted an increased 30-day mortality; the odds ratio, was 1.12 (95% confidence interval (CI) 1.09 to 1.14). This fell to 1.05 (95% CI 1.02 to 1.08) when adjusted for outcome predictors including acute illness severity. The trend for readmissions was to progressively increase over time; the median times between consecutive admissions formed an exponential time series. Efforts to reduce or avoid readmissions may depend on an ability to modify the underlying chronic disease.

Measures against radiation disaster/terrorism and radiation emergency medical assistance team

International Nuclear Information System (INIS)

Tominaga, Takako; Akashi, Makoto

2016-01-01

The probability of occurrence of radiological terrorism and disaster in Japan is not low. For this reason, preparations for coping with the occurrence of radiological terrorism should be an urgent issue. This paper describes the radiation medical system and the threat of radiological terrorism and disaster in Japan, and introduces the Radiation Emergency Medical Assistance Team (REMAT), one of the radiation accident/disaster response organizations at the National Institute of Radiological Sciences. Radiation exposure medical systems in Japan are constructed only in the location of nuclear facilities and adjacent prefectures. These medical systems have been developed only for the purpose of medical correspondence at the time of nuclear disaster, but preparations are not made by assuming measures against radiological terrorism. REMAT of the National Institute of Radiological Sciences is obligated to dispatch persons to the requesting prefecture to support radiation medical care in case of nuclear disaster or radiation accident. The designation of nuclear disaster orientated hospitals in each region, and the training of nuclear disaster medical staffing team were also started, but preparations are not enough. In addition to enhancing and strengthening experts, specialized agencies, and special forces dealing with radiological terrorism, it is essential to improve regional disaster management capacity and terrorism handling capacity. (A.O.)

Experiences of violence, burnout and job satisfaction in Korean nurses in the emergency medical centre setting.

Science.gov (United States)

Yoon, Hee Sook; Sok, Sohyune R

2016-12-01

The aim of this study was to examine the experience of violence in relation to burnout and job satisfaction in Korean nurses in the emergency medical centre setting. Participants were 236 nurses in the emergency medical centre setting of three metropolitan areas in Korea. Measures included a general characteristics form, characteristics related to experiences of violence, the Maslach Burnout Inventory and the Minnesota Satisfaction Questionnaire. Data were collected from June 2013 to February 2014. In the prediction model, 33.4% of burnout was explained and 35.7% for job satisfaction. The greatest influence on burnout was handling violence, followed by verbal abuse. The greatest influence on job satisfaction was physical threat, followed by handling violence. The study shows that burnout and job satisfaction of Korean nurses in the emergency medical centre setting are related to experiences of violence such as verbal abuse, physical threat and physical violence, as well as handling violence. © 2016 John Wiley & Sons Australia, Ltd.

Meanings about bioethics that emerged in a medical curriculum

Directory of Open Access Journals (Sweden)

Villegas-Múnera, Elsa María

2016-07-01

Full Text Available This study was carried out in a medical curriculum in Medellín, Colombia. Its goal was to correlate the meanings about bioethics that emerged in the educational guidance with those produced among students and professors. A methodological triangulation was used, namely: analysis of the curriculum foundation documents; a representative survey to students, and interviews and focal groups. Results revealed that the main problem of bioethics in the curriculum is the dissociation between the discursive emphasis ascribed to the training in that field, and its development in the curricular practice. The triad patient –student – professor, projected to the family and the community, emerged as the foundation of the curriculum inasmuch as they are the protagonic agents of their lives. It is then possible to overcome the marginality of patients and the community when they are considered only as objects of study.

[Pre-hospital management of adults with life-threatening emergencies].

Science.gov (United States)

Wattel, Francis; Dubois, François

2012-01-01

, fewer voluntary firemen, hospital reorganization, tight funding, difficulties of medical dispatching, and the varying skills of "first-on-the-scene "emergency workers. Grievances include late emergency responses, inappropriate medical care, and dispatching to the wrong facility. This raises the question of equal opportunity for all in a country with widely varying geographic features and population density. Improvement in the system's efficiency will require a series of objectives to be met in varied and complementary--Enhanced functional coordination, by speeding up the deployment of the ANTARES digital radio-frequency transmission network (Adaptation Nationale des Transmissions Aux Risques Et aux Secours).--Implementation of a network of emergency services with varying degrees of emergency healthcare management related to the technical nature of the facilities. Three levels of emergency healthcare must be made available: level 1 is provided by local hospitals, level 2 includes support facilities available in general hospitals (not necessarily the nearest hospital), and level 3 provides specialized healthcare in large and/or training hospitals with specialized departments. Life-threatening emergency situations are to be handled by level 2 or 3 facilities. Specific facilities must be selected as reference centers. In France, the ARS (Agences Régionales de Santé) is in charge of this procedure, as it provide funding for healthcare continuity--Reducing inequalities in access to emergency care. This will involve improving the network of SDIS brigades, making local medical facilities more responsive, delegating more medical procedures, on-site telemedicine, providing more helicopters equipped with healthcare facilities, more automated external defibrillators, and more dedicated neuro-vascular units.--First aid training must be made widely available. The French National Academy of Medicine has approved ten recommendations regarding organization and facilities.

Hand hygiene in emergency medical services.

Science.gov (United States)

Teter, Jonathan; Millin, Michael G; Bissell, Rick

2015-01-01

Hospital-acquired infections (HAIs) affect millions of patients annually (World Health Organization. Guidelines on Hand Hygiene in Healthcare. Geneva: WHO Press; 2009). Hand hygiene compliance of clinical staff has been identified by numerous studies as a major contributing factor to HAIs around the world. Infection control and hand hygiene in the prehospital environment can also contribute to patient harm and spread of infections. Emergency medical services (EMS) practitioners are not monitored as closely as hospital personnel in terms of hand hygiene training and compliance. Their ever-changing work environment is less favorable to traditional hospital-based aseptic techniques and education. This study aimed to determine the current state of hand hygiene practices among EMS providers and to provide recommendations for improving practices in the emergency health services environment. This study was a prospective, observational prevalence study and survey, conducted over a 2-month period. We selected participants from visits to three selected hospital emergency departments in the mid-Atlantic region. There were two data components to the study: a participant survey and hand swabs for pathogenic cultures. This study recruited a total sample of 62 participants. Overall, the study revealed that a significant number of EMS providers (77%) have a heavy bacterial load on their hands after patient care. All levels of providers had a similar distribution of bacterial load. Survey results revealed that few providers perform hand hygiene before (34%) or in between patients (24%), as recommended by the Centers for Disease Control and Prevention guidelines. This study demonstrates that EMS providers are potential vectors of microorganisms if proper hand hygiene is not performed properly. Since EMS providers treat a variety of patients and operate in a variety of environments, providers may be exposed to potentially pathogenic organisms, serving as vectors for the exposure of

Emergency telephone consultations: a new course for medical students.

Science.gov (United States)

Schaufelberger, Mireille; Harris, Michael; Frey, Peter

2012-12-01

Using the telephone for consultations is now common practice. Although there is a clear need for specific training for telephone consultations, it is uncommon for it to be taught in medical school. A practical course on emergency telephone consultations (ECTs) was designed for the medical degree course at the University of Bern Medical School. During the module, each of the volunteer fifth-year medical students had to perform two simulated telephone consultations. Medical students in their first year of medical school acted as simulated patients (SPs), and they gave immediate feedback to the participants. Nineteen per cent of fifth-year students voluntarily undertook the ETC course. The course was rated 'very informative' by 68 per cent of the participants, and 'informative' by 32 per cent. Ninety-four per cent of the attendees recorded a personal learning gain, and 68 per cent suggested that the course should be obligatory. All the participants thought that the SPs played their roles realistically. In their rating of the ETC, the fifth-year students gave it a mean mark of 5.5 (out of a maximum of 6), suggesting that they thought it had been very successful. Students became aware of their need for ETC training through the course itself, and they recommended that it should be obligatory. The ETC pilot received a highly positive response from lead clinicians who anticipated a rising number of telephone consultations, and who have to deal with trainees who have not been taught about how to deal with ETCs. As a result, the Faculty of Medicine decided to make the course obligatory. © Blackwell Publishing Ltd 2012.

Quality of prescription of high-alert medication and patient safety in pediatric emergency

Directory of Open Access Journals (Sweden)

V. Vieira de Melo

2014-01-01

Full Text Available Objective: Verify the importance of compliance by prescribed doses of high-alert medications in unit of pediatric emergency in patient safety. Method: This was a cross-sectional descriptive study conducted in a unit of pediatric emergency, for March to April of 2012. This study included all prescriptions that contained at least one high-alert medication, excluding all of others. The data were analyzed using Microsoft Office Excel® version 2007, and the study was approved by the Research Ethics Committee of the Hospital. Results: This study included prescriptions for 100 patients with a mean age of 5.2 ± 4.2 years. Were identified 983 (40.1% high-alert medications (21 different, with predominance of injectable solutions (834, 84,8%, and of these 727 (73.95% were electrolytes. The analysis of the dose was possible for 641 electrolytes and 104 non-electrolytes, being the dose inadequacies observed for some medications. Was observed concentration absent to 189 (18.9% prescribed medications, these with liquid pharmaceutical form or aerosol. Was observed also the absence of maximum dose for 8 (36.3% prescribed drugs “if necessary”. Conclusión: The inadequacies of doses of high-alert medications identified in this study may compromise patient safety, demonstrating the importance of knowledge of multidisciplinary health care team by this subject, in this context, it is noteworthy that the acting of a clinical pharmacist together with the health multidisciplined team can contributes with the review of drug prescriptions, reducing potential errors and collaborating with patient safety.

Prevalence and relief of pain in trauma patients in Emergency Medical Services

NARCIS (Netherlands)

Lisette Schoonhoven; T. Meijs; Sivera Berben; A. van Vugt; P. van Grunsven

2011-01-01

The aim of this study was to give insight in the prevalence of pain, and the (effect of) pain management according to the national emergency medical services analgesia protocol in trauma patients in the Netherlands. The retrospective document study included adult and alert trauma patients. Data

Understanding the value of mixed methods research: the Children's Safety Initiative-Emergency Medical Services.

Science.gov (United States)

Hansen, Matthew; O'Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

2016-07-01

Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children's Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Eating disorder emergencies: understanding the medical complexities of the hospitalized eating disordered patient.

Science.gov (United States)

Cartwright, Martina M

2004-12-01

Eating disorders are maladaptive eating behaviors that typically develop in adolescence and early adulthood. Psychiatric maladies and comorbid conditions, especially insulin-dependent diabetes mellitus, frequently co-exist with eating disorders. Serious medical complications affecting all organs and tissues can develop and result in numerous emergent hospitalizations. This article reviews the pathophysiologies of anorexia nervosa, bulimia nervosa, and orthorexia nervosa and discusses the complexities associated with the treatment of medical complications seen in these patients.

47 CFR 11.55 - EAS operation during a State or Local Area emergency.

Science.gov (United States)

2010-10-01

..., earthquakes, heavy snows, icing conditions, widespread fires, etc. Man-made emergencies may include: toxic gas...) SDARS licensees and DBS providers may participate in EAS at the state and local level and make their...

Autonomic nervous system activity as risk predictor in the medical emergency department: a prospective cohort study.

Science.gov (United States)

Eick, Christian; Rizas, Konstantinos D; Meyer-Zürn, Christine S; Groga-Bada, Patrick; Hamm, Wolfgang; Kreth, Florian; Overkamp, Dietrich; Weyrich, Peter; Gawaz, Meinrad; Bauer, Axel

2015-05-01

To evaluate heart rate deceleration capacity, an electrocardiogram-based marker of autonomic nervous system activity, as risk predictor in a medical emergency department and to test its incremental predictive value to the modified early warning score. Prospective cohort study. Medical emergency department of a large university hospital. Five thousand seven hundred thirty consecutive patients of either sex in sinus rhythm, who were admitted to the medical emergency department of the University of Tübingen, Germany, between November 2010 and March 2012. None. Deceleration capacity of heart rate was calculated within the first minutes after emergency department admission. The modified early warning score was assessed from respiratory rate, heart rate, systolic blood pressure, body temperature, and level of consciousness as previously described. Primary endpoint was intrahospital mortality; secondary endpoints included transfer to the ICU as well as 30-day and 180-day mortality. One hundred forty-two patients (2.5%) reached the primary endpoint. Deceleration capacity was highly significantly lower in nonsurvivors than survivors (2.9 ± 2.1 ms vs 5.6 ± 2.9 ms; p model yielded an area under the receiver-operator characteristic curve of 0.706 (0.667-0.750). Implementing deceleration capacity into the modified early warning score model led to a highly significant increase of the area under the receiver-operator characteristic curve to 0.804 (0.770-0.835; p capacity was also a highly significant predictor of 30-day and 180-day mortality as well as transfer to the ICU. Deceleration capacity is a strong and independent predictor of short-term mortality among patients admitted to a medical emergency department.

Provision of prehospital emergency medical services in Punjab, Pakistan: Case study of a public sector provider.

Science.gov (United States)

Sriram, Veena M; Naseer, Rizwan; Hyder, Adnan A

2017-12-01

The availability and quality of emergency medical services in low- and middle-income countries, including Pakistan, are extremely limited. New models for prehospital emergency medical services provision have recently emerged across multiple sectors, and research on these models is urgently needed to inform current and future emergency medical services systems in low-resource settings. The objective of this case study was to provide a comprehensive description of the organizational structure and service delivery model of a public sector provider in the Punjab Province of Pakistan, Rescue 1122, with a focus on operations in Lahore. We used case study methodology to systematically describe the organizational model of Rescue 1122. Qualitative data were collected during an in-person site visit to Lahore in June 2013. Three sources were utilized-semi-structured in-depth interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. Rescue 1122 is based on a legal framework that provides public financing for EMS, resulting in financial stability for the service. The organization has also reportedly taken positive steps in engaging with communities, and in coordinating across EMS, fire and rescue. We noted benefits and challenges in scaling up the service to all districts in Punjab. Finally, some areas of improvement include supply chain management and expanded data utilization. Our case study highlights key components of the model, areas for strengthening, and opportunities for further research. Rescue 1122 provides an example of a government-financed and operated emergency medical system in a low-resource setting. Copyright © 2017. Published by Elsevier Inc.

Enhancing the Motivation for Rural Career: The Collaboration between the Local Government and Medical School.

Science.gov (United States)

Seguchi, Masaru; Furuta, Noriko; Kobayashi, Seiji; Kato, Kazuhiro; Sasaki, Kouji; Hori, Hiroki; Okuno, Masataka

2015-07-01

The shortage of medical workforce in rural areas is a global long-standing problem. Due to the severity of shortages in the medical workforce, Mie prefectural government has collaborated with a medical school and the municipal governments to increase the rural medical workforce. Since 2010, this collaboration has led to an annual lecture series on rural practice for medical students. We distributed questionnaires at the beginning and end of the lecture series to examine the effect of this program. The questionnaire consisted of two parts that included an understanding of rural practice and the motivation to work in rural areas. The lecture series significantly improved the responses to the following questions "Rural practice is interesting" (p motivation of medical students and their interest in a rural career. While collaboration between the local government and medical school rarely occurs in planning medical education programs, this approach may offer a promising way to foster local health professionals.

Sexual rape in children and adolescents: a medical emergency

Directory of Open Access Journals (Sweden)

García Piña Corina Araceli

2014-07-01

Full Text Available Sexual rape is defined as vaginal, anal or oral sex with violent and forceful penetration of the penis or of any other object. Patients who have been raped are a medical emergency which requires immediate attention, if possible, within 24 to 72 hours, since there is the risk of sustaining external and internal injuries and of acquiring a sexually transmitted infection (STI. Detection and Centers for Disease Control (CDC have reported that the maximum effective- ness of HIV prophylaxis is obtained when given within the first 24 to 72 hours post exposure.

Legal, Social, Ethical, and Medical Perspectives on the Care of the Statutory Rape Adolescent in the Emergency Department.

Science.gov (United States)

Tsai, Shiu-Lin; Acosta, Elvira; Cardenas, Toni; Sigall, Jeremy K; Van Geem, Kevin

2017-07-01

Rapes involving adolescents who present to the emergency department (ED) are fraught with ethical and legal complexities and are often emotionally turbulent for patients, their families, and medical providers. Management requires a thoughtful approach from multiple standpoints, including legal, psychosocial, ethical, and medical ones. However, there is no standardized sexual assault education for emergency medicine residents, and management practices vary widely. 1,2 We present a hypothetical statutory rape case based on real cases that occurred in New York City and bring together the perspectives of an attorney on the legal parameters, two social workers on the psychosocial issues, an ethicist on the moral considerations, and a pediatric emergency physician-who is also a sexual assault forensic examiner-on the medical treatments. We aim to provide a framework for physicians to navigate issues of patient-physician privilege involving minors, privacy rules, and mandatory reporting laws. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Facebook as a learning environment for teaching medical emergencies in dental practice.

Science.gov (United States)

Alshiekhly, Ulla; Arrar, Rebal; Barngkgei, Imad; Dashash, Mayssoon

2015-01-01

Social media can be part of the formal education of health professsionals and in their lifelong learning activities. The effectiveness of Facebook, an online social medium, application for educational purposes was evaluated in this study. It was used to serve as a teaching medium of a course in medical emergencies in dental practice (MEDP). Syrian dental students were invited to join a Facebook group "Medical emergencies in dental practice" during the second semester of the academic year 2013-2014. The group privacy settings were changed from an open group to a closed group after the registration period. Administrators of the group published 61 posts during the course period, which extended for one month. Students' progress in learning was evaluated using self-assessment questionnaires administered to the students before and after the course. These questionnaires also queried their opinions regarding the use of Facebook as an educational modality. Qualitative statistics, Wilcoxon signed ranks and Mann-Whitney U-tests were used to analyze the data. Out of 388 students registered in this course, 184 completed it. Two-third of students agreed that Facebook was useful in education. Their impressions of this course were 17.4% as excellent, 52.2% as very good. P values of the self-assessment questions of Wilcoxon signed ranks test were Facebook as a social medium provides a unique learning environment. It allows students to discuss topics more openly in a flexible setting with less rigid time and place constraints. In the light of this study it was found that Facebook may be useful in teaching medical emergencies in dental practice in its theoretical aspect.

National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

Science.gov (United States)

Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

2018-01-01

Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

Emergency Medicine: On the Frontlines of Medical Education Transformation.

Science.gov (United States)

Holmboe, Eric S

2015-11-01

Emergency medicine (EM) has always been on the frontlines of healthcare in the United States. I experienced this reality first hand as a young general medical officer assigned to an emergency department (ED) in a small naval hospital in the 1980s. For decades the ED has been the only site where patients could not be legally denied care. Despite increased insurance coverage for millions of Americans as a result of the Affordable Care Act, ED directors report an increase in patient volumes in a recent survey.1 EDs care for patients from across the socioeconomic spectrum suffering from a wide range of clinical conditions. As a result, the ED is still one of few components of the American healthcare system where social justice is enacted on a regular basis. Constant turbulence in the healthcare system, major changes in healthcare delivery, technological advances and shifting demographic trends necessitate that EM constantly adapt and evolve as a discipline in this complex environment.

Emergency preparedness: a responsibility of the medical profession

International Nuclear Information System (INIS)

Sammons, J.H.

1986-01-01

There are a series of things that we might do with regard to emergency planning. Some are clearly obvious, some perhaps are less so. Obviously, we should try to prevent a disaster from occurring. But we know that disasters are going to happen. Second, we should attempt to minimize the number of casualties in the event of an emergency. A part of planning is traffic control, with the traffic control designed to prevent that particular difficulty. Clearly we need to prevent additional casualties once the natural or man-made disaster has occurred. Without question, we have to rescue the injured, we have to be able to provide first aid, and we have to make value judgments instantly on who needs aid and who does not. Obviously, the medical community has to supply the leaders in terms of the care of the injured. Equally obvious is that other people in the community, such as the governor, the mayor, the city manager, the chief of police, and the fire chief, have to be involved. When you become involved in emergency planning, remember that there are other people in the health care family. It is not just physicians who are important; the Red Cross, nurses, public health agencies, those in state radiation control programs, and many others also are important. And let us not forget the people with specialized training in nuclear medicine, as well as radiologists and radiation oncologists

Emergency preparedness at Ignalina NPP

International Nuclear Information System (INIS)

Kairys, A.

1998-01-01

Brief review of Ignalina NPP safety upgrading and personnel preparedness to act in cases of accidents is presented. Though great activities are performed in enhancing the plant operation safety, the Ignalina NPP management pays a lot of attention to preparedness for emergency elimination and take measures to stop emergency spreading. A new Ignalina NPP emergency preparedness plan was drawn up and became operational. It is the main document to carry out organizational, technical, medical, evacuation and other activities to protect plant personnel, population, the plant and the environment from accident consequences. Great assistance was rendered by Swedish experts in drawing this new emergency preparedness plan. The plan consists of 3 parts: general part, operative part and appendixes. The plan is applied to the Ignalina NPP personnel, Special and Fire Brigade and also to other contractor organizations personnel carrying out works at Ignalina NPP. There are set the following emergency classes: incident, emergency situation, alert, local emergency, general emergency. Separate intervention level corresponds to each emergency class. Overview of personnel training to act in case of an emergency is also presented

The Emergency Medical System in Greece: Opening Aeolus' Bag of Winds.

Science.gov (United States)

Kotsiou, Ourania S; Srivastava, David S; Kotsios, Panagiotis; Exadaktylos, Aristomenis K; Gourgoulianis, Konstantinos I

2018-04-13

An Emergency Medical Service (EMS) system must encompass a spectrum of care, with dedicated pre-hospital and in-hospital medical facilities. It has to be organised in such a way as to include all necessary services—such as triage accurate initial assessment, prompt resuscitation, efficient management of emergency cases, and transport to definitive care. The global economic downturn has had a direct effect on the health sector and poses additional threats to the healthcare system. Greece is one of the hardest-hit countries. This manuscript aims to present the structure of the Greek EMS system and the impact of the current economic recession on it. Nowadays, primary care suffers major shortages in crucial equipment, unmet health needs, and ineffective central coordination. Patients are also facing economic limitations that lead to difficulties in using healthcare services. The multi-factorial problem of in-hospital EMS overcrowding is also evident and has been linked with potentially poorer clinical outcomes. Furthermore, the ongoing refugee crisis challenges the national EMS. Adoption of a triage scale, expansion of the primary care network, and an effective primary–hospital continuum of care are urgently needed in Greece to provide comprehensive, culturally competent, and high-quality health care.

Factors influencing the suicide intervention skills of emergency medical services providers.

Science.gov (United States)

Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

2017-01-01

Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers' ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. EMS: Emergency medical services; SIRI: Suicide intervention response inventory.

[Medical rescue of China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake].

Science.gov (United States)

Liu, Ya-hua; Yang, Hui-ning; Liu, Hui-liang; Wang, Fan; Hu, Li-bin; Zheng, Jing-chen

2013-05-01

To summarize and analyze the medical mission of China National Earthquake Disaster Emergency Search and Rescue Team (CNESAR) in Lushan earthquake, to promote the medical rescue effectiveness incorporated with search and rescue. Retrospective analysis of medical work data by CNESAR from April 21th, 2013 to April 27th during Lushan earthquake rescue, including the medical staff dispatch and the wounded case been treated. The reasonable medical corps was composed by 22 members, including 2 administrators, 11 doctors [covering emergency medicine, orthopedics (joints and limbs, spinal), obstetrics and gynecology, gastroenterology, cardiology, ophthalmology, anesthesiology, medical rescue, health epidemic prevention, clinical laboratory of 11 specialties], 1 ultrasound technician, 5 nurses, 1 pharmacist, 1 medical instrument engineer and 1 office worker for propaganda. There were two members having psychological consultants qualifications. The medical work were carried out in seven aspects, including medical care assurance for the CNESAR members, first aid cooperation with search and rescue on site, clinical work in refugees' camp, medical round service for scattered village people, evacuation for the wounded, mental intervention, and the sanitary and anti-epidemic work. The medical work covered 24 small towns, and medical staff established 3 medical clinics at Taiping Town, Shuangshi Town of Lushan County and Baoxing County. Medical rescue, mental intervention for the old and kids, and sanitary and anti-epidemic were performed at the above sites. The medical corps had successful evacuated 2 severe wounded patients and treated the wounded over thousands. Most of the wounded were soft tissue injuries, external injury, respiratory tract infections, diarrhea, and heat stroke. Compared with the rescue action in 2008 Wenchuan earthquake, the aggregation and departure of rescue team in Lushan earthquake, the traffic control order in disaster area, the self-aid and buddy aid

Evaluating acute medical admissions through emergency departments in Hong Kong: can one adjust for case-mix variation?

Science.gov (United States)

Rainer, T H; Sollich, P; Piotrowski, T; Coolen, A C C; Cheng, B; Graham, C A

2012-12-01

Healthcare systems are under pressure to efficiently and safely reduce acute care admissions to hospital. There is a need to develop a standardised system for assessing emergency department performance which takes into account case-mix variation. The objective of this study was to derive and validate a standardised tool for assessing variations in medical admissions through emergency departments in Hong Kong. Retrospective study of patients attending emergency departments of 14 acute hospitals in Hong Kong. Data were retrieved from a centralised administrative database. Of 2,531,225 patients who attended emergency departments between 1 January 2001 and 31 December 2003, 780,444 (30.8%) were admitted to medical wards. A model derived from 2001 data shows well-calibrated admission probabilities, with an area under the receiver operating characteristic curve for probability of admission of 90.3 (95% CI ±0.11). The areas under the receiver operating characteristic curves for 2002 and 2003 validation sets were 89.9 (95% CI ±0.11) and 89.0 (95% CI ±0.12), respectively. With an averaged benchmark, reductions in medical admissions of up to 19% could be achieved, while under the most optimistic assumption, reductions of up 36% could be achieved. A tool for benchmarking hospital medical admissions and minimising case-mix variation has been derived and validated in Hong Kong, but it requires further validation in other healthcare systems given the wide variations in admission thresholds internationally. This may be used as one potential method to evaluate the performance of emergency departments against a common standard.

Research of an emergency medical system for mass casualty incidents in Shanghai, China: a system dynamics model.

Science.gov (United States)

Yu, Wenya; Lv, Yipeng; Hu, Chaoqun; Liu, Xu; Chen, Haiping; Xue, Chen; Zhang, Lulu

2018-01-01

Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program. Intervention scenarios were designed as adjusting scales of MCIs, allocation of ambulances, allocation of emergency medical staff, and efficiency of organization and command. Mortality increased with the increasing scale of MCIs, medical rescue capability of hospitals was relatively good, but the efficiency of organization and command was poor, and the prehospital time was too long. Mortality declined significantly when increasing ambulances and improving the efficiency of organization and command; triage and on-site first-aid time were shortened if increasing the availability of emergency medical staff. The effect was the most evident when 2,000 people were involved in MCIs; however, the influence was very small under the scale of 5,000 people. The keys to decrease the mortality of MCIs were shortening the prehospital time and improving the efficiency of organization and command. For small-scale MCIs, improving the utilization rate of health resources was important in decreasing the mortality. For large-scale MCIs, increasing the number of ambulances and emergency medical professionals was the core to decrease prehospital time and mortality. For super-large-scale MCIs, increasing health resources was the premise.

Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices.

Science.gov (United States)

Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

2015-01-01

Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics.

Improving medical students’ knowledge of genetic disease: a review of current and emerging pedagogical practices

Science.gov (United States)

Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

2015-01-01

Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student’s critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. PMID:26604852

Initial activities of a radiation emergency medical assistance team to Fukushima from Nagasaki

International Nuclear Information System (INIS)

Matsuda, Naoki; Yoshida, Kouji; Nakashima, Kanami; Iwatake, Satoshi; Morita, Naoko; Ohba, Takashi; Yusa, Takeshi; Kumagai, Atsushi; Ohtsuru, Akira

2013-01-01

As an urgent response to serious radiological accidents in the Fukushima Daiichi nuclear power plant, the radiation emergency medical assistance team (REMAT) from Nagasaki University landed at Fukushima on March 14, 2011, two days after the initiation of radiation crisis by the hydrogen explosion at Unit-1 reactor. During a succession of unexpected disasters, REMAT members were involved in various activities for six days, such as setting the base for radiological triage at the Fukushima Medical University, considerations for administration of stable iodine, and risk communication with health care workers. This report briefly describes what happened around REMAT members and radiation doses measured during their activities. -- Highlights: ► The radiation emergency medical assistance team from Nagasaki was sent to Fukushima. ► The practical action level for body surface contamination was 100 kcpm. ► The ambient radiation dose in Fukushima drastically elevated on March 15, 2011. ► Higher than 10 kBq of I-131, Cs-134, and Cs-137 were detected in soil samples. ► The effective dose of the team members ranged between 51.7 and 127.8 μSv in 6 days

The geographical mobility of recently graduated medical doctors

DEFF Research Database (Denmark)

Drejer, Ina; Holm, Jacob Rubæk; Petersen, Karin Dam

specialize to become general practitioners (GPs). Access to medical services is included among the services important for ensuring the basics in a welfare society. The analysis is limited to general practitioners (GPs), although access to other types of medical professionals is also an important aspect......University graduates are not evenly distributed geographically, and attraction and retention of university graduates is high on the agenda in many regional development strategies. In this paper we study the geographical mobility of a particular type of university graduates: medical doctors who...... of local access to medical services. We have chosen GPs because they – except in cases of emergency – are the main entrance to medical services in Denmark. We study how different factors may influence where GPs choose to set up medical practice. We pay particular attention to the importance of local...

Evaluation of the Medical Care of Patients with Hypertension in an Emergency Department and in Ambulatory Hypertension Unit

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Fernando Nobre

2002-02-01

Full Text Available OBJECTIVE: To evaluate the characteristics of the patients receiving medical care in the Ambulatory of Hypertension of the Emergency Department, Division of Cardiology, and in the Emergency Unit of the Clinical Hospital of the Ribeirão Preto Medical School. METHODS: Using a protocol, we compared the care of the same hypertensive patients in on different occasions in the 2 different places. The characteristics of 62 patients, 29 men with a mean age of 57 years, were analyzed between January 1996 and December 1997. RESULTS: The care of these patients resulted in different medical treatment regardless of their clinical features and blood pressure levels. Thus, in the Emergency Unit, 97% presented with symptoms, and 64.5% received medication to rapidly reduce blood pressure. In 50% of the cases, nifedipine SL was the elected medication. Patients who applied to the Ambulatory of Hypertension presenting with similar features, or, in some cases, presenting with similar clinically higher levels of blood pressure, were not prescribed medication for a rapid reduction of blood pressure at any of the appointments. CONCLUSION: The therapeutic approach to patients with high blood pressure levels, symptomatic or asymptomatic, was dependent on the place of treatment. In the Emergency Unit, the conduct was, in the majority of cases, to decrease blood pressure immediately, whereas in the Ambulatory of Hypertension, the same levels of blood pressure, in the same individuals, resulted in therapeutic adjustment with nonpharmacological management. These results show the need to reconsider the concept of hypertensive crises and their therapeutical implications.

[Management of an elderly patient in the emergency room at the end of life : A medical ethics challenge].

Science.gov (United States)

Michels, G; Nies, R; Ortmann, S; Pfister, R; Salomon, F

2018-04-01

A 94-year-old patient with cardiogenic shock due to myocardial infarction was admitted via the emergency room. A coronary angiography and intensive care were requested. The need for care due to dementia was known. After case discussion in the interdisciplinary and multiprofessional treatment team, the decision for a palliative care concept in the form of symptom control was made in the emergency room, taking into account the patient's medical history, the current situation, and the presumed patient consent. The integration of medical ethics aspects and palliative medicine into "geriatric emergency medicine" will present a challenge in the future.

Impact of interventions for patients refusing emergency medical services transport.

Science.gov (United States)

Alicandro, J; Hollander, J E; Henry, M C; Sciammarella, J; Stapleton, E; Gentile, D

1995-06-01

To evaluate the effect of a documentation checklist and on-line medical control contact on ambulance transport of out-of-hospital patients refusing medical assistance. Consecutive patients served by four suburban ambulance services who initially refused emergency medical services (EMS) transport to the hospital were prospectively enrolled. In phase 1 (control phase), all patients who initially refused medical attention or transport had an identifying data card completed. In phase 2 (documentation phase), out-of-hospital providers completed a similar data card that contained a checklist of high-risk criteria for a poor outcome if not transported. In phase 3 (intervention phase), a data card similar to that used in phase 2 was completed, and on-line medical control was contacted for all patients with high-risk criteria who refused transport. The primary endpoint was the percentage of patients transported to the hospital. A total of 361 patients were enrolled. Transport rate varied by phase: control, 17 of 144 (12%); documentation, 11 of 150 (7%); and intervention, 12 of 67 (18%) (chi-square, p = 0.023). Transport of high-risk patients improved with each intervention: control, two of 60 (3%); documentation, seven of 70 (10%); and intervention, 12 of 34 (35%) (chi-square, p = 0.00003). Transport of patients without high-risk criteria decreased with each intervention: control, 15 of 84 (18%); documentation, four of 80 (5%); and intervention, 0 of 33 (0%) (p = 0.0025). Of the 28 patients for whom medical control was contacted, 12 (43%) were transported to the hospital, and only three of these 12 patients (25%) were released from the ED. Contact with on-line medical control increased the likelihood of transport of high-risk patients who initially refused medical assistance. The appropriateness of the decreased transport rate of patients not meeting high-risk criteria needs further evaluation.

National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module II. Human Systems and Patient Assessment.

Science.gov (United States)

National Highway Traffic Safety Administration (DOT), Washington, DC.

This instructor's lesson plan guide on human systems and patient assessment is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Four units are presented: (1) medical terminology, which covers some common prefixes and suffixes and the use of the medical dictionary; (2) an overview of the…

Homogenization of locally resonant acoustic metamaterials towards an emergent enriched continuum.

Science.gov (United States)

Sridhar, A; Kouznetsova, V G; Geers, M G D

This contribution presents a novel homogenization technique for modeling heterogeneous materials with micro-inertia effects such as locally resonant acoustic metamaterials. Linear elastodynamics is used to model the micro and macro scale problems and an extended first order Computational Homogenization framework is used to establish the coupling. Craig Bampton Mode Synthesis is then applied to solve and eliminate the microscale problem, resulting in a compact closed form description of the microdynamics that accurately captures the Local Resonance phenomena. The resulting equations represent an enriched continuum in which additional kinematic degrees of freedom emerge to account for Local Resonance effects which would otherwise be absent in a classical continuum. Such an approach retains the accuracy and robustness offered by a standard Computational Homogenization implementation, whereby the problem and the computational time are reduced to the on-line solution of one scale only.

Emergency Medical Services Professionals’ Attitudes About Community Paramedic Programs

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Robert J. Steeps

2017-05-01

Full Text Available Introduction: The number of community paramedic (CP programs has expanded to mitigate the impact of increased patient usage on emergency services. However, it has not been determined to what extent emergency medical services (EMS professionals would be willing to participate in this model of care. With this project, we sought to evaluate the perceptions of EMS professionals toward the concept of a CP program. Methods: We used a cross-sectional study method to evaluate the perceptions of participating EMS professionals with regard to their understanding of and willingness to participate in a CP program. Approximately 350 licensed EMS professionals currently working for an EMS service that provides coverage to four states (Missouri, Arkansas, Kansas, and Oklahoma were invited to participate in an electronic survey regarding their perceptions toward a CP program. We analyzed interval data using the Mann-Whitney U test, Kruskal-Wallis one-way analysis of variance, and Pearson correlation as appropriate. Multivariate logistic regression was performed to examine the impact of participant characteristics on their willingness to perform CP duties. Statistical significance was established at p ≤ 0.05. Results: Of the 350 EMS professionals receiving an invitation, 283 (81% participated. Of those participants, 165 (70% indicated that they understood what a CP program entails. One hundred thirty-five (58% stated they were likely to attend additional education in order to become a CP, 152 (66% were willing to perform CP duties, and 175 (75% felt that their respective communities would be in favor of a local CP program. Using logistic regression with regard to willingness to perform CP duties, we found that females were more willing than males (OR = 4.65; p = 0.03 and that those participants without any perceived time on shift to commit to CP duties were less willing than those who believed their work shifts could accommodate additional duties (OR = 0.20; p