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Sample records for medical emergency team

  1. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger

    2008-01-01

    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  2. Constructing Common Information Space across Distributed Emergency Medical Teams

    DEFF Research Database (Denmark)

    Zhang, Zhan; Sarcevic, Aleksandra; Bossen, Claus

    2017-01-01

    This paper examines coordination and real-time information sharing across four emergency medical teams in a high-risk and distributed setting as they provide care to critically injured patients within the first hour after injury. Through multiple field studies we explored how common understanding...

  3. [Medical emergency teams are activated less than expected].

    Science.gov (United States)

    Frydshou, Andreas; Gillesberg, Inger

    2013-02-18

    Medical emergency teams (MET) are established at several Danish hospitals. We report experiences from 2010-2011 at a university hospital with 73,360 admissions in 2011. MET is activated less than expected as a systematic track and trigger system is not implemented yet. The most common trigger of MET is respiratory problems. MET have an important role of limitations of therapy or do not resuscitate orders in patients with critical irreversible illness. One in five patients seen by MET were admitted to the intensive care unit. Currently the Capital Region of Denmark covering 12 hospitals is implementing a full rapid response system at all hospitals.

  4. Advanced airway management--a medical emergency response team perspective.

    Science.gov (United States)

    Haldane, A G

    2010-09-01

    To determine the number of medical emergency response team (MERT) patients undergoing advanced airway management in the peri-evacuation phase and to determine the indications for airway interventions undertaken in flight. This was a retrospective study. Data was collected from patient report and mission debrief forms completed after each MERT mission during Operation HERRICK 10 (April-October 2009). All patients that received advanced airway interventions before or during evacuation were identified. MERTs were involved in the primary transfer of 534 patients during the period studied, 56 (10.5%) underwent advanced airway management, of which 31 (5.8% of total) were initiated by the MERT in the peri-evacuation phase. Twenty five cases (4.7%) underwent advanced airway management by other pre-hospital providers prior to MERT arrival. Of the 31 advanced airway interventions undertaken in-flight, cardiac arrest was the primary indication in only nine cases. The figure of 56 patients requiring advanced airway management is at the higher end of the range expected from the study of historical military data. This may reflect the doctrine of "intelligent tasking", that is sending this physician-led team to the most seriously injured casualties.

  5. Crisis resource management, simulation training and the medical emergency team.

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    Gillon, Stuart; Radford, Sam; Chalwin, Richard; Devita, Michael; Endacott, Ruth; Jones, Daryl

    2012-09-01

    Recently there has been increased focus on improved detection and management of deteriorating patients in Australian hospitals. Since the introduction of the medical emergency team (MET) model there has been an increased role for intensive care unit staff in responding to deterioration of patients in hospital wards. Review and management of MET patients differs from the traditional model of ward patient review, as ICU staff may not know the patient. Furthermore, assessment and intervention is often time-critical and must occur simultaneously. Finally, about 10% of MET patients require intensive care-level interventions to be commenced on the ward, and this requires participation of non-ICU-trained ward staff. • To date, the interventions performed by MET staff and approaches to training responders have been relatively under investigated, particularly in the Australian and New Zealand context. In this article we briefly review the principles of the MET and contend that activation of the MET by ward staff represents a response to a medical crisis. We then outline why MET intervention differs from traditional ward-based doctor-patient encounters, and emphasise the importance of non-technical skills during the MET response. Finally, we suggest ways in which the skills required for crisis resource management within the MET can be taught to ICU staff, and the potential benefits, barriers and difficulties associated with the delivery of such training in New Zealand and Australia.

  6. Medical Emergency Team syndromes and an approach to their management

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    Jones, Daryl; Duke, Graeme; Green, John; Briedis, Juris; Bellomo, Rinaldo; Casamento, Andrew; Kattula, Andrea; Way, Margaret

    2006-01-01

    Introduction Most literature on the medical emergency team (MET) relates to its effects on patient outcome. Less information exists on the most common causes of MET calls or on possible approaches to their management. Methods We reviewed the calling criteria and clinical causes of 400 MET calls in a teaching hospital. We propose a set of minimum standards for managing a MET review and developed an approach for managing common problems encountered during MET calls. Results The underlying reasons for initiating MET calls were hypoxia (41%), hypotension (28%), altered conscious state (23%), tachycardia (19%), increased respiratory rate (14%) and oliguria (8%). Infection, pulmonary oedema, and arrhythmias featured as prominent causes of all triggers for MET calls. The proposed minimum requirements for managing a MET review included determining the cause of the deterioration, documenting the events surrounding the MET, establishing a medical plan and ongoing medical follow-up, and discussing the case with the intensivist if certain criteria were fulfilled. A systematic approach to managing episodes of MET review was developed based on the acronym 'A to G': ask and assess; begin basic investigations and resuscitation, call for help if needed, discuss, decide, and document, explain aetiology and management, follow-up, and graciously thank staff. This approach was then adapted to provide a management plan for episodes of tachycardia, hypotension, hypoxia and dyspnoea, reduced urinary output, and altered conscious state. Conclusion A suggested approach permits audit and standardization of the management of MET calls and provides an educational framework for the management of acutely unwell ward patients. Further evaluation and validation of the approach are required. PMID:16507153

  7. Tactical emergency medical support: physician involvement and injury patterns in tactical teams.

    Science.gov (United States)

    Gildea, Jon R; Janssen, Alan R

    2008-11-01

    Medical support provided by physicians in police tactical teams has been firmly embraced by the medical community. Our study revisited the 1995 study inquiring into injury patterns in police tactical teams. A national survey was completed by 209 members of tactical teams throughout the country over a 6-week period. An electronic survey was submitted to the National Tactical Officers Association, the International Tactical Emergency Medical Support Association, and state tactical associations. Teams reporting physician utilization were 47% of the whole (69% were presentpolice tactical teams and a need for extensive involvement in all aspects of team health, with special attention to daily health and physical fitness.

  8. Effectiveness of the Medical Emergency Team: the importance of dose.

    Science.gov (United States)

    Jones, Daryl; Bellomo, Rinaldo; DeVita, Michael A

    2009-01-01

    Up to 17% of hospital admissions are complicated by serious adverse events unrelated to the patients presenting medical condition. Rapid Response Teams (RRTs) review patients during early phase of deterioration to reduce patient morbidity and mortality. However, reports of the efficacy of these teams are varied. The aims of this article were to explore the concept of RRT dose, to assess whether RRT dose improves patient outcomes, and to assess whether there is evidence that inclusion of a physician in the team impacts on the effectiveness of the team. A review of available literature suggested that the method of reporting RRT utilization rate, (RRT dose) is calls per 1,000 admissions. Hospitals with mature RRTs that report improved patient outcome following RRT introduction have a RRT dose between 25.8 and 56.4 calls per 1,000 admissions. Four studies report an association between increasing RRT dose and reduced in-hospital cardiac arrest rates. Another reported that increasing RRT dose reduced in-hospital mortality for surgical but not medical patients. The MERIT study investigators reported a negative relationship between MET-like activity and the incidence of serious adverse events. Fourteen studies reported improved patient outcome in association with the introduction of a RRT, and 13/14 involved a Physician-led MET. These findings suggest that if the RRT is the major method for reviewing serious adverse events, the dose of RRT activation must be sufficient for the frequency and severity of the problem it is intended to treat. If the RRT dose is too low then it is unlikely to improve patient outcomes. Increasing RRT dose appears to be associated with reduction in cardiac arrests. The majority of studies reporting improved patient outcome in association with the introduction of an RRT involve a MET, suggesting that inclusion of a physician in the team is an important determinant of its effectiveness.

  9. Personal networks enabling remote assistance for medical emergency team

    NARCIS (Netherlands)

    Hartog, F.T.H. den; Schmidt, J.R.; Vries, A. de

    2005-01-01

    Personal Networks provide the technology that is needed to interconnect the various private networks of a single user (home network, office network, Personal Area Network, and others) seamlessly, at any time and in any place. This can be useful in healthcare. In case of medical emergencies, it can

  10. Personal networks enabling remote assistance for medical emergency team

    NARCIS (Netherlands)

    Hartog, F.T.H. den; Schmidt, J.R.; Vries, A. de

    2005-01-01

    Personal Networks provide the technology that is needed to interconnect the various private networks of a single user (home network, office network, Personal Area Network, and others) seamlessly, at any time and in any place. This can be useful in healthcare. In case of medical emergencies, it can p

  11. Does medical emergency team intervention reduce the prevalence of emergency endotracheal intubation complications?

    Science.gov (United States)

    Kim, Go-Woon; Koh, Younsuck; Lim, Chae-Man; Han, Myongja; An, Jiyoung; Hong, Sang-Bum

    2014-01-01

    Emergency endotracheal intubation (EEI) is a complex process that leads to various complications. Previous studies mainly demonstrated that the Medical Emergency Team (MET) intervention reduced the incidence of cardiac arrest, however, the impact of a MET on airway management has not been investigated in detail. Our purpose was to confirm the impact of a MET on airway management and compare the incidence of complications of EEI before and after MET intervention in a general ward. We performed an observational study and reviewed 318 patients intubated by a MET in a general ward. The patients enrolled during the control (2007) and study (2009) periods were 103 and 215, respectively. Cardiopulmonary resuscitation requiring emergency intubation in a general ward was reduced after MET intervention at the Asan Medical Center (39.8% vs. 19.1%, p<0.001). Pre-intubation and post-intubation oxygen saturation levels were higher after MET intervention (pre-intubation, 80% before vs. 92% after MET, p<0.001; post-intubation, 95% before vs. 99% after MET, p<0.001). The use of vasopressors after intubation decreased as a result of MET intervention (62.1% before vs. 36.7% after MET, p<0.001). Hypotension was also reduced (34% before vs. 8.8% after MET, p<0.001). Early interventions of a MET changed the causes of emergency intubation in a general ward from cardiopulmonary resuscitation to respiratory distress or shock and improved hypoxemia and hypotension related to emergency intubation. The MET intervention is safe and effective system for emergency intubation in a general ward.

  12. 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.

  13. Prehospital intraosseus access with the bone injection gun by a helicopter-transported emergency medical team.

    NARCIS (Netherlands)

    Gerritse, B.M.; Scheffer, G.J.; Draaisma, J.M.T.

    2009-01-01

    BACKGROUND: To evaluate the use of the bone injection gun to obtain vascular access in the prehospital setting by an Helicopter-Transported Emergency Medical Team. METHODS: Prospective descriptive study to assess the frequency and success rate of the use of the bone injection gun in prehospital care

  14. 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.

  15. Education and Training of Emergency Medical Teams: Recommendations for a Global Operational Learning Framework.

    Science.gov (United States)

    Amat Camacho, Nieves; Hughes, Amy; Burkle, Frederick M; Ingrassia, Pier Luigi; Ragazzoni, Luca; Redmond, Anthony; Norton, Ian; von Schreeb, Johan

    2016-10-21

    An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide. Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system. The Emergency Medical Teams (EMTs) initiative, as part of the Word Health Organization's Global Health Emergency Workforce program, aims to address these shortcomings by improved EMT coordination, and mechanisms to ensure quality and accountability of national and international EMTs. An essential component to reach this goal is appropriate education and training. Multiple disaster education and training programs are available. However, most are centred on individuals' professional development rather than on the EMTs operational performance. Moreover, no common overarching or standardised training frameworks exist. In this report, an expert panel review and discuss the current approaches to disaster education and training and propose a three-step operational learning framework that could be used for EMTs globally. The proposed framework includes the following steps: 1) ensure professional competence and license to practice, 2) support adaptation of technical and non-technical professional capacities into the low-resource and emergency context and 3) prepare for an effective team performance in the field. A combination of training methodologies is also recommended, including individual theory based education, immersive simulations and team training. Agreed curriculum and open access training materials for EMTs need to be further developed, ideally through collaborative efforts between WHO, operational EMT organizations, universities, professional bodies and training agencies.  Keywords: disasters; education; emergencies; global health; learning.

  16. Defining Components of Team Leadership and Membership in Prehospital Emergency Medical Services.

    Science.gov (United States)

    Crowe, Remle P; Wagoner, Robert L; Rodriguez, Severo A; Bentley, Melissa A; Page, David

    2017-01-01

    Teamwork is critical for patient and provider safety in high-stakes environments, including the setting of prehospital emergency medical services (EMS). We sought to describe the components of team leadership and team membership on a single patient call where multiple EMS providers are present. We conducted a two-day focus group with nine subject matter experts in crew resource management (CRM) and EMS using a structured nominal group technique (NGT). The specific question posed to the group was, "What are the specific components of team leadership and team membership on a single patient call where multiple EMS providers are present?" After round-robin submission of ideas and in-depth discussion of the meaning of each component, participants voted on the most important components of team leadership and team membership. Through the NGT process, we identified eight components of team leadership: a) creates an action plan; b) communicates; c) receives, processes, verifies, and prioritizes information; d) reconciles incongruent information; e) demonstrates confidence, compassion, maturity, command presence, and trustworthiness; f) takes charge; g) is accountable for team actions and outcomes; and h) assesses the situation and resources and modifies the plan. The eight essential components of team membership identified included: a) demonstrates followership, b) maintains situational awareness, c) demonstrates appreciative inquiry, d) does not freelance, e) is an active listener, f) accurately performs tasks in a timely manner, g) is safety conscious and advocates for safety at all times, and h) leaves ego and rank at the door. This study used a highly structured qualitative technique and subject matter experts to identify components of teamwork essential for prehospital EMS providers. These findings and may be used to help inform the development of future EMS training and assessment initiatives.

  17. 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,…

  18. A web-based teamwork skills training program for emergency medical teams.

    Science.gov (United States)

    Entin, Eleen B; Sidman, Jason; Mizrahi, Gilbert; Stewart, Barry; Lai, Fuji; Neal, Lisa; Mackenzie, Colin; Xiao, Yan

    2007-01-01

    T-TRANE is a scenario-based teamwork skills training program for emergency medical teams that uses web-enabled collaborative technologies. The program assumes students are skilled in clinical techniques but have minimal formal knowledge of teamwork. By providing training that focuses on teamwork skills in emergency medical settings, the program is designed to rapidly increase team proficiency. The program is comprised of information about and examples of teamwork skills, and scenario-based training exercises that provide practice in strategies to promote teamwork such as conducting pre-planning and debriefing sessions. T-TRANE is comprised of four modules, with both live (synchronous) interactive sessions and self-paced (asynchronous) sessions that students can complete at their convenience within scheduled intervals. The program includes an Instructor's Guide that provides the designated instructor the necessary support to conduct the training. The approach used in this program can be adapted to any domain in which distributed teams will benefit from pre-deployment training.

  19. Transition from a traditional code team to a medical emergency team and categorization of cardiopulmonary arrests in a children's center.

    Science.gov (United States)

    Hunt, Elizabeth A; Zimmer, Karen P; Rinke, Michael L; Shilkofski, Nicole A; Matlin, Carol; Garger, Catherine; Dickson, Conan; Miller, Marlene R

    2008-02-01

    To study the effect of an intervention on prevention of respiratory arrest and cardiopulmonary arrest (CPA) and to characterize ward CPAs by preceding signs and symptoms and initial cardiac rhythm. A before-and-after interventional trial (12 months preintervention and 12 months postintervention). A tertiary care, academic children's hospital. Admitted patients who subsequently had either the code team or pediatric medical emergency team (PMET) called or who had a respiratory arrest or CPA on the wards. Intervention Transition from a traditional code team to a PMET that responds to clinically deteriorating children in noncritical care areas. Combined rate of respiratory arrests and CPAs, rate of CPAs, and rate of respiratory arrests on the wards and agreement between independent reviewers on categorization of CPAs. There was no change in the rate of CPAs on the wards. However, there was a 73% decrease in the incidence of respiratory arrests (0.23 respiratory arrests/1000 patient-days pre-PMET vs 0.06 post-PMET, P = .03). There was 100% agreement between reviewers on categorization of CPAs. Transition to a PMET was not associated with a change in CPAs but was associated with a significant decrease in the incidence of ward respiratory arrests. We also describe children who may have benefited from the PMET but whose data were not captured by current outcome measures. Finally, we present a new method for categorization of ward CPAs based on preceding signs and symptoms and initial cardiac rhythm.

  20. A 'mixed reality' simulator concept for future Medical Emergency Response Team training.

    Science.gov (United States)

    Stone, Robert J; Guest, R; Mahoney, P; Lamb, D; Gibson, C

    2017-08-01

    The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts. Until now, the provision of airborne pre-deployment MERT training had been dependent on either the availability of an operational aircraft (eg, the CH-47 Chinook helicopter) or access to one of only two ground-based facsimiles of the Chinook's rear cargo/passenger cabin. Although MERT training has high priority, there will always be competition with other military taskings for access to helicopter assets (and for other platforms in other branches of the Armed Forces). This paper describes the development of an inexpensive, reconfigurable and transportable MERT training concept based on 'mixed reality' technologies-in effect the 'blending' of real-world objects of training relevance with virtual reality reconstructions of operational contexts. 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/.

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

    Directory of Open Access Journals (Sweden)

    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

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

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    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.

  3. Obstetric medical emergency teams are a step forward in maternal safety!

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    Al Kadri Hanan

    2010-01-01

    Full Text Available Background and Aim : The medical emergency team (MET system was introduced successfully worldwide. With the exception of a few research publications, most of the described teams are based on patients′ medical rather than obstetric management. The objective of this study was to review literature on the outcome of obstetric MET implementation. Materials and Methods : Systematic review has been done through searching MEDLINE, the Cochrane Library, relevant articles references, and contact with experts. The author and one other researcher independently selected literature on the establishment or implementation of obstetric MET. There were no restrictions on language, sample size, type of publication, or duration of follow up. Results : Three publications were identified: Catanzarite et al., Gosman et al., and Skupski et al. They were heterogeneous in terms of the method of implementation and the outcomes discussed. None of them discussed obstetric MET implementation in developing countries. Conclusion: In the literature, there is a lack of reporting and probably of implementation of Obstetrics METs. Therefore, there is a need for more standardized experiences and reports on the implementation of various types of Obstetrics METs. We propose here a design for Obstetrics METs to be implemented in developing countries, aiming to reduce maternal mortality and morbidity resulting from obstetric hemorrhage.

  4. [Developing an attitude scale towards attempted suicide cases for evaluating emergency medical teams (ASETSA)].

    Science.gov (United States)

    Er, Gülastan; Şimşek, Zeynep; Aker, Ahmet Tamer

    2013-01-01

    Suicide attempt is one of the most important risk factors for completed suicide, and generally, the first intervention is performed in the emergency department. The attitudes of health professionals towards suicide attempt cases affect their treatment and medical care. There is no related attitude assessment scale for health professionals in Turkey. The aim of this study was to develop a scale for assessing the attitudes of emergency medical teams towards cases of attempted suicide. In this methodological, epidemiological study, a pool of 140 items was compiled using a previously developed similar scale available in the literature, as well as, testimonies of health professionals. Two hundred and fifty-one doctors, nurses and emergency medical technicians from 14 local hospitals in Sanlıurfa were included in this study. Surface validity was determined using the Lawshe content validity index and ratio. Factor analysis (principal components) was used to evaluate structural validity and internal consistency (Cronbach's alpha), and test-retest reliability was analyzed. The mean age of the study cohort was 27.9 ± 5.15 years, and 50% of the participants were female. A 28-entry attitude scale, which explained 58.5% of the total variance, was developed, including subscales for prevention and protection, individual help, institutional help, triggers and psychopathology, casual attributions, and medical help. The Cronbach's alpha parameter of the scale was 0.84. In test-retest analysis; there is no significant difference between point averages of the first and last application of the scale. The psychometric features of the developed scale were determined to be acceptable.

  5. Training of medical teams on-site for individual and coordinated response in emergency management

    DEFF Research Database (Denmark)

    Andersen, Verner

    2003-01-01

    involved in the complete preparedness: fire brigade, police, medical team, civil defence, etc. All these modules will in the end be integrated on a common integration platform, either to a fully-fledged system covering all aspects of training for the complete preparedness, or for creating a dedicated...... system for specific training set-ups for specific groups of trainees. The first module completed as a commercial system, "Training of medical teams on site", will be presented....

  6. Teammate Familiarity, Teamwork, and Risk of Workplace Injury in Emergency Medical Services Teams.

    Science.gov (United States)

    Hughes, Ashley M; Patterson, P Daniel; Weaver, Matthew D; Gregory, Megan E; Sonesh, Shirley C; Landsittel, Douglas P; Krackhardt, David; Hostler, David; Lazzara, Elizabeth H; Wang, Xiao; Vena, John E; Salas, Eduardo; Yealy, Donald M

    2017-07-01

    Increased teammate familiarity in emergency medical services (EMS) promotes development of positive teamwork and protects against workplace injury. Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent partnerships and tested the hypothesized role of teamwork as a mediator in the relationship between teammate familiarity and injury with the PROCESS macro. We received 2566 completed surveys from 333 clinicians, of which 297 were retained. Mean participation was 40.5% (standard deviation [SD] = 20.5%) across EMS agencies. Survey respondents were primarily white (93.8%), male (67.3%), and ranged between 21-62 years of age (M = 37.4, SD = 9.7). Seventeen percent were prehospital nurses. Respondents worked a mean of 3 shifts with recent teammates in the 8 weeks preceding the survey (M = 3.06, SD = 4.4). We examined data at the team level, which suggest positive views of teamwork (M = 5.92, SD = 0.69). Our hypothesis that increased teammate familiarity protects against adverse safety outcomes through development of positive teamwork was not supported. Teamwork factor Partner Adaptability and Backup Behavior is a likely mediator (odds ratio = 1.03, P = .05). When dyad familiarity is high and there are high levels of backup behavior, the likelihood of injury is increased. The relationship between teammate familiarity and outcomes is complex. Teammate adaptation and backup behavior is a likely mediator of this relationship in EMS teams with greater familiarity. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  7. Baseline hospital performance and the impact of medical emergency teams: Modelling vs. conventional subgroup analysis

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    Hillman Ken

    2009-12-01

    Full Text Available Abstract Background To compare two approaches to the statistical analysis of the relationship between the baseline incidence of adverse events and the effect of medical emergency teams (METs. Methods Using data from a cluster randomized controlled trial (the MERIT study, we analysed the relationship between the baseline incidence of adverse events and its change from baseline to the MET activation phase using quadratic modelling techniques. We compared the findings with those obtained with conventional subgroup analysis. Results Using linear and quadratic modelling techniques, we found that each unit increase in the baseline incidence of adverse events in MET hospitals was associated with a 0.59 unit subsequent reduction in adverse events (95%CI: 0.33 to 0.86 after MET implementation and activation. This applied to cardiac arrests (0.74; 95%CI: 0.52 to 0.95, unplanned ICU admissions (0.56; 95%CI: 0.26 to 0.85 and unexpected deaths (0.68; 95%CI: 0.45 to 0.90. Control hospitals showed a similar reduction only for cardiac arrests (0.95; 95%CI: 0.56 to 1.32. Comparison using conventional subgroup analysis, on the other hand, detected no significant difference between MET and control hospitals. Conclusions Our study showed that, in the MERIT study, when there was dependence of treatment effect on baseline performance, an approach based on regression modelling helped illustrate the nature and magnitude of such dependence while sub-group analysis did not. The ability to assess the nature and magnitude of such dependence may have policy implications. Regression technique may thus prove useful in analysing data when there is a conditional treatment effect.

  8. Emergency teams in Danish emergency departments

    DEFF Research Database (Denmark)

    Lafrenz, Thomas; Lindberg, Søren Østergaard; La Cour, Jeppe Lerche;

    2012-01-01

    The use of designated emergency teams for cardiac arrest and trauma patients is widely implemented. However, the use of designated teams in Danish emergency departments (EDs) has not been investigated. Our aim was to investigate the use and staffing of emergency teams in Danish EDs....

  9. Bench-to-bedside review: The MET syndrome – the challenges of researching and adopting medical emergency teams

    Science.gov (United States)

    Tee, Augustine; Calzavacca, Paolo; Licari, Elisa; Goldsmith, Donna; Bellomo, Rinaldo

    2008-01-01

    Studies of hospital performance highlight the problem of 'failure to rescue' in acutely ill patients. This is a deficiency strongly associated with serious adverse events, cardiac arrest, or death. Rapid response systems (RRSs) and their efferent arm, the medical emergency team (MET), provide early specialist critical care to patients affected by the 'MET syndrome': unequivocal physiological instability or significant hospital staff concern for patients in a non-critical care environment. This intervention aims to prevent serious adverse events, cardiac arrests, and unexpected deaths. Though clinically logical and relatively simple, its adoption poses major challenges. Furthermore, research about the effectiveness of RRS is difficult to conduct. Sceptics argue that inadequate evidence exists to support its widespread application. Indeed, supportive evidence is based on before-and-after studies, observational investigations, and inductive reasoning. However, implementing a complex intervention like RRS poses enormous logistic, political, cultural, and financial challenges. In addition, double-blinded randomised controlled trials of RRS are simply not possible. Instead, as in the case of cardiac arrest and trauma teams, change in practice may be slow and progressive, even in the absence of level I evidence. It appears likely that the accumulation of evidence from different settings and situations, though methodologically imperfect, will increase the rationale and logic of RRS. A conclusive randomised controlled trial is unlikely to occur. All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident. Arthur Schopenhauer (1788–1860), German philosopher PMID:18254927

  10. Differences in outcomes between ICU attending and senior resident physician led medical emergency team responses✩

    Science.gov (United States)

    Morris, David S.; Schweickert, William; Holena, Daniel; Handzel, Robert; Sims, Carrie; Pascual, Jose L.; Sarani, Babak

    2013-01-01

    Introduction Although rapid response systems (RRS) have been shown to decrease the incidence of cardiac arrest (CA), there are no studies evaluating optimal staffing. We hypothesize that there are no outcome differences between ICU physician and senior resident led events. Methods A retrospective study of the RRS database at a single, academic hospital was performed from July 1, 2006 to May 31, 2010. Surgical patients and those in the ICU were excluded. Daytime (D) was defined as 7 am–5 pm Monday through Friday, and weekends were defined as 5 pm on Friday to 6:59 am on Monday. The nurse to patient ratio is constant during all shifts. An ICU physician leads daytime events on weekdays whereas night/weekend (NW) events are led by residents. NW events were compared against D events using chi square or Fischer’s exact test. Significance was defined as p ideal team composition. PMID:22841611

  11. 一线核应急医学救援队伍建设%Construction of Frontline Medical Rescue Team for Nuclear Emergency

    Institute of Scientific and Technical Information of China (English)

    李泽; 吴宣树; 唐维平

    2014-01-01

    Objective To analyze the problems existing in the construction of frontline medical rescue team for nuclear radiation emergency, and put forward improving measures.Methods The practice of medical res-cue team for nuclear emergency was analyzed combining with the field exercise experience .Results Construction of frontline nuclear emergency rescue team has such weaknesses as inefficient organization , shortage of profession-als, intermittent training, insufficient renewal of medical supplies .Conclusion The following measures could be adopted to improve the rescue ability of frontline nuclear medical emergency rescue team , including devising scien-tific emergency rescue plans, enhancing field emergency rescue exercises , optimizing medical supplies, and perfec-ting information building of emergency rescue .%目的:分析一线核辐射应急医学救援队伍建设存在的问题,研究改进措施。方法根据核辐射应急医学救援队伍建设的实际,结合实地演练经验开展理论分析。结果当前一线核应急救援队伍还普遍存在宏观管理体系松散、专业救治人才缺乏、进修培训不连贯、救治药材更新配套缓慢等薄弱环节。结论通过科学制定应急救援预案、强化应急救援实战演练、优化药材供应储备、完善应急救援信息化支撑等手段,可提高一线核医学应急救援队伍的救治能力。

  12. Tactical emergency medical support.

    Science.gov (United States)

    Rinnert, Kathy J; Hall, William L

    2002-11-01

    As increases in criminal activity collide with more aggressive law enforcement postures, there is more contact between police officers and violent felons. Civilian law enforcement special operations teams routinely engage suspects in these violent, dynamic, and complex interdiction activities. Along with these activities comes the substantial and foreseeable risk of death or grievous harm to law officers, bystanders, hostages, or perpetrators. Further, law enforcement agencies who attempt to apprehend dangerous, heavily armed criminals with a special operations team that lacks the expertise to treat the medical consequences that may arise from such a confrontation may be negligent of deliberate indifference. Meanwhile, evidence exists within the military, civilian law enforcement, and medical literature that on-scene TEMS serves to improve mission success and team safety and health, while decreasing morbidity and mortality in the event of an injury or illness suffered during operations. National professional organizations within law enforcement and emergency medicine have identified and support the fundamental need for mission safety and the development of a standard model to train and incorporate TEMS into law enforcement special operations. The overall objective of TEMS is to minimize the potential for injury and illness and to promote optimal medical care from the scene of operations to a definitive care facility. The design, staffing, and implementation of a TEMS program that maximally uses the community resources integrates previously disparate law enforcement, EMS, and emergency medical/trauma center functions to form a new continuum of care [55].

  13. Understanding medical practice team roles.

    Science.gov (United States)

    Hills, Laura

    2015-01-01

    Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. This article describes in detail Belbin's highly regarded and widely used team role theory and summarizes four additional behavioral team role theories and systems. It offers lessons learned when applying team role theory to practice. Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.

  14. 玉树地震应急医学救援人员结构分析%Structural analysis of members in Yushu earthquake emergency medical relief team

    Institute of Scientific and Technical Information of China (English)

    沈燕; 张鹭鹭; 刘源; 刘旭; 林俊聪

    2012-01-01

    目的 分析玉树地震应急医学救援人员结构,为应急医学救援队伍优化配置提供依据.方法 对参与玉树地震救援的来自青海省44个卫生单位的911名医学救援队员进行全面问卷调查及部分访谈并进行描述性分析.结果 在总体卫生专业技术人员中,男女比例为1:0.4;外科专业卫生技术人员最多,其次为相关护理专业,内科专业位居第3位;本科及以上学历者占53.6%,以中级职称为主;临床专业技术人员年龄分布主要集中在36~45岁,护理人员年龄则集中在23~32岁.结论 玉树地震应急医学救援人员结构相对合理,但是也要深化医学救援队伍建设,在更大的范围实现专业优化配置.%Objective To analyze the structure of members in Yushu earthquake emergency medical relief team, in order to provide basis for optimal allocation of emergency medical relief team. Methods 911 members in Yushu earthquake emergency medical relief team from 44 medical units of Qinghai Province were investigated by comprehensive questionnaire survey and interviews, and the results were analyzed descriptively. Results Among all professional medical workers, male to female ratio was 1:0.4; most of them were surgical professional health workers, followed by the relevant care professionals. medical professional was ranked in the third place; works with bachelor degree or above were accounted for 53-6%, most of them had medium-grade professional title: the age distribution of clinical professional and technical personnel was mainly between 36 to 45 years old, the age of nurses was concentrated in 23 to 32 years old. Conclusion Structure of members in Yushu earthquake emergency medical medical relief team is relatively reasonable, but it also need to deepen medical rescue team building, to achieve professional optimization configuration in a larger range.

  15. Rudeness and Medical Team Performance.

    Science.gov (United States)

    Riskin, Arieh; Erez, Amir; Foulk, Trevor A; Riskin-Geuz, Kinneret S; Ziv, Amitai; Sela, Rina; Pessach-Gelblum, Liat; Bamberger, Peter A

    2017-02-01

    Rudeness is routinely experienced by medical teams. We sought to explore the impact of rudeness on medical teams' performance and test interventions that might mitigate its negative consequences. Thirty-nine NICU teams participated in a training workshop including simulations of acute care of term and preterm newborns. In each workshop, 2 teams were randomly assigned to either an exposure to rudeness (in which the comments of the patient's mother included rude statements completely unrelated to the teams' performance) or control (neutral comments) condition, and 2 additional teams were assigned to rudeness with either a preventative (cognitive bias modification [CBM]) or therapeutic (narrative) intervention. Simulation sessions were evaluated by 2 independent judges, blind to team exposure, who used structured questionnaires to assess team performance. Rudeness had adverse consequences not only on diagnostic and intervention parameters (mean therapeutic score 3.81 ± 0.36 vs 4.31 ± 0.35 in controls, P team processes (such as information and workload sharing, helping and communication) central to patient care (mean teamwork score 4.04 ± 0.34 vs 4.43 ± 0.37, P performance of medical teams. Moreover, exposure to rudeness debilitated the very collaborative mechanisms recognized as essential for patient care and safety. Interventions focusing on teaching medical professionals to implicitly avoid cognitive distraction such as CBM may offer a means to mitigate the adverse consequences of behaviors that, unfortunately, cannot be prevented. Copyright © 2017 by the American Academy of Pediatrics.

  16. 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.

  17. The relationship between survival after out-of-hospital cardiac arrest and process measures for emergency medical service ambulance team performance.

    Science.gov (United States)

    Chen, Tsung-Tai; Ma, Matthew Huei-Ming; Chen, Fen-Ju; Hu, Fu-Chang; Lu, Yu-Cheng; Chiang, Wen-Chu; Ko, Patrick Chow-In

    2015-12-01

    International institutes have developed their own clinical performance indicators for ambulance services. It is unknown whether these process measures are related to survival of patients after out-of-hospital cardiac arrest (OHCA). We aimed to determine whether Emergency Medical Service (EMS)-related ambulance team process measures correlate with patient survival. Four years of observational data were collected from an urban EMS OHCA registry. The two process measures were achieving an EMS response time ≤4 min and prehospital ROSC (return of spontaneous circulation). The outcome measure was survival to discharge. We used the GLMM (generalised linear mixed model) with stepwise selection to examine this process-outcome link at the patient and EMS team levels, respectively. We analyzed 3856 OHCA patients distributed across forty-three EMS ambulance teams. Survival to discharge was observed in 193 (5%) patients. The two EMS team process measures were positively associated with an improvement in survival at the patient level after case-mix adjustment. However, they were not associated with improvement in the risk-adjusted survival rate. The EMS team-level process measures proposed by international institutes may not predict the risk-adjusted survival rate. Using these measures to motivate EMS teams to improve their quality performance would be questionable. Increased efforts should be devoted to constructing more pivotal EMS team-level process measures that are tightly linked to survival. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Emergency Medical Services

    Science.gov (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people and specially equipped facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  19. The Ebola Vaccine Team B: a model for promoting the rapid development of medical countermeasures for emerging infectious disease threats.

    Science.gov (United States)

    Osterholm, Michael; Moore, Kristine; Ostrowsky, Julie; Kimball-Baker, Kathleen; Farrar, Jeremy

    2016-01-01

    In support of accelerated development of Ebola vaccines from preclinical research to clinical trials, in November, 2014, the Wellcome Trust and the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota established the Wellcome Trust-CIDRAP Ebola Vaccine Team B initiative. This ongoing initiative includes experts with global experience in various phases of bringing new vaccines to market, such as funding, research and development, manufacturing, determination of safety and efficacy, regulatory approval, and vaccination delivery. It also includes experts in community engagement strategies and ethical issues germane to vaccination policies, including eight African scientists with direct experience in developing and implementing vaccination policies in Africa. Ebola Vaccine Team B members have worked on a range of vaccination programmes, such as polio eradication (Africa and globally), development of meningococcal A disease vaccination campaigns in Africa, and malaria and HIV/AIDS vaccine research. We also provide perspective on how this experience can inform future situations where urgent development of vaccines is needed, and we comment on the role that an independent, expert group such as Team B can have in support of national and international public health authorities toward addressing a public health crisis.

  20. Interprofessional Learning – Development and Implementation of Joint Medical Emergency Team Trainings for Medical and Nursing Students at Universitätsmedizin Greifswald

    Directory of Open Access Journals (Sweden)

    Partecke, Maud

    2016-04-01

    Full Text Available Introduction: Interprofessional collaboration is of great importance in clinical practice, particularly in the field of emergency medicine. The professions involved in providing emergency care must work hand in hand, and tasks and routines must be coordinated effectively. However, medical and nursing students have only few opportunities to experience interprofessional cooperation during their formal training. Addressing this situation, the Department of Anesthesiology and the Vocational School of Greifswald University Medical School initiated a project to increase patient safety by integrating interprofessional human factor training into the curriculum of both health professions. This manuscript addresses how an interprofessional course module focusing on clinical emergency medicine can be taught with an emphasis on competency and problem-solving. In addition, it was important to identify suitable instruments for systematic quality development and assurance of this teaching and learning format.Project description: The aim of the project, which took place from October 2013 to September 2015, was the development, implementation and evaluation of a simulation-based, interprofessional course module on clinical emergency medicine. Target groups were medical and nursing students. Modern pedagogical models and methods were applied to the design and teaching of the course content. The project was carried out in separate phases: definition, planning, practical implementation, evaluation and documentation. The project was accompanied by systematic quality development. Established guidelines for quality-centered school development were applied to quality development, assurance and evaluation.Results: Over two years, a 16 credit-hour course module was developed and then taught and evaluated during the 2014 and 2015 summer semesters. A total of 120 medical students and 120 nursing students participated in the course module. Eighteen teachers from medicine

  1. Medical emergencies in Goa

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2010-01-01

    Full Text Available 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.

  2. Training teams for emergency management

    NARCIS (Netherlands)

    Schaafstal, A.M.; Johnston, J.H.; Oser, R.L.

    2001-01-01

    Emergency management (EM), the decision making involved in directing the relief operation after a disaster or otherwise catastrophic accident is an issue of great public and private concern because of the high stakes involved. Due to the nature of emergencies, and especially mass emergencies, EM tea

  3. 44 CFR 206.43 - Emergency support teams.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Emergency support teams. 206... Emergency support teams. The Federal Coordinating Officer may activate emergency support teams, composed of... emergency. These emergency support teams assist the FCO in carrying out his/her responsibilities under...

  4. Emergency Medical Service

    Science.gov (United States)

    1980-01-01

    Lewis Research Center helped design the complex EMS Communication System, originating from space operated telemetry, including the telemetry link between ambulances and hospitals for advanced life support services. In emergency medical use telemetry links ambulances and hospitals for advanced life support services and allows transmission of physiological data -- an electrocardiogram from an ambulance to a hospital emergency room where a physician reads the telemetered message and prescribes emergency procedures to ambulance attendants.

  5. Emergency team calls for critically ill non-trauma patients in the emergency department

    DEFF Research Database (Denmark)

    Jensen, Søren Marker; Do, Hien Quoc; Rasmussen, Søren W.

    2015-01-01

    BACKGROUND: Handling critically ill patients is a complex task for Emergency Department (ED) personnel. Initial treatment is of major importance and requires adequately experienced ED doctors to initiate and decide for the right medical or surgical treatment. Our aim was, with regard to clinical...... presentation, management and mortality to describe adult non-trauma patients that upon ED arrival elicited emergency team calls. METHODS: An observational study of adult patients (≥ 18 years) admitted to a regional ED with conditions that elicited acute team activation and additional emergency team.......004). Additionally, 115 adult patients were admitted to the ICU directly from the ED without eliciting an emergency team call during the study period. These patients mainly comprised patients who were intoxicated, were unconscious or had respiratory failure. CONCLUSION: The majority of emergency team call patients...

  6. Saving the On-Scene Time for Out-of-Hospital Cardiac Arrest Patients: The Registered Nurses' Role and Performance in Emergency Medical Service Teams

    Science.gov (United States)

    Lin, Ming-Wei; Wu, Che-Yu; Pan, Chih-Long; Tian, Zhong; Wen, Jyh-Horng

    2017-01-01

    For out-of-hospital cardiac arrest (OHCA) patients, every second is vital for their life. Shortening the prehospital time is a challenge to emergency medical service (EMS) experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs) participating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247 cases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O), critical (NT-C), and noncritical (NT-NC) cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (T-CS), fracture fixation (T-F), and general trauma (T-G) cases. The average on-scene time of RN-attended cases showed a decrease of 21.05% in NT-O, 3.28% in NT-C, 0% in NT-NC, 18.44% in T-CS, 13.56% in T-F, and 3.46% in T-G compared to non-RN-attended. In NT-O and T-CS cases, the RNs' attendance can notably save the on-scene time with a statistical significance (P = .016 and .017, resp.). Furthermore, the return of spontaneous circulation within two hours (ROSC2 h) rate in the NT-O cases was increased by 12.86%. Based on the findings, the role of RNs in the EMTs could save the golden time in the prehospital medical care in Taiwan. PMID:28280734

  7. Saving the On-Scene Time for Out-of-Hospital Cardiac Arrest Patients: The Registered Nurses’ Role and Performance in Emergency Medical Service Teams

    Directory of Open Access Journals (Sweden)

    Ming-Wei Lin

    2017-01-01

    Full Text Available For out-of-hospital cardiac arrest (OHCA patients, every second is vital for their life. Shortening the prehospital time is a challenge to emergency medical service (EMS experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs participating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247 cases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O, critical (NT-C, and noncritical (NT-NC cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (T-CS, fracture fixation (T-F, and general trauma (T-G cases. The average on-scene time of RN-attended cases showed a decrease of 21.05% in NT-O, 3.28% in NT-C, 0% in NT-NC, 18.44% in T-CS, 13.56% in T-F, and 3.46% in T-G compared to non-RN-attended. In NT-O and T-CS cases, the RNs’ attendance can notably save the on-scene time with a statistical significance (P=.016 and .017, resp.. Furthermore, the return of spontaneous circulation within two hours (ROSC2 h rate in the NT-O cases was increased by 12.86%. Based on the findings, the role of RNs in the EMTs could save the golden time in the prehospital medical care in Taiwan.

  8. China Medical Team: Medical rescue for “4.25” Nepal earthquake

    Directory of Open Access Journals (Sweden)

    Xi Lin

    2017-08-01

    Full Text Available In recent years, global natural disasters have been frequent and resulted in great casualties and property loss. Since Wenchuan earthquake, the disaster emergency rescue system of China has obtained considerable development in various aspects including team construction, task scheduling, personnel training, facilities and equipments, logistics, etc. On April 25, 2015, an earthquake that measured 8.1 on the Richter scale attacked Nepal. Chinese government firstly organized a medical team, named China Medical Team, and sent it to the attacked region in Nepal to implement medical rescue. The medical team completed the rescue mission successfully and creatively based on their experiences.

  9. Haiti rescue experiences to the construction of the National Emergency Medical Rescue Team%从海地救援行动谈国家应急医疗救援队建设

    Institute of Scientific and Technical Information of China (English)

    苏义; 杨国斌; 袁波; 徐晓莉; 王与荣; 易学明

    2011-01-01

    以南京军区南京总医院为主抽组的中国医疗防疫救护队,闻令而动,科学抽组,圆满完成海地国际人道主义医疗救援任务.文中通过总结海地国际医疗救援经验,进一步验证了国家应急医疗救援队组建模式的科学性、创新性,并为国家应急医疗救援队下一步建设提供了参考,理清了思路.%The National Emergency Medical Rescue Team, mainly composed by Nanjing General Hospital of Nanjing Military Command, responding immediately to an order, being organized scientifically, fulfilled the mission of international medical humanitari-anism rescue in Haiti. By summarizing the experiences of the international medical rescue mission in Haiti, this article, having justified the scientific and innovative formation of the National Emergency Medical Rescue Team, paves the way to the further construction of the National Emergency Medical Rescue Team.

  10. [Involvement of medical representatives in team medical care].

    Science.gov (United States)

    Hirotsu, Misaki; Sohma, Michiro; Takagi, Hidehiko

    2009-04-01

    In recent years, chemotherapies have been further advanced because of successive launch of new drugs, introduction of molecular targeting, etc., and the concept of so-called Team Medical Care ,the idea of sharing interdisciplinary expertise for collaborative treatment, has steadily penetrated in the Japanese medical society. Dr. Naoto Ueno is a medical oncologist at US MD Anderson Cancer Center, the birthplace of the Team Medical Care. He has advocated the concept of ABC of Team Oncology by positioning pharmaceutical companies as Team C. Under such team practice, we believe that medical representatives of a pharmaceutical company should also play a role as a member of the Team Medical Care by providing appropriate drug use information to healthcare professionals, supporting post-marketing surveillance of treated patients, facilitating drug information sharing among healthcare professionals at medical institutions, etc.

  11. Emergency units’ team leadership in case of increased workload

    National Research Council Canada - National Science Library

    Kristjan Jovanov; Vasja Roblek

    2016-01-01

    ... and age of the team members? Purpose: The purpose of the research was to find out what are the opinions from the members of the emergency team about managerial and communication skills of leaders of emergency teams in crisis situations...

  12. Measuring teamwork performance: Validity testing of the Team Emergency Assessment Measure (TEAM) with clinical resuscitation teams.

    Science.gov (United States)

    Cooper, Simon; Cant, Robyn; Connell, Cliff; Sims, Lyndall; Porter, Joanne E; Symmons, Mark; Nestel, Debra; Liaw, Sok Ying

    2016-04-01

    To test the resuscitation non-technical Team Emergency Assessment Measure (TEAM) for feasibility, validity and reliability, in two Australian Emergency Departments (ED). Non-technical (teamwork) skills have been identified as inadequate and as such have a significant impact on patient safety. Valid and reliable teamwork assessment tools are an important element of performance assessment and debriefing processes. A quasi experimental design based on observational ratings of resuscitation non-technical skills in two metropolitan ED. Senior nursing staff rated 106 adult resuscitation team events over a ten month period where three or more resuscitation team members attended. Resuscitation events, team performance and validity and reliability data was collected for the TEAM. Most rated events were for full cardiac resuscitation (43%) with 3-15 team members present for an average of 45 min. The TEAM was found to be feasible and quickly completed with minimal or no training. Discriminant validity was good as was internal consistency with a Cronbach alpha of 0.94. Uni-dimensional and concurrent validity also reached acceptable standards, 0.94 and >0.63 (p=performance indicating a need for leadership training. The TEAM is a feasible, valid and reliable non-technical assessment measure in simulated and real clinical settings. Emergency teams need to develop leadership skills through training and reflective debriefing. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Quality of care using a multidisciplinary team in the emergency room

    DEFF Research Database (Denmark)

    Christensen, Dorthea; Maaløe, Rikke; Jensen, Nanna Martin;

    2011-01-01

    Bispebjerg Hospital has implemented a multidisciplinary team reception of critically ill and severely injured patients at the Emergency Department (ED), termed emergency call (EC) and trauma call (TC). The aim of this study was to describe the course, medical treatment and outcome for patients re...... received by this multidisciplinary team and to evaluate the quality of acute medical treatment of these patients....

  14. Emergency Medical Services Program Guide.

    Science.gov (United States)

    Georgia Univ., Athens. Dept. of Vocational Education.

    This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

  15. Field Organization and Disaster Medical Assistance Teams.

    Science.gov (United States)

    Arziman, Ibrahim

    2015-10-01

    Disasters cause an acute deterioration in all stages of life. An area affected by the disaster in which the normal activities of life are disrupted is described as a "Field" in disaster terminology. Although it is not easy to define the borders of this zone, the area where there is normally functioning society is accepted as the boundary. Disaster management is the responsibility of the local government. However, in many large disaster responses many non-governmental and international organizations play a role. A Disaster Medical Team is a trained, mobile, self-contained, self-sufficient, multidisciplinary medical team that can act in the acute phase of a sudden-onset disaster (48 to 72 hours after its occurrence) to provide medical treatment in the affected area. The medical team can include physicians, nurses, paramedics and EMTS, technicians, personnel to manage logistics, security and others. Various models of Disaster Medical Teams can be observed around the world. There is paucity of evidence based literature regarding DMTs. There is a need for epidemiological studies with rigorous designs and sampling. In this section of the special edition of the journal, field organizations in health management during disasters will be summarized, with emphasis on preparedness and response phases, and disaster medical teams will be discussed.

  16. [The importance of simulation in team training on obstetric emergencies: results of the first phase of the national plan for continuous medical training].

    Science.gov (United States)

    Maio Matos, Francisco; Sousa Gomes, Andrea; Costa, Fernando Jorge; Santos Silva, Isabel; Carvalhas, Joana

    2012-01-01

    Obstetric emergencies are unexpected and random. The traditional model for medical training of these acute events has included lectures combined with sporadic clinical experiences, but this educational method has inherent limitations. Given the variety of manual skills that must be learned and high-risk environment, Obstetrics is uniquely suited for simulation. New technological educational tools provide an opportunity to learn and master technical skills needed in emergent situations as well as the opportunity to rehearse and learn from mistakes without risks to patients. The goals of this study are to assess which are the factors that trainees associate to human fallibility before and after clinical simulation based training; to compare the confidence level to solve emergent obstetric situations between interns and experts with up to 5 years of experience before and after training, and to determine the value that trainees give to simulation as a teaching tool on emergent events. 31 physicians participated at this course sessions. After the course, we verified changes in the factores that trainees associate to human fallibility, an increase in confidence level to solve emergent obstetric and an increase in the value that trainees give to simulation as a teaching tool.

  17. 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...

  18. 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...

  19. [Pediatric emergencies in the emergency medical service].

    Science.gov (United States)

    Silbereisen, C; Hoffmann, F

    2015-01-01

    Out-of-hospital pediatric emergencies occur rarely but are feared among medical personnel. The particular characteristics of pediatric cases, especially the unaccustomed anatomy of the child as well as the necessity to adapt the drug doses to the little patient's body weight, produce high cognitive and emotional pressure. In an emergency standardized algorithms can facilitate a structured diagnostic and therapeutic approach. The aim of this article is to provide standardized procedures for the most common pediatric emergencies. In Germany, respiratory problems, seizures and analgesia due to trauma represent the most common emergency responses. This article provides a practical approach concerning the diagnostics and therapy of emergencies involving children.

  20. Leading teams during simulated pediatric emergencies: a pilot study

    Directory of Open Access Journals (Sweden)

    Coolen EH

    2015-01-01

    Full Text Available Ester H Coolen,1 Jos M Draaisma,2 Sabien den Hamer,3 Jan L Loeffen2 1Department of Pediatric Surgery, Amalia Children’s Hospital, Radboud University Medical Center, 2Department of Pediatrics, Amalia Children’s Hospital, Radboud University Medical Center, 3Department of Communication Science, Radboud University, Nijmegen, the Netherlands Purpose: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. Methods: We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. Results: The coaching style (mean 54.5%, SD 7.8 is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1. This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. Conclusion: The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency. Keywords

  1. Distributed virtual environment for emergency medical training

    Science.gov (United States)

    Stytz, Martin R.; Banks, Sheila B.; Garcia, Brian W.; Godsell-Stytz, Gayl M.

    1997-07-01

    In many professions where individuals must work in a team in a high stress environment to accomplish a time-critical task, individual and team performance can benefit from joint training using distributed virtual environments (DVEs). One professional field that lacks but needs a high-fidelity team training environment is the field of emergency medicine. Currently, emergency department (ED) medical personnel train by using words to create a metal picture of a situation for the physician and staff, who then cooperate to solve the problems portrayed by the word picture. The need in emergency medicine for realistic virtual team training is critical because ED staff typically encounter rarely occurring but life threatening situations only once in their careers and because ED teams currently have no realistic environment in which to practice their team skills. The resulting lack of experience and teamwork makes diagnosis and treatment more difficult. Virtual environment based training has the potential to redress these shortfalls. The objective of our research is to develop a state-of-the-art virtual environment for emergency medicine team training. The virtual emergency room (VER) allows ED physicians and medical staff to realistically prepare for emergency medical situations by performing triage, diagnosis, and treatment on virtual patients within an environment that provides them with the tools they require and the team environment they need to realistically perform these three tasks. There are several issues that must be addressed before this vision is realized. The key issues deal with distribution of computations; the doctor and staff interface to the virtual patient and ED equipment; the accurate simulation of individual patient organs' response to injury, medication, and treatment; and an accurate modeling of the symptoms and appearance of the patient while maintaining a real-time interaction capability. Our ongoing work addresses all of these issues. In this

  2. [Emergency medical aid in a paediatrics context].

    Science.gov (United States)

    Branchard, Delphine; Tentillier, Éric; Gillet, Stéphane; Naud, Julien

    2016-01-01

    In France, the organisation of aid involves the intervention of the emergency medical services (Samu), which coordinate the medical regulation platforms for site 15 and the mobile emergency and intensive care services (Smur). Since they were created, the Samu have been tirelessly adapting their response to the various characteristics of pre-hospital assignments. Pre- and inter-hospital paediatrics has seen the development of specialised teams with the aim of providing effective aid which is adapted to the youngest and most vulnerable patients.

  3. Analysis and development of multiprofessional teams in medical rehabilitation

    OpenAIRE

    Körner, Mirjam

    2008-01-01

    Team analysis and team development are important instruments of organizational development and quality management. They contribute to team optimization in medical rehabilitation. Team analysis allows assessment of strengths and weaknesses of teams, resulting in possible recommendations for team development. So far there are only a few empirical studies and little practical experience analyzing multiprofessional teams in the health care field and inpatient medical rehabilitation in particular....

  4. Emergency Medical Technicians and Paramedics

    Science.gov (United States)

    ... Projected Employment, 2024 Change, 2014-24 Employment by Industry Percent Numeric SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program Emergency medical technicians and paramedics ...

  5. 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 Ned

  6. Emergency medical services: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Jelenko, C.; Frey, C.F.

    1976-01-01

    The organization and delivery of emergency care are reviewed in a book based on the judgments of 28 national leaders in various fields. It is noted that acute illness has become a major health problem due to the rapid growth of the United States and the increased demands of consumers for improved medical care. Critical needs in the field of emergency care are identified as communications, prompt and proper rescue handling, rapid and careful transportation of victims, and adequate emergency care at hospitals. The long-term solution to the problem of injury is viewed as prevention through efforts made by educators, industrialists, engineers, public health officials, and private citizens. The statement is made that accidents are exceeded only by heart disease, neoplasms, and cerebral vascular disease as a major cause of death in the United States. The dimensions of the accident problem are explored. Other topics addressed are: motor vehicle trauma and emergency medical services; the provision of emergency care to cardiac patients; medicolegal implications of emergency care; and field treatment and transport of emergency victims. The importance of telecommunications, emergency medical technician training, and public education is stressed. Hospital education and training for emergency department personnel are detailed for physicians and nurses. Functional and design aspects of hospital emergency departments are described, and the role of community planning in the provision of emergency health services is considered. A checklist for airport disaster planning and a Michigan law regarding emergency medical services are appended.

  7. Team-based primary care: The medical assistant perspective.

    Science.gov (United States)

    Sheridan, Bethany; Chien, Alyna T; Peters, Antoinette S; Rosenthal, Meredith B; Brooks, Joanna Veazey; Singer, Sara J

    2016-11-15

    Team-based care has the potential to improve primary care quality and efficiency. In this model, medical assistants (MAs) take a more central role in patient care and population health management. MAs' traditionally low status may give them a unique view on changing organizational dynamics and teamwork. However, little empirical work exists on how team-based organizational designs affect the experiences of low-status health care workers like MAs. The aim of this study was to describe how team-based primary care affects the experiences of MAs. A secondary aim was to explore variation in these experiences. In late 2014, the authors interviewed 30 MAs from nine primary care practices transitioning to team-based care. Interviews addressed job responsibilities, teamwork, implementation, job satisfaction, and learning. Data were analyzed using a thematic networks approach. Interviews also included closed-ended questions about workload and job satisfaction. Most MAs reported both a higher workload (73%) and a greater job satisfaction (86%) under team-based primary care. Interview data surfaced four mechanisms for these results, which suggested more fulfilling work and greater respect for the MA role: (a) relationships with colleagues, (b) involvement with patients, (c) sense of control, and (d) sense of efficacy. Facilitators and barriers to these positive changes also emerged. Team-based care can provide low-status health care workers with more fulfilling work and strengthen relationships across status lines. The extent of this positive impact may depend on supporting factors at the organization, team, and individual worker levels. To maximize the benefits of team-based care, primary care leaders should recognize the larger role that MAs play under this model and support them as increasingly valuable team members. Contingent on organizational conditions, practices may find MAs who are willing to manage the increased workload that often accompanies team-based care.

  8. Failure to activate the in-hospital emergency team: causes and outcomes

    Science.gov (United States)

    Barbosa, Vera; Gomes, Ernestina; Vaz, Senio; Azevedo, Gustavo; Fernandes, Gonçalo; Ferreira, Amélia; Araujo, Rui

    2016-01-01

    Objective To determine the incidence of afferent limb failure of the in-hospital Medical Emergency Team, characterizing it and comparing the mortality between the population experiencing afferent limb failure and the population not experiencing afferent limb failure. Methods A total of 478 activations of the Medical Emergency Team of Hospital Pedro Hispano occurred from January 2013 to July 2015. A sample of 285 activations was obtained after excluding incomplete records and activations for patients with less than 6 hours of hospitalization. The sample was divided into two groups: the group experiencing afferent limb failure and the group not experiencing afferent limb failure of the Medical Emergency Team. Both populations were characterized and compared. Statistical significance was set at p ≤ 0.05. Result Afferent limb failure was observed in 22.1% of activations. The causal analysis revealed significant differences in Medical Emergency Team activation criteria (p = 0.003) in the group experiencing afferent limb failure, with higher rates of Medical Emergency Team activation for cardiac arrest and cardiovascular dysfunction. Regarding patient outcomes, the group experiencing afferent limb failure had higher immediate mortality rates and higher mortality rates at hospital discharge, with no significant differences. No significant differences were found for the other parameters. Conclusion The incidence of cardiac arrest and the mortality rate were higher in patients experiencing failure of the afferent limb of the Medical Emergency Team. This study highlights the need for health units to invest in the training of all healthcare professionals regarding the Medical Emergency Team activation criteria and emergency medical response system operations. PMID:28099639

  9. Emergency units’ team leadership in case of increased workload

    OpenAIRE

    Kristjan Jovanov; Vasja Roblek

    2016-01-01

    Research Question: Are there any statistically significant differences in the characteristics of the management in emergency activities in cases of increased scope of workd depending on location institutions and by sex and age of the team members? Purpose: The purpose of the research was to find out what are the opinions from the members of the emergency team about managerial and communication skills of leaders of emergency teams in crisis situations, which in turn affe...

  10. In-flight Medical Emergencies

    Directory of Open Access Journals (Sweden)

    Amit Chandra

    2013-09-01

    Full Text Available Introduction: Research and data regarding in-flight medical emergencies during commercial air travel are lacking. Although volunteer medical professionals are often called upon to assist, there are no guidelines or best practices to guide their actions. This paper reviews the literature quantifying and categorizing in-flight medical incidents, discusses the unique challenges posed by the in-flight environment, evaluates the legal aspects of volunteering to provide care, and suggests an approach to managing specific conditions at 30,000 feet.Methods: We conducted a MEDLINE search using search terms relevant to aviation medical emergencies and flight physiology. The reference lists of selected articles were reviewed to identify additional studies.Results: While incidence studies were limited by data availability, syncope, gastrointestinal upset, and respiratory complaints were among the most common medical events reported. Chest pain and cardiovascular events were commonly associated with flight diversion.Conclusion: When in-flight medical emergencies occur, volunteer physicians should have knowledge about the most common in-flight medical incidents, know what is available in on-board emergency medical kits, coordinate their therapy with the flight crew and remote resources, and provide care within their scope of practice. [West J Emerg Med. 2013;14(5:499–504.

  11. 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...

  12. Training van crisismanagement-teams [Training of emergency management teams

    NARCIS (Netherlands)

    Berlo, M.P.W. van; Stroomer, S.; Bosch, K. van den

    2003-01-01

    Een rampenplan of bedrijfsnoodplan bestaat veelal slechts uit een lijst met telefoonnummers, of het is een plan dat niet is geactualiseerd. Bovendien is het trainen van crisismanagement-teams lastig omdat crises vaak een onvoorspelbaar karakter hebben. in deze bijdrage worden twee methoden beschreve

  13. Infradian rhythms in medical ambulance team dispatches

    Science.gov (United States)

    Dudin, S. A.

    2012-12-01

    We describe the results of a spectral and correlation analysis of changes in the daily dispatches of ambulance teams over 3 years. The results show fluctuations with periods of 7, 41, 50-51, 68-82, 136, 227, and 310-365 days and small-amplitude fluctuations with periods of 11, 13-14, 17-18, 23, 29, 31, 36, and 58 days. Some of these coincide with the predictions of Tibetan medical sources. The periods under observation closely match the changes in the gradient of the Earth's electric field potential.

  14. The emergency department medical director.

    Science.gov (United States)

    Mayer, T A

    1987-02-01

    This article has presented an overview of the duties, responsibilities, and management roles of the emergency department Medical Director, a position that can be among the most challenging, stimulating, and exciting in medicine. However, prior to accepting a position as an Emergency Department medical director, one should have a clear understanding of what the job entails. Careful discussions with the hospital administration, medical staff, nursing personnel, and staff emergency physicians should be undertaken to learn the perceptions of these people and expectations of the position. Once the job has been accepted, using the roles, responsibilities, and duties detailed herein may be of benefit--but should always be applied with good judgment, tactful cooperation, and common sense. Finally, it should not be surprising to a medical director to find, as Spinoza did many years ago, that the excellent thing he aspires to are as difficult as they are rare.

  15. The dynamics of team cognition: A process-oriented theory of knowledge emergence in teams.

    Science.gov (United States)

    Grand, James A; Braun, Michael T; Kuljanin, Goran; Kozlowski, Steve W J; Chao, Georgia T

    2016-10-01

    Team cognition has been identified as a critical component of team performance and decision-making. However, theory and research in this domain continues to remain largely static; articulation and examination of the dynamic processes through which collectively held knowledge emerges from the individual- to the team-level is lacking. To address this gap, we advance and systematically evaluate a process-oriented theory of team knowledge emergence. First, we summarize the core concepts and dynamic mechanisms that underlie team knowledge-building and represent our theory of team knowledge emergence (Step 1). We then translate this narrative theory into a formal computational model that provides an explicit specification of how these core concepts and mechanisms interact to produce emergent team knowledge (Step 2). The computational model is next instantiated into an agent-based simulation to explore how the key generative process mechanisms described in our theory contribute to improved knowledge emergence in teams (Step 3). Results from the simulations demonstrate that agent teams generate collectively shared knowledge more effectively when members are capable of processing information more efficiently and when teams follow communication strategies that promote equal rates of information sharing across members. Lastly, we conduct an empirical experiment with real teams participating in a collective knowledge-building task to verify that promoting these processes in human teams also leads to improved team knowledge emergence (Step 4). Discussion focuses on implications of the theory for examining team cognition processes and dynamics as well as directions for future research. (PsycINFO Database Record

  16. Team knowledge research: emerging trends and critical needs.

    Science.gov (United States)

    Wildman, Jessica L; Thayer, Amanda L; Pavlas, Davin; Salas, Eduardo; Stewart, John E; Howse, William R

    2012-02-01

    This article provides a systematic review of the team knowledge literature and guidance for further research. Recent research has called attention to the need for the improved study and understanding of team knowledge. Team knowledge refers to the higher level knowledge structures that emerge from the interactions of individual team members. We conducted a systematic review of the team knowledge literature, focusing on empirical work that involves the measurement of team knowledge constructs. For each study, we extracted author degree area, study design type, study setting, participant type, task type, construct type, elicitation method, aggregation method, measurement timeline, and criterion domain. Our analyses demonstrate that many of the methodological characteristics of team knowledge research can be linked back to the academic training of the primary author and that there are considerable gaps in our knowledge with regard to the relationships between team knowledge constructs, the mediating mechanisms between team knowledge and performance, and relationships with criteria outside of team performance, among others. We also identify categories of team knowledge not yet examined based on an organizing framework derived from a synthesis of the literature. There are clear opportunities for expansion in the study of team knowledge; the science of team knowledge would benefit from a more holistic theoretical approach. Human factors researchers are increasingly involved in the study of teams. This review and the resulting organizing framework provide researchers with a summary of team knowledge research over the past 10 years and directions for improving further research.

  17. A Model for Capturing Team Adaptation in Simulated Emergencies

    DEFF Research Database (Denmark)

    Paltved, Charlotte; Musaeus, Peter

    2013-01-01

    Introduction/Background: Acute critical situations and emergencies are among the most challenging situations in medicine where acute care teams are often constituted on an ad hoc basis. In such types of teams, it is obvious that excellent performance depends on the ability of the team to function...... events like closed-loop communication.1 A more nuanced understanding of team communication has the potential to enhance scholarship in interprofessional endeavours. In high risk environments, team performance depends on the ability of teams to quickly alter actions in response to rapidly changing...... and reviewed. The research design used an explorative case study methodology to answer the research question: Which factors most strongly mediate adaptive team performance? Results: Through an iterative, inductive process, data supported the building of the Team Adaptation Tool (TATool) that captures...

  18. Emergency department team communication with the patient: the patient's perspective.

    Science.gov (United States)

    McCarthy, Danielle M; Ellison, Emily P; Venkatesh, Arjun K; Engel, Kirsten G; Cameron, Kenzie A; Makoul, Gregory; Adams, James G

    2013-08-01

    Effective communication is important for the delivery of quality care. The Emergency Department (ED) environment poses significant challenges to effective communication. The objective of this study was to determine patients' perceptions of their ED team's communication skills. This was a cross-sectional study in an urban, academic ED. Patients completed the Communication Assessment Tool for Teams (CAT-T) survey upon ED exit. The CAT-T was adapted from the psychometrically validated Communication Assessment Tool (CAT) to measure patient perceptions of communication with a medical team. The 14 core CAT-T items are associated with a 5-point scale (5 = excellent); results are reported as the percent of participants who responded "excellent." Responses were analyzed for differences based on age, sex, race, and operational metrics (wait time, ED daily census). There were 346 patients identified; the final sample for analysis was 226 patients (53.5% female, 48.2% Caucasian), representing a response rate of 65.3%. The scores on CAT-T items (reported as % "excellent") ranged from 50.0% to 76.1%. The highest-scoring items were "let me talk without interruptions" (76.1%), "talked in terms I could understand" (75.2%), and "treated me with respect" (74.3%). The lowest-scoring item was "encouraged me to ask questions" (50.0%). No differences were noted based on patient sex, race, age, wait time, or daily census of the ED. The patients in this study perceived that the ED teams were respectful and allowed them to talk without interruptions; however, lower ratings were given for items related to actively engaging the patient in decision-making and asking questions. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Video conferencing versus telephone calls for team work across hospitals: a qualitative study on simulated emergencies

    Directory of Open Access Journals (Sweden)

    Hagen Oddvar

    2009-11-01

    Full Text Available Abstract Background Teamwork is important for patient care and outcome in emergencies. In rural areas, efficient communication between rural hospitals and regional trauma centers optimise decisions and treatment of trauma patients. Little is known on potentials and effects of virtual team to team cooperation between rural and regional trauma teams. Methods We adapted a video conferencing (VC system to the work process between multidisciplinary teams responsible for trauma as well as medical emergencies between one rural and one regional (university hospital. We studied how the teams cooperated during simulated critical scenarios, and compared VC with standard telephone communication. We used qualitative observations and interviews to evaluate results. Results The team members found VC to be a useful tool during emergencies and for building "virtual emergency teams" across distant hospitals. Visual communication combined with visual patient information is superior to information gained during ordinary telephone calls, but VC may also cause interruptions in the local teamwork. Conclusion VC can improve clinical cooperation and decision processes in virtual teams during critical patient care. Such team interaction requires thoughtful organisation, training, and new rules for communication.

  20. Employee Knowledge Sharing in Work Teams: Effects of Team Diversity, Emergent States, and Team Leadership

    Science.gov (United States)

    Noh, Jae Hang

    2013-01-01

    Knowledge sharing in work teams is one of the critical team processes. Without sharing of knowledge, work teams and organizations may not be able to fully utilize the diverse knowledge brought into work teams by their members. The purpose of this study was to investigate antecedents and underlying mechanisms influencing the extent to which team…

  1. Employee Knowledge Sharing in Work Teams: Effects of Team Diversity, Emergent States, and Team Leadership

    Science.gov (United States)

    Noh, Jae Hang

    2013-01-01

    Knowledge sharing in work teams is one of the critical team processes. Without sharing of knowledge, work teams and organizations may not be able to fully utilize the diverse knowledge brought into work teams by their members. The purpose of this study was to investigate antecedents and underlying mechanisms influencing the extent to which team…

  2. Preparing for medical emergencies in the dental office.

    Science.gov (United States)

    Morrison, A D; Goodday, R H

    1999-05-01

    If you discover an unconscious patient in your office, attend to the ABCs while you evaluate the patient's medical history and piece together the events leading up to the emergency. These actions will help you arrive at a diagnosis. Then as the emergency cart and team arrive, you will be able to provide good, safe care to stabilize the patient and get him or her to a medical facility.

  3. Privatization and emergency medical services.

    Science.gov (United States)

    Reissman, S G

    1997-01-01

    Osborne and Gaebler's Reinventing Government has sparked discussion amongst elected officials, civil servants, the media, and the general public regarding advantages of privatizing government services. Its support stems from an effort to provide services to municipalities while reducing taxpayer expenditure. Many echo the sentiment of former New York Governor Mario Cuomo, who said, "It is not government's obligation to provide services, but to see that they're provided." Even in the area of public safety, privatization has found a "market." In many localities, privatizing Emergency Medical Services (EMS) is a popular and successful method for providing ambulance services. Privately owned ambulance services staff and respond to medical emergencies in a given community as part of the 9-1-1 emergency response system. Regulations for acceptable response times, equipment, and other essential components of EMS systems are specified by contract. This allows the municipality oversight of the service provided, but it does not provide the service directly. As will be discussed, this "contracting-out" model has many benefits. Privatizing EMS services is a decision based not only on cost-savings, but on accountability. A thorough evaluation must be utilized in the selection process. Issues of efficiency, effectiveness, quality, customer service, responsiveness, and equity must be considered by the government, in addition to cost of service. The uncertain future of health care in the United States has led those in EMS to look beyond the field's internal market to explore additional opportunities for expanding and redefining its roles beyond emergency care. It is important, however, to consider how emergency medical care, the original role of EMS, can be best delivered. Responding to emergencies is not just one of the functions involved in this field, it is the principal function from which public perception of EMS is formed, and from which support for entering other markets can

  4. Using Rituals to Strengthen Your Medical Practice Team.

    Science.gov (United States)

    Hills, Laura

    2015-01-01

    Rituals can cement the identity of and strengthen the bonds between any people, including the members of the medical practice team. This article presents the idea that the medical practice manager is in the ideal position to create and use rituals for team building. It defines the term ritual, and explores how rituals differ from customs or traditions. As well, it describes six benefits of rituals and the hallmarks of the most effective team rituals; describes seven creative and interesting corporate rituals that medical practice managers can study for inspiration; suggests 20 excellent opportunities within the medical practice calendar year for medical practice team rituals; and identifies six kinds of rituals that are used in organizations. Finally, this article provides a four-step action plan for ritualizing your medical practice team's morning huddles.

  5. 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.

  6. University of North Carolina's experience with state medical assistance teams.

    Science.gov (United States)

    Strickler, Jeff; Murtaugh, Lisa; Hoffman, Randy

    2010-01-01

    Events in the last several years have shown a clear need for better preparation regarding disaster management. In an effort to improve this preparation, North Carolina implemented state medical assistant teams to provide alternative care facilities, decontamination facilities, and shelter assistance during times of disaster. This article explores these teams from the perspective of the University of North Carolina, which serves as a lead agency for one of these teams. Key components of the team, training provided, and lessons learned will be discussed.

  7. 重大化学灾害事件医学应急救援预案的准备%Preparation of contingency plan of emergency medical response team for catastrophic chemical disasters

    Institute of Scientific and Technical Information of China (English)

    赵建; 丁日高

    2016-01-01

    在各类灾害事件处置和救援过程中,应急救援预案是一切行动的核心,是各种具体行动有序、高效展开,以及减少事故影响和损失最为有效的保证。本文拟以“天津港8·12特大爆炸事故”为背景,分析重大化学灾害事件医学应急救援预案准备过程中应关注的重要因素,并对预案内容提出具体建议。%In the management of disasters of any kinds,including the catastrophic chemical disasters,the contingency plan is,definitely,a saga for the efficient practice of the detailed and technically sophisticated rescue work,which is a guarantee for mini⁃mizing the negative impacts and loses of various kinds induced by the disaster. Backgrounded on the“Tianjin Port 8 · 12 Catastrophic Explosion Accident”,which was heavily involved with large amounts of chemicals of many kinds,key planning factors to be consid⁃ered in making the contingency plan for the emergency medical response team are discussed,and suggestions for some of the details within a certain kind of a plan are also provided.

  8. Leadership emergence in engineering design teams.

    Science.gov (United States)

    Guastello, Stephen J

    2011-01-01

    Leaders emerge from leaderless groups as part of a more complex emerging social structure. Several studies have shown that the emerging structure is aptly described by a swallowtail catastrophe model where the control parameters differ depending on whether creative problem solving, production, coordination-intensive, or emergency management groups are involved. The present study explored creative problem solving further where the participants were engaged in real-world tasks extending over several months rather than short laboratory tasks. Participants were engineering students who were organized into groups of to people who designed, built, and tested a prototype product that would solve a real-world problem. At the th week of work they completed a questionnaire indicating who was most like the leader of their group, second most like the leader, along with other questions about individuals' contributions to the group process. Results showed that the swallowtail model (R = .) exhibited a strong advantage over the linear alternative model (R = .) for predicting leadership emergence. The three control variables were control of the task, creative contributions to the group's work, and facilitating the creative contributions of others.

  9. Medical Team Training Programs in Health Care

    Science.gov (United States)

    2005-01-01

    DOM, renamed LifewingsTM), and Geriatric Interdisciplinary Team Training ( GITT )—from a comprehensive review of the literature (refer to Baker et al...response checklist,” which trainees are required to use in the OR. Geriatric Interdisciplinary Team Training ( GITT ) The primary purpose of GITT is to... GITT provides interdisciplinary team training for physicians, nurses, nurse practitioners, social workers, pharmacists, therapists, and

  10. Designated Medical Directors for Emergency Medical Services: Recruitment and Roles

    Science.gov (United States)

    Slifkin, Rebecca T.; Freeman, Victoria A.; Patterson, P. Daniel

    2009-01-01

    Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban…

  11. Medical Emergency Team Tutored Learning Environment

    Science.gov (United States)

    2008-05-01

    which tapered off somewhat in later years. The outcome of that design work is described thoroughly in the Results section below. Designs ranged from...The family notes that he went to a basketball game three to four days before falling ill, and that his cousin who went with him is also now home

  12. 实兵演习中野战医疗队应急保障的实践与思考%Emergency Support of Field Medical Team Participating in Maneuver: Practice and Thought

    Institute of Scientific and Technical Information of China (English)

    王浈; 杨洋; 俞冠东

    2012-01-01

    Combing the practice of field medical team participating in maneuver, the author put forward some viewpoints: Laying stress on the drill key points according to the mission demand of different stages of the maneuver ; testing the ability of medical support in actual combat environment; studying the difficult subjects to discover problems and solve them, so as to temper the medical team and improving training effects.%通过野战医疗队参加实兵对抗演习的实践,提出应根据演习不同阶段任务需求,突出演练重点,在实战环境中检验卫勤保障能力,研训重难点课题,发现问题并探讨解决途径,达到磨炼卫勤队伍,以练促训的目的.

  13. [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.

  14. 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.

  15. 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…

  16. Code Blue Emergencies: A Team Task Analysis and Educational Initiative

    Directory of Open Access Journals (Sweden)

    James W. Price

    2012-04-01

    Full Text Available Introduction: The objective of this study was to identify factors that have a positive or negative influence on resuscitation team performance during emergencies in the operating room (OR and post-operative recovery unit (PAR at a major Canadian teaching hospital. This information was then used to implement a team training program for code blue emergencies. Methods: In 2009/10, all OR and PAR nurses and 19 anesthesiologists at Vancouver General Hospital (VGH were invited to complete an anonymous, 10 minute written questionnaire regarding their code blue experience. Survey questions were devised by 10 recovery room and operation room nurses as well as 5 anesthesiologists representing 4 different hospitals in British Columbia. Three iterations of the survey were reviewed by a pilot group of nurses and anesthesiologists and their feedback was integrated into the final version of the survey. Results: Both nursing staff (n = 49 and anesthesiologists (n = 19 supported code blue training and believed that team training would improve patient outcome. Nurses noted that it was often difficult to identify the leader of the resuscitation team. Both nursing staff and anesthesiologists strongly agreed that too many people attending the code blue with no assigned role hindered team performance. Conclusion: Identifiable leadership and clear communication of roles were identified as keys to resuscitation team functioning. Decreasing the number of people attending code blue emergencies with no specific role, increased access to mock code blue training, and debriefing after crises were all identified as areas requiring improvement. Initial team training exercises have been well received by staff.

  17. Effect of obstetric team training on team performance and medical technical skills: a randomised controlled trial.

    Science.gov (United States)

    Fransen, A F; van de Ven, J; Merién, A E R; de Wit-Zuurendonk, L D; Houterman, S; Mol, B W; Oei, S G

    2012-10-01

    To determine whether obstetric team training in a medical simulation centre improves the team performance and utilisation of appropriate medical technical skills of healthcare professionals. Cluster randomised controlled trial. The Netherlands. The obstetric departments of 24 Dutch hospitals. The obstetric departments were randomly assigned to a 1-day session of multiprofessional team training in a medical simulation centre or to no such training. Team training was given with high-fidelity mannequins by an obstetrician and a communication expert. More than 6 months following training, two unannounced simulated scenarios were carried out in the delivery rooms of all 24 obstetric departments. The scenarios, comprising a case of shoulder dystocia and a case of amniotic fluid embolism, were videotaped. The team performance and utilisation of appropriate medical skills were evaluated by two independent experts. Team performance evaluated with the validated Clinical Teamwork Scale (CTS) and the employment of two specific obstetric procedures for the two clinical scenarios in the simulation (delivery of the baby with shoulder dystocia in the maternal all-fours position and conducting a perimortem caesarean section within 5 minutes for the scenario of amniotic fluid embolism). Seventy-four obstetric teams from 12 hospitals in the intervention group underwent teamwork training between November 2009 and July 2010. The teamwork performance in the training group was significantly better in comparison to the nontraining group (median CTS score: 7.5 versus 6.0, respectively; P = 0.014). The use of the predefined obstetric procedures for the two clinical scenarios was also significantly more frequent in the training group compared with the nontraining group (83 versus 46%, respectively; P = 0.009). Team performance and medical technical skills may be significantly improved after multiprofessional obstetric team training in a medical simulation centre. © 2012 The Authors BJOG An

  18. [The place, role and importance of emergency medical care in the Serbian health care system].

    Science.gov (United States)

    Nikić-Sovilj, Ljiljana

    2009-01-01

    Emergency medical assistance is immediate, the current medical support that is provided hurted person to avoid any possible harmful consequences for his life and health. Emergency medical aid is part of the health care system that is rarely thought, but is still expected to be available always and continuously in case of need. Emergency medical assistance should always be available throughout the territory where people live, because there is no adequate replacement. Emergency Medical Services and emergency medical transportation services are health care that is provided in terms of all persons in the state of medical urgency. In urgent or emergency conditions, health care can be provided on the site of injuries and disease or health institution. Cases of medical urgency are ranked by degrees. The first and most difficult level of medical urgency indicate all urgent pathological conditions, diseases, injuries and poisoning, which occur in the workplace and public places. To expect medical team of emergency medical assistance at the scene intervened medical urgency, it is necessary to make call it. Call the phone number refers to the 94. Call sent to this number to receive orderly dispatcher. Dispatchers are employees who perform their work in the dispatching center. They appear in the phone number 94, made the assessment and screening calls, worry about the degree of urgency, and the absorption team, which team is the nearest place of the event. After received calls they send expert medical teams to the place of accident. In the dispatching center work always doctor and medical technician. Emergency medical care cases is a great professional and educational challenge and imposes a constant need in education of doctors and the whole emergency medical teams. Education of all employees in the state of emergency care is required continualy and for students too to receive new knowledge in the field of medical urgency by various professional purposes.

  19. An initial experience with "team learning" in medical education.

    Science.gov (United States)

    Haidet, Paul; O'Malley, Kimberly J; Richards, Boyd

    2002-01-01

    Team learning is an approach to large-group teaching that combines the strengths of small-group interactive learning with teacher-driven content delivery. Team learning has been used successfully in professional disciplines other than medicine. The authors describe a field test of team learning in the setting of an internal medicine residency noontime lecture in the spring of 2000 at Baylor College of Medicine. They surveyed residents on their attitudes toward the usefulness of the lecture content before and after the session and surveyed them on their engagement in learning. Residents reported their engagement as high and demonstrated favorable changes in their attitudes about the usefulness of the lecture content to their daily medical practice. The authors describe their adaptation of the team-learning approach and conclude that team learning may be a useful new pedagogic tool in medical education.

  20. Just allocation and team loyalty: a new virtue ethic for emergency medicine

    Science.gov (United States)

    Girod, J; Beckman, A

    2005-01-01

    When traditional virtue ethics is applied to clinical medicine, it often claims as its goal the good of the individual patient, and focuses on the dyadic relationship between one physician and one patient. An alternative model of virtue ethics, more appropriate to the practice of emergency medicine, will be outlined by this paper. This alternative model is based on the assumption that the appropriate goal of the practice of emergency medicine is a team approach to the medical wellbeing of individual patients, constrained by the wellbeing of the patient population served by a particular emergency department. By defining boundaries and using the key virtues of justice and team loyalty, this model fits emergency practice well and gives care givers the conceptual clarity to apply this model to various conflicts both within the department and with those outside the department. PMID:16199595

  1. Academic Primer Series: Five Key Papers about Team Collaboration Relevant to Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Michael Gottlieb

    2017-02-01

    Full Text Available Team collaboration is an essential for success both within academics and the clinical environment. Often, team collaboration is not explicitly taught during medical school or even residency, and must be learned during one’s early career. In this article, we aim to summarize five key papers about team collaboration for early career clinician educators. We conducted a consensus-building process among the writing team to generate a list of key papers that describe the importance or significance of team collaboration, seeking input from social media sources. The authors then used a three-round voting methodology akin to a Delphi study to determine the most important papers from the initially generated list. The five most important papers on the topic of team collaboration, as determined by this mixed group of junior faculty members and faculty developers, are presented in this paper. For each included publication, a summary was provided along with its relevance to junior faculty members and faculty developers. Five key papers about team collaboration are presented in this publication. These papers provide a foundational background to help junior faculty members with collaborating in teams both clinically and academically. This list may also inform senior faculty and faculty developers about the needs of junior faculty members. [West J Emerg Med. 2017;18(2303-310.

  2. [Developing team reflexivity as a learning and working tool for medical teams].

    Science.gov (United States)

    Riskin, Arieh; Bamberger, Peter

    2014-01-01

    Team reflexivity is a collective activity in which team members review their previous work, and develop ideas on how to modify their work behavior in order to achieve better future results. It is an important learning tool and a key factor in explaining the varying effectiveness of teams. Team reflexivity encompasses both self-awareness and agency, and includes three main activities: reflection, planning, and adaptation. The model of briefing-debriefing cycles promotes team reflexivity. Its key elements include: Pre-action briefing--setting objectives, roles, and strategies the mission, as well as proposing adaptations based on what was previously learnt from similar procedures; Post-action debriefing--reflecting on the procedure performed and reviewing the extent to which objectives were met, and what can be learnt for future tasks. Given the widespread attention to team-based work systems and organizational learning, efforts should be made toward ntroducing team reflexivity in health administration systems. Implementation could be difficult because most teams in hospitals are short-lived action teams formed for a particular event, with limited time and opportunity to consciously reflect upon their actions. But it is precisely in these contexts that reflexive processes have the most to offer instead of the natural impulsive collective logics. Team reflexivity suggests a potential solution to the major problems of iatorgenesis--avoidable medical errors, as it forces all team members to participate in a reflexive process together. Briefing-debriefing technology was studied mainly in surgical teams and was shown to enhance team-based learning and to improve quality-related outcomes and safety.

  3. Leading teams during simulated pediatric emergencies: a pilot study.

    Science.gov (United States)

    Coolen, Ester H; Draaisma, Jos M; den Hamer, Sabien; Loeffen, Jan L

    2015-01-01

    Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. The coaching style (mean 54.5%, SD 7.8) is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1). This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency.

  4. Leading teams during simulated pediatric emergencies: a pilot study

    Science.gov (United States)

    Coolen, Ester H; Draaisma, Jos M; den Hamer, Sabien; Loeffen, Jan L

    2015-01-01

    Purpose Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. Methods We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. Results The coaching style (mean 54.5%, SD 7.8) is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1). This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. Conclusion The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency. PMID:25610010

  5. [An emergency team working closely with the patient].

    Science.gov (United States)

    Selma, Toufik; Chermak, Mustapha; Limani, Mohammed; Rochard, Jacques; Wendlandt, Jérôme; Hernandez, Angélique

    2015-01-01

    ERIC 77 is a rapid response team for emergency psychiatric situations. This cross-sector service based at Marne-la-Vallée general hospital represents a supplementary network in psychiatric patient care. The analysis of the professionals receiving calls as well as the link with the sector are critical in determining the success of patient care. Each risk is measured in order to provide adapted and personalised care.

  6. Conflict in medical teams: opportunity or danger?

    NARCIS (Netherlands)

    L.L. Greer; O. Saygi; H. Aaldering; C.K.W. de Dreu

    2012-01-01

    Objectives  Intragroup conflicts often occur when people are called upon to collaborate in the accomplishment of a task. For example, when surgeons and nurses work together during an operation, conflicts may emerge because of differences in functional understanding. Whether these conflicts are benef

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

    OpenAIRE

    Furniss, D.; Blandford, A.

    2006-01-01

    Emergency medical dispatch (EMD) is typically a team activity, requiring fluid coordination and communication between team members. Such working situations have often been described in terms of distributed cognition (DC), a framework for understanding team working. DC takes account of factors such as shared representations and artefacts to support reasoning about team working. Although the language of DC has been developed over several years, little attention has been paid to developing a met...

  8. Using TOSCE (Team Objective Structured Clinical Examination in the second national medical sciences olympiad in Iran

    Directory of Open Access Journals (Sweden)

    Mitra Amini

    2012-01-01

    Full Text Available Introduction: Second National Medical Sciences Olympiad was done in Shiraz in August 2010 with aim of indentifying scientifically talented individuals, motivating students and orienting extracurricular activities. This Olympiad was done in 3 areas, basic sciences, clinical sciences and management. In clinical sciences, we used TOSCE (Team Objective Structured Clinical Examination. In this article we report the details of this exam and participants′ satisfaction. Materials and Methods: This Olympiad in Clinical Medical Sciences was held in 2 levels: Individual and team. In the team stage, 9 teams from 9 universities participated. We used TOSCE for measuring clinical competency of teams. Each team consisted of 3 students. We designed 12 stations based on emergency medicine in medical and surgical fields. The time considered for each station was 15 min, after doing this exam the view of students was measured using a valid and reliable questionnaire. Results: Most of the students believed that TOSCE was a useful examination for measuring competency. More than 50% of students reported that success in this exam needs clinical competency, team work and problem solving ability. Nearly, half (48.1% of students believed that 15 min is not enough for each station and they need more time. Conclusion: The results of this study showed that this kind of exam is useful for measuring clinical competency from students′ viewpoint .

  9. 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.

  10. Does Young Age Merit Increased Emergency Department Trauma Team Response?

    Directory of Open Access Journals (Sweden)

    Holmes, James F.

    2013-11-01

    Full Text Available ntroduction: To determine if increased trauma team response results in alterations in resource use in a population of children<6 years, especially in those least injured. Methods: We conducted a retrospective before and after study of children <6 years sustaining blunt trauma and meeting defined prehospital criteria. We compared hospitalization rates and missed injuries (injuries identified after discharge from the emergency department/hospital among patients with and without an upgraded trauma team response. We compared the computed tomography (CT rate and laboratory testing rate among minimally injured patients (Injury Severity Score [ISS] 6. Results: We enrolled 352 patients with 180 (mean age 2.7 ± 1.5 years in the upgrade cohort and 172 (mean age 2.6 ± 1.5 years in the no-upgrade cohort. Independent predictors of hospital admission in a regression analysis included: Glasgow Coma Scale <14 (odds ratio [OR]=11.4, 95% confidence interval [CI] 2.3, 56, ISS (OR=1.55, 95% CI 1.33, 1.81, and evaluation by the upgrade trauma team (OR=5.66, 95% CI 3.14, 10.2. In the 275 patients with ISS < 6, CT (relative risk=1.34, 95% CI 1.09, 1.64 and laboratory tests (relative risk=1.71, 95% CI 1.39, 2.11 were more likely to be obtained in the upgrade cohort as compared to the no-upgrade cohort. We identified no cases of a missed diagnosis. Conclusion: Increasing the trauma team response based upon young age results in increased resource use without altering the rate of missed injuries. In hospitals with ED physicians capable of evaluating and treating injured children, increasing ED trauma team resources solely for young age of the patient is not recommended. [West J Emerg Med. 2013;14(6:569–575.

  11. [Flight nurses' comprehension about their role in the multiprofesional team of aero-medical transport].

    Science.gov (United States)

    Scuissiato, Dayane Reinhardt; Boffi, Letícia Valois; da Rocha, Roseline da Rocha; Montezeli, Juliana Helena; Bordin, Michelle Taverna; Peres, Aida Maris

    2012-01-01

    This is a descriptive qualitative research which aimed at identifying the flight nurses' comprehension by about their role in the aero-medical multiprofesional team. A semi-structured interview was carried out with eight flight nurses from Curitiba-PR, from June to August 2009. The speeches were analyzed by the content analysis, from which three categories emerged. The first describes the responsibilities of the flight nurses as managers of the aero-medical mission, planning for before, during and after the transport, what includes the aircraft check-list and knowledge of the patient's case. The second category deals with aspects of these professionals as care providers to the aero-transferred patient. The third describes communication and team-work as fundamental requirements for flight nurses. It was concluded that the nurse in aero-medical team mixes management and caring in his/her professional practice by the use of specific competences.

  12. Occupational emerging risks affecting international virtual project Team Results

    Directory of Open Access Journals (Sweden)

    Dumitraşcu-Băldău Iulia

    2017-01-01

    Full Text Available The expansion of internet access, high-speed connection services, collaborative work platforms and tools, allowed employees to interact virtually offering companies the possibility to develop projects around the world, reducing operational costs and gain competitive advantage. Realizing the advantages and disadvantages of developing a project team in an international virtual work environment, requires adopting specific strategies to construct an effective team and ensure the project success. One of the most important disadvantages that we identified is that the new work environment brings new risks for both team members and managers. So, it becomes mandatory to identify and analyze the occupational emerging risks and their impact on the productivity of virtual team members, in order to prevent them efficiently and to ensure the safety and health of employees in a virtual working environment. This paper aims to highlight the necessity for project managers and organizations, to include in their specific project strategies, an efficient occupational risks management in the virtual workplace, to obtain a continuously improved virtual working environment, so to achieve a high performance from virtual employees.

  13. Disaster medical assistance teams: what psychosocial support is needed?

    Science.gov (United States)

    Stevens, Garry; Byrne, Simon; Raphael, Beverley; Ollerton, Richard

    2008-01-01

    The objective of this preliminary study was to evaluate the perceptions of internationally deployed Disaster Medical Assistance Team (DMAT) personnel regarding the psychosocial support needs of these teams. The DMAT questionnaire was sent to 34 members of Australian medical teams involved in deployments to the 2004 Southeast Asian tsunami and the 2006 Java earthquake. Twenty personnel (59%) completed this survey, which reviewed key deployment stressors, specific support strategies, and the support needs of team members, their families, and team leaders. A key aspect of the survey was to determine whether the perceived psychosocial needs would be supported best within with existing provisions and structures, or if they would be enhanced by further provisions, including the deployment of mental health specialists. There was strong support for brief reviews of stress management strategies as part of the pre-deployment briefing, and access to written stress management information for both team members and their families. However, more comprehensive provisions, including pre-deployment, stress-management training programs for personnel and intra-deployment family support programs, received lower levels of support. The availability of mental health-related training for the team leader role and access to consultation with mental health specialists was supported, but this did not extend to the actual deployment of mental health specialists. In this preliminary study, clear trends toward the maintenance of current mental health support provisions and the role of the DMAT leader were evident. A follow-up study will examine the relationship between team-leader, psychosocial support strategies and team functioning.

  14. Emergency Medical Rescue in a Radiation Environment

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-09-14

    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.

  15. Patient perspectives on communication with the medical team: pilot study using the Communication Assessment Tool-Team (CAT-T).

    Science.gov (United States)

    Mercer, Laura Min; Tanabe, Paula; Pang, Peter S; Gisondi, Michael A; Courtney, D Mark; Engel, Kirsten G; Donlan, Sarah M; Adams, James G; Makoul, Gregory

    2008-11-01

    Effective communication is an essential aspect of high-quality patient care and a core competency for physicians. To date, assessment of communication skills in team-based settings has not been well established. We sought to tailor a psychometrically validated instrument, the Communication Assessment Tool, for use in Team settings (CAT-T), and test the feasibility of collecting patient perspectives of communication with medical teams in the emergency department (ED). A prospective, cross-sectional study in an academic, tertiary, urban, Level 1 trauma center using the CAT-T, a 15-item instrument. Items were answered via a 5-point scale, with 5 = excellent. All adult ED patients (> or = 18 y/o) were eligible if the following exclusion criteria did not apply: primary psychiatric issues, critically ill, physiologically unstable, non-English speaking, or under arrest. 81 patients were enrolled (mean age: 44, S.D. = 17; 44% male). Highest ratings were for treating the patient with respect (69% excellent), paying attention to the patient (69% excellent), and showing care and concern (69% excellent). Lowest ratings were for greeting the patient appropriately (54%), encouraging the patient to ask questions (54%), showing interest in the patient's ideas about his or her health (53% excellent), and involving the patient in decisions as much as he or she wanted (53% excellent). Although this pilot study has several methodological limitations, it demonstrates a signal that patient assessment of communication with the medical team is feasible and offers important feedback. Results indicate the need to improve communication in the ED. In the ED, focusing on the medical team rather then individual caregivers may more accurately reflect patients' experience.

  16. Emergency medical epidemiology in Assam, India

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2009-01-01

    Full Text Available Background: Assam, with its capital in Dispur has one of the highest rates of infant and maternal mortality in India. Being under both tribal and hilly regions, it has lacked adequate healthcare and emergency services. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments, prior to launching emergency services across the state. Materials and Methods: On a prospective basis and using a stratified random sampling design, all emergencies presenting to the three government hospitals in Guwahati, Assam, which handle 90% of all emergencies currently, were studied on specially designed datasheets in order to collect data. Emergency medical technicians (EMTs were placed in the Casualty of the medical colleges and recorded all emergencies on the datasheet. The collected data was then analysed for stratification and mapping of emergencies. In addition, retrospective data for a period of 15 days was collected from the emergency case registers of all three hospitals and the adjoining district civil hospitals, in order to give a wider perspective of the nature of emergencies. Results: A total of 2169 emergencies were recorded over a seven-day prospective and fifteen-day retrospective period. Guwahati Medical College Hospital attended to majority of emergencies (42%, which were mainly of the nature of pregnancies (22.7%, accidents (12.2% or assaults (15.4% and fever related. Maximum emergencies also presented from the border districts, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents and assaults, while females presented with pregnancies as emergencies. Conclusion: Potential emergency services need to target young pregnant females. Law and order needs to be also tightened in order to curb accidents and assaults among young males.

  17. Operative team communication during simulated emergencies: Too busy to respond?

    Science.gov (United States)

    Davis, W Austin; Jones, Seth; Crowell-Kuhnberg, Adrianna M; O'Keeffe, Dara; Boyle, Kelly M; Klainer, Suzanne B; Smink, Douglas S; Yule, Steven

    2017-05-01

    Ineffective communication among members of a multidisciplinary team is associated with operative error and failure to rescue. We sought to measure operative team communication in a simulated emergency using an established communication framework called "closed loop communication." We hypothesized that communication directed at a specific recipient would be more likely to elicit a check back or closed loop response and that this relationship would vary with changes in patients' clinical status. We used the closed loop communication framework to code retrospectively the communication behavior of 7 operative teams (each comprising 2 surgeons, anesthesiologists, and nurses) during response to a simulated, postanesthesia care unit "code blue." We identified call outs, check backs, and closed loop episodes and applied descriptive statistics and a mixed-effects negative binomial regression to describe characteristics of communication in individuals and in different specialties. We coded a total of 662 call outs. The frequency and type of initiation and receipt of communication events varied between clinical specialties (P communication events than anesthesiologists. For the average participant, directed communication increased the likelihood of check back by at least 50% (P = .021) in periods preceding acute changes in the clinical setting, and exerted no significant effect in periods after acute changes in the clinical situation. Communication patterns vary by specialty during a simulated operative emergency, and the effect of directed communication in eliciting a response depends on the clinical status of the patient. Operative training programs should emphasize the importance of quality communication in the period immediately after an acute change in the clinical setting of a patient and recognize that communication patterns and needs vary between members of multidisciplinary operative teams. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Team behaviors in emergency care: a qualitative study using behavior analysis of what makes team work

    Directory of Open Access Journals (Sweden)

    Mazzocato Pamela

    2011-11-01

    Full Text Available Abstract Objective Teamwork has been suggested as a promising approach to improving care processes in emergency departments (ED. However, for teamwork to yield expected results, implementation must involve behavior changes. The aim of this study is to use behavior analysis to qualitatively examine how teamwork plays out in practice and to understand eventual discrepancies between planned and actual behaviors. Methods The study was set in a Swedish university hospital ED during the initial phase of implementation of teamwork. The intervention focused on changing the environment and redesigning the work process to enable teamwork. Each team was responsible for entire care episodes, i.e. from patient arrival to discharge from the ED. Data was collected through 3 days of observations structured around an observation scheme. Behavior analysis was used to pinpoint key teamwork behaviors for consistent implementation of teamwork and to analyze the contingencies that decreased or increased the likelihood of these behaviors. Results We found a great discrepancy between the planned and the observed teamwork processes. 60% of the 44 team patients observed were handled solely by the appointed team members. Only 36% of the observed patient care processes started according to the description in the planned teamwork process, that is, with taking patient history together. Beside this behavior, meeting in a defined team room and communicating with team members were shown to be essential for the consistent implementation of teamwork. Factors that decreased the likelihood of these key behaviors included waiting for other team members or having trouble locating each other. Getting work done without delay and having an overview of the patient care process increased team behaviors. Moreover, explicit instructions on when team members should interact and communicate increased adherence to the planned process. Conclusions This study illustrates how behavior analysis

  19. Team behaviors in emergency care: a qualitative study using behavior analysis of what makes team work.

    Science.gov (United States)

    Mazzocato, Pamela; Forsberg, Helena Hvitfeldt; Schwarz, Ulrica von Thiele

    2011-11-15

    Teamwork has been suggested as a promising approach to improving care processes in emergency departments (ED). However, for teamwork to yield expected results, implementation must involve behavior changes. The aim of this study is to use behavior analysis to qualitatively examine how teamwork plays out in practice and to understand eventual discrepancies between planned and actual behaviors. The study was set in a Swedish university hospital ED during the initial phase of implementation of teamwork. The intervention focused on changing the environment and redesigning the work process to enable teamwork. Each team was responsible for entire care episodes, i.e. from patient arrival to discharge from the ED. Data was collected through 3 days of observations structured around an observation scheme. Behavior analysis was used to pinpoint key teamwork behaviors for consistent implementation of teamwork and to analyze the contingencies that decreased or increased the likelihood of these behaviors. We found a great discrepancy between the planned and the observed teamwork processes. 60% of the 44 team patients observed were handled solely by the appointed team members. Only 36% of the observed patient care processes started according to the description in the planned teamwork process, that is, with taking patient history together. Beside this behavior, meeting in a defined team room and communicating with team members were shown to be essential for the consistent implementation of teamwork. Factors that decreased the likelihood of these key behaviors included waiting for other team members or having trouble locating each other. Getting work done without delay and having an overview of the patient care process increased team behaviors. Moreover, explicit instructions on when team members should interact and communicate increased adherence to the planned process. This study illustrates how behavior analysis can be used to understand discrepancies between planned and observed

  20. State Defense Force Monograph Series. Winter 2006, Medical Support Teams

    Science.gov (United States)

    2006-01-01

    assets for mobile support teams, labs, immunizations, latent TB screening, and post-deployment assessments.” (COL Eric Allely, Maryland State Surgeon...infarctions ! Diabetes ! Mental health problems ! Hypertension ! Diarrhea ! Heat injuries 30 State Defense Force Monograph Series, Summer 2006...for dysentery and vomiting ! Viral meningitis ! Injuries due to off-site fighting ! Tuberculosis ! HIV ! Special medical needs. See Figures 3

  1. [Significance of Multi-center Obstetrics Perioperative Team Training Including Various Medical Staffs].

    Science.gov (United States)

    Komasawa, Nobuyasu; Fujita, Daisuke; Nakayama, Mai; Fujiwara, Shunsuke; Mihara, Ryosuke; Okada, Daisuke; Omoto, Haruka; Tanaka, Motoshige; Nishihara, Isao; Minami, Toshiaki

    2016-02-01

    We report the development of a multi-center/multispecialist obstetrics perioperative team training program. Participants were members of the team, including anesthesiologists, obstetricians, and operation nurses. A questionnaire survey was conducted prior to course participation to clarify any questions team members had. The courses included a lecture and simulation training with scenario-based discussions or the use of a simulator. Scenarios included massive bleeding during cesarean section, massive bleeding after vaginal delivery, and emergency cesarean section for premature placental abruption. After each course, participants discussed problems associated with obstetrics medical safety in the context of each theme. Simulation-based perioperative team training with anesthesiologists, obstetricians, and operation nurses may serve as a vehicle to promote perioperative obstetrics patient safety.

  2. 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,...

  3. Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study

    Science.gov (United States)

    Mundt, Marlon P.; Agneessens, Filip; Tuan, Wen-Jan; Zakletskaia, Larissa I.; Kamnetz, Sandra A.; Gilchrist, Valerie J.

    2016-01-01

    Background Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. Objective To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. Methods A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. Participants 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Results Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (Rate Ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds Ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes. Conclusions Primary care teams which relied on frequent daily face-to-face communication among more

  4. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module X. Medical Emergencies.

    Science.gov (United States)

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

    This instructor's lesson plan guide on medical emergencies is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Ten units of study are presented: (1) diabetic emergencies; (2) anaphylactic reactions; (3) exposure to environmental extremes; (4) alcoholism and drug abuse; (5) poisoning and…

  5. 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/...

  6. Autonomic dysreflexia: a medical emergency

    Science.gov (United States)

    Bycroft, J; Shergill, I; Choong, E; Arya, N; Shah, P

    2005-01-01

    Autonomic dysreflexia is an important clinical diagnosis that requires prompt treatment to avoid devastating complications. The condition may present itself to all members of medical and surgical specialties, who may not be accustomed to treating it. It is the clinician's responsibility to have a basic understanding of the pathophysiology of the condition and the simple steps required to treat it. PMID:15811886

  7. 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…

  8. 武警部队执行地震救援中的药材保障%Medicinal materials guarantee of earthquake emergency medical relief team of the Chinese People’s Armed Police Forces

    Institute of Scientific and Technical Information of China (English)

    贺智; 安茜; 谢红; 郭海涛; 叶路

    2015-01-01

    Objective To develop a reasonable and scientific scheme for medicinal materials that disaster relief teams of the Chinese People’s Armed Police Forces (CPAPF) should carry in earthquake relief work. Methods The cases of disposition of medicinal materials of the disaster relief teams of the CPAPF in Wenchuan and Yushu Earthquake areas , 2008 and 2010 respectively, were investigated. The relevant disease spectra during the early periods of earthquake (within 3 days) were analyzed. In addition, literatrure review and expert counseling were used. According to the maximum outpatient quantity of 800 persons, the bases of medicinal materials needed for single appropriate medical skills were calculated based on the“Standard for the guarantee of military related medicines”and the“Standards of millitary matrerials of the Chinese Armed Police Forces”, and with the method of management of single disease cases. Thus the species of medicinal materials and quantities thererof necessary for the relief teams during the first 3 days after earthquake were determined . Results A detailed list of medicinal materials any relief team should carry during the first 3 days after earthquake, including 10 categories with 87 species, had been developed. Conclusion A reasonable and scientific scheme for medicinal materials carried by disaster relief teams of the CPAPF in earthquake relief work based on quantitative study has been made, thus providing a useful model for reference.%目的:为武警部队医学救援队携运药材制定合理、科学的药材保障配置方案。方法分析总结汶川和玉树地震救援中药材配置方面的现状,并根据地震早期伤病谱,采用文献调研法、以《军队相关药材保障标准》及《武警部队战材标准》为基本依据,借鉴单病种病例管理方法,同时结合救援专家建议,计算单项适宜医学治疗技术所需的药材保障基数,从而确定武警部队医学救援队

  9. [Medical technologist as a member of infection control team].

    Science.gov (United States)

    Okuzumi, Katsuko; Ieiri, Tamio

    2005-11-01

    For the prevention of infection at institutions, an Anti-nosocomial Infection Committee or an Infection Control Team (ICT) is organized at each institution according to its scale. We report the present status of the ICT managed mainly by medical technologists engaged in microbiological examination (certified medical microbiological technologists) at Dokkyo University School of Medicine. Since this hospital is an educational hospital, the department of clinical laboratory medicine cooperates with the microbiological laboratory of the clinical laboratory in infection control education of medical workers (such as medical students, nursing students, physicians and nurses) in infection diagnosis, infection control/infection management. Since infection control is achieved by improvement in hygiene knowledge and its practice in all citizens, we also attached importance to publicity activities associated with microbiology for patients, their families, and all medical workers.

  10. Emergency medical equipment on board German airliners.

    Science.gov (United States)

    Hinkelbein, Jochen; Neuhaus, Christopher; Wetsch, Wolfgang A; Spelten, Oliver; Picker, Susanne; Böttiger, Bernd W; Gathof, Birgit S

    2014-01-01

    Medical emergencies often occur on commercial airline flights, but valid data on their causes and consequences are rare. Therefore, it is unclear what emergency medical equipment is necessary. Although a minimum standard for medical equipment is defined in regulations, additional material is not standardized and may vary significantly between different airlines. German airlines operating aircrafts with more than 30 seats were selected and interviewed with a 5-page written questionnaire between August 2011 and January 2012. Besides pre-packed and required emergency medical material, drugs, medical devices, and equipment lists were queried. If no reply was received, airlines were contacted another three times by e-mail and/or phone. Descriptive analysis was used for data presentation and interpretation. From a total of 73 German airlines, 58 were excluded from analysis (eg, those not providing passenger transport). Fifteen airlines were contacted and data of 13 airlines were available for analysis (two airlines did not participate). A first aid kit was available on all airlines. Seven airlines reported having a doctor's kit, and another four provided an "emergency medical kit." Four airlines provided an automated external defibrillator (AED)/electrocardiogram (ECG). While six airlines reported providing anesthesia drugs, a laryngoscope, and endotracheal tubes, another four airlines did not provide even a resuscitator bag. One airline did not provide any material for cardiopulmonary resuscitation (CPR). Although the minimal material required according to European aviation regulations is provided by all airlines for medical emergencies, there are significant differences in the provision of additional material. The equipment on most airlines is not sufficient for the treatment of specific emergencies according to published medical guidelines (eg, for CPR or acute myocardial infarction). © 2014 International Society of Travel Medicine.

  11. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  12. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  13. Emergence of differing electronic communication norms within partially distributed teams

    NARCIS (Netherlands)

    Cheshin, A.; Kim, Y.; Bos, N.D.; Nan, N.; Olson, J.S.

    2013-01-01

    Modern organizations often consist of teams in which some people are collocated and some are remote. These teams are in-between being entirely virtual to entirely face-to-face and are referred to as partially distributed teams. Partially distributed teams function and operate in two different media

  14. Using CrisisKit and MOPED to improve emergency management team training

    NARCIS (Netherlands)

    Rijk, R. van; Berlo, M. van

    2004-01-01

    In order to reduce the effects of a disaster, people in the emergency management organization have to be trained. In recent years training emergency management teams has become a bigger issue. A realistic and effective training of emergency management teams however is a difficult matter. We search f

  15. Diabetic foot infections: a team-oriented review of medical and surgical management

    Directory of Open Access Journals (Sweden)

    Claire M Capobianco

    2010-09-01

    Full Text Available As the domestic and international incidence of diabetes and metabolic syndrome continues to rise, health care providers need to continue improving management of the long-term complications of the disease. Emergency department visits and hospital admissions for diabetic foot infections are increasingly commonplace, and a like-minded multidisciplinary team approach is needed to optimize patient care. Early recognition of severe infections, medical stabilization, appropriate antibiotic selection, early surgical intervention, and strategic plans for delayed reconstruction are crucial components of managing diabetic foot infections. The authors review initial medical and surgical management and staged surgical reconstruction of diabetic foot infections in the inpatient setting.

  16. Team Performance in Emergency Medicine (MedTeams), Draft 3, Instructor Guide

    Science.gov (United States)

    1997-01-01

    MANAGEMENT Attending Physician Charge Nurse Unit Clerk Clinical "Leadership Operations Management Display Slide 1-5 Team Roles in the ED Team Roles in...Followers ♦ Understand team roles ♦ Provide information for decision making ♦ Accept ownership for team decisions ♦ View feedback as an opportunity to

  17. Leadership Identity Development Through Reflection and Feedback in Team-Based Learning Medical Student Teams.

    Science.gov (United States)

    Alizadeh, Maryam; Mirzazadeh, Azim; Parmelee, Dean X; Peyton, Elizabeth; Mehrdad, Neda; Janani, Leila; Shahsavari, Hooman

    2017-07-28

    Studies on leadership identity development through reflection with Team-Based Learning (TBL) in medical student education are rare. We assumed that reflection and feedback on the team leadership process would advance the progression through leadership identity development stages in medical students within the context of classes using TBL. This study is a quasi-experimental design with pretest-posttest control group. The pretest and posttest were reflection papers of medical students about their experience of leadership during their TBL sessions. In the intervention group, TBL and a team-based, guided reflection and feedback on the team leadership process were performed at the end of all TBL sessions. In the other group, only TBL was used. The Stata 12 software was used. Leadership Identity was treated both as a categorical and quantitative variable to control for differences in baseline and gender variables. Chi-square, t tests, and linear regression analysis were performed. The population was a cohort of 2015-2016 medical students in a TBL setting at Tehran University of Medical Sciences, School of Medicine. Teams of four to seven students were formed by random sorting at the beginning of the academic year (intervention group n = 20 teams, control group n = 19 teams). At baseline, most students in both groups were categorized in the Awareness and Exploration stage of leadership identity: 51 (52%) in the intervention group and 59 (55%) in the control group: uncorrected χ(2)(3) = 15.6, design-based F(2.83, 108) = 4.87, p = .003. In the posttest intervention group, 36 (36%) were in exploration, 33 (33%) were in L-identified, 20 (20%) were in Leadership Differentiated, and 10 (10%) were in the Generativity. None were in the Awareness or Integration stages. In the control group, 3 (20%) were in Awareness, 56 (53%) were in Exploration, 35 (33%) were in Leader Identified, 13 (12%) were in Leadership Differentiated. None were in the Generativity and Integration stages

  18. Medical Geology : a globally emerging discipline

    OpenAIRE

    Joseph E. Bunnell; Robert B. Finkelman; Centeno, Jose A.; Selinus, O. (Olle)

    2007-01-01

    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 l...

  19. [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.

  20. Leading teams during simulated pediatric emergencies: a pilot study

    NARCIS (Netherlands)

    Coolen, E.H.; Draaisma, J.M.T.; Hamer, S. den; Loeffen, J.L.C.M.

    2015-01-01

    PURPOSE: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often rep

  1. Building Virtual Teams: Experiential Learning Using Emerging Technologies

    Science.gov (United States)

    Hu, Haihong

    2015-01-01

    Currently, virtual teams are being used exponentially in higher education and business because of the development of technologies and globalization. These teams have become an essential approach for collaborative learning as well as task completion. Team learning, especially in an online format, can be challenging due to lack of effective…

  2. Leading teams during simulated pediatric emergencies: a pilot study

    NARCIS (Netherlands)

    Coolen, E.H.; Draaisma, J.M.T.; Hamer, S. den; Loeffen, J.L.C.M.

    2015-01-01

    PURPOSE: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often rep

  3. Team Communication Influence on Procedure Performance: Findings From Interprofessional Simulations with Nursing and Medical Students.

    Science.gov (United States)

    Reising, Deanna L; Carr, Douglas E; Gindling, Sally; Barnes, Roxie; Garletts, Derrick; Ozdogan, Zulfukar

    Interprofessional team performance is believed to be dependent on the development of effective team communication skills. Yet, little evidence exists in undergraduate nursing programs on whether team communication skills affect team performance. A secondary analysis of a larger study on interprofessional student teams in simulations was conducted to determine if there is a relationship between team communication and team procedure performance. The results showed a positive, significant correlation between interprofessional team communication ratings and procedure accuracy in the simulation. Interprofessional team training in communication skills for nursing and medical students improves the procedure accuracy in a simulated setting.

  4. Medication errors recovered by emergency department pharmacists.

    Science.gov (United States)

    Rothschild, Jeffrey M; Churchill, William; Erickson, Abbie; Munz, Kristin; Schuur, Jeremiah D; Salzberg, Claudia A; Lewinski, Daniel; Shane, Rita; Aazami, Roshanak; Patka, John; Jaggers, Rondell; Steffenhagen, Aaron; Rough, Steve; Bates, David W

    2010-06-01

    We assess the impact of emergency department (ED) pharmacists on reducing potentially harmful medication errors. We conducted this observational study in 4 academic EDs. Trained pharmacy residents observed a convenience sample of ED pharmacists' activities. The primary outcome was medication errors recovered by pharmacists, including errors intercepted before reaching the patient (near miss or potential adverse drug event), caught after reaching the patient but before causing harm (mitigated adverse drug event), or caught after some harm but before further or worsening harm (ameliorated adverse drug event). Pairs of physician and pharmacist reviewers confirmed recovered medication errors and assessed their potential for harm. Observers were unblinded and clinical outcomes were not evaluated. We conducted 226 observation sessions spanning 787 hours and observed pharmacists reviewing 17,320 medications ordered or administered to 6,471 patients. We identified 504 recovered medication errors, or 7.8 per 100 patients and 2.9 per 100 medications. Most of the recovered medication errors were intercepted potential adverse drug events (90.3%), with fewer mitigated adverse drug events (3.9%) and ameliorated adverse drug events (0.2%). The potential severities of the recovered errors were most often serious (47.8%) or significant (36.2%). The most common medication classes associated with recovered medication errors were antimicrobial agents (32.1%), central nervous system agents (16.2%), and anticoagulant and thrombolytic agents (14.1%). The most common error types were dosing errors, drug omission, and wrong frequency errors. ED pharmacists can identify and prevent potentially harmful medication errors. Controlled trials are necessary to determine the net costs and benefits of ED pharmacist staffing on safety, quality, and costs, especially important considerations for smaller EDs and pharmacy departments. Copyright (c) 2009 American College of Emergency Physicians

  5. The Medical Service teams up with an external laboratory

    CERN Multimedia

    2015-01-01

    Since January, the CERN Medical Service has been collaborating with Proxilis, a medical testing laboratory in Meyrin, to carry out blood tests.   Sylvie Leprat, a nurse from the Proxilis laboratory, comes to the CERN Medical Service (Building 57, first floor) at 8 a.m. every morning to take blood samples. These samples are then taken from CERN to the Proxilis laboratory, where they are analysed by machines, lab technicians or the team's biologist. The results are first conveyed to CERN doctors over the telephone. Then, at the end of the day, they are incorporated into the patient's medical file for validation and possible comments by CERN doctors, before being e-mailed to the patient. People at CERN who are having blood tests done outside the context of their regular medical check-up receive an e-mail inviting them to choose a day and time for the blood samples to be taken. This provides a flexible service that allows appointments to be arranged according to their availability a...

  6. REMINDER: In a medical emergency call 74444

    CERN Multimedia

    2005-01-01

    What happened? A CERN colleague, complaining of pains that might indicate serious heart problem, went to the ?infirmary' on the Prévessin site for medical aid. He was unaware that the ?infirmary' was in fact no such thing, but the office of the French contractors' medical practitioner, and, on top of that, it was closed. He therefore took his own car and went to the CERN Fire Station on the Meyrin Site (Building 65). 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? You must call the CERN internal number 74444 in the event of serious and acute illness, and do not have to present yourself in person or get somebody to go with you. This number is not reserved exclusively for accident, pollution, fire etc. The Firemen can prodice professional assistance at all times as required: first aid on the spot, amulance transport and medical assistance as necessary. ...

  7. Pediatric emergency medical services and their drawbacks

    Directory of Open Access Journals (Sweden)

    Abdullah Foraih Al-Anazi

    2012-01-01

    Full Text Available Aim: To survey the literature on Pediatric Emergency Medical Services (PEMS with an aim to focus its drawbacks and emphasize the means of improvement. Materials and Methods: Published articles selected for inclusion were based on the significance and understanding of literature search on different aspects of PEMS. To meet this criterion, PubMed, PubMed Central, Science Direct, Uptodate, Med Line, comprehensive databases, Cochrane library and the Internet (Google, Yahoo were thoroughly searched. Results: PEMS provide out-of-hospital medical care and/or transport the patients to definitive care. The task force represents specialties of ambulance transport, first aid, emergency medical care, life saving, trauma, emergency medicine, water rescue, and extrication. Preliminary care is undertaken to save the patients from different medical exigencies. The techniques and procedures of basic and advanced life-support are employed. A large number of weaknesses are recorded in PEMS system, such as ambulance transport irregularities, deficit equipment, lack of expertise, and ignorance of the pre-hospital care providers. These are discussed with special reference to a few examples of medical exigencies. Conclusions: The appointments in PEMS should be regularized with specific qualifications, experience, and expertise in different areas. Responsibility of PEMS should not be left to pre-hospital care providers, who are non clinicians and lack proper education and training. Pediatricians should be adequately trained to play an active role in PEMS. Meetings should be convened to discuss the lapses and means of improvement. Networks of co-operation between pre-hospital providers and experts in the emergency department should be established.

  8. Identifying and training non-technical skills of nuclear emergency response teams

    Energy Technology Data Exchange (ETDEWEB)

    Crichton, M.T. E-mail: m.crichton@abdn.ac.uk; Flin, R

    2004-08-01

    Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams.

  9. Dr. Kotnis Medical Team Performs Free Medical Service in Inner Mongolia

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    <正>The year 2010 is the birth centenary of Dr. Dwarkanath Kotnis, a great internationalist fighter who came to China as a member of the Indian Aid-China Medical Team in the 1930s, for which CPAFFC held a series of commemorative activities.

  10. Team-based assessment of professional behavior in medical students

    Directory of Open Access Journals (Sweden)

    HOJAT RAEE

    2004-07-01

    Full Text Available Introducrion: Self and peer assessment provides important information about the individual’s performance and behavior in all aspects of their professional environment work. The aim of this study is to evaluate the professional behavior and performance in medical students in the form of team based assessment. Methods: In a cross-sectional study, 100 medical students in the 7th year of education were randomly selected and enrolled; for each student five questionnaires were filled out, including one self-assessment, two peer assessments and two residents assessment. The scoring system of the questionnaires was based on seven point Likert scale. After filling out the questions in the questionnaire, numerical data and written comments provided to the students were collected, analyzed and discussed. Internal consistency (Cronbach’s alpha of the questionnaires was assessed. A p<0.05 was considered as significant. Results: Internal consistency was acceptable (Cronbach’s alpha 0.83. Interviews revealed that the majority of students and assessors interviewed found the method acceptable. The range of scores was 1-6 (Mean±SD=4.39±0.57 for the residents' assessment, 2-6 (Mean±SD=4.49±0.53 for peer assessment, and 3-7 (Mean±SD=5.04±0.32 for self-assessment. There was a significant difference between self assessment and other methods of assessment. Conclusions: This study demonstrates that a team-based assessment is an acceptable and feasible method for peer and self-assessment of medical students’ learning in a clinical clerkship, and has some advantages over traditional assessment methods. Further studies are needed to focus on the strengths and weaknesses.

  11. Team-based assessment of professional behavior in medical students

    Science.gov (United States)

    RAEE, HOJAT; AMINI, MITRA; MOMEN NASAB, AMENEH; MALEK POUR, ABDOLRASOUL; JAFARI, MOHAMMAD MORAD

    2014-01-01

    Introduction: Self and peer assessment provides important information about the individual’s performance and behavior in all aspects of their professional environment work. The aim of this study is to evaluate the professional behavior and performance in medical students in the form of team based assessment. Methods: In a cross-sectional study, 100 medical students in the 7th year of education were randomly selected and enrolled; for each student five questionnaires were filled out, including one self-assessment, two peer assessments and two residents assessment. The scoring system of the questionnaires was based on seven point Likert scale.  After filling out the questions in the questionnaire, numerical data and written comments provided to the students were collected, analyzed and discussed. Internal consistency (Cronbach’s alpha) of the questionnaires was assessed. A p<0.05 was considered as significant level. Results: Internal consistency was acceptable (Cronbach’s alpha 0.83). Interviews revealed that the majority of students and assessors interviewed found the method acceptable. The range of scores was 1-6 (Mean±SD=4.39±0.57) for the residents' assessment, 2-6 (Mean±SD= 4.49±0.53) for peer assessment, and 3-7 (Mean±SD=5.04±0.32) for self-assessment. There was a significant difference between self assessment and other methods of assessment. Conclusions: This study demonstrates that a team-based assessment is an acceptable and feasible method for peer and self-assessment of medical students’ learning in a clinical clerkship, and has some advantages over traditional assessment methods. Further studies are needed to focus on the strengths and weaknesses. PMID:25512933

  12. [Helicopter emergency medical service missions at night: 2 years of experience in the Dutch Regional Emergency Healthcare Network East].

    Science.gov (United States)

    Hoogerwerf, Nico; Heijne, Amon; Geeraedts, Leo M G; van Riessen, Christine; Scheffer, Gert-Jan

    2010-01-01

    To study whether there are differences between day and night in the dispatch of helicopter emergency medical services (HEMS) and in their response and travelling times, medical treatment and transport of patients. Retrospective, descriptive study. All data on helicopter emergency medical service (HEMS) missions available 24/7 from Nijmegen, the Netherlands, during 2007 and 2008 were collected. All missions in this period were divided into daytime and night-time missions. Next, the reason for dispatch, the duration of distinct times during the mission, the method of transport of the HEMS team, medical treatments and patient transport were compared. In 2007 and 2008 the HEMS team was dispatched 2891 times. 1107 patients were treated during daytime and 479 during the night. The mean distance to the incident scene was longer for night missions. During night-time the HEMS team was dispatched more often for road traffic accidents and violence-related accidents but less often for falls, drowning, horse riding accidents and people becoming trapped (non-traffic-related). There were no differences in medical treatment given by the HEMS physician between day and night, but fewer patients were transported by helicopter at night. Travelling times and on-scene times were only slightly different. The number of dispatches of the HEMS team at night was higher than expected, but night missions were cancelled more often due to weather conditions than missions by day. Prehospital times and operations of the Netherlands HEMS differed slightly between day and night.

  13. Emergency calls and need for emergency care in patients looked after by a palliative care team: Retrospective interview study with bereaved relatives

    Directory of Open Access Journals (Sweden)

    Graf Bernhard M

    2008-08-01

    Full Text Available Abstract Background During the last stage of life, palliative care patients often experience episodes of respiratory distress, bleeding, pain or seizures. In such situations, caregivers may call emergency medical services leading to unwanted hospital admissions. The study aims to show the influence of our palliative care team to reducing emergency calls by cancer patients or their relatives during the last six month of life. Methods Fifty relatives of deceased patients who had been attended by our palliative care team were randomly selected. Data was obtained retrospectively during a structured interview. In addition to demographic data, the number of emergency calls made during the final six months of the patient's life, the reason for the call and the mental compound score (MCS-12 of the caregivers was registered. Results Forty-six relatives agreed to the interview. Emergency calls were placed for 18 patients (39% during the final six months of their lives. There were a total of 23 emergency calls. In 16 cases (70% the patient was admitted to the hospital. Twenty-one (91% of the calls were made before patients had been enrolled to receive palliative care from the team, and two (9% were made afterwards. The mean mental compound score of the caregivers at the time of the interview was 41 (range 28–57. There was a lack of correlation between MCS-12 and number of emergency calls. Conclusion Emergency calls were more likely to occur if the patients were not being attended by our palliative care team. Because of the lack of correlation between MCS-12 and the number of emergency calls, the MCS-12 cannot indicate that acutely stressful situations triggered the calls. However, we conclude that special palliative care programs can reduce psychosocial strain in family caregivers. Therefore, the number of emergency calls may be reduced and this fact allows more palliative patients to die at home.

  14. [Professional satisfaction for doctors of the Mobile Emergency Team and the Emergency Coordinator Office 061. Region of Murcia].

    Science.gov (United States)

    Carrillo-García, C; Martínez-Roche, M E; Vivo-Molina, M C; Quiñonero-Méndez, F; Gómez-Sánchez, R; Celdrán-Gil, F

    2014-01-01

    The objective was to analyze the phenomenon of work satisfaction of doctors of the Mobile Emergency Team and the Emergency Coordinator Office 061 of the Region of Murcia. A observational, analytical and cross-sectional study of development carried out with the medical staff of the Casualty and Emergency Operations Department 061 of the Region of Murcia. Data collection was carried out in December 2013 and January 2014. NTP 394 was used. Work satisfaction: general satisfaction scale. nonparametric tests for 2 samples or k samples depending on type of comparison. A participation rate of 88.2% was obtained, in relation to the general job satisfaction, the average of the participants was 69.55 (SD = 14.4). Of the 15 items that make up the questionnaire, « work colleagues » is the factor with which doctors are more satisfied with, indicating that up to an 87%, show a positive assessment on this point. Being the second aspect most respondents valued their « job stability » with a percentage of positive ratings of 76.7%. The main findings clearly demonstrate the importance of inter-professional relations and human potential as the cornerstone in the exercise of the activity of healthcare professionals. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  15. Presentations by ambulance under the NSW Mental Health Act to an emergency department with a 24-hour mental health team.

    Science.gov (United States)

    Skopek, Michaela A; Francis, Jeryl Lynn

    2016-10-01

    The objective of this study was to examine the presentations of patients by ambulance, under Section 20 of the NSW Mental Health Act of 2007, to a hospital emergency department (ED) with a 24-hour Mental Health Team. Patient records between December 2013 and December 2014 were audited and analysed in Excel. There were 47 such presentations: 51% required a mental health admission. Patients required management for up to six of the nine identified mental health and physical problems. As the number of clinical problems in these patients increased, the length of their stay and the likelihood of discharge to home increased. The need for psychiatric admission did not appear to prolong their length of stay, though chemical sedation did. The availability of an ED mental health team did assist in achieving a length of stay that was in keeping with Australian National Emergency Access Target guidelines. A 24-hour ED mental health team provided specialised assessment and management for patients, alongside the necessary emergency medical intervention. This team assisted in easing the increasing pressure on the ED and minimising the patients' length of stay. The team redirected patients requiring admission, facilitated timely discharge of others and revoked Section 20 when less restrictive care was appropriate. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  16. Team learning in medical education: initial experiences at ten institutions.

    Science.gov (United States)

    Searle, Nancy S; Haidet, Paul; Kelly, P Adam; Schneider, Virginia F; Seidel, Charles L; Richards, Boyd F

    2003-10-01

    In the midst of curricular reforms that frequently call for reducing lectures and increasing small-group teaching, there is a crisis in faculty time for teaching. This paper describes the initial experiences of ten institutions with team learning (TL), a teaching method which fosters small-group learning in a large-class setting. After initial pilot studies at one institution, nine additional institutions implemented TL in one or more courses. Within 18 months, TL has been used in 40 courses (from.5% to 100% of the time) and all ten institutions will increase its use next year. We surmise that this relatively rapid spread of TL into the medical curriculum is due to the sound pedagogy and efficiency of TL as well as the modest financial resources and support we have provided to partner institutions.

  17. Perspectives on a Multidisciplinary Team Approach to Implementation of Planned Emergent Use Research.

    Science.gov (United States)

    Racedo Africano, Carlos J; Gallo de Moraes, Alice; Smischney, Nathan J

    2015-09-19

    In this paper we present the viewpoints of three members of a research team, on the approach to teamwork in the development of an emergent use clinical trial when dealing with diversity of opinions, in order to facilitate stakeholder buy-in. We also discuss a specific approach to the coordination of the team members, which in our opinion had a positive impact on the implementation of the project. We also comment on the influence of the team organization in the timeline and completion of a clinical trial. We hope to start a conversation on team dynamics in the design of clinical trials, especially in the context of emergent use research.

  18. 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.

  19. [Pediatric emergencies in the Grenoble Medical Center].

    Science.gov (United States)

    Lebrun, E; Bost, M

    1988-01-01

    In the Grenoble Medical Centre, pediatric emergency admissions have been drastically influenced by the opening of an Emergency Unit in May 1983. Our work was carried out one year after the opening in order to study the characteristics of the admitted children. The enquiry was done over 4 months, one month for each season of that year. A total of 1,382 children were included in the study. Thirty-four percent were seen for a medical advice (66% hospitalized). Children seen for medical advice are younger and mostly migrants. They live close to the hospital and are brought most often for fever. Fifty one per cent directly brought to the hospital by their parents for a first pediatric advice (49% were sent by their personal physician). Children directly brought by their parents are in majority infants and migrants. They are mostly admitted at night and morning and during the week-end. They are more frequently followed within the public mother-child health protection system ("Service de Protection Maternelle et Infantile", PMI).

  20. [Discussion about health assessment and epidemic prevention mode for China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake].

    Science.gov (United States)

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

    2013-05-01

    To discuss health assessment and epidemic prevention in earthquake rescue, to establish emergency health and epidemic prevention mode for the national earthquake emergency medical rescue team scientifically, and to provide references and consultations for emergency hygiene and epidemic prevention measures in disaster medicine. China National Earthquake Disaster Emergency Search and Rescue Team gathered and evaluated environment, food, drinking water and other health related information around more than 2000 earthquake victims in Baoxing County, Shuangshi Town and Qingren Township from 20th April 2013 to 27th by using methods such as field epidemiological investigations. The national earthquake emergency medical rescue team spread comprehensive evaluation focusing on the local epidemics, find out the starting point of epidemic prevention, and then built reporting system in disaster area. The team also formulated the emergency detection system of food and drinking water and carried out health education. After the golden 72 hours, by comprehensive evaluation the establishment of early response in disaster area and spreading epidemic prevention, this team achieved the full coverage of three in the earthquake area, the resettlement of residents and families in that area and gradually formed a disaster medical rescue hygiene and epidemic prevention mode.

  1. Emergency Medical Service Personnel Recognize Pediatric Concussions.

    Science.gov (United States)

    Speirs, Joshua N; Lyons, Matthew I; Johansson, Bert E

    2017-01-01

    Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed. This first of its kind pilot study was designed to assess EMS personnel's ability to recognize and triage pediatric concussions. Our findings show EMS providers are statistically identical in their ability to recognize and triage concussions to physicians. The performance of our MD participants was lower than expected. Larger studies are needed to further investigate EMS providers' ability to recognize a concussion.

  2. 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.

  3. 32 CFR 1656.20 - Expenses for emergency medical care.

    Science.gov (United States)

    2010-07-01

    ... reasonable expenses for emergency medical care, including hospitalization, of ASWs who suffer illness or... date on which the expense was incurred. (f) Cost of emergency medical care including hospitalization... 32 National Defense 6 2010-07-01 2010-07-01 false Expenses for emergency medical care. 1656.20...

  4. 75 FR 27917 - Emergency Medical Services Week, 2010

    Science.gov (United States)

    2010-05-18

    ... medical education, train themselves on the latest life-saving techniques, and maintain vital emergency... Proclamation 8519--Emergency Medical Services Week, 2010 Executive Order 13542--Providing an Order of... President ] Proclamation 8519 of May 13, 2010 Emergency Medical Services Week, 2010 By the President of...

  5. 77 FR 36039 - Federal Interagency Committee on Emergency Medical Services

    Science.gov (United States)

    2012-06-15

    ... National Highway Traffic Safety Administration Federal Interagency Committee on Emergency Medical Services... Interagency Committee on Emergency Medical Services. SUMMARY: NHTSA announces a meeting of the Federal Interagency Committee on Emergency Medical Services (FICEMS) to be held in the Washington, DC area....

  6. 78 FR 30727 - Emergency Medical Services Week, 2013

    Science.gov (United States)

    2013-05-22

    ... Documents#0;#0; ] Proclamation 8982 of May 17, 2013 Emergency Medical Services Week, 2013 By the President... calm under pressure delivers comfort to neighbors in need. During Emergency Medical Services Week, we... proclaim May 19 through May 25, 2013, as Emergency Medical Services Week. I encourage all Americans...

  7. 31 CFR 544.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 544.508 Section 544.508 Money and Finance: Treasury Regulations Relating to Money and...

  8. 77 FR 31143 - Emergency Medical Services Week, 2012

    Science.gov (United States)

    2012-05-24

    ... President Proclamation 8824--Emergency Medical Services Week, 2012 Proclamation 8825--National Safe Boating..., in communities across our country, men and women providing emergency medical services (EMS) stand at... efficiency at a moment's notice. During Emergency Medical Services Week, we honor their...

  9. 48 CFR 1842.7003 - Emergency medical services and evacuation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Emergency medical services... NASA Contract Clauses 1842.7003 Emergency medical services and evacuation. The contracting officer must insert the clause at 1852.242-78, Emergency Medical Services and Evacuation, in all solicitations...

  10. 31 CFR 593.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 593.508 Section 593.508 Money and Finance: Treasury Regulations Relating to Money and...

  11. 31 CFR 547.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 547.508 Section 547.508 Money and Finance: Treasury Regulations Relating to Money and...

  12. Emergent team roles in organizational meetings: Identifying communication patterns via cluster analysis.

    OpenAIRE

    Lehmann-Willenbrock, N.K.; Beck, S.J.; Kauffeld, S.

    2016-01-01

    Previous team role taxonomies have largely relied on self-report data, focused on functional roles, and described individual predispositions or personality traits. Instead, this study takes a communicative approach and proposes that team roles are produced, shaped, and sustained in communicative behaviors. To identify team roles communicatively, 59 regular organizational meetings were videotaped and analyzed. Cluster analysis revealed five emergent roles: the solution seeker, the problem anal...

  13. A literature review of medical record keeping by foreign medical teams in sudden onset disasters.

    Science.gov (United States)

    Jafar, Anisa J N; Norton, Ian; Lecky, Fiona; Redmond, Anthony D

    2015-04-01

    Medical records are a tenet of good medical practice and provide one method of communicating individual follow-up arrangements, informing research data, and documenting medical intervention. The objective of this review was to look at one source (the published literature) of medical records used by foreign medical teams (FMTs) in sudden onset disasters (SODs). The published literature was searched systematically for evidence of what medical records have been used by FMTs in SODs. Findings The style and content of medical records kept by FMTs in SODs varied widely according to the published literature. Similarly, there was great variability in practice as to what happens to the record and/or the data from the record following its use during a patient encounter. However, there was a paucity of published work comprehensively detailing the exact content of records used. Interpretation Without standardization of the content of medical records kept by FMTs in SODs, it is difficult to ensure robust follow-up arrangements are documented. This may hinder communication between different FMTs and local medical teams (LMTs)/other FMTs who may then need to provide follow-up care for an individual. Furthermore, without a standard method of reporting data, there is an inaccurate picture of the work carried out. Therefore, there is not a solid evidence base for improving the quality of future response to SODs. Further research targeting FMTs and LMTs directly is essential to inform any development of an internationally agreed minimum data set (MDS), for both recording and reporting, in order that FMTs can reach the World Health Organization (WHO) standards for FMT practice.

  14. 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...

  15. Implementation of team training in medical education in Denmark

    DEFF Research Database (Denmark)

    Østergaard, H T; Østergaard, Ditte; Lippert, A

    2008-01-01

    In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type...... of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use...... of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies...

  16. Patients' views of teamwork in the emergency department offer insights about team performance.

    Science.gov (United States)

    Henry, Beverly W; McCarthy, Danielle M; Nannicelli, Anna P; Seivert, Nicholas P; Vozenilek, John A

    2016-06-01

    Research into efforts to engage patients in the assessment of health-care teams is limited. To explore, through qualitative methods, patient awareness of teamwork-related behaviours observed during an emergency department (ED) visit. Researchers used semi-structured question guides for audio-recorded interviews and analysed their verbatim transcripts. Researchers conducted individual phone interviews with 6 teamwork subject matter experts (SMEs) and held 5 face-to-face group interviews with patients and caregivers (n = 25) about 2 weeks after discharge from the emergency department (ED). SMEs suggested that a range of factors influence patient perspectives of teams. Many patients perceived the health-care team within the context of their expectations of an ED visit and their treatment plan. Four themes emerged: (i) patient-centred views highlight gaps in coordination and communication; (ii) team processes do concern patients; (iii) patients are critical observers of ways that team members present their team roles; (iv) patients' observations of team members relate to patients' views of team effectiveness. Analysis also indicated that patients viewed health-care team members' interactions with each other as proxy for how team members actually felt about patients. Results from both sets of interviews (SME and patient) indicated that patient observations of teamwork could add to assessment of team processes/frameworks. Patients' understanding about teamwork organization seemed helpful and witnessed interteam communication appeared to influence patient confidence in the team. Patients perspectives are an important part of assessment in health care and suggest potential areas for improvement through team training. © 2013 John Wiley & Sons Ltd.

  17. Measuring teamwork and conflict among Emergency Medical Technician personnel

    Science.gov (United States)

    Patterson, P. Daniel; Weaver, Matthew D.; Weaver, Sallie J.; Rosen, Michael A.; Todorova, Gergana; Weingart, Laurie R.; Krackhardt, David; Lave, Judith R.; Arnold, Robert M.; Yealy, Donald M.; Salas, Eduardo

    2011-01-01

    Objective We sought to develop a reliable and valid tool for measuring teamwork among Emergency Medical Technician (EMT) partnerships. Methods We adapted existing scales and developed new items to measure components of teamwork. After recruiting a convenience sample of 39 agencies, we tested a 122-item draft survey tool. We performed a series of Exploratory Factor Analyses (EFA) and Confirmatory Factor Analysis (CFA) to test reliability and construct validity, describing variation in domain and global scores using descriptive statistics. Results We received 687 completed surveys. The EFA analyses identified a 9-factor solution. We labeled these factors [1] Team Orientation, [2] Team Structure & Leadership, [3] Partner Communication, Team Support, & Monitoring, [4] Partner Trust and Shared Mental Models, [5] Partner Adaptability & Back-Up Behavior, [6] Process Conflict, [7] Strong Task Conflict, [8] Mild Task Conflict, and [9] Interpersonal Conflict. We tested a short form (30-item SF) and long form (45-item LF) version. The CFA analyses determined that both the SF and LF versions possess positive psychometric properties of reliability and construct validity. The EMT-TEAMWORK-SF has positive internal consistency properties with a mean Cronbach’s alpha coefficient ≥0.70 across all 9-factors (mean=0.84; min=0.78, max=0.94). The mean Cronbach’s alpha coefficient for the EMT-TEAMWORK-LF version was 0.87 (min=0.79, max=0.94). There was wide variation in weighted scores across all 9 factors and the global score for the SF and LF versions. Mean scores were lowest for the Team Orientation factor (48.1, SD 21.5 SF; 49.3 SD 19.8 LF) and highest (more positive) for the Interpersonal Conflict factor (87.7 SD 18.1 for both SF and LF). Conclusions We developed a reliable and valid survey to evaluate teamwork between EMT partners. PMID:22128909

  18. Trauma team activation varies across Dutch emergency departments: a national survey

    NARCIS (Netherlands)

    Egberink, Rolf; Otten, Harm-Jan; IJzerman, Maarten Joost; van Vugt, Arie B.; Doggen, Catharina Jacoba Maria

    2015-01-01

    Background Tiered trauma team response may contribute to efficient in-hospital trauma triage by reducing the amount of resources required and by improving health outcomes. This study evaluates current practice of trauma team activation (TTA) in Dutch emergency departments (EDs). Methods A survey was

  19. Trauma team activation varies across Dutch emergency departments: a national survey

    NARCIS (Netherlands)

    Egberink, Rolf; Otten, Harm-Jan; IJzerman, Maarten J.; Vugt, van Arie B.; Doggen, Carine J.M.

    2015-01-01

    Background Tiered trauma team response may contribute to efficient in-hospital trauma triage by reducing the amount of resources required and by improving health outcomes. This study evaluates current practice of trauma team activation (TTA) in Dutch emergency departments (EDs). Methods A survey w

  20. Emerging medical technologies and emerging conceptions of health.

    Science.gov (United States)

    Stempsey, William E

    2006-01-01

    Using ideas gleaned from the philosophy of technology of Martin Heidegger and Hans Jonas and the philosophy of health of Georges Canguilhem, I argue that one of the characteristics of emerging medical technologies is that these technologies lead to new conceptions of health. When technologies enable the body to respond to more and more challenges of disease, we thus establish new norms of health. Given the continued development of successful technologies, we come to expect more and more that our bodies should be able to respond to ever-new challenges of environment and disease by establishing ever-new norms of health. Technologies may aim at the prevention and treatment of disease, but they also bring about modifications of what we consider normal for the human being. Thus, new norms of health arise from technological innovation.

  1. Prehospital emergency medical services in Malaysia.

    Science.gov (United States)

    Hisamuddin, N A R Nik; Hamzah, M Shah; Holliman, C James

    2007-05-01

    Once a very slowly developing country in a Southeast Asia region, Malaysia has undergone considerable change over the last 20 years after the government changed its focus from agriculture to developing more industry and technology. The well-known "Vision 2020," introduced by the late Prime Minister, set a target for the nation to be a developed country in the Asia region by the year 2020. As the economy and standard of living have improved, the demand from the public for a better health care system, in particular, emergency medical services (EMS), has increased. Despite the effort by the government to improve the health care system in Malaysia, EMS within the country are currently limited, best described as being in the "developing" phase. The Ministry of Health, Ministry of Education, Civil Defense, and non-governmental organizations such as Red Crescent and St. John's Ambulance, provide the current ambulance services. At the present time, there are no uniform medical control or treatment protocols, communication systems, system management, training or education, or quality assurance policies. However, the recent development of and interest in an Emergency Medicine training program has gradually led to improved EMS and prehospital care.

  2. Consequences of Participating in Multidisciplinary Medical Team Meetings for Surgical, Nonsurgical, and Supporting Specialties

    NARCIS (Netherlands)

    Molleman, Eric; Broekhuis, Manda; Stoffels, Renee; Jaspers, Frans

    2010-01-01

    This study examines the consequences for medical specialists of participating in multidisciplinary medical team meetings in terms of perceived clinical autonomy, domain distinctiveness, and professional accountability. These consequences may influence their willingness to cooperate and the quality o

  3. 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.

  4. 中国国家地震灾害紧急救援队芦山地震医疗救援工作分析%Medical rescue of China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake

    Institute of Scientific and Technical Information of China (English)

    刘亚华; 杨慧宁; 刘惠亮; 王藩; 陈金宏; 胡利斌; 郑静晨

    2013-01-01

    目的 总结并分析中国国家地震灾害紧急救援队医疗分队参加2013年四川芦山地震救援任务的经验,为提高与搜索、营救相结合的医疗救援能力提供借鉴.方法 回顾性分析2013年4月21日至27日中国国家地震灾害紧急救援队参加四川芦山地震救援工作中,各医疗分队出队人员及医疗救护伤病员的资料.结果 医疗分队由22人组成,其中2名管理人员,11名医生(急诊、关节四肢、脊柱、妇产、消化、心内、眼科、麻醉、救援医学、卫生防疫、检验11个专业),1名超声技师,5名护士,1名药剂师,1名医疗器械工程师及1名内勤宣传人员;22人中有2名心理咨询师,人员组成合理;从队内医疗保障、现场搜救医疗配合、安置区医疗点、巡诊、伤病员后送、心理干预、卫生防疫7个方面全面开展工作.医疗救援分队先后在24个乡镇完成救援及医疗巡诊,并在芦山太平镇、双石镇、宝兴县城建立3个医疗点开展医疗救治、高龄老人和儿童的心理干预、卫生防疫等,成功转运2名重伤员,诊治伤病员数千人次.伤员中以地震致软组织损伤、外伤以及呼吸道感染、腹泻、中暑病例为主.结论 与2008年的四川汶川地震救援相比,芦山地震救援力量的集结与出动速度、灾区有序的交通管制以及灾区群众的自救互救使灾害所致伤亡降至最低.此次芦山地震灾区采取的与搜救相结合的医疗救援模式,体现了实施方式随救援阶段不同而转变,人员配比与救援任务相适应,工作重点与救援时间相结合.%Objective 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.Methods Retrospective analysis of medical work data by CNESAR from April 21th,2013 to April 27th during Lushan earthquake

  5. Linking nurse characteristics, team member effectiveness, practice environment, and medication error incidence.

    Science.gov (United States)

    Fasolino, Tracy; Snyder, Rita

    2012-01-01

    Clinical unit nurse characteristics, practice environment, and team member effectiveness are assumed to play a critical role in medication safety. This study used a multimethod approach to examine the association of these factors with medication errors. Findings suggested that older, more experienced registered nurses made less medication errors. Environment and team member effectiveness were not strongly associated with medication error incidence. Numerous system factors limited implementation and outcomes of this safety study and are discussed.

  6. Undergraduate medical education in emergency medical care: a nationwide survey at German medical schools.

    Science.gov (United States)

    Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix

    2009-05-12

    Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.

  7. Undergraduate medical education in emergency medical care: A nationwide survey at German medical schools

    Directory of Open Access Journals (Sweden)

    Timmermann Arnd

    2009-05-01

    Full Text Available Abstract Background Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Methods Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Results Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21; problem-based learning at 29% (n = 10, e-learning at 3% (n = 1, and internship in ambulance service is mandatory at 11% (n = 4. In terms of assessment methods, multiple-choice exams (15 to 70 questions are favoured (89%, n = 31, partially supplemented by open questions (31%, n = 11. Some faculties also perform single practical tests (43%, n = 15, objective structured clinical examination (OSCE; 29%, n = 10 or oral examinations (17%, n = 6. Conclusion Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard

  8. Experience from the medical rescue mobile team for security and protection against nuclear, chemical, and biological emergency events during the World Expo Shanghai 2010%世博安保"三防"医学救援应急机动组的组建

    Institute of Scientific and Technical Information of China (English)

    倪俊; 喻芳; 尚甜甜

    2011-01-01

    During the World Expo Shanghai 2010, the No 85 Hospital of the Chinese People's Liberation Army participated in the medical rescue against nuclear, chemical, and biologic emergency events. A specific medical rescue mobile team was established, made up of medical officers, nurses, and drivers. The medical personnel came from the departments of burn, orthopedics, general surgery, respiratory diseases, neurology, etc.,all with the middle or higher professional titles. All of them had gone into the disaster relief in the earthquake-stricken area of Wenchuan, Sichuan Province,participated in the Olympic security and crisis control,and several military exercises organized by the military area command and had excellent military quality, health service insurance ability, and professional skills. In addition, they received training of theories on individual nuclear radiation, chemical events, and biological terrorist attack, and basic skills of individual protection and first aid, rapid response, and co-training, so that they became experts in one thing and versatile at many. An emergency plan had been developed in advance. In the light of the realistic situation of traffic in Shanghai, several flexible driving routes were planned so as to determine the best way to reach the emergency spot. During the waiting periods the personnel remained in the hospital and would set off in 18 min after receiving the order.During the period of standby for the World Expo lasting 8 months, the medical rescue emergency mobile group not only did its work to perfection, but also stored up necessary personnel and skills for the potential nuclear,chemical, and biological emergency events that should occur in the future, peacetime or wartime.%2010年,中国人民解放军第八五医院参与了上海世博会的"三防"医学救援工作,组成"三防"医学救援应急机动组,成员包括军医、护士和司机.医务人员来自烧伤外科、骨科、普外科、呼吸科、神经内科

  9. Sketching Awareness: A Participatory Study to Elicit Designs for Supporting Ad Hoc Emergency Medical Teamwork

    Science.gov (United States)

    Kusunoki, Diana; Sarcevic, Aleksandra; Zhang, Zhan; Yala, Maria

    2014-01-01

    Prior CSCW research on awareness in clinical settings has mostly focused on higher-level team coordination spanning across longer-term trajectories at the department and inter-department levels. In this paper, we offer a perspective on what awareness means within the context of an ad hoc, time- and safety-critical medical setting by looking at teams treating severely ill patients with urgent needs. We report findings from four participatory design workshops conducted with emergency medicine clinicians at two regional emergency departments. Workshops were developed to elicit design ideas for information displays that support awareness in emergency medical situations. Through analysis of discussions and clinicians’ sketches of information displays, we identified five features of teamwork that can be used as a foundation for supporting awareness from the perspective of clinicians. Based on these findings, we contribute rich descriptions of four facets of awareness that teams manage during emergency medical situations: team member awareness, elapsed time awareness, teamwork-oriented and patient-driven task awareness, and overall progress awareness. We then discuss these four awareness types in relation to awareness facets found in the CSCW literature. PMID:25870498

  10. Hazard perception in emergency medical service responders.

    Science.gov (United States)

    Johnston, K A; Scialfa, C T

    2016-10-01

    The perception of on-road hazards is critically important to emergency medical services (EMS) professionals, the patients they transport and the general public. This study compared hazard perception in EMS and civilian drivers of similar age and personal driving experience. Twenty-nine EMS professionals and 24 non-professional drivers were given a dynamic hazard perception test (HPT). The EMS group demonstrated an advantage in HPT that was independent of simple reaction time, another indication of the validity of the test. These results are also consistent with the view that professional driving experience results in changes in the ability to identify and respond to on-road hazards. Directions for future research include the development of a profession-specific hazard perception tool for both assessment and training purposes.

  11. Work stress in emergency medical technicians.

    Science.gov (United States)

    Neale, A V

    1991-09-01

    To better understand the dynamics underlying their high turnover rate, emergency medical technicians (EMTs) were asked to participate in a union-sponsored study. Fifty-two percent of 200 EMT union members returned the three mailed questionnaires: the Occupational Stress Index, which assesses stress, strain, and coping; the Staff Burnout Scale for Health Professionals; and a survey that probed areas of job satisfaction. The sample had high stress, strain, and burnout scores. Coping skills were within the normal range. Burnout, stress, strain, and coping (BSS&C) were significantly related to job satisfaction, worry about infectious diseases, and perceptions of being poorly treated by emergency room personnel and fire fighters. BSS&C also were related to being upset by "runs" related to injuries from violence, drug overdoses, and exposure. Job dissatisfaction was related to attitudes that the job adversely affects one's family, that the EMT quarters are uncomfortable, and that administrators are not knowledgeable of the job demands and skills of EMTs. Areas of great discontent were the low salary of the profession and the inadequacy of the equipment.

  12. 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

  13. Emergency team and action plan; Brigada de emergencia y plan de accion de emergencia

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez Gorgerino, Ruben Dario [Central Hidroelectrica Itaipu, Hernandarias (Paraguay)]. E-mail: jimenez@itaipu.gov.br

    1998-07-01

    This work reports the various activities developed by a commission designated for the investigation of the fire occurred in the excitation panel of the generator unit 16, for the execution of two tasks: short term creation of plant emergency team, and a long term implementation of emergency action plan.

  14. Helping primary care teams emerge through a quality improvement program.

    Science.gov (United States)

    Hilts, Linda; Howard, Michelle; Price, David; Risdon, Cathy; Agarwal, Gina; Childs, Anne

    2013-04-01

    Approaches to improving the quality of health care recognize the need for systems and cultures that facilitate optimal care. Interpersonal relationships and dynamics are a key factor in transforming a system to one that can achieve quality. The Quality in Family Practice (QIFP) program encompasses clinical and practice management using a comprehensive tool of family practice indicators. The objective of this study was to explore and describe the views of staff regarding changes in the clinical practice environment at two affiliated academic primary care clinics (comprising one Family Health Team, FHT) who participated in QIFP. An FHT in Hamilton, Canada, worked through the quality tool in 2008/2009. A qualitative exploratory case study approach was employed to examine staff perceptions of the process of participating. Semi-structured interviews were conducted in early 2010 with 43 FHT staff with representation from physicians, nurses, allied health professionals, support staff and managers. Interviews were audio-taped and transcribed verbatim. A modified template approach was used for coding, with a complexity theory perspective of analysis. Themes included importance of leadership, changes to practice environment, changes to communication, an increased understanding of team roles and relationships, strengthened teamwork, flattening of hierarchy through empowerment, changes in clinical care and clinical impacts, challenges and rewards and sustainability. The program resulted in perceived changes to relationships, teamwork and morale. Addressing issues of leadership, role clarity, empowerment, flattening of hierarchy and teamwork may go a long way in establishing and maintaining a quality culture.

  15. Planning a pharmacy-led medical mission trip, part 2: servant leadership and team dynamics.

    Science.gov (United States)

    Brown, Dana A; Brown, Daniel L; Yocum, Christine K

    2012-06-01

    While pharmacy curricula can prepare students for the cognitive domains of pharmacy practice, mastery of the affective aspects can prove to be more challenging. At the Gregory School of Pharmacy, medical mission trips have been highly effective means of impacting student attitudes and beliefs. Specifically, these trips have led to transformational changes in student leadership capacity, turning an act of service into an act of influence. Additionally, building team unity is invaluable to the overall effectiveness of the trip. Pre-trip preparation for teams includes activities such as routine team meetings, team-building activities, and implementation of committees, as a means of promoting positive team dynamics. While in the field, team dynamics can be fostered through activities such as daily debriefing sessions, team disclosure times, and provision of medical services.

  16. 31 CFR 587.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... Licensing Policy § 587.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons designated in or pursuant to § 587.201(a) is... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency...

  17. How to improve the performance of a good medical practice team: twelve techniques.

    Science.gov (United States)

    Hills, Laura

    2013-01-01

    It is incredibly easy to ignore the medical practice team that is doing a good job. However, when we allow good performers to continue as they are, they probably won't improve. Their performance may even worsen. This is unfortunate because with a little bit of effort and support, good performers can often learn to excel. This article offers 12 techniques medical practice managers can use to bring their team members from good performance to excellent. It describes how to use goal-setting, work assignments, modeling, confidence building, team retreats, rewards, incentives, and reinforcement to ratchet up a good medical practice team's performance. This article also identifies the signs of medical employee mediocrity. It describes why setting higher expectations of your medical practice employees will ultimately improve their performance. Finally, this article suggests 10 practical and affordable strategies that medical practice managers can use to reinforce excellent performance in their good employees.

  18. [Role and future aspects of hospital clinical laboratories in medical team approaches].

    Science.gov (United States)

    Suwabe, Akira

    2011-09-01

    The recent progress in medicine increases the routine works of the physicians or nurses and decreases the chances to obtain the new information on the laboratory medicine. Although the patients desire to know their test results in detail, it is likely to be difficult to obtain them from the physician in charge. Thereby, the quality of the medical services may be deteriorated. In these situations, needs of the medical team approaches in which the medical technologists (MTs) in the hospital laboratories participate are increasing. In Japan, there are a variety of medical team approaches in which MTs are involved. In our university hospital, MTs play important roles in the infection control team (ICT), in the nutrition support team (NST), in the educational class for the patients with diabetes mellitus, in the clinical research center, in the order-made medicine realizing project, in the infertility center and in the laboratory information room. In April 2010, the new payment system for the team approaches such as ICT or NST was established. In the future, the team approaches other than ICT or NST could be chosen for the subjects for the payment if they are recognized as important. The goal of the team approaches is to realize a patient-oriented medicine. MTs can reconfirm that they are working as one of the medical staffs through these team approaches. It is important to always find out a possibility of new team approaches.

  19. 31 CFR 588.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 588.508 Section 588.508 Money and Finance: Treasury Regulations Relating to Money and...

  20. 31 CFR 594.507 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 594.507 Section 594.507 Money and Finance: Treasury Regulations Relating to Money and...

  1. 31 CFR 545.517 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 545.517 Section 545.517 Money and Finance: Treasury Regulations Relating to Money and...

  2. 31 CFR 536.507 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... medical services. The provision of nonscheduled emergency medical services to a specially designated... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 536.507 Section 536.507 Money and Finance: Treasury Regulations Relating to Money and...

  3. [The characteristics of the organization of emergency medical care in the Republic of Dagestan].

    Science.gov (United States)

    Magomedova, S A; Edinarova, I E

    2010-01-01

    The analysis is presented relating the organization of emergency medical care in the Republic of Dagestan. The analysis of official statistic data revealed that from 2005 and until the present time there is a sustained increase of resourcing to this form of service by the population both in the republic in general and in urban areas. The increase of appealability among urban population is significantly higher than in the republic. This characteristic trait can be explained by the fact that the rural areas of the Republic continue to significantly log behind in the provision with main types of medical services. According the official statistic data, in 2005 the difference in appealability between urban and rural areas consisted 133, in 2006 ? 128, in 2007 ? 115, in 2008 ? 102 per 1000 of population. In the structure of emergency calls from rural and urban population the cases of sudden diseases. The portion of emergency calls by chronic patients has a clear tendency to decrease both among rural and urban population. The mentioned trends need the adjustment of organization of emergency medical care in rural areas, including intensive development of material technical and manpower of rural substations of emergency medical care. It is timely to consider the issue of development in the Republic of Dagestan the twenty-four-hour integrated consultative control board of emergency medical care to advice by phone the medical emergency teams, the personnel of district hospitals and feldsher obsteritian stations and general practitioners.

  4. 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...

  5. 3. Medical emergencies in primary schools and school ownership of ...

    African Journals Online (AJOL)

    RICHY

    Key words:Schools, First Aid Boxes, Medical Emergencies. ABSTRACT ... average school-aged child spends 28% of the day and. 1 ... exercise sessions, break time interaction with friends which on the ... Part of such emergency preparedness by school ought to ... emergency, staff should take emergency action without. 5.

  6. Effects of a pharmacist-led pediatrics medication safety team on medication-error reporting.

    Science.gov (United States)

    Costello, Jennifer L; Torowicz, Deborah Lloyd; Yeh, Timothy S

    2007-07-01

    The effects of a pharmacist-led pediatrics medication safety team (PMST) on the frequency and severity of medication errors reported were studied. This study was conducted in a pediatric critical care center (PCCC) in three phases. Phase 1 consisted of retrospective collection of medication-error reports before any interventions were made. Phases 2 and 3 included prospective collection of medication-error reports after several interventions. Phase 2 introduced a pediatrics clinical pharmacist to the PCCC. A pediatrics clinical pharmacist-led PMST (including a pediatrics critical care nurse and pediatrics intensivist), a new reporting form, and educational forums were added during phase 3 of the study. In addition, education focus groups were held for all intensive care unit staff. Outcomes for all phases were measured by the number of medication-error reports processed, the number of incidents, error severity, and the specialty of the reporter. Medication-error reporting increased twofold, threefold, and sixfold between phases 1 and 2, phases 2 and 3, and phases 1 and 3, respectively. Error severity decreased over the three time periods. In phases 1, 2, and 3, 46%, 8%, and 0% of the errors were classified as category D or E, respectively. Conversely, the reporting of near-miss errors increased from 9% in phase 1 to 38% in phase 2 and to 51% in phase 3. An increase in the number of medication errors reported and a decrease in the severity of errors reported were observed in a PCCC after implementation of a PMST, provision of education to health care providers, and addition of a clinical pharmacist.

  7. Team behaviors in emergency care: a qualitative study using behavior analysis of what makes team work

    OpenAIRE

    Mazzocato Pamela; Hvitfeldt Forsberg Helena; von Thiele Schwarz Ulrica

    2011-01-01

    Abstract Objective Teamwork has been suggested as a promising approach to improving care processes in emergency departments (ED). However, for teamwork to yield expected results, implementation must involve behavior changes. The aim of this study is to use behavior analysis to qualitatively examine how teamwork plays out in practice and to understand eventual discrepancies between planned and actual behaviors. Methods The study was set in a Swedish university hospital ED during the initial ph...

  8. Effectiveness of Team-Based Learning in teaching Medical Genetics to Medical Undergraduates.

    Science.gov (United States)

    Ismail, Noor Akmal Shareela

    2016-03-01

    This study explores the experience of both learners and a teacher during a team-based learning (TBL) session. TBL involves active learning that allows medical students to utilise their visual, auditory, writing and kinetic learning styles in order to strengthen their knowledge and retain it for longer, which is important with regard to applying basic sciences in clinical settings. This pilot study explored the effectiveness of TBL in learning medical genetics, and its potential to replace conventional lectures. First-year medical students (n = 194) studying at Universiti Kebangsaan, Malaysia, during 2014/2015 were selected to participate in this study. The topic of 'Mutation and Mutation Analysis' was selected, and the principles of TBL were adhered to during the study. It was found that the students' performance in a group readiness test was better than in individual readiness tests. The effectiveness of TBL was further shown in the examination, during which the marks obtained were tremendously improved. Collective commentaries from both the learners and the teacher recommended TBL as another useful tool in learning medical genetics. Implementation strategies should be advanced for the benefit of future learners and teachers.

  9. [Organization and improvement of emergency medical care for industrial city population in republic of Kazakhstan].

    Science.gov (United States)

    Ibraeva, A Sh; Kausova, G K

    2013-06-01

    The aim of the research was to develop recommendations for organization and improvement of emergency medical care in Shymkent (Chimkent) - a rapidly developing financial and industrial center in Southern Kazakhstan. It was found that the average annual daily load of iresuscitative teams and pediatric intensive care increased, which is associated with an increased frequency of severe cases, complications of disease of adults and children requiring intensive care therapy. Another objective measure that reflects the level of organization of Acute care of population is the specialization of rig team and timeliness arrival of the call. The highest level of the specialization of rig was observed in cardiac and critical care teams. The highest level of the indicator of average residence time teams on the call was observed in pediatric intensive care.

  10. Training residents and nurses to work as a patient-centered care team on a medical ward.

    Science.gov (United States)

    Laird-Fick, Heather S; Solomon, David; Jodoin, Christine; Dwamena, Francesca C; Alexander, Kim; Rawsthorne, Larry; Banker, Tammy; Gourineni, Nandu; Aloka, Feras; Frankel, Richard M; Smith, Robert C

    2011-07-01

    To train medical residents and nurses to work together as a patient-centered care (PCC) team on a medical ward and test its feasibility, nurses' learning, and patient outcomes. Working with administrative leadership, we consolidated residents' patients on one 32-bed ward. Already training residents in an evidence-based patient-centered method, we now trained 5 nurse leaders similarly, and they then trained all staff nurses. A national consultant visited twice. Specific team-building activities for nurses and residents fostered ward interactions. We used a retrospective pre/post/6-month post-design to evaluate nurses' knowledge and self-efficacy of patient-centered skills. Patients were assigned non-randomly to our unit or comparison units from our emergency room; using a post-test only design, the primary endpoint was patient satisfaction. 28 trained nurses showed improvement in knowledge (p=0.02) and self-efficacy (p=0.001). 81 treatment patients showed no improvement in satisfaction (p=0.44). Training nurses in patient-centered practices were effective. Unique in this country, we also trained nurses and residents together as a PCC team on a medical ward and showed it was feasible and well accepted. We provide a template for team training and urge that others explore this important new area and contribute to its further development. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Academic Primer Series: Five Key Papers about Team Collaboration Relevant to Emergency Medicine

    Science.gov (United States)

    Gottlieb, Michael; Grossman, Catherine; Rose, Emily; Sanderson, William; Ankel, Felix; Swaminathan, Anand; Chan, Teresa M.

    2017-01-01

    Introduction Team collaboration is an essential for success both within academics and the clinical environment. Often, team collaboration is not explicitly taught during medical school or even residency, and must be learned during one’s early career. In this article, we aim to summarize five key papers about team collaboration for early career clinician educators. Methods We conducted a consensus-building process among the writing team to generate a list of key papers that describe the importance or significance of team collaboration, seeking input from social media sources. The authors then used a three-round voting methodology akin to a Delphi study to determine the most important papers from the initially generated list. Results The five most important papers on the topic of team collaboration, as determined by this mixed group of junior faculty members and faculty developers, are presented in this paper. For each included publication, a summary was provided along with its relevance to junior faculty members and faculty developers. Conclusion Five key papers about team collaboration are presented in this publication. These papers provide a foundational background to help junior faculty members with collaborating in teams both clinically and academically. This list may also inform senior faculty and faculty developers about the needs of junior faculty members. PMID:28210368

  12. Academic Primer Series: Five Key Papers about Team Collaboration Relevant to Emergency Medicine.

    Science.gov (United States)

    Gottlieb, Michael; Grossman, Catherine; Rose, Emily; Sanderson, William; Ankel, Felix; Swaminathan, Anand; Chan, Teresa M

    2017-02-01

    Team collaboration is an essential for success both within academics and the clinical environment. Often, team collaboration is not explicitly taught during medical school or even residency, and must be learned during one's early career. In this article, we aim to summarize five key papers about team collaboration for early career clinician educators. We conducted a consensus-building process among the writing team to generate a list of key papers that describe the importance or significance of team collaboration, seeking input from social media sources. The authors then used a three-round voting methodology akin to a Delphi study to determine the most important papers from the initially generated list. The five most important papers on the topic of team collaboration, as determined by this mixed group of junior faculty members and faculty developers, are presented in this paper. For each included publication, a summary was provided along with its relevance to junior faculty members and faculty developers. Five key papers about team collaboration are presented in this publication. These papers provide a foundational background to help junior faculty members with collaborating in teams both clinically and academically. This list may also inform senior faculty and faculty developers about the needs of junior faculty members.

  13. Customer satisfaction measurement in emergency medical services.

    Science.gov (United States)

    Kuisma, Markku; Määttä, Teuvo; Hakala, Taisto; Sivula, Tommi; Nousila-Wiik, Maria

    2003-07-01

    The annual patient volume in emergency medical services (EMS) systems is high worldwide. However, there are no comprehensive studies on customer satisfaction for EMS. The authors report how a customer satisfaction survey on EMS patients was conducted, the results, and the possible causes for dissatisfaction. Two prospective customer satisfactions surveys were conducted in an urban EMS system. Consecutive patients treated by EMS received a postal questionnaire approximately two weeks after service. Satisfaction was measured in a scale from 1 (very poor) to 5 (excellent). Neither EMS personnel nor patients were made aware prospectively that patient satisfaction would be measured. Response rates to the surveys were 36.8% (432/1,175) in 2000 and 40.0% (464/1,150) in 2002. The mean general grades for the service were 4.6 and 4.5, respectively. Patients reported the highest degree of dissatisfaction when they were not taken to their hospital of choice, when they perceived that the paramedics were not able to meet their needs, and when paramedics did not introduce themselves or communicate directly with the patient's relatives. In high-volume calls (i.e., frequent chief complaints), the general satisfaction was highest in patients with arrhythmias, breathing difficulties, and hypoglycemia. Patients with drug overdose included the highest proportion of unsatisfied patients. None of the background variables (e.g., gender, transport decision, working shift) was statistically related to general patient satisfaction. This study shows that customer satisfaction surveys can be successfully conducted for EMS. EMS systems should consider routinely using customer satisfaction surveys as a tool for quality measurement and improvement.

  14. [Role of pharmacists in the medical team--attempting palliative care].

    Science.gov (United States)

    Ishiguro, T; Takahashi, M; Kato, H; Abe, C; Shioya, A; Ishiguro, T; Yoshizawa, T; Yoshizawa, A

    1999-12-01

    The Pharmacy Department at our hospital is attempting to develop methods for palliative care, for example of cancer pain or smelly tumors. The participation of pharmacists on the medical team for home care is necessary, because the supply of proper drugs for patients' individual conditions is indispensable in palliative care. Communication between not only patients, but also between their families and us, as well as the maintenance of close contact with the medical team, are important in home care.

  15. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital].

    Science.gov (United States)

    Rodríguez Artalejo, F; González Montalvo, J I; Sanz Segovia, F; Jaramillo Gómez, E; Banegas Banegas, J R; Rodríguez Mañas, L; Carbonell Collar, A

    1989-10-14

    The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.

  16. Expanding the Role of Emergency Medical Services in Homeland Security

    Science.gov (United States)

    2013-03-01

    Medical Services FEMA Federal Emergency Management Agency FBI Federal Bureau of Investigation H1N1 Influenza a Virus HIPAA Health Information...Smyth, William G. Manley, Daniel E. Summers, Nels D. Sanddal, Teri L. Sanddal, et al. “Realities of Rural Emergency Medical Services Disaster

  17. 31 CFR 595.507 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services to a specially designated terrorist... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 595.507 Section 595.507 Money and Finance: Treasury Regulations Relating to Money and...

  18. 31 CFR 548.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 548.508 Section 548.508 Money and Finance: Treasury Regulations Relating to Money and...

  19. 31 CFR 542.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 542.508 Section 542.508 Money and Finance: Treasury Regulations Relating to Money and...

  20. 31 CFR 543.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 543.508 Section 543.508 Money and Finance: Treasury Regulations Relating to Money and...

  1. 31 CFR 551.507 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 551.507 Section 551.507 Money and Finance: Treasury Regulations Relating to Money and...

  2. 31 CFR 541.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 541.508 Section 541.508 Money and Finance: Treasury Regulations Relating to Money and...

  3. 31 CFR 546.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 546.508 Section 546.508 Money and Finance: Treasury Regulations Relating to Money and...

  4. 31 CFR 537.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 537.508 Section 537.508 Money and Finance: Treasury Regulations Relating to Money and...

  5. Basic Training Program for Emergency Medical Technician Ambulance: Course Guide.

    Science.gov (United States)

    Fucigna, Joseph T.; And Others

    In an effort to upgrade or further develop the skills levels of all individuals involved in the emergency medical care service, this training program was developed for the National Highway Safety Bureau. This specific course is an attempt to organize, conduct, and standardize a basic training course for emergency medical technicians (EMTs). The…

  6. Employability Competencies for Entry Level Emergency Medical Aides.

    Science.gov (United States)

    Werner, Claire

    This document describes competencies needed by persons who complete the Los Angeles Schools' emergency medical aide competency-based program, which is designed to enhance their ability to obtain certification as an Emergency Medical Technician (EMT). The overall competency statement ("goal") of the program heads each page and is defined by one or…

  7. Emerging research trends in medical textiles

    CERN Document Server

    Gokarneshan, N; Rajendran, V; Lavanya, B; Ghoshal, Arundhathi

    2015-01-01

    This book provides a comprehensive review of the significant researches reported during the recent years in the field of medical textiles. It also highlights the use of new types of fibres in developing medical textile products and their promising role in the respective areas of application. Considerable developments have taken place in the development of medical textiles for varied applications.

  8. 38 CFR 1.485 - Medical emergencies.

    Science.gov (United States)

    2010-07-01

    ... §§ 1.460 through 1.499 of this part may be disclosed to medical personnel who have a need for... identifying information may be disclosed to medical personnel of the Food and Drug Administration (FDA) who... name and address of the medical personnel to whom disclosure was made and their affiliation with...

  9. 42 CFR 2.51 - Medical emergencies.

    Science.gov (United States)

    2010-10-01

    ... identifying information may be disclosed to medical personnel who have a need for information about a patient... information may be disclosed to medical personnel of the Food and Drug Administration (FDA) who assert a... forth in writing: (1) The name of the medical personnel to whom disclosure was made and...

  10. Simulation in Medical School Education: Review for Emergency Medicine

    OpenAIRE

    Shahram Lotfipour; T. Kent Denmark; Christopher Erik McCoy; Srinidhi Subraya Bhat; Elizabeth ter Haar; Bharath Chakravarthy

    2011-01-01

    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 documente...

  11. 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.

  12. Perspective: a business school view of medical interprofessional rounds: transforming rounding groups into rounding teams.

    Science.gov (United States)

    Bharwani, Aleem M; Harris, G Chad; Southwick, Frederick S

    2012-12-01

    An effective interprofessional medical team can efficiently coordinate health care providers to achieve the collective outcome of improving each patient's health. To determine how current teams function, four groups of business students independently observed interprofessional work rounds on four different internal medicine services in a typical academic hospital and also interviewed the participants. In all instances, caregivers had formed working groups rather than working teams. Participants consistently exhibited parallel interdependence (individuals working alone and assuming their work would be coordinated with other caregivers) rather than reciprocal interdependence (individuals working together to actively coordinate patient care), the hallmark of effective teams. With one exception, the organization was hierarchical, with the senior attending physician possessing the authority. The interns exclusively communicated with the attending physician in one-on-one conversations that excluded all other members of the team. Although nurses and pharmacists were often present, they never contributed their ideas and rarely spoke.The authors draw on these observations to form recommendations for enhancing interprofessional rounding teams. These are to include the bedside nurse, pharmacist, and case manager as team members, begin with a formal team launch that encourages active participation by all team members, use succinct communication protocols, conduct work rounds in a quiet, distraction-free environment, have teams remain together for longer durations, and receive teamwork training and periodic coaching. High-performing businesses have effectively used teams for decades to achieve their goals, and health care professionals should follow this example.

  13. Enhancing the effectiveness of team debriefings in medical simulation: more best practices.

    Science.gov (United States)

    Lyons, Rebecca; Lazzara, Elizabeth H; Benishek, Lauren E; Zajac, Stephanie; Gregory, Megan; Sonesh, Shirley C; Salas, Eduardo

    2015-03-01

    Teamwork is a vital component of optimal patient care. In both clinical settings and medical education, a variety of approaches are used for the development of teamwork skills. Yet, for team members to receive the full educational benefit of these experiential learning opportunities, postsimulation feedback regarding the team's performance must be incorporated. Debriefings are among the most widely used form of feedback regarding team performance. A team debriefing is a facilitated or guided dialogue that takes place between team members following an action period to review and reflect on team performance. Team members discuss their perceptions of what occurred, why it occurred, and how they can enhance their performance. Simulation debriefing allows for greater control and planning than are logistically feasible for on-the-job performance. It is also unique in that facilitators of simulation-based training are generally individuals external to the team, whereas debriefing on the job is commonly led by an internal team member or conducted without a specified facilitator. Consequently, there is greater opportunity for selecting and training facilitators for team simulation events. Thirteen Best Practices: The 13 best practices, extracted from existing training and debriefing research, are organized under three general categories: (1) preparing for debriefing, (2) facilitator responsibilities during debriefing, and (3) considerations for debriefing content. For each best practice, considerations and practical implications are provided to facilitate the implementation of the recommended practices. The 13 best practices presented in this article should help health care organizations by guiding team simulation administrators, self-directed medical teams, and debriefing facilitators in the optimization of debriefing to support learning for all team members.

  14. The Impact of Rudeness on Medical Team Performance: A Randomized Trial.

    Science.gov (United States)

    Riskin, Arieh; Erez, Amir; Foulk, Trevor A; Kugelman, Amir; Gover, Ayala; Shoris, Irit; Riskin, Kinneret S; Bamberger, Peter A

    2015-09-01

    Iatrogenesis often results from performance deficiencies among medical team members. Team-targeted rudeness may underlie such performance deficiencies, with individuals exposed to rude behavior being less helpful and cooperative. Our objective was to explore the impact of rudeness on the performance of medical teams. Twenty-four NICU teams participated in a training simulation involving a preterm infant whose condition acutely deteriorated due to necrotizing enterocolitis. Participants were informed that a foreign expert on team reflexivity in medicine would observe them. Teams were randomly assigned to either exposure to rudeness (in which the expert's comments included mildly rude statements completely unrelated to the teams' performance) or control (neutral comments). The videotaped simulation sessions were evaluated by 3 independent judges (blinded to team exposure) who used structured questionnaires to assess team performance, information-sharing, and help-seeking. The composite diagnostic and procedural performance scores were lower for members of teams exposed to rudeness than to members of the control teams (2.6 vs 3.2 [P = .005] and 2.8 vs 3.3 [P = .008], respectively). Rudeness alone explained nearly 12% of the variance in diagnostic and procedural performance. A model specifying information-sharing and help-seeking as mediators linking rudeness to team performance explained an even greater portion of the variance in diagnostic and procedural performance (R(2) = 52.3 and 42.7, respectively). Rudeness had adverse consequences on the diagnostic and procedural performance of the NICU team members. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance. Copyright © 2015 by the American Academy of Pediatrics.

  15. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit.

    Science.gov (United States)

    Harwood, Rowan H; Goldberg, Sarah E; Whittamore, Kathy H; Russell, Catherine; Gladman, John Rf; Jones, Rob G; Porock, Davina; Lewis, Sarah A; Bradshaw, Lucy E; Elliot, Rachel A

    2011-05-13

    Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences. We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period. Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers. We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective. We will perform a controlled clinical trial comparing in-patient management on a specialist Medical and Mental Health Unit with standard care. Study participants are patients over the age of 65, admitted as an emergency to a single general hospital, and identified on the Acute Medical Admissions Unit as being 'confused'. Sample size is 300 per group. The evaluation design has been adapted to accommodate pressures on bed management and patient flows. If beds are available on the specialist Unit, the clinical service allocates patients at random between the Unit and standard care on general or geriatric medical wards. Once admitted, randomised patients and their carers are invited to take part in a follow up study, and baseline data are collected. Quality of care and patient experience are assessed in a non-participant observer study. Outcomes are ascertained at a follow up home visit 90 days after randomisation, by a researcher blind to allocation. The primary outcome is days spent at home (for those admitted from home), or days spent in the same care home (if admitted from a care home). Secondary outcomes include mortality, institutionalisation, resource use, and scaled outcome measures, including quality of life, cognitive function, disability, behavioural and

  16. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit

    Directory of Open Access Journals (Sweden)

    Gladman John RF

    2011-05-01

    Full Text Available Abstract Background Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences. We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period. Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers. We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective. Methods/design We will perform a controlled clinical trial comparing in-patient management on a specialist Medical and Mental Health Unit with standard care. Study participants are patients over the age of 65, admitted as an emergency to a single general hospital, and identified on the Acute Medical Admissions Unit as being 'confused'. Sample size is 300 per group. The evaluation design has been adapted to accommodate pressures on bed management and patient flows. If beds are available on the specialist Unit, the clinical service allocates patients at random between the Unit and standard care on general or geriatric medical wards. Once admitted, randomised patients and their carers are invited to take part in a follow up study, and baseline data are collected. Quality of care and patient experience are assessed in a non-participant observer study. Outcomes are ascertained at a follow up home visit 90 days after randomisation, by a researcher blind to allocation. The primary outcome is days spent at home (for those admitted from home, or days spent in the same care home (if admitted from a care home. Secondary outcomes include mortality, institutionalisation, resource use, and scaled outcome measures, including quality of

  17. Emotional Intelligence in Library Disaster Response Assistance Teams: Which Competencies Emerged?

    Science.gov (United States)

    Wilkinson, Frances C.

    2015-01-01

    This qualitative study examines the relationship between emotional intelligence competencies and the personal attributes of library disaster response assistance team (DRAT) members. Using appreciative inquiry protocol to conduct interviews at two academic libraries, the study presents findings from emergent thematic coding of interview…

  18. Emotional Intelligence in Library Disaster Response Assistance Teams: Which Competencies Emerged?

    Science.gov (United States)

    Wilkinson, Frances C.

    2015-01-01

    This qualitative study examines the relationship between emotional intelligence competencies and the personal attributes of library disaster response assistance team (DRAT) members. Using appreciative inquiry protocol to conduct interviews at two academic libraries, the study presents findings from emergent thematic coding of interview…

  19. 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.

  20. 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.

  1. Evaluation of Dutch Helicopter Emergency Medical Services in transporting children

    NARCIS (Netherlands)

    Peters, J.H.; Beekers, C.; Eijk, R.J.R.; Edwards, M.J.; Hoogerwerf, N.

    2014-01-01

    OBJECTIVE: In the Netherlands, helicopter emergency medical services (HEMS) function as an adjunct to paramedic ambulance service delivering hospital-level medical care to a prehospital location. The main goal of Dutch HEMS is to provide on-scene medical expertise and not primarily to serve as trans

  2. Coordination of Emergency Medical Services for a Major Road Traffic Accident on a Swiss Suburban Highway.

    Science.gov (United States)

    Dami, Fabrice; Fuchs, Vincent; Péclard, Etienne; Potin, Mathieu; Vallotton, Laurent; Carron, Pierre-Nicolas

    2009-06-01

    On 9th April 2008 at 2:14 p.m., on the highway between Lausanne and Vevey in western Switzerland, there was a 72-car pileup including five trucks that caused one death and injured 26 others. The relatively light toll was attributed to reduced vehicular speeds on account of foggy weather, together with the quick actions and effectiveness of the first responders and the excellent collaboration between the various rescue groups (medical rescue services, fire and police departments). For the first time, we used an innovative on-site medical command and control system, based on a binomial team. Two hours after the accident, the last of the injured had been evacuated and first aid on the site had ended. This article describes how the Emergency Medical Services from the State of Vaud, Switzerland, handled the situation and how the binomial team is structured.

  3. [How to establish a medical team for patients with critical bleeding].

    Science.gov (United States)

    Suwabe, Akira

    2014-12-01

    The medical guidelines for critical bleeding were published by several medical societies, and they declared the importance of approaches by teams composed of various kinds of medical staff. A medical team dealing with critical bleeding is characterized as an ad hoc type team, since the team is inactivated after its individual work is finished. Its characteristics are: 1)it is hard to predict when to be organized, 2) extremely rapid responses are required, and 3) staff outside the hospital,such as the Red Cross Society, are involved. To promote medical teams, it is very important: 1)to standardize the public guidelines for individual hospitals, 2) to define the roles of staff with their affiliations, posts, and phone numbers, 3) to simulate events, and 4) to have irregular but continuous meetings. Furthermore, it is important to involve manufacturers in our activities for innovating new test apparatuses or systems, and also to stress the significance of such team approaches to the nation and government, such as the Ministry of Health, Labour and Welfare, in order to secure additional points in the health insurance payment system. (Review).

  4. Insight into team competence in medical, nursing and respiratory therapy students.

    Science.gov (United States)

    Sigalet, Elaine L; Donnon, Tyrone L; Grant, Vincent

    2015-01-01

    This study provides information for educators about levels of competence in teams comprised of medical, nursing and respiratory therapy students after receiving a simulation-based team-training (SBT) curriculum with and without an additional formalized 30-min team-training (TT) module. A two-group pre- and post-test research design was used to evaluate team competence with respect to leadership, roles and responsibilities, communication, situation awareness and resource utilization. All scenarios were digitally recorded and evaluated using the KidSIM Team Performance Scale by six experts from medicine, nursing and respiratory therapy. The lowest scores occurred for items that reflected situation awareness. All teams improved their aggregate scores from Time 1 to Time 2 (p teams in the intervention group achieved significantly higher performance scores at Time 1 (Cohen's d = 0.92, p teams demonstrated significant improvement in their ability to work more effectively by Time 2. The results suggest that situational awareness is an advanced expectation for the undergraduate student team. The provision of a formalized TT module prior to engaging student teams in a simulation-based TT curriculum led to significantly higher performances at Time 1 and 2.

  5. JGME-ALiEM Hot Topics in Medical Education: Analysis of a Multimodal Online Discussion About Team-Based Learning.

    Science.gov (United States)

    Riddell, Jeff; Patocka, Catherine; Lin, Michelle; Sherbino, Jonathan

    2017-02-01

    Team-based learning (TBL) is an instructional method that is being increasingly incorporated in health professions education, although use in graduate medical education (GME) has been more limited. To curate and describe themes that emerged from a virtual journal club discussion about TBL in GME, held across multiple digital platforms, while also evaluating the use of social media in online academic discussions. The Journal of Graduate Medical Education (JGME) and the Academic Life in Emergency Medicine blog facilitated a weeklong, open-access, virtual journal club on the 2015 JGME article "Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching." Using 4 stimulus questions (hosted on a blog as a starting framework), we facilitated discussions via the blog, Twitter, and Google Hangouts on Air platforms. We evaluated 2-week web analytics and performed a thematic analysis of the discussion. The virtual journal club reached a large international audience as exemplified by the blog page garnering 685 page views from 241 cities in 42 countries. Our thematic analysis identified 4 domains relevant to TBL in GME: (1) the benefits and barriers to TBL; (2) the design of teams; (3) the role of assessment and peer evaluation; and (4) crowdsourced TBL resources. The virtual journal club provided a novel forum across multiple social media platforms, engaging authors, content experts, and the health professions education community in a discussion about the importance, impediments to implementation, available resources, and logistics of adopting TBL in GME.

  6. Medical Operations Support for ISS Operations - The Role of the BME Operations Team Leads

    Science.gov (United States)

    Janney, Rob; Sabatier, Veronica

    2010-01-01

    This slide presentation reviews the role of the biomedical flight controllers (BMEs), and BME Operations Team Leads (OTLs) in providing medical support for personnel on the International Space Station. This presentation will concentrate on role of the BME OTLs, who provide the integration function across the integration function across all Crew Health Care System (CHeCS) disciplines for operational products and medical procedures.

  7. Impact of a Hurricane Shelter Viral Gastroenteritis Outbreak on a Responding Medical Team.

    Science.gov (United States)

    Gaither, Joshua B; Page, Rianne; Prather, Caren; Paavola, Fred; Garrett, Andrew L

    2015-08-01

    Introduction In late October of 2012, Hurricane Sandy struck the northeast United States and shelters were established throughout the impacted region. Numerous cases of infectious viral gastroenteritis occurred in several of these shelters. Such outbreaks are common and have been well described in the past. Early monitoring for, and recognition of, the outbreak allowed for implementation of aggressive infection control measures. However, these measures required intensive medical response team involvement. Little is known about how such outbreaks affect the medical teams responding to the incident. Hypothesis/Problem Describe the impact of an infectious viral gastroenteritis outbreak within a single shelter on a responding medical team. The number of individuals staying in the single shelter each night (as determined by shelter staff) and the number of patients treated for symptoms of viral gastroenteritis were recorded each day. On return from deployment, members of a single responding medical team were surveyed to determine how many team members became ill during, or immediately following, their deployment. The shelter population peaked on November 5, 2012 with 811 individuals sleeping in the shelter. The first patients presented to the shelter clinic with symptoms of viral gastroenteritis on November 4, 2012, and the last case was seen on November 21, 2012. A total of 64 patients were treated for nausea, vomiting, or diarrhea over the 17-day period. A post-deployment survey was sent to 66 deployed medical team members and 45 completed the survey. Twelve (26.7%) of the team members who responded to the survey experienced symptoms of probable viral gastroenteritis. Team members reported onset of symptoms during deployment as well as after returning home. Symptoms started on days 4-8, 8-14, on the trip home, and after returning home in four, four, two, and two team members, respectively. Medical teams providing shelter care during viral gastroenteritis outbreaks are

  8. Increasing Medical Practice Team Commitment: Twenty-Five Strategies.

    Science.gov (United States)

    Hills, Laura

    2016-01-01

    Employee commitment is one of the most important principles of practice man- agement. Yet commitment is delicate; it must be carefully earned, and it can easily deteriorate. This article explores practical strategies the medical practice manager can use to assess, foster, and increase employee commitment. It de- fines commitment and how commitment is manifested in employee attitudes and behavior. It provides a 10-question guide medical practice managers can use to assess employee commitment, and a four-part roadmap that will inspire commitment through leadership. This article also offers 25 hands-on strate- gies to increase employee commitment, and more than a dozen questions to guide difficult conversations with employees when their commitment level to the medical practice is low or unclear. Finally, this article suggest four drivers of employee commitment and a five-part strategy medical practice managers can use to model commitment through their own leadership.

  9. Serving with Pharmacy Students: Reflections from a Medical Mission Team Leader and Preceptor

    Directory of Open Access Journals (Sweden)

    Dana A. Brown

    2016-10-01

    Full Text Available The medical mission field is an innovative setting for training and evaluating health care professional students. The motivating factor of serving indigent populations as a means of a humanitarian, or oftentimes a spiritual act, makes medical missions an attractive option for student participation. At the Gregory School of Pharmacy, medical mission teams are an integral part of the pharmacy program, including the opportunity for students to earn elective credit during their fourth year. This commentary provides five key elements to consider when serving with, training and evaluating pharmacy students from the perspective of a team leader and preceptor.

  10. Review on the administration and effectiveness of team-based learning in medical education.

    Science.gov (United States)

    Hur, Yera; Cho, A Ra; Kim, Sun

    2013-12-01

    Team-based learning (TBL) is an active learning approach. In recent years, medical educators have been increasingly using TBL in their classes. We reviewed the concepts of TBL and discuss examples of international cases. Two types of TBL are administered: classic TBL and adapted TBL. Combining TBL and problem-based learning (PBL) might be a useful strategy for medical schools. TBL is an attainable and efficient educational approach in preparing large classes with regard to PBL. TBL improves student performance, team communication skills, leadership skills, problem solving skills, and cognitive conceptual structures and increases student engagement and satisfaction. This study suggests recommendations for administering TBL effectively in medical education.

  11. "That's not how we do it": managing the inherited medical practice team.

    Science.gov (United States)

    Hills, Laura

    2013-01-01

    Most medical practice managers who take a new job will inherit an existing team. Those first few days on the job are critical because they can determine whether or not the new manager will succeed. This article provides a game plan for new medical practice managers so they get off on the right foot with their inherited teams. It suggests strategies for learning about the team's culture and for demonstrating visibly that there is a new manager in the job. It offers guidelines about introducing the new manager to the inherited team, discussing past experiences, and establishing new expectations. This article further provides practical tips for serving as a role model, gaining allies, and dealing with troublemakers quickly and effectively. It suggests strategies for speaking about the previous practice manager and for creating excitement with the inherited team. Finally, this article offers a set of 15 questions a new manager can ask members of the inherited team to get to know them, an additional 25-point team assessment instrument, and a step-by-step strategy for raising the bar for mediocre, lackluster, or dysfunctional inherited teams.

  12. Toward Ubiquitous Communication Platform for Emergency Medical Care

    Science.gov (United States)

    Ishibashi, Kenichi; Morishima, Naoto; Kanbara, Masayuki; Sunahara, Hideki; Imanishi, Masami

    Interaction between emergency medical technicians (EMTs) and doctors is essential in emergency medical care. Doctors require diverse information related to a patient to provide efficient aid. In 2005, we started the Ikoma119 project and have developed a ubiquitous communication platform for emergency medical care called Mobile ER. Our platform, which is based on wireless internet technology, has such desirable properties as low-cost, location-independent service, and ease of service introduction. We provide an overview of our platform and describe the services that we have developed. We also discuss the remaining issues to realize our platform's actual operation.

  13. Information delivery in team communication of MCR operators for an emergency task

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kwang Sub; Park, Jin Kyun; Jung, Won Dae

    2005-01-01

    Team performance is a major measure to evaluate the ability of team when a lot of people perform a task of common purpose such as the main control room operators in the nuclear power plant. A team performance is affected the collaboration and communication among operators under dynamic situation as well as by the cognitive process of each team member. Specially, under the emergency situation, more clear and apparent communication in a team is a critical key for the appropriate response to emergency situation. As a general human factor analysis accesses the operator's behavior, it leads to a resulting action of planning, decision, problem-solving. In order to access the internal information and background information of his/her behavior, the verbal protocol analysis is applied. The impact factors on the team performance are derived from the state of the art for team performance, and it is found that the communication is a common key for all impact factors. And, in turn, the impact factors for the communication are accesses and the more detailed analysis is performed. The recorded data for the operator training for emergency situation of nuclear power plant training center are analyzed according to the verbal protocol analysis that are being generally utilized in cognitive psychology, educational psychology, and cognitive science. Two aspects, external (syntax) and internal (symantic) aspects of communication are reviewed. From the syntax analysis, it is found that the task of each step in EOP is separated according to each corresponding operator and the ordinary training is important, and the weak-points for a sentence presentation can be found team-by-team. And, from the symantic analysis for the diagnostic procedure of EOP is performed and the communication errors due to different situation awareness by operators could be found, and it lead to a diagnosis failure. The factors for different symantic cognition for a situation are analyzed and the affecting

  14. Team Resilience as a Second-Order Emergent State: A Theoretical Model and Research Directions

    Science.gov (United States)

    Bowers, Clint; Kreutzer, Christine; Cannon-Bowers, Janis; Lamb, Jerry

    2017-01-01

    Resilience has been recognized as an important phenomenon for understanding how individuals overcome difficult situations. However, it is not only individuals who face difficulties; it is not uncommon for teams to experience adversity. When they do, they must be able to overcome these challenges without performance decrements.This manuscript represents a theoretical model that might be helpful in conceptualizing this important construct. Specifically, it describes team resilience as a second-order emergent state. We also include research propositions that follow from the model. PMID:28861013

  15. Team Resilience as a Second-Order Emergent State: A Theoretical Model and Research Directions

    Directory of Open Access Journals (Sweden)

    Clint Bowers

    2017-08-01

    Full Text Available Resilience has been recognized as an important phenomenon for understanding how individuals overcome difficult situations. However, it is not only individuals who face difficulties; it is not uncommon for teams to experience adversity. When they do, they must be able to overcome these challenges without performance decrements.This manuscript represents a theoretical model that might be helpful in conceptualizing this important construct. Specifically, it describes team resilience as a second-order emergent state. We also include research propositions that follow from the model.

  16. Who is on the medical team?: Shifting the boundaries of belonging on the ICU.

    Science.gov (United States)

    Rodriquez, Jason

    2015-11-01

    Medical teamwork promises to improve communication and collaboration in the healthcare industry, yet critics argue teamwork is little more than a new managerial discourse to obscure traditional workplace hierarchies. Based on 300 h of participant-observation and 35 interviews with staff of a medical intensive care unit at an academic medical center, this article argues that teamwork is neither a panacea for coordinating complex care nor is it simply a discourse to control workers; rather, it is an ongoing social activity characterized by boundary-work, negotiation, and resistance over the terms of membership. This study identifies three processual and temporal phases of families' participation in medical teams: (1) Constructing Teamwork, (2) Deflection and Resistance, and (3) Reintegration. Staff leveraged ambiguities in the meaning of teamwork to manage patients' family members' participation on the ICU Team. Family involvement changed in patterned ways that reflected the power staff had to define the team and the character of teamwork. Families participated on the team at admission, but their involvement narrowed considerably as staff implemented diagnostic and treatment plans. When staff determined a patient was appropriate for palliation, families were reintegrated back into a leading role on the team as surrogate decision-makers. This study advances current understandings of medical teamwork, staff-family interactions, and it highlights the value of qualitative methods in social-science research about medicine.

  17. A Quality Improvement Project to Improve Family Recognition of Medical Team Member Roles.

    Science.gov (United States)

    Hayes, Rebecca M; Wickline, Afton; Hensley, Christina; Cowen, Kelsey; Jessie, Ashley; Akers, Melanie; Dolan, Jenna; Pritt, Audra; Goodrich, Shea; O'Neill, Kelly; Flesher, Susan L

    2015-09-01

    Previous studies have shown that inpatients and families in academic settings have a limited ability to recall either their medical team members or the roles of those members. This is an important issue for patient and family satisfaction as well as patient safety. The objective of this study was to increase families' recognition of medical team members' roles. We established a multidisciplinary quality improvement leadership team, measured family recognition of medical team members and their roles, and conducted 2 PDSA (Plan-Do-Study-Act) cycles. The first intervention was standardization of the content and delivery of our verbal team introductions to ensure inclusion of essential elements and family engagement. The second intervention was addition of an informational white board in each patient room. The prospective study included 105 families in the preintervention phase, 103 post-PDSA cycle 1, and 92 post-PDSA cycle 2. After conduction of 2 PDSA cycles, the recognition of the attending role increased from 49% to 87% (P = .000), the resident role from 39% to 73% (P = .000), and the medical student from 75% to 89% (P = .038). The multidisciplinary quality improvement model was effective in improving family recognition of the roles of attending physicians, resident physicians, and medical students. Consistent attention to engaging the families and explaining our roles as well as providing informational white boards are effective interventions to facilitate this process. Copyright © 2015 by the American Academy of Pediatrics.

  18. The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China

    Directory of Open Access Journals (Sweden)

    Xu Liu

    2015-12-01

    Full Text Available Purpose: Performance assessments of earthquake medical rapid response teams (EMRRTs, particularly the first responders deployed to the hardest hit areas following major earthquakes, should consider efficient and effective use of resources. This study assesses the daily technical efficiency of EMRRTs in the emergency period immediately following the 2010 Yushu earthquake in China. Methods: Data on EMRRTs were obtained from official daily reports of the general headquarters for Yushu earthquake relief, the emergency office of the National Ministry of Health, and the Health Department of Qinghai Province, for a sample of data on 15 EMRRTs over 62 days. Data envelopment analysis was used to examine the technical efficiency in a constant returns to scale model, a variable returns to scale model, and the scale efficiency of EMRRTs. Tobit regression was applied to analyze the effects of corresponding influencing factors. Results: The average technical efficiency scores under constant returns to scale, variable returns to scale, and the scale efficiency scores of the 62 units of analysis were 77.95%, 89.00%, and 87.47%, respectively. The staff-to-bed ratio was significantly related to global technical efficiency. The date of rescue was significantly related to pure technical efficiency. The type of institution to which an EMRRT belonged and the staff-to-bed ratio were significantly related to scale efficiency. Conclusions: This study provides evidence that supports improvements to EMRRT efficiency and serves as a reference for earthquake emergency medical rapid assistance leaders and teams.

  19. How the nuclear safety team conducts emergency exercises at the IEA-R1 reactor

    Energy Technology Data Exchange (ETDEWEB)

    Vaz, Antonio C.A.; Silva, Davilson G.; Toyoda, Eduardo Y.; Santia, Paulo S.; Conti, Thadeu N.; Semmler, Renato; Carvalho, Ricardo N., E-mail: acavaz@ipen.br, E-mail: dgsilva@ipen.br, E-mail: eytoyoda@ipen.br, E-mail: psantia@ipen.br, E-mail: tnconti@ipen.br, E-mail: rsemmler@ipen.b, E-mail: rncarval@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    This work introduces the Diagram of Emergency Exercise Coordination designed by the Nuclear Safety Team for better Emergency Exercise coordination. The Nuclear Safety Team was created with the mission of avoiding, preventing and mitigating the causes and effects of accidents at the IEA-R1. The facility where we conduct our work is located in an area of a huge population, what increases the responsibility of our mission: conducting exercises and training are part of our daily activities. During the Emergency Exercise, accidents ranked 0-4 on INES (International Nuclear Events Scale) are simulated and involve: Police Department, Fire Department, workers, people from the community, and others. In the last exercise held in June 2014, the scenario contemplated a terrorist organization action that infiltrated in a group of students who were visiting the IEA-R1, tried to steal fresh fuel element to fabricate a dirty bomb. Emergency procedures and plans, timeline and metrics of the actions were applied to the Emergency Exercise evaluation. The next exercise will be held in November, with the simulation of the piping of the primary cooling circuit rupture, causing the emptying of the pool and the lack of cooling of the fuel elements in the reactor core: this will be the scenario. The skills acquired and the systems improvement have been very important tools for the reactor operation safety and the Nuclear Safety Team is making technical efforts so that these Emergency Exercises may be applied to other nuclear and radiological facilities. Equally important for the process of improving nuclear safety is the emphasis placed on implementing quality improvements to the human factor in the nuclear safety area, a crucial element that is often not considered by those outside the nuclear sector. Surely, the Diagram of Emergency Exercise Coordination application will improve and facilitate the organization, coordination and evaluation tasks. (author)

  20. Hand Washing Practices Among Emergency Medical Services Providers

    National Research Council Canada - National Science Library

    Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

    2015-01-01

    Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS...

  1. 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....

  2. Bringing the best of medical librarianship to the patient team.

    Science.gov (United States)

    Shearer, Barbara S; Seymour, Anne; Capitani, Cheryl

    2002-01-01

    This article introduces a series of articles examining the state of the medical library profession as practiced in the clinical context. It is widely understood that many changes across the spectrum of medical librarianship practice have been brought about by both technological advances and economic realities. These changes have created strains felt by many in the profession. Discussions of evolving roles for medical librarians that have gone on for years have taken on a new sense of urgency, not just because support of library services is at stake, but also because new opportunities, which many are eager to explore, await librarians. In June 2000, an editorial appearing in a mainstream medical journal proposed a reinvention of clinical librarianship that, if designed as presented in the editorial, would have a dramatic effect on current hospital-based library practice. This series of articles was developed in an effort to provide thoughtful consideration of the "informationist" model and to present new ways to look at the core competencies that define the profession.

  3. Strategies for reducing medication errors in the emergency department

    Directory of Open Access Journals (Sweden)

    Weant KA

    2014-07-01

    Full Text Available Kyle A Weant,1 Abby M Bailey,2 Stephanie N Baker2 1North Carolina Public Health Preparedness and Response, North Carolina Department of Health and Human Services, Raleigh, NC, 2University of Kentucky HealthCare, Department of Pharmacy Services, Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA Abstract: Medication errors are an all-too-common occurrence in emergency departments across the nation. This is largely secondary to a multitude of factors that create an almost ideal environment for medication errors to thrive. To limit and mitigate these errors, it is necessary to have a thorough knowledge of the medication-use process in the emergency department and develop strategies targeted at each individual step. Some of these strategies include medication-error analysis, computerized provider-order entry systems, automated dispensing cabinets, bar-coding systems, medication reconciliation, standardizing medication-use processes, education, and emergency-medicine clinical pharmacists. Special consideration also needs to be given to the development of strategies for the pediatric population, as they can be at an elevated risk of harm. Regardless of the strategies implemented, the prevention of medication errors begins and ends with the development of a culture that promotes the reporting of medication errors, and a systematic, nonpunitive approach to their elimination. Keywords: emergency medicine, pharmacy, medication errors, pharmacists, pediatrics

  4. A Telematic Support System for Emergency Medical Services

    Directory of Open Access Journals (Sweden)

    Michael Protogerakis

    2013-08-01

    Full Text Available The presented system is part of the research project Medon-@ ix for the safe application of information technology in preclinical emergency health care. It aims at supporting members of the emergency medical services (EMS at the incident location from a remote Competence Centre. In this paper cases in which a telematic support system can be used will be outlined. This includes the assistance of medical and non-medical staff in emergency incidents. The functional and non-functional requirements for the on site medical devices, the documentation system and the medical decision support system in the Competence Centre will be outlined. This paper also presents a possible hardware and software system architecture approach to a telematic support system.

  5. A medical team approach to children who fail to progress in school.

    Science.gov (United States)

    Cartwright, J D; Rosin, M F; Price, Y

    1980-02-16

    A multidisciplinary team composed of a psychologist, a speech therapist, an occupational therapist, a remedial teacher and a social worker and headed by a paediatrician examined 502 children referred for failure at school. The advantages and disadvantages of the team approach to such children are discussed. The establishment of multidisciplinary teams comprising medical, paramedical and educational members to diagnose and treat these children's problems and to monitor their progress, together with close liaison with the educational and welfare authorities, is recommended as being in the best interests of the child.

  6. Development of a rapid response plan for intraoperative emergencies: the Circulate, Scrub, and Technical Assistance Team.

    Science.gov (United States)

    Earle, David; Betti, Diane; Scala, Emilia

    2017-01-01

    Unplanned intraoperative events are inevitable and cause stress and inefficiency among staff. We believe that developing a technical rapid response team with explicitly defined, narrow roles would reduce the amount of chaos during such emergencies. This article provides a detailed description of the development and implementation of such a program. In-situ simulation of an intraoperative emergency was used for a formal assessment of the current practice. Debriefing sessions identified areas of improvement and solicited solutions. A multidisciplinary working group then developed and implemented the technical rapid response team based on the needs assessment. The program was designed to create a Circulating, Scrubbing, and Technical Assistance Team that helps with equipment, supplies, anesthesia, and communication. We anticipate the program will foster a culture of safety, and promote positive relationships and attitudes of the entire multidisciplinary team. In the future, research regarding patient outcomes and staff satisfaction and safety attitudes may help provide objective evidence of the benefits of the program. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Primary care emergency team training in situ means learning in real context

    Science.gov (United States)

    Brandstorp, Helen; Halvorsen, Peder A.; Sterud, Birgitte; Haugland, Bjørgun; Kirkengen, Anna Luise

    2016-01-01

    Objective The purpose of our study was to explore the local learning processes and to improve in situ team training in the primary care emergency teams with a focus on interaction. Design, setting and subjects As participating observers, we investigated locally organised trainings of teams constituted ad hoc, involving nurses, paramedics and general practitioners, in rural Norway. Subsequently, we facilitated focus discussions with local participants. We investigated what kinds of issues the participants chose to elaborate in these learning situations, why they did so, and whether and how local conditions improved during the course of three and a half years. In addition, we applied learning theories to explore and challenge our own and the local participants’ understanding of team training. Results In situ team training was experienced as challenging, engaging, and enabling. In the training sessions and later focus groups, the participants discussed a wide range of topics constitutive for learning in a sociocultural perspective, and topics constitutive for patient safety culture. The participants expanded the types of training sites, themes and the structures for participation, improved their understanding of communication and developed local procedures. The flexible structure of the model mirrors the complexity of medicine and provides space for the participants’ own sense of responsibility. Conclusion Challenging, monthly in situ team trainings organised by local health personnel facilitate many types of learning. The flexible training model provides space for the participants’ own sense of responsibility and priorities. Outcomes involve social and structural improvements, including a sustainable culture of patient safety. Key Points Challenging, monthly in situ team trainings, organised by local health personnel, facilitate many types of learning.The flexible structure of the training model mirrors the complexity of medicine and the realism of the

  8. Does Emotional Intelligence Change during Medical School Gross Anatomy Course? Correlations with Students' Performance and Team Cohesion

    Science.gov (United States)

    Holman, Michelle A.; Porter, Samuel G.; Pawlina, Wojciech; Juskewitch, Justin E.; Lachman, Nirusha

    2016-01-01

    Emotional intelligence (EI) has been associated with increased academic achievement, but its impact on medical education is relatively unexplored. This study sought to evaluate change in EI, performance outcomes, and team cohesion within a team-based medical school anatomy course. Forty-two medical students completed a pre-course and post-course…

  9. Does Emotional Intelligence Change during Medical School Gross Anatomy Course? Correlations with Students' Performance and Team Cohesion

    Science.gov (United States)

    Holman, Michelle A.; Porter, Samuel G.; Pawlina, Wojciech; Juskewitch, Justin E.; Lachman, Nirusha

    2016-01-01

    Emotional intelligence (EI) has been associated with increased academic achievement, but its impact on medical education is relatively unexplored. This study sought to evaluate change in EI, performance outcomes, and team cohesion within a team-based medical school anatomy course. Forty-two medical students completed a pre-course and post-course…

  10. Medical Rescue of China International Search & Rescue Team (CISAR) in Nepal Earthquake.

    Science.gov (United States)

    Yang, Jiong; Yang, Zhen; Lv, Qi; Liu, Hai-Feng; Ding, Hui; Yu, Meng-Yang; Zeng, Xi-Huan; Wang, Xin; Fan, Hao-Jun

    2016-05-18

    On April 25, 2015, a massive 8.1-magnitude earthquake struck Nepal at 2:11 pm (Beijing time). The 68-member-strong China International Search & Rescue Team (CISAR) left for Nepal at 6 am, April 26, to help with relief work. The CISAR was the first foreign team to rescue a survivor who was trapped beneath the rubble in the Gongabu area after the earthquake. On May 8, the team fulfilled the search-and-rescue mission and returned to Beijing. During the 2 weeks of rescue work, the team treated more than 3700 victims and cleared approximately 430 buildings. In this rescue mission, 10 experienced medical officers (including nine doctors and a nurse) from the General Hospital of Chinese People's Armed Police Force (PAP) comprised the medical team of CISAR. In this report, we focus on the medical rescues by CISAR and discuss the characteristics of the medical rescue in Nepal. (Disaster Med Public Health Preparedness. 2016;page 1 of 3).

  11. Designing emergency-medical-service helicopter interiors using virtual manikins.

    Science.gov (United States)

    Michalski, Rafal; Grobelny, Jerzy

    2014-01-01

    Researchers employed digital manikins to determine the space necessary in an emergency-medical-service helicopter to effectively and efficiently conduct life-saving medical procedures. To simulate resuscitation with appropriate digital human models, they used Anthropos ErgoMAX modeling software in the 3D Studio Max environment.

  12. 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

  13. 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 r

  14. Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

    Directory of Open Access Journals (Sweden)

    Peter Aitken

    2012-02-01

    Full Text Available It is likely that calls for disaster medical assistance teams (DMATs continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support.Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster.The response rate for this survey was 50% (59/118. Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59 strongly agreeing. Only one respondent (2% disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59, however, 34% (20/59 felt that transport to the site itself was problematic. Only 37% (22/59 felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59 and 47% (28/59 respectively, while only 28% (17/59 felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59 felt that equipment could be moved easily between areas by team members and 37% (22/59 that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59.This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between 20 and 40 kg, which would assist

  15. Relief for maritime medical emergencies through telematics.

    Science.gov (United States)

    Anogianakis, G; Maglavera, S; Pomportsis, A

    1998-12-01

    MERMAID is a European Union (EU)-financed maritime telemedicine project with global reach and 24-h multilingual capability, so as to serve multinational crews working in the isolation of the world's oceans. It provides a model for the provision of healthcare services based on the electronic transmission of medical information via ISDN-based video conferencing. This model is not limited to medical diagnostics, but it encompasses all cases in which the actual delivery of healthcare services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an extensive telecommunications infrastructure that includes both satellite transmission for ship to shore communication and an extensive ground-based network for summoning expert medical help from around the world so as to meet the project's multilinguality requirements and, therefore, the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low-, medium-, and high-bandwidth data requirements) are considered, while the full range of network choices (digital land lines, cellular/wireless, satellite, and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their lifecycle. Finally, out of that, MERMAID utilizes advanced land-based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  16. Implementation of a Team-based Physician Staffing Model at an Academic Emergency Department

    Directory of Open Access Journals (Sweden)

    Jose V. Nable

    2014-09-01

    Full Text Available Introduction: There is scant literature regarding the optimal resident physician staffing model of academic emergency departments (ED that maximizes learning opportunities. A department of emergency medicine at a large inner-city academic hospital initiated a team-based staffing model. Its pre-interventional staffing model consisted of residents and attending physicians being separately assigned patients, resulting in residents working with two different faculty providers in the same shift. This study aimed to determine if the post-interventional team-based system, in which residents were paired with a single attending on each shift, would result in improved residents’ learning and clinical experiences as manifested by resident evaluations and the number of patients seen. Methods: This retrospective before-and-after study at an academic ED with an annual volume of 52,000 patients examined the mean differences in five-point Likert-scale evaluations completed by residents assessing their ED rotation experiences in both the original and team-based staffing models. The residents were queried on their perceptions of feeling part of the team, decision-making autonomy, clinical experience, amount of supervision, quality of teaching, and overall rotational experience. We also analyzed the number of patients seen per hour by residents. Paired sample t-tests were performed. Residents who were in the program in the year preceding and proceeding the intervention were eligible for inclusion. Results: 34 of 38 eligible residents were included (4 excluded for lack of evaluations in either the pre- or post-intervention period. There was a statistically significant improvement in resident perception of the quality and amount of teaching, 4.03 to 4.27 (mean difference=0.24, p=0.03. There were non-statistically significant trends toward improved mean scores for all other queries. Residents also saw more patients following the initiation of the team-based model

  17. Policies for managing emergency medical services in mass casualty incidents.

    Science.gov (United States)

    Adini, B; Bodas, M; Nilsson, H; Peleg, K

    2017-09-01

    Diverse decision-making is needed in managing mass casualty incidents (MCIs), by emergency medical services (EMS). The aim of the study was to review consensus among international experts concerning policies of EMS management during MCIs. Applicability of 21 EMS policies was tested through a 2-cycle modified e-Delphi process, in which 38 multi-disciplinary experts from 10 countries participated. Threshold for approving proposed solutions was defined as consensus of >80%. Policies that did not achieve the targeted consensus were reviewed to detect variability according to respondents' origin country. 16 policies were endorsed in the first cycle including collaboration between ambulance service providers; implementing a unified mode of operation; preparing criteria for ground versus aerial evacuation; and, developing support systems for caregivers exposed to violence. An additional policy which proposed that senior EMS officers should not necessarily act as on-site MCI commanders was endorsed in the second cycle. Demographic breakdown of views concerning non-consensual policies revealed differences according to countries of origin. Assigning ambulances to off-duty team members was highly endorsed by experts from Israel and South Africa and strongly rejected by European respondents. Avoiding entry to risk areas until declared safe was endorsed by European, Asian and Oceanic experts, but rejected by Israeli, South African and North American experts. Despite uniqueness of countries and EMS agencies, solutions to most dilemmas were applicable to all organizations, regardless of location or affiliation. Cultural diversity was found concerning readiness to implement military-civilian collaboration in MCIs and a rigid separation between work-leisure responsibilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. The Danish quality database for prehospital emergency medical services

    DEFF Research Database (Denmark)

    Frischknecht Christensen, Erika; Berlac, Peter Anthony; Nielsen, Henrik;

    2016-01-01

    AIM OF DATABASE: The aim of the Danish quality database for prehospital emergency medical services (QEMS) is to assess, monitor, and improve the quality of prehospital emergency medical service care in the entire prehospital patient pathway. The aim of this review is to describe the design......: Descriptive data included age, region, and Danish Index for Emergency Care including urgency level. CONCLUSION: QEMS is a new database under establishment and is expected to provide the basis for quality improvement in the prehospital setting and in the entire patient care pathway, for example, by providing...

  19. Comparison of lecture and team-based learning in medical ethics education.

    Science.gov (United States)

    Ozgonul, Levent; Alimoglu, Mustafa Kemal

    2017-01-01

    Medical education literature suggests that ethics education should be learner-centered and problem-based rather than theory-based. Team-based learning is an appropriate method for this suggestion. However, its effectiveness was not investigated enough in medical ethics education. Is team-based learning effective in medical ethics education in terms of knowledge retention, in-class learner engagement, and learner reactions? This was a prospective controlled follow-up study. We changed lecture with team-based learning method to teach four topics in a 2-week medical ethics clerkship, while the remaining topics were taught by lectures. For comparison, we formed team-based learning and lecture groups, in which the students and instructor are the same, but the topics and teaching methodologies are different. We determined in-class learner engagement by direct observation and student satisfaction by feedback forms. Student success for team-based learning and lecture topics in the end-of-clerkship exam and two retention tests performed 1 year and 2 years later were compared. Ethical considerations: Ethical approval for the study was granted by Akdeniz University Board of Ethics on Noninvasive Clinical Human Studies Ethics committee. Short-term knowledge retention did not differ; however, team-based learning was found superior to lecture at long-term retention tests. Student satisfaction was high with team-based learning and in-class engagement was better in team-based learning sessions. Our results on learner engagement and satisfaction with team-based learning were similar to those of previous reports. However, knowledge retention results in our study were contrary to literature. The reason might be the fact that students prepared for the end-of-clerkship pass/fail exam (short term) regardless of the teaching method. But, at long-term retention tests, they did not prepare for the exam and answered the questions just using the knowledge retained in their memories. Our

  20. Foreign medical teams: what role can they play in response to a catastrophic disaster in the US?

    Science.gov (United States)

    Hanfling, Dan; Bouri, Nidhi

    2013-12-01

    Hurricane Katrina demonstrated that a catastrophic event in the continental United States (US) can overwhelm domestic medical response capabilities. The recent focus on response planning for a catastrophic earthquake in the New Madrid Seismic Zone and the detonation of an improvised nuclear device also underscore the need for improved plans. The purpose of this analysis is to identify the potential role of foreign medical teams (FMTs) in providing medical response to a catastrophic event in the US. We reviewed existing policies and frameworks that address medical response to catastrophic events and humanitarian emergencies and assess current response capabilities by a variety of FMTs. While several policies and plans outline the role of the US in providing medical assistance during foreign disasters, further planning is necessary to identify how the US will integrate foreign medical assistance during a domestic catastrophic event. We provide an overview of considerations related to federal roles and responsibilities for managing and integrating FMTs into the overarching domestic medical response to a catastrophic disaster occurring in the continental US.

  1. 76 FR 4151 - National Emergency Medical Services Advisory Council Teleconference Meeting

    Science.gov (United States)

    2011-01-24

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council... Transportation (DOT). Title: National Emergency Medical Services Advisory Council Teleconference Meeting. ACTION: National Emergency Medical Services Advisory Council (NEMSAC); notice of Teleconference Meeting....

  2. 76 FR 15043 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2011-03-18

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... (NHTSA), Department of Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services... public. The purpose of NEMSAC is to provide a nationally recognized council of emergency medical...

  3. 76 FR 15044 - Federal Interagency Committee on Emergency Medical Service (FICEMS) Teleconference Meeting

    Science.gov (United States)

    2011-03-18

    ... National Highway Traffic Safety Administration Federal Interagency Committee on Emergency Medical Service.... ACTION: Meeting Notice--Federal Interagency Committee on Emergency Medical Services. SUMMARY: NHTSA announces a teleconference meeting of the Federal Interagency Committee on Emergency Medical...

  4. 77 FR 46802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2012-08-06

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... medical services representatives and consumers to provide advice and recommendations regarding Emergency... of Emergency Medical Services, 1200 New Jersey Avenue SE., NTI-140, Washington, DC 20590,...

  5. 77 FR 27278 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2012-05-09

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... services representatives and consumers to provide advice and recommendations regarding Emergency Medical... Transportation, Office of Emergency Medical Services, 1200 New Jersey Avenue SE., NTI-140, Washington, DC...

  6. 75 FR 71791 - National Emergency Medical Services Advisory Council Meeting Notice

    Science.gov (United States)

    2010-11-24

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council Meeting...). ACTION: National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... public. The purpose of NEMSAC is to provide a nationally recognized council of emergency medical...

  7. 78 FR 67463 - National Emergency Medical Services Advisory Council (NEMSAC) and Federal Interagency Committee...

    Science.gov (United States)

    2013-11-12

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC) and Federal Interagency Committee on Emergency Medical Services (FICEMS); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council and...

  8. 78 FR 801 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2013-01-04

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... 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...

  9. 77 FR 9297 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2012-02-16

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... council of emergency medical services (EMS) representatives and consumers to provide advice and..., Director, U.S. Department of Transportation, Office of Emergency Medical Services, 1200 New Jersey...

  10. 76 FR 64174 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2011-10-17

    ... TRANSPORTATION National Highway Traffic Safety Administration National Emergency Medical Services Advisory... emergency medical services representatives and consumers to provide advice and recommendations regarding Emergency Medical Services (EMS) to DOT's NHTSA. DATES: The meeting will be held on December 13, 2011,...

  11. 77 FR 12908 - Appointment/Reappointment to the National Emergency Medical Services Advisory Council (NEMSAC)

    Science.gov (United States)

    2012-03-02

    ... the National Emergency Medical Services Advisory Council (NEMSAC). SUMMARY: NHTSA is soliciting... nationally recognized council of emergency medical services (EMS) representatives and consumers to provide..., Office of Emergency Medical Services, Attn: NEMSAC, 1200 New Jersey Avenue SE., NTI-140, Washington,...

  12. Using off-the-shelf medical devices for biomedical signal monitoring in a telemedicine system for emergency medical services.

    Science.gov (United States)

    Thelen, Sebastian; Czaplik, Michael; Meisen, Philipp; Schilberg, Daniel; Jeschke, Sabina

    2015-01-01

    In order to study new methods of telemedicine usage in the context of emergency medical services, researchers need to prototype integrated telemedicine systems. To conduct a one-year trial phase-intended to study a new application of telemedicine in German emergency medical services-we used off-the-shelf medical devices and software to realize real-time patient monitoring within an integrated telemedicine system prototype. We demonstrate its feasibility by presenting the integrated real-time patient monitoring solution, by studying signal delay and transmission robustness regarding changing communication channel characteristics, and by evaluating issues reported by the physicians during the trial phase. Where standards like HL7 and the IEEE 11073 family are intended to enable interoperability of product grade medical devices, we show that research prototypes benefit from the use of web technologies and simple device interfaces, as they simplify product development for a manufacturer and ease integration efforts for research teams. Embracing this approach for the development of new medical devices eases the constraint to use off-the-shelf products for research trials investigating innovative use of telemedicine.

  13. Development and validation of an instrument for measuring the quality of teamwork in teaching teams in postgraduate medical training (TeamQ)

    NARCIS (Netherlands)

    Slootweg, Irene A; Lombarts, Kiki M J M H; Boerebach, Benjamin C M; Heineman, Maas Jan; Scherpbier, Albert J J A; van der Vleuten, Cees P M

    2014-01-01

    BACKGROUND: Teamwork between clinical teachers is a challenge in postgraduate medical training. Although there are several instruments available for measuring teamwork in health care, none of them are appropriate for teaching teams. The aim of this study is to develop an instrument (TeamQ) for measu

  14. Development and validation of an instrument for measuring the quality of teamwork in teaching teams in postgraduate medical training (TeamQ.

    Directory of Open Access Journals (Sweden)

    Irene A Slootweg

    Full Text Available Teamwork between clinical teachers is a challenge in postgraduate medical training. Although there are several instruments available for measuring teamwork in health care, none of them are appropriate for teaching teams. The aim of this study is to develop an instrument (TeamQ for measuring teamwork, to investigate its psychometric properties and to explore how clinical teachers assess their teamwork.To select the items to be included in the TeamQ questionnaire, we conducted a content validation in 2011, using a Delphi procedure in which 40 experts were invited. Next, for pilot testing the preliminary tool, 1446 clinical teachers from 116 teaching teams were requested to complete the TeamQ questionnaire. For data analyses we used statistical strategies: principal component analysis, internal consistency reliability coefficient, and the number of evaluations needed to obtain reliable estimates. Lastly, the median TeamQ scores were calculated for teams to explore the levels of teamwork.In total, 31 experts participated in the Delphi study. In total, 114 teams participated in the TeamQ pilot. The median team response was 7 evaluations per team. The principal component analysis revealed 11 factors; 8 were included. The reliability coefficients of the TeamQ scales ranged from 0.75 to 0.93. The generalizability analysis revealed that 5 to 7 evaluations were needed to obtain internal reliability coefficients of 0.70. In terms of teamwork, the clinical teachers scored residents' empowerment as the highest TeamQ scale and feedback culture as the area that would most benefit from improvement.This study provides initial evidence of the validity of an instrument for measuring teamwork in teaching teams. The high response rates and the low number of evaluations needed for reliably measuring teamwork indicate that TeamQ is feasible for use by teaching teams. Future research could explore the effectiveness of feedback on teamwork in follow up measurements.

  15. Development and validation of an instrument for measuring the quality of teamwork in teaching teams in postgraduate medical training (TeamQ).

    Science.gov (United States)

    Slootweg, Irene A; Lombarts, Kiki M J M H; Boerebach, Benjamin C M; Heineman, Maas Jan; Scherpbier, Albert J J A; van der Vleuten, Cees P M

    2014-01-01

    Teamwork between clinical teachers is a challenge in postgraduate medical training. Although there are several instruments available for measuring teamwork in health care, none of them are appropriate for teaching teams. The aim of this study is to develop an instrument (TeamQ) for measuring teamwork, to investigate its psychometric properties and to explore how clinical teachers assess their teamwork. To select the items to be included in the TeamQ questionnaire, we conducted a content validation in 2011, using a Delphi procedure in which 40 experts were invited. Next, for pilot testing the preliminary tool, 1446 clinical teachers from 116 teaching teams were requested to complete the TeamQ questionnaire. For data analyses we used statistical strategies: principal component analysis, internal consistency reliability coefficient, and the number of evaluations needed to obtain reliable estimates. Lastly, the median TeamQ scores were calculated for teams to explore the levels of teamwork. In total, 31 experts participated in the Delphi study. In total, 114 teams participated in the TeamQ pilot. The median team response was 7 evaluations per team. The principal component analysis revealed 11 factors; 8 were included. The reliability coefficients of the TeamQ scales ranged from 0.75 to 0.93. The generalizability analysis revealed that 5 to 7 evaluations were needed to obtain internal reliability coefficients of 0.70. In terms of teamwork, the clinical teachers scored residents' empowerment as the highest TeamQ scale and feedback culture as the area that would most benefit from improvement. This study provides initial evidence of the validity of an instrument for measuring teamwork in teaching teams. The high response rates and the low number of evaluations needed for reliably measuring teamwork indicate that TeamQ is feasible for use by teaching teams. Future research could explore the effectiveness of feedback on teamwork in follow up measurements.

  16. System of acute medical support to emergency during dental treatment.

    Science.gov (United States)

    Kawahara, M; Takeshita, T; Akita, S

    1986-01-01

    The Resuscitation Committee of Hiroshima City Dental Association was established in 1983 in order to provide acute medical support in case of emergency during dental treatment at private dental clinics. This Committee is composed of representatives from the Hiroshima City Dental Association, Hiroshima University School of Dentistry, Hiroshima University School of Medicine, Hiroshima City Health Bureau, and Hiroshima City Fire and Ambulance Department. A portable ECG monitor with defibrillator and a resuscitation kit are held in readiness at the Hiroshima University Hospital. In case of emergency during dental treatment at a private dental clinic, we hurry to the clinic with the resuscitation set and give emergency treatment. We have been involved in two cases of emergency since this system started. Both of them recovered without any sequelae. Besides these activities, we give lectures annually to dentists and dental hygienists on the treatment of medical emergencies.

  17. [Career planning for explanation of clinical test results and program of inspections: developing medical technologists for team medical care].

    Science.gov (United States)

    Uchida, Misuko

    2013-04-01

    Current medical care is subdivided according to medical advances, and sophistication and new techniques are necessary. In this setting, doctors and nurses have been explaining to and consulting patients about their medical examinations; however, in recent years, medical technologists have performed these duties at the start of the team's medical care. Therefore, we think it is possible for patients to receive clear and convincing explanations. Most patients cannot understand their examination data, which are written using numbers and charts, etc. Recently, the Nagano Medical Technologist Society has been developing technologists who could explain examination results to patients. This development training included hospitality and communication. The certificate of completion will be issued in March when the program starts.

  18. Physiological Synchronization in Emergency Response Teams: Subjective Workload, Drivers and Empaths.

    Science.gov (United States)

    Guastello, Stephen J; Marra, David E; Perna, Claire; Castro, Julian; Gomez, Maribeth; Peressini, Anthony F

    2016-04-01

    Behavioral and physiological synchronization have important implications for work teams with regard to workload management, coordinated behavior and overall functioning. This study extended previous work on the nonlinear statistical structure of GSR series in dyads to larger teams and included subjective ratings of workload and contributions to problem solving. Eleven teams of 3 or 4 people played a series of six emergency response (ER) games against a single opponent. Seven of the groups worked under a time pressure instruction at the beginning of the first game. The other four groups were not given that instruction until the beginning of the fourth game. The optimal lag length for the teams, which appeared to be phase-locked, was substantially shorter than that obtained previously for loosely-coupled dyads. There was a complex nonlinear effect from the time pressure manipulation on the autocorrelation over time that reflected workload and fatigue dynamics that were operating. The R2 values for linear and nonlinear statistical models differed by less than .01. The average amount of influence from one ER team member to another was 4.5-4.7% of the variance in GSR readings. ER team members were classified as drivers and empaths, based on the autocorrelations and transfer influences to and from other players in the GSR time series. Empaths were rated by their peers as making more types of positive contributions to the problem solving discussions than others, and drivers received the lowest ratings. Larger Lyapunov exponents that were calculated from the GSR time series were positively correlated with individuals' ratings of subjective workload and were negatively correlated with leadership indicators. Several directions for further research are outlined.

  19. Ensuring safe and quality medication use in nuclear medicine: a collaborative team achieves compliance with medication management standards.

    Science.gov (United States)

    Beach, Trent A; Griffith, Karen; Dam, Hung Q; Manzone, Timothy A

    2012-03-01

    As hospital nuclear medicine departments were established in the 1960s and 1970s, each department developed detailed policies and procedures to meet the specialized and specific handling requirements of radiopharmaceuticals. In many health systems, radiopharmaceuticals are still unique as the only drugs not under the control of the health system pharmacy; however, the clear trend--and now an accreditation requirement--is to merge radiopharmaceutical management with the overall health system medication management system. Accomplishing this can be a challenge for both nuclear medicine and pharmacy because each lacks knowledge of the specifics and needs of the other field. In this paper we will first describe medication management standards, what they cover, and how they are enforced. We will describe how we created a nuclear medicine and pharmacy team to achieve compliance, and we will present the results of their work. We will examine several specific issues raised by incorporating radiopharmaceuticals in the medication management process and describe how our team addressed those issues. Finally, we will look at how the medication management process helps ensure ongoing quality and safety to patients through multiple periodic reviews. The reader will gain an understanding of medication management standards and how they apply to nuclear medicine, learn how a nuclear medicine and pharmacy team can effectively merge nuclear medicine and pharmacy processes, and gain the ability to achieve compliance at the reader's own institution.

  20. 3 CFR 8383 - Proclamation 8383 of May 20, 2009. Emergency Medical Services Week, 2009

    Science.gov (United States)

    2010-01-01

    ... responders, emergency medical technicians, paramedics, nurses, physicians, and many others. These highly... skills. All share a common aspiration to help those in need, and during Emergency Medical Services...

  1. 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.

  2. Simulation in medical school education: review for emergency medicine.

    Science.gov (United States)

    Chakravarthy, Bharath; Ter Haar, Elizabeth; Bhat, Srinidhi Subraya; McCoy, Christopher Eric; Denmark, T Kent; Lotfipour, Shahram

    2011-11-01

    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.

  3. Losing a valued member of the medical practice team.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    Losing a valued member of your staff can be disruptive, painful, and costly to your medical practice. And despite your best intentions and impeccable employee management policies and skills, things will happen beyond your control, and people move on. Being prepared for that possibility will help you minimize and contain the damage and move your practice forward. This article suggests 15 strategies that you can use to mitigate the effects of losing a valued employee. These include strategies to protect your practice's interests and several that will smooth the transition for your remaining staff. This article also describes 10 ways that losing a valued employee can impact a practice. It offers 10 additional strategies to help you cope with the death of an employee, one of the most difficult challenges a practice manager may ever face. This article further suggests several easy-to-implement practice management techniques that will help you soften the blow of employee turnover. It offers a sample farewell letter to announce an employee's departure from your practice and suggests six knowledge transfer questions to ask before the employee leaves. Finally, this article provides a comprehensive list of more than 30 thoughtful, eye-opening, and revealing questions that you can ask in an employee exit interview or exit survey.

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

    Science.gov (United States)

    Furniss, Dominic; Blandford, Ann

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

  5. Is networking different with part-time working colleagues? A study of medical teams.

    NARCIS (Netherlands)

    Heiligers, P.; Jong, J. de; Groenewegen, P.; Hingstman, L.

    2007-01-01

    Changes in work arrangements like the introduction of part-time work can affect both formal and informal organization. This study will focus on informal networks amongst teams of medical specialists, some but not all of which include part-time workers. Are there notable differences in the structure

  6. Team communication amongst clinical teachers in a formal meeting of post graduate medical training

    NARCIS (Netherlands)

    Slootweg, I.A.; Scherpbier, A.; Leeuw, R. van Der; Heineman, M.J.; Vleuten, C. van der; Lombarts, K.M.

    2016-01-01

    The importance of team communication, or more specifically speaking up, for safeguarding quality of patient care is increasingly being endorsed in research findings. However, little is known about speaking up of clinical teachers in postgraduate medical training. In order to determine how clinical

  7. Team communication amongst clinical teachers in a formal meeting of post graduate medical training

    NARCIS (Netherlands)

    Slootweg, I.A.; Scherpbier, A.; Leeuw, R. van Der; Heineman, M.J.; Vleuten, C. van der; Lombarts, K.M.

    2016-01-01

    The importance of team communication, or more specifically speaking up, for safeguarding quality of patient care is increasingly being endorsed in research findings. However, little is known about speaking up of clinical teachers in postgraduate medical training. In order to determine how clinical t

  8. Cancellations of (helicopter-transported) mobile medical team dispatches in the Netherlands

    NARCIS (Netherlands)

    Giannakopoulos, G.F.; Lubbers, W.D.; Christiaans, H.M.T.; van Exter, P.; Bet, P.; Hugen, P.J.C.; Innemee, G.; Schubert, E.; de Lange-Klerk, E.S.M.; Goslings, J.C.; Jukema, G.N.

    2010-01-01

    The trauma centre of the Trauma Center Region North-West Netherlands (TRNWN) has consensus criteria for Mobile Medical Team (MMT) scene dispatch. The MMT can be dispatched by the EMS-dispatch centre or by the on-scene ambulance crew and is transported by helicopter or ground transport. Although much

  9. Medical emergencies on board commercial airlines: is documentation as expected?

    Science.gov (United States)

    Sand, Michael; Morrosch, Stephan; Sand, Daniel; Altmeyer, Peter; Bechara, Falk G

    2012-12-12

    The purpose of this study was to perform a descriptive, content-based analysis on the different forms of documentation for in-flight medical emergencies that are currently provided in the emergency medical kits on board commercial airlines. Passenger airlines in the World Airline Directory were contacted between March and May 2011. For each participating airline, sample in-flight medical emergency documentation forms were obtained. All items in the sample documentation forms were subjected to a descriptive analysis and compared to a sample "medical incident report" form published by the International Air Transport Association (IATA). A total of 1,318 airlines were contacted. Ten airlines agreed to participate in the study and provided a copy of their documentation forms. A descriptive analysis revealed a total of 199 different items, which were summarized into five sub-categories: non-medical data (63), signs and symptoms (68), diagnosis (26), treatment (22) and outcome (20). The data in this study illustrate a large variation in the documentation of in-flight medical emergencies by different airlines. A higher degree of standardization is preferable to increase the data quality in epidemiologic aeromedical research in the future.

  10. Roles of the Team Physician.

    Science.gov (United States)

    Kinderknecht, James

    2016-07-01

    The roles of the team physician are much more than providing medical coverage at a sport's event. The team physician has numerous administrative and medical responsibilities. The development of an emergency action plan is an essential administrative task as an example. The implementation of the components of this plan requires the team physician to have the necessary medical knowledge and skill. An expertise in returning an athlete to play after an injury or other medical condition is a unique attribute of the trained team physician. The athlete's return to participation needs to start with the athlete's safety and best medical interests but not inappropriately restrict the individual from play. The ability to communicate on numerous levels needs to be a characteristic of the team physician. There are several potential ethical conflicts the team physician needs to control. These conflicts can create unique medicolegal issues. The true emphasis of the team physician is to focus on what is best for the athlete.

  11. The role of the emergency services in the optimisation of primary angioplasty: experience from London and the Heart Attack Team.

    Science.gov (United States)

    Dalby, Miles; Whitbread, Mark

    2013-08-22

    Early ambulance services often confined their activities to a "scoop and run" approach, conveying sick patients quickly to the nearest emergency department. With the advent of modern ST-elevation myocardial infarction (STEMI) management and primary percutaneous coronary intervention (PPCI), the role of the emergency medical service (EMS) has expanded significantly. This review discusses the critical and evolving collaboration between the EMS and the heart attack centre. Speed of reperfusion is a major determinant of outcome in STEMI and, whilst the patient delay (symptom to call time) has a central role in this, system delay (first medical contact to balloon time) is linked to mortality and is used to measure the response of a PPCI programme and is a key element of contemporary guidelines. In addition to rapid diagnosis and transfer to the heart attack centre, the EMS has to deliver a growing number of established treatments including resuscitation and drug therapy. EMS also continually needs to develop expertise in new techniques such as advanced management of cardiac arrest patients, including automated cardiopulmonary resuscitation, and will need to deliver newer therapies if trials support their use, including cooling and preconditioning. Ultimately, the EMS has a central role in the management of STEMI patients which needs to be fully aligned with the heart attack centres. This integration of services is perhaps best regarded as the Heart Attack Team.

  12. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module XI. Obstetric/Gynecologic Emergencies.

    Science.gov (United States)

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

    This instructor's lesson plan guide on obstetric/gynecologic emergencies is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Six units of study are presented: (1) anatomy and physiology of the female reproductive system; (2) patient assessment; (3) pathophysiology and management of gynecologic…

  13. Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments.

    Science.gov (United States)

    Wijesekera, Olindi; Reed, Amanda; Chastain, Parker S; Biggs, Shauna; Clark, Elizabeth G; Kole, Tamorish; Chakrapani, Anoop T; Ashish, Nandy; Rajhans, Prasad; Breaud, Alan H; Jacquet, Gabrielle A

    2016-12-01

    Introduction Without a universal Emergency Medical Services (EMS) system in India, data on the epidemiology of patients who utilize EMS are limited. This retrospective chart review aimed to quantify and describe the burden of disease and patient demographics of patients who arrived by EMS to four Indian emergency departments (EDs) in order to inform a national EMS curriculum.

  14. Pharmacists on primary care teams: Effect on antihypertensive medication management in patients with type 2 diabetes.

    Science.gov (United States)

    Omran, Dima; Majumdar, Sumit R; Johnson, Jeffrey A; Tsuyuki, Ross T; Lewanczuk, Richard Z; Guirguis, Lisa M; Makowsky, Mark; Simpson, Scot H

    2015-01-01

    To identify which activities produced a significant improvement in blood pressure control in patients with type 2 diabetes when pharmacists were added to primary care teams. This prespecified, secondary analysis evaluated medication management data from a randomized controlled trial. The primary outcome was a change in treatment, defined as addition, dosage increase, or switching of an antihypertensive medication during the 1-year study period. The secondary outcome was a change in antihypertensive medication adherence using the medication possession ratio (MPR). The 200 evaluable trial patients had a mean age of 59 (SD, 11) years, 44% were men, and mean blood pressure was 130 (SD, 16)/74 (SD, 10) mm Hg at baseline. Treatment changes occurred in 45 (42%) of 107 patients in the intervention group and 24 (26%) of 93 patients in the control group (RR, 1.63; 95% CI, 1.08-2.46). Addition of a new medication was the most common type of change, occurring in 34 (32%) patients in the intervention group and 17 (18%) patients in the control group (P = 0.029). Adherence to antihypertensive medication was high at baseline (MPR, 93%). Although medication adherence improved in the intervention group (MPR, 97%) and declined in the control group (MPR, 91%), the difference between groups was not significant (P = 0.21). The observed improvement in blood pressure control when pharmacists were added to primary care teams was likely achieved through antihypertensive treatment changes and not through improvements in antihypertensive medication adherence.

  15. The culture of patient safety from the perspective of the pediatric emergency nursing team

    Directory of Open Access Journals (Sweden)

    Taise Rocha Macedo

    Full Text Available Abstract OBJECTIVE To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. METHOD A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. RESULTS Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. CONCLUSION Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario.

  16. 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.

  17. Radiation dose from medical imaging: a primer for emergency physicians.

    Science.gov (United States)

    Jones, Jesse G A; Mills, Christopher N; Mogensen, Monique A; Lee, Christoph I

    2012-05-01

    Medical imaging now accounts for most of the US population's exposure to ionizing radiation. A substantial proportion of this medical imaging is ordered in the emergency setting. We aim to provide a general overview of radiation dose from medical imaging with a focus on computed tomography, as well as a literature review of recent efforts to decrease unnecessary radiation exposure to patients in the emergency department setting. We conducted a literature review through calendar year 2010 for all published articles pertaining to the emergency department and radiation exposure. The benefits of imaging usually outweigh the risks of eventual radiation-induced cancer in most clinical scenarios encountered by emergency physicians. However, our literature review identified 3 specific clinical situations in the general adult population in which the lifetime risks of cancer may outweigh the benefits to the patient: rule out pulmonary embolism, flank pain, and recurrent abdominal pain in inflammatory bowel disease. For these specific clinical scenarios, a physician-patient discussion about such risks and benefits may be warranted. Emergency physicians, now at the front line of patients' exposure to ionizing radiation, should have a general understanding of the magnitude of radiation dose from advanced medical imaging procedures and their associated risks. Future areas of research should include the development of protocols and guidelines that limit unnecessary patient radiation exposure.

  18. Expectations and requests regarding team training interventions to promote interdisciplinary collaboration in medical rehabilitation – A qualitative study

    OpenAIRE

    Müller, C; Plewnia, A.; Becker, S; Rundel, M.; Zimmermann, L.; Körner, M

    2015-01-01

    Background Interdisciplinary teamwork and team interventions are highly valued in the rehabilitation sector because they can improve outcomes of care for persons with complex health problems. However, little is known about expectations and requests regarding team interventions, especially in medical rehabilitation. This study aimed to explore how clinical managers and health professionals within multidisciplinary rehabilitation teams describe their expectations and requests regarding team-tra...

  19. Medical capability team: the clinical microsystem for combat healthcare delivery in counterinsurgency operations.

    Science.gov (United States)

    Clark, Susz; Van Steenvort, Jon K

    2008-01-01

    Today's operational environment in the support of counterinsurgency operations requires greater tactical and operational flexibility and diverse medical capabilities. The skills and organizations required for full spectrum medical operations are different from those of the past. Combat healthcare demands agility and the capacity for rapid change in clinical systems and processes to better support the counterinsurgency environment. This article proposes the Army Medical Department (AMEDD) develop and implement the medical capability team (MCT) for combat healthcare delivery. It discusses using the concept of the brigade combat team to develop medical capability teams as the unit of effectiveness to transform frontline care; provides a theoretical overview of the MCT as a "clinical microsystem"; discusses MCT leadership, training, and organizational support, and the deployment and employment of the MCT in a counterinsurgency environment. Additionally, this article proposes that the AMEDD initiate the development of an AMEDD Combat Training Center of Excellence to train and validate the MCTs. The complexity of combat healthcare demands an agile and campaign quality AMEDD with joint expeditionary capability in order to promote the best patient outcomes in a counterinsurgency environment.

  20. Medical student-developed obesity education program uses modified team-based learning to motivate adolescents.

    Science.gov (United States)

    McAndrew, Sarah; Jackman, Carina; Sisto, Paola Palma

    2012-01-01

    Childhood obesity is reaching epidemic proportions and requires intervention. To educate high school (HS) students on the effects of obesity and implement small healthy changes. Train medical students to educate and motivate adolescents and utilize a modified team-based learning format. A medical student-created HS-based module was developed to educate adolescents on obesity's effects on health. Over 2 years, 25 medical students from each semester were trained and presented to 1590 freshmen and sophomores at suburban HSs in Milwaukee, Wisconsin. The program included an interactive power point and a 30-day challenge to make small measurable changes in their current health behaviors. A modified team-based learning format was included to engage students and increase classroom interaction. Medical students reported the program improved their ability to communicate with adolescents and enhanced their training as future physicians. Teachers felt students had sustained retention of knowledge at the end of 30 days and the majority of students fulfilled their self-imposed challenge. A student-run HS obesity education module using a portion of team-based learning was successfully implemented into HS health science curriculums, exposed medical students to community advocacy while educating and motivating adolescents to improve health behaviors.

  1. Icon and user interface design for emergency medical information systems: a case study.

    Science.gov (United States)

    Salman, Y Batu; Cheng, Hong-In; Patterson, Patrick E

    2012-01-01

    A usable medical information system should allow for reliable and accurate interaction between users and the system in emergencies. A participatory design approach was used to develop a medical information system in two Turkish hospitals. The process consisted of task and user analysis, an icon design survey, initial icon design, final icon design and evaluation, and installation of the iconic medical information system with the icons. We observed work sites to note working processes and tasks related to the information system and interviewed medical personnel. Emergency personnel then participated in the design process to develop a usable graphical user interface, by drawing icon sketches for 23 selected tasks. Similar sketches were requested for specific tasks such as family medical history, contact information, translation, addiction, required inspections, requests and applications, and nurse observations. The sketches were analyzed and redesigned into computer icons by professional designers and the research team. A second group of physicians and nurses then tested the understandability of the icons. The user interface layout was examined and evaluated by system users, followed by the system's installation. Medical personnel reported the participatory design process was interesting and believed the resulting designs would be more familiar and friendlier.

  2. Emergency medical rescue efforts after a major earthquake: lessons from the 2008 Wenchuan earthquake.

    Science.gov (United States)

    Zhang, Lulu; Liu, Xu; Li, Youping; Liu, Yuan; Liu, Zhipeng; Lin, Juncong; Shen, Ji; Tang, Xuefeng; Zhang, Yi; Liang, Wannian

    2012-03-01

    Major earthquakes often result in incalculable environmental damage, loss of life, and threats to health. Tremendous progress has been made in response to many medical challenges resulting from earthquakes. However, emergency medical rescue is complicated, and great emphasis should be placed on its organisation to achieve the best results. The 2008 Wenchuan earthquake was one of the most devastating disasters in the past 10 years and caused more than 370,000 casualties. The lessons learnt from the medical disaster relief effort and the subsequent knowledge gained about the regulation and capabilities of medical and military back-up teams should be widely disseminated. In this Review we summarise and analyse the emergency medical rescue efforts after the Wenchuan earthquake. Establishment of a national disaster medical response system, an active and effective commanding system, successful coordination between rescue forces and government agencies, effective treatment, a moderate, timely and correct public health response, and long-term psychological support are all crucial to reduce mortality and morbidity and promote overall effectiveness of rescue efforts after a major earthquake.

  3. Review on emergency medical response against terrorist attack.

    Science.gov (United States)

    Wang, De-Wen; Liu, Yao; Jiang, Ming-Min

    2014-01-01

    Terrorism is a global issue and a constant international threat. As a result, anti-terrorism and emergency response strategies are tasks of critical importance that have a direct impact on the national security of every country in the world. This paper reviews new characteristics of international anti-terrorism measures and offers an in-depth reflection on emergency medical response countermeasures; additionally, this paper presents the goals of related research, which include: 1) to present a model of a highly efficient medical response command; 2) to introduce the pre-planning phases of the emergency medical response; 3) to establish a response system capable of handling various types of terror attacks; 4) to promote anti-terrorism awareness to the general public and emphasize its prevention; and 5) to continue basic investigations into emergency medical responses for various types of terrorist attacks (for example, the classifications and characteristics of new injuries, pathophysiology, prevention and treatment of the resultant stress disorders, improved high-efficiency medical response measures and equipment, etc.).

  4. 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.

  5. Medication errors of nurses in the emergency department.

    Science.gov (United States)

    Ehsani, Seyyedeh Roghayeh; Cheraghi, Mohammad Ali; Nejati, Amir; Salari, Amir; Esmaeilpoor, Ayeshe Haji; Nejad, Esmaeil Mohammad

    2013-01-01

    Patient safety is one of the main concepts in the field of healthcare provision and a major component of health services quality. One of the important stages in promotion of the safety level of patients is identification of medication errors and their causes. Medical errors such as medication errors are the most prevalent errors that threaten health and are a global problem. Execution of medication orders is an important part of the treatment and care process and is regarded as the main part of the nurses' performance. The purpose of this study was to explore the medication error reporting rate, error types and their causes among nurses in the emergency department. In this descriptive study, 94 nurses of the emergency department of Imam Khomeini Hospital Complex were selected based on census in 2010-2011. Data collection tool was a researcher-made questionnaire consisting of two parts: demographic information, and types and causes of medication errors. After confirming content-face validity, reliability of the questionnaire was determined to be 0.91 using Cronbach's alpha test. Data analyses were performed by descriptive statistics and inferential statistics. SPSS-16 software was used in this study and P values less than 0.05 were considered significant. The mean age of the nurses was 27.7 ± 3.4 years, and their working experience was 7.3 ± 3.4 years. Of participants 46.8% had committed medication errors in the past year, and the majority (69.04%) had committed the errors only once. Thirty two nurses (72.7%) had not reported medication errors to head nurses or the nursing office. The most prevalent types of medication errors were related to infusion rates (33.3%) and administering two doses of medicine instead of one (23.8%). The most important causes of medication errors were shortage of nurses (47.6%) and lack of sufficient pharmacological information (30.9%). This study showed that the risk of medication errors among nurses is high and medication errors are a

  6. Human resources issues and Australian Disaster Medical Assistance Teams: results of a national survey of team members

    Directory of Open Access Journals (Sweden)

    Peter Aitken

    2012-05-01

    Full Text Available Background: Calls for disaster medical assistance teams (DMATs are likely to continue in response to international disasters. As part of a national survey, this study was designed to evaluate Australian DMAT experience in relation to the human resources issues associated with deployment. Methods: Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. Results: The response rate for this survey was 50% (59/118. Most personnel had deployed to the Asian Tsunami affected areas with DMAT members having significant clinical and international experience. While all except one respondent stated they received a full orientation prior to deployment, only 34% of respondents (20/59 felt their role was clearly defined pre deployment. Approximately 56% (33/59 felt their actual role matched their intended role and that their clinical background was well suited to their tasks. Most respondents were prepared to be available for deployment for 1 month (34%, 20/59. The most common period of notice needed to deploy was 6–12 hours for 29% (17/59 followed by 12–24 hours for 24% (14/59. The preferred period of overseas deployment was 14–21 days (46%, 27/59 followed by 1 month (25%, 15/59 and the optimum shift period was felt to be 12 hours by 66% (39/59. The majority felt that there was both adequate pay (71%, 42/59 and adequate indemnity (66%, 39/59. Almost half (49%, 29/59 stated it was better to work with people from the same hospital and, while most felt their deployment could be easily covered by staff from their workplace (56%, 33/59 and caused an inconvenience to their colleagues (51%, 30/59, it was less likely to interrupt service delivery in their workplace (10%, 6/59 or cause an inconvenience to patients (9%, 5/59. Deployment was felt to

  7. Impact of team-versus ward-aligned clinical pharmacy on unintentional medication discrepancies at admission.

    Science.gov (United States)

    Byrne, Sharon M; Grimes, Tamasine C; Jago-Byrne, Marie-Claire; Galvin, Mairéad

    2017-02-01

    Background Medication reconciliation at admission to hospital reduces the prevalence of medication errors. Strategies are needed to ensure timely and efficient delivery of this service. Objective To investigate the effect of aligning clinical pharmacy services with consultant teams, by pharmacists attending post-admission ward rounds, in comparison to a ward-based service, on prevalence of unintentional unresolved discrepancies 48 h into admission. Setting A 243-bed public university teaching hospital in Ireland. Method A prospective, uncontrolled before-after observational study. A gold standard preadmission medication list was completed for each patient and compared with the patient's admission medication prescription and discrepancies were noted. Unresolved discrepancies were examined at 48 h after admission to determine if they were intentional or unintentional. Main outcome measured Number of patients with one or more unintentional, unresolved discrepancy 48 h into admission. Results Data were collected for 140 patients, of whom 73.5% were over 65 years of age. There were no differences between before (ward-aligned) and after (team-aligned) groups regarding age, number of medications or comorbidities. There was a statistically significant reduction in the prevalence of unintentional, unresolved discrepancy(s) per patient (67.3 vs. 27.3%, p medication (13.7 vs. 4.1%, p medications and comorbidities (adjusted odds ratio 4.9, 95% confidence interval 2.3-10.6). Conclusion A consultant team-based clinical pharmacy service contributed positively to medication reconciliation at admission, reducing the prevalence of unintentional, unresolved discrepancy(s) present 48 h after admission.

  8. 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

    2017-08-15

    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.

  9. Emerging programmed aging mechanisms and their medical implications.

    Science.gov (United States)

    Goldsmith, Theodore C

    2016-01-01

    For many generations programmed aging in humans was considered theoretically impossible and medical attempts to treat or delay age-related diseases were based on non-programmed aging theories. However, there is now an extensive theoretical basis for programmed mammal aging and substantially funded medical research efforts based on programmed aging theories are underway. This article describes the very different disease mechanism concepts that logically result from the theories and the impacts emerging programmed aging mechanisms will have on funding and performing medical research on age-related conditions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. [Medical short stay unit for geriatric patients in the emergency department: clinical and healthcare benefits].

    Science.gov (United States)

    Pareja, Teresa; Hornillos, Mercedes; Rodríguez, Miriam; Martínez, Javier; Madrigal, María; Mauleón, Coro; Alvarez, Bárbara

    2009-01-01

    To evaluate the impact of comprehensive geriatric assessment and management of high-risk elders in a medical short stay unit located in the emergency department of a general hospital. We performed a descriptive, prospective study of patients admitted to the medical short stay unit for geriatric patients of the emergency department in 2006. A total of 749 patients were evaluated, with a mean (standard deviation) stay in the unit of 37 (16) h. The mean age was 86 (7) years; 57% were women, and 50% had moderate-severe physical impairment and dementia. Thirty-five percent lived in a nursing home. The most frequent reason for admission was exacerbation of chronic cardiopulmonary disease. Multiple geriatric syndromes were identified. The most frequent were immobility, pressure sores and behavioral disorders related to dementia. Seventy percent of the patients were discharged to home after being stabilized and were followed-up by the geriatric clinic and day hospital (39%), the home care medical team (11%), or the nursing home or primary care physician (20%). During the month after discharge, 17% were readmitted and 7.7% died, especially patients with more advanced age or functional impairment. After the unit was opened, admissions to the acute geriatric unit fell by 18.2%. Medical short stay units for geriatric patients in emergency departments may be useful for geriatric assessment and treatment of exacerbations of chronic diseases. These units can help to reduce the number of admissions and optimize the care provided in other ambulatory and domiciliary geriatric settings.

  11. [Characterization of the physical symptoms of stress in the emergency health care team].

    Science.gov (United States)

    Farias, Sílvia Maria de Carvalho; Teixeira, Olga Lúcia de Carvalho; Moreira, Walter; Oliveira, Márcia Aparecida Ferreira de; Pereira, Maria Odete

    2011-06-01

    Nursing professionals working in Emergency Care suffer from the physical symptoms of stress in their everyday activity. The objective of this study was to characterize these symptoms using the Occupational Stress Indicator, a semi-structured instrument. To do this, the authors created open questions that were applied in interviews that were recorded and analyzed. The researchers listed the following physical symptoms: headache, a sensation of fatigue, leg pain, and tachycardia. According to reports form the workers, pain always resulted from emotional stress or appeared after providing emergency care, which suggests the workers find it very difficult to differentiate physical from mental stress. The investigation found that there is a need for measures to follow workers in their working activity. A manual was created, containing basic suggestions to improve the quality of life of the health team.

  12. Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum

    Directory of Open Access Journals (Sweden)

    Ambrose H. Wong

    2015-10-01

    Full Text Available Introduction: While treating potentially violent patients in the emergency department (ED, both patients and staff may be subject to unintentional injury. Emergency healthcare providers are at the greatest risk of experiencing physical and verbal assault from patients. Preliminary studies have shown that a teambased approach with targeted staff training has significant positive outcomes in mitigating violence in healthcare settings. Staff attitudes toward patient aggression have also been linked to workplace safety, but current literature suggests that providers experience fear and anxiety while caring for potentially violent patients. The objectives of the study were (1 to develop an interprofessional curriculum focusing on improving teamwork and staff attitudes toward patient violence using simulation-enhanced education for ED staff, and (2 to assess attitudes towards patient aggression both at pre- and post-curriculum implementation stages using a survey-based study design. Methods: Formal roles and responsibilities for each member of the care team, including positioning during restraint placement, were predefined in conjunction with ED leadership. Emergency medicine residents, nurses and hospital police officers were assigned to interprofessional teams. The curriculum started with an introductory lecture discussing de-escalation techniques and restraint placement as well as core tenets of interprofessional collaboration. Next, we conducted two simulation scenarios using standardized participants (SPs and structured debriefing. The study consisted of a survey-based design comparing pre- and post-intervention responses via a paired Student t-test to assess changes in staff attitudes. We used the validated Management of Aggression and Violence Attitude Scale (MAVAS consisting of 30 Likert-scale questions grouped into four themed constructs. Results: One hundred sixty-two ED staff members completed the course with >95% staff participation

  13. Knowledge and use of emergency contraception by medical doctors ...

    African Journals Online (AJOL)

    Knowledge and use of emergency contraception by medical doctors on internship in ... while about a quarter (26.9%) routinely counsel women about ECP use. ... We recommend that in.service training should focus more on EC to improve the ...

  14. 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…

  15. 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,…

  16. 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…

  17. Emergency Medical Technician. Competency Based Education Curriculum. Student Material.

    Science.gov (United States)

    Spotts, Sue Ann

    Beginning with an introductory handbook, this competency-based curriculum contains 13 modules for an 81-hour secondary- or postsecondary-level course for Emergency Medical Technician (EMT). Introductory materials include module component descriptions and information for administering an EMT training program, such as an instructor's schedule, list…

  18. National Apprenticeship and Training Standards for Emergency Medical Technicians.

    Science.gov (United States)

    Employment and Training Administration (DOL), Washington, DC.

    Developed jointly by several professional organizations and government agencies, these national standards depict the essential skills, knowledge, and ability required of certified emergency medical technicians (EMT) to provide optimal prehospital care and transportation to the sick and injured. Topics covered include definitions of terms EMT's…

  19. Training Program for Emergency Medical Technician: Dispatcher. 1--Course Guide.

    Science.gov (United States)

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

    The material presented in this course guide is designed to aid administrators in setting up and administering the emergency medical technician (EMT) dispatcher course. Descriptions of the overall objectives and scope of the course are presented, including behavioral objectives for eleven units of instruction covering the following emergency…

  20. Vital Signs Predict Rapid-Response Team Activation within Twelve Hours of Emergency Department Admission

    Directory of Open Access Journals (Sweden)

    James M. Walston

    2016-05-01

    Full Text Available Introduction: Rapid-response teams (RRTs are interdisciplinary groups created to rapidly assess and treat patients with unexpected clinical deterioration marked by decline in vital signs. Traditionally emergency department (ED disposition is partially based on the patients’ vital signs (VS at the time of hospital admission. We aimed to identify which patients will have RRT activation within 12 hours of admission based on their ED VS, and if their outcomes differed. Methods: We conducted a case-control study of patients presenting from January 2009 to December 2012 to a tertiary ED who subsequently had RRT activations within 12 hours of admission (early RRT activations. The medical records of patients 18 years and older admitted to a non-intensive care unit (ICU setting were reviewed to obtain VS at the time of ED arrival and departure, age, gender and diagnoses. Controls were matched 1:1 on age, gender, and diagnosis. We evaluated VS using cut points (lowest 10%, middle 80% and highest 10% based on the distribution of VS for all patients. Our study adheres to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology guidelines for reporting observational studies. Results: A total of 948 patients were included (474 cases and 474 controls. Patients who had RRT activations were more likely to be tachycardic (odds ratio [OR] 2.02, 95% CI [1.25-3.27], tachypneic (OR 2.92, 95% CI [1.73-4.92], and had lower oxygen saturations (OR 2.25, 95% CI [1.42-3.56] upon arrival to the ED. Patients who had RRT activations were more likely to be tachycardic at the time of disposition from the ED (OR 2.76, 95% CI [1.65-4.60], more likely to have extremes of systolic blood pressure (BP (OR 1.72, 95% CI [1.08-2.72] for low BP and OR 1.82, 95% CI [1.19-2.80] for high BP, higher respiratory rate (OR 4.15, 95% CI [2.44-7.07] and lower oxygen saturation (OR 2.29, 95% CI [1.43-3.67]. Early RRT activation was associated with increased healthcare

  1. Emergency medical services in India: the present and future.

    Science.gov (United States)

    Sharma, Mohit; Brandler, Ethan S

    2014-06-01

    India is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.

  2. Smartphones and Medical Applications in the Emergency Department Daily Practice.

    Science.gov (United States)

    Jahanshir, Amirhosein; Karimialavijeh, Ehsan; Sheikh, Hojjat; Vahedi, Motahar; Momeni, Mehdi

    2017-01-01

    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. 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. 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 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. 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.

  3. The emergence of multidisciplinary teams for interagency service delivery in europe: is historical institutionalism wrong?

    Science.gov (United States)

    van Raak, Arno; Paulus, Aggie

    2008-12-01

    In Europe, a well-known problem is the coordination of interagency service delivery to independently living older persons, disabled persons or persons suffering from chronic illness. Coordination is necessary in order for the users to receive services at the appropriate time and place. Based on historical institutionalism, which focuses on the path dependency of the development of government policy and organizational and professional rules, it can be stated that coordination requires organizational models or other solutions that fit the characteristics of the context ('configuration') for which the solution is intended. The western European countries have different configurations. Remarkably, across these countries, we see the emergence of multidisciplinary teams as a solution to the problem of coordination. Consequently, if we take the above statement to mean that a solution should fit all the configuration's characteristics, we must reject the statement. However, when we assume that a solution should fit particular configurational characteristics, we must not. We take the second position and we argue that multidisciplinary teams have emerged because they fit one particular feature that is similar in the countries: professionalism and professional fragmentation.

  4. Measuring non-technical skills in medical emergency care: a review of assessment measures

    Directory of Open Access Journals (Sweden)

    Simon Cooper

    2010-01-01

    Full Text Available Simon Cooper1, Ruth Endacott2, Robyn Cant11School of Nursing and Midwifery, Monash University, Gippsland Campus, Churchill, Victoria, Australia; 2School of Nursing and Midwifery, University of Plymouth, Drake Circus, Plymouth UKAim: To review the literature on non-technical skills and assessment methods relevant to emergency care.Background: Non-technical skills (NTS include leadership, teamwork, decision making and situation awareness, all of which have an impact on healthcare outcomes. Significant concerns have been raised about the rates of adverse medical events, many of which are attributed to NTS failures.Methods: Ovid, Medline, ProQUEST, PsycINFO and specialty websites were searched for NTS measures using applicable access strategies, inclusion and exclusion criteria. Publications identified were assessed for relevance.Results: A range of non-technical skill measures relevant to emergency care was identified: leadership (n = 5, teamwork (n = 7, personality/behavior (n = 3 and situation awareness tools (n = 1. Of these, 9 have been used with emergency care populations/clinicians. All had varying degrees of reliability and validity. In the last decade there has been some development of teamwork measures specific to emergency care with a predominantly global and collective rating of broad skills.Conclusion: A variety of non-technical skill measures are available; only a few have been used in the emergency care arena. There is a need for an increase in the focused assessment of teamwork skills for a greater understanding of team performance to enhance patient safety in medical emergency care.Keywords: non-technical skills, teamwork, medical emergency, standards

  5. 78 FR 24802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2013-04-26

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... nationally recognized council of emergency medical services representatives and consumers, is to advise and... (NHTSA), U.S. Department of Transportation (DOT). ACTION: Meeting Notice--National Emergency...

  6. 76 FR 22166 - Renewal of Charter for the National Emergency Medical Services Advisory Council (NEMSAC)

    Science.gov (United States)

    2011-04-20

    ... of the National Emergency Medical Services Advisory Council to provide advice and recommendations regarding emergency medical services (EMS) matters to the U.S. Department of Transportation, National... National Highway Traffic Safety Administration Renewal of Charter for the National Emergency...

  7. 76 FR 39977 - National Emergency Medical Services Advisory Council Teleconference Meeting

    Science.gov (United States)

    2011-07-07

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council... nationally recognized council of Emergency Medical Services (EMS) representatives and consumers to provide... proper arrangements. FOR FURTHER INFORMATION CONTACT: Drew Dawson, Director, Office of Emergency...

  8. Critical outcomes: clinical and team performance across acute illness scenarios in emergency departments of critical access hospitals.

    Science.gov (United States)

    Coleman, Nana Ekua; Baker, David; Gallo, Jonathan; Slonim, Anthony D

    2012-01-01

    In their provision of acute care services, emergency department (ED) providers in critical access hospitals (CAHs) are uniquely challenged by limitations in personnel, facility resources, and available expertise. We sought to define the impact of team behaviors among ED staff in CAHs on clinical performance by studying the relationship between team and clinical performance scores across 100 simulated scenarios. Team and clinical performance scores were calculated for each scenario using standardized checklists to quantify goal achievement and aggregated across teams and scenario types. These scores were compared using bivariate analysis and correlated with clinical and team performance outcomes using Pearson's correlation (r coefficient). There was a positive correlation between team and clinical performance across all scenarios; the relationship was statistically significant (pteam performance may be a function of the critical care event itself or the unique characteristics of CAHs that make them more vulnerable when faced with high acuity, complex, and infrequently encountered clinical scenarios. © 2011 National Association for Healthcare Quality.

  9. [Team dynamics and clinical performance of medical students in web-based and high-fidelity simulations].

    Science.gov (United States)

    Bang, Jae Beum; Yoon, Yoo Sang; Lee, Young Hwan; Lee, Sam Beom

    2014-12-01

    The importance of team dynamics with regard to clinical performance is being emphasized to improve patient safety and the quality of health care. The aim of this study was to examine the correlation and differences in team dynamics and team clinical performance in a web-based simulation (WS) and high-fidelity simulation (HS) in the medical students. The simulations were held for 15 teams of fourth year medical students (n=52). They were given two clinical cases, dyspnea (case 1) and chest pain (case 2) by WS and then HS. The scores on the team dynamics and the team's clinical performance were analyzed by paired t-test and multiple regression using SPSS version 21.0 (IBM Corp.). The teamwork scores on case 2 (22.67 ± 6.58) were higher than for case 1 in the HS (20.47 ± 7.22). Team clinical performance scores were the same the WS and HS. Team clinical performances were significantly associated with team dynamics in both cases by HS. Teamwork scores of team dynamics were each explanation on case 1 (74.9%), case 2 (63.4%) in the HS. The team dynamics and clinical performance can improve if undergraduate medical students have more opportunities. They should be trained in these endeavors to become future doctors for which scenario-based simulations could be valuable.

  10. Implementation of a Transdisciplinary Team for the Transition Support of Medically and Socially Complex Youth.

    Science.gov (United States)

    Ciccarelli, Mary R; Gladstone, Erin B; Armstrong Richardson, Eprise A J

    2015-01-01

    This article reports the ongoing work of a statewide transition support program which serves youth ages 11 to 22 with medically complex conditions and socially complex lives. Seven years of transition support services have led to program evolution demonstrated via a descriptive summary of the patients along with both families' and primary care providers' responses to satisfaction surveys. An illustrative case is used to highlight the types of expertise needed in specialized transition service delivery for patients with significant complexity. The team's analysis of their transdisciplinary work processes further explains the work. Nearly three hundred youth with complex needs are served yearly. Families and primary care providers express high satisfaction with the support of the services. The case example shows the broad array of transition-specific services engaged beyond the usual skill set of pediatric or adult care coordination teams. Transdisciplinary team uses skills in collaboration, support, learning, and compromise within a trusting and respectful environment. They describe the shared responsibility and continuous learning of the whole team. Youth with complex medical conditions and complex social situations are at higher risk for problems during transition. Serving this population with a transdisciplinary model is time consuming and requires advanced expertise but, with those investments, we can meet the expectations of the youth, their families and primary care providers. Successful transdisciplinary teamwork requires sustained and focused investment. Further work is needed to describe the complexity of this service delivery along with distinct transition outcomes and costs comparisons. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Do emergency physicians attribute drug-related emergency department visits to medication-related problems?

    Science.gov (United States)

    Hohl, Corinne M; Zed, Peter J; Brubacher, Jeffrey R; Abu-Laban, Riyad B; Loewen, Peter S; Purssell, Roy A

    2010-06-01

    Adverse drug events represent the most common cause of preventable nonsurgical adverse events in medicine but may remain undetected. Our objective is to determine the proportion of drug-related visits emergency physicians attribute to medication-related problems. This prospective observational study enrolled adults presenting to a tertiary care emergency department (ED) during 12 weeks. Drug-related visits were defined as ED visits caused by adverse drug events. The definition of adverse drug event was varied to examine both narrow and broad adverse drug event classification systems. Clinical pharmacists evaluated all patients for drug-related visits, using standardized assessment algorithms, and then followed patients until hospital discharge. Interrater agreement for the clinical pharmacist diagnosis of drug-related visit was assessed. Emergency physicians, blinded to the clinical pharmacist opinion, were interviewed at the end of each shift to determine whether they attributed the visit to a medication-related problem. An independent committee reviewed and adjudicated all cases in which the emergency physicians' and clinical pharmacists' assessments were discordant, or either the emergency physician or clinical pharmacist was uncertain. The primary outcome was the proportion of drug-related visits attributed to a medication-related problem by emergency physicians. Nine hundred forty-four patients were enrolled, of whom 44 patients received a diagnosis of the narrowest definition of an adverse drug event, an adverse drug reaction (4.7%; 95% confidence interval [CI] 3.5% to 6.2%). Twenty-seven of these were categorized as medication-related by emergency physicians (61.4%; 95% CI 46.5% to 74.3%), 10 were categorized as uncertain (22.7%; 95% CI 12.9% to 37.1%), and 7 categorized as a non-medication-related problem (15.9%; 95% CI 8.0% to 29.5%). Seventy-eight patients (8.3%; 95% CI 6.7% to 10.2%) received a diagnosis of an adverse drug event caused by an adverse drug

  12. Team-Based Development of Medical Devices: An Engineering–Business Collaborative

    Science.gov (United States)

    Eberhardt, Alan W.; Johnson, Ophelia L.; Kirkland, William B.; Dobbs, Joel H.; Moradi, Lee G.

    2016-01-01

    There is a global shift in the teaching methodology of science and engineering toward multidisciplinary, team-based processes. To meet the demands of an evolving technical industry and lead the way in engineering education, innovative curricula are essential. This paper describes the development of multidisciplinary, team-based learning environments in undergraduate and graduate engineering curricula focused on medical device design. In these programs, students actively collaborate with clinicians, professional engineers, business professionals, and their peers to develop innovative solutions to real-world problems. In the undergraduate senior capstone courses, teams of biomedical engineering (BME) and business students have produced and delivered numerous functional prototypes to satisfied clients. Pursuit of commercialization of devices has led to intellectual property (IP) disclosures and patents. Assessments have indicated high levels of success in attainment of student learning outcomes and student satisfaction with their undergraduate design experience. To advance these projects toward commercialization and further promote innovative team-based learning, a Master of Engineering (MEng) in Design and Commercialization was recently launched. The MEng facilitates teams of graduate students in engineering, life sciences, and business who engage in innovation-commercialization (IC) projects and coursework that take innovative ideas through research and development (R&D) to create marketable devices. The activities are structured with students working together as a “virtual company,” with targeted outcomes of commercialization (license agreements and new start-ups), competitive job placement, and/or career advancement. PMID:26902869

  13. Team-Based Development of Medical Devices: An Engineering-Business Collaborative.

    Science.gov (United States)

    Eberhardt, Alan W; Johnson, Ophelia L; Kirkland, William B; Dobbs, Joel H; Moradi, Lee G

    2016-07-01

    There is a global shift in the teaching methodology of science and engineering toward multidisciplinary, team-based processes. To meet the demands of an evolving technical industry and lead the way in engineering education, innovative curricula are essential. This paper describes the development of multidisciplinary, team-based learning environments in undergraduate and graduate engineering curricula focused on medical device design. In these programs, students actively collaborate with clinicians, professional engineers, business professionals, and their peers to develop innovative solutions to real-world problems. In the undergraduate senior capstone courses, teams of biomedical engineering (BME) and business students have produced and delivered numerous functional prototypes to satisfied clients. Pursuit of commercialization of devices has led to intellectual property (IP) disclosures and patents. Assessments have indicated high levels of success in attainment of student learning outcomes and student satisfaction with their undergraduate design experience. To advance these projects toward commercialization and further promote innovative team-based learning, a Master of Engineering (MEng) in Design and Commercialization was recently launched. The MEng facilitates teams of graduate students in engineering, life sciences, and business who engage in innovation-commercialization (IC) projects and coursework that take innovative ideas through research and development (R&D) to create marketable devices. The activities are structured with students working together as a "virtual company," with targeted outcomes of commercialization (license agreements and new start-ups), competitive job placement, and/or career advancement.

  14. Managing the culturally diverse medical practice team: twenty-five strategies.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.

  15. The culture of patient safety from the perspective of the pediatric emergency nursing team.

    Science.gov (United States)

    Macedo, Taise Rocha; Rocha, Patricia Kuerten; Tomazoni, Andreia; Souza, Sabrina de; Anders, Jane Cristina; Davis, Karri

    2016-01-01

    To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario. Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento

  16. Assessment of first-year medical students' perceptions of teaching and learning through team-based learning sessions.

    Science.gov (United States)

    Obad, Adam S; Peeran, Ahmed A; Shareef, Mohammad Abrar; Alsheikh, Wissal J; Kalagi, Dana A; AlAmodi, Abdulhadi A; Khan, Tehreem A; Shaikh, Abdul Ahad; Ganguly, Paul; Yaqinuddin, Ahmed

    2016-12-01

    Team-based learning (TBL) is an emerging teaching and learning strategy being employed in medical schools. The College of Medicine at Alfaisal University has adopted a TBL approach as an instructional method for first-year medical students. The aim of the present study was to describe the TBL method employed at Alfaisal University College of Medicine and to assess first-year medical students' perceptions of this learning modality for the anatomy- and physiology-based blocks/courses in organ systems form of curriculum. A five-point Likert scale questionnaire was structured based on Kirkpatrick's theory and assessed three major domains: reaction, learning, and behavior. Confirmatory factor analysis (CFA) and Cronbach's α-coefficient tests were used to assess the validity and reliability of the construct, respectively. CFA showed an adequate validity of the survey and Cronbach's α revealed an acceptable internal uniformity (0.69). A total of 185 respondents rated reaction, learning, and behavior toward introduction of TBL as 3.53 ± 1.01, 3.59 ± 1.12, and 3.57 ± 1.12, respectively. Excellent students rated TBL highly in all major domains compared with borderline students (reaction, behavior, and learning domains with P values of Students who had prior teamwork experience rated TBL higher in terms of their learning experience compared with those who were rarely involved in team work. This study demonstrated that Alfaisal University first-year medical students perceived TBL positively as a teaching and learning strategy for functional anatomy, and prior involvement in teamwork and academic performance correlates with higher ratings of TBL. Copyright © 2016 the American Physiological Society.

  17. 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.

  18. Impact of standardized patients on the training of medical students to manage emergencies

    Science.gov (United States)

    Herbstreit, Frank; Merse, Stefanie; Schnell, Rainer; Noack, Marcel; Dirkmann, Daniel; Besuch, Anna; Peters, Jürgen

    2017-01-01

    Abstract Background: Teaching emergency management should educate medical students not only for facts and treatment algorithms but also for time effective physical examination, technical skills, and team interaction. We tested the hypothesis, that using standardized emergency patients would be more effective in transmitting knowledge and skills compared with a more traditional teaching approach. Methods: Medical students (n = 242) in their fourth (second clinical) year were randomized to receive either training on standardized patients simulating 3 emergency settings (“acute chest pain,” “stroke,” and “acute dyspnea/asthma”) or traditional small group seminars. Before and after the respective training pathways, the students’ knowledge base (multiple-choice examination) and practical performance (objective structured clinical examination using 3 different emergency scenarios) were assessed. Results: Teaching using standardized patients resulted in a significant albeit small improvement in objective structured clinical examination scores (61.2 ± 3 for the standardized patient trained group vs 60.3 ± 3.5 for the traditional seminar group; P = 0.017, maximum achievable score: 66), but no difference in the written examination scores (27.4 ± 2.4 vs 27.0 ± 4.4; P = 0.341; maximum achievable score: 30). Conclusion: Teaching management of emergencies using standardized patients can improve medical students’ performance in clinical tests, and a change from traditional seminars in favor of practice sessions with standardized patients does not compromise the learning of medical facts. PMID:28151877

  19. Administration Medication Errors in Emergency Department in Level III Hospital

    Directory of Open Access Journals (Sweden)

    Silvia González Gómez

    2012-09-01

    Full Text Available • Objective: To determine the prevalence of medication errors associated with the administration in the emergency room of University Hospital Marques de Valdecilla. • Introduction: Adverse events related to health care, are increasingly common, it is estimated that between 44000 and 98000 people served in U.S. hospitals die from adverse events related to health care. In 7000 these deaths are caused by medication errors. In Spain the studies speak of similar figures. The emergency services are excluded usually in these studies because of its particular characteristics, but also are well known that these are characteristics (speed of decision-making, not having systems in unit dose dispensing ... what is expected that mistakes can be produced in larger numbers in emergency services in the areas of Spain hospitalization. • Method: This is a descriptive study in which cross-examine a sample of 627 administrations made in different areas of attention of the Emergency Department Valdecilla Hospital, in different time slots, months of the year and days a week. Between the months of January and December 2009.• Results: Have detected 119 errors in 627 observations, the most common error is log.• Conclusions: We have found a lower incidence of error 2.7%, comparing with other work (10%. While most of the studies reviewed speak of medication errors in general, including prescription, transcription, and administration.

  20. Recruitment and retention of emergency medical technicians: a qualitative study.

    Science.gov (United States)

    Patterson, P Daniel; Probst, Janice C; Leith, Katherine H; Corwin, Sara J; Powell, M Paige

    2005-01-01

    Emergency medical technicians (EMTs) are critical to out-of-hospital care, but maintaining staff can be difficult. The study objective was to identify factors that contribute to recruitment and retention of EMTs and paramedics. Information was drawn from three focus groups of EMT-Basic, EMT-Intermediate, and EMT-Paramedic personnel recruited from participants at an annual conference. Thoughts and feelings of EMTs and paramedics were investigated using eight questions designed to explore entry into emergency medical services, what it is like to be an EMT or paramedic, and the EMT educational process. Data were analyzed at the group level for common themes using NVivo. For a majority of respondents, emergency medical services was not a primary career path. Most respondents entered the industry as an alternate or replacement for a nursing career or as a second career following military medic service. The majority of respondents believed the job was stressful yet rewarding, and although it negatively affected their personal lives, the occupation gave them a sense of accomplishment and belonging. Respondents expressed a preference for EMT education resulting in college credit or licensure versus professional certification. Job-related stress produced by numerous factors appears to be a likely contributor to low employee retention. Recruitment and retention efforts should address study findings, incorporating key findings into educational, evaluation, and job enhancement programs.

  1. 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/

  2. Salivary markers of work stress in an emergency team of urban police (1 degree step).

    Science.gov (United States)

    Zefferino, R; Facciorusso, A; Lasalvia, M; Narciso, M; Nuzzaco, A; Lucchini, R; L'Abbate, N

    2006-01-01

    Stress is usually defined as the experience of negative events or the perceptions of distress and negative affect that are associated with the inability to cope with them. The parameter most suitable for large-scale field studies is the determination of endocrine activity by measurement of salivary cortisol. The aim of the present study is to identify the presence of sources of stress in an emergency team of urban police and to objective such stress using the PSS (Professional Stress Scale) test and bioumoral markers as salivary cortisol and interleukin 1 /f (IL-IB). We studied 30 policemen who belonged to an emergency team. Salivary samples were collected at the start and at the end of the work-shift. As control we used the same subjects during the holiday. T test was performed to evaluate the differences between the means, the Chi Square's Test was performed to determine the statistically significant association between PSS subscales and salivary cortisol and ILl-B concentrations. Thirty policeman were evaluated, their mean age was 44,5 years, their mean work experience was 17,1 years. The PSS test indicated high scores in three subscales, they were work load, organizational structure and processes and lack of resources. SALIVARY CORTISOL: The mean concentration at the start of work-shift was higher than at the end of shift-work (pwork (start and end) and during the holiday (Pwork load" (pwork-shift resulted higher than at the end, such reduction was statistically significant (Pwork (pwork related stress in urban police employed in an emergency team. We might conclude that salivary IL-1B and cortisol are useful markers of stress. We think that our findings, surely preliminary, have be corroborated by the study of vegetative parameters (heart rate, heart rate variability) that is still current. It might be useful to evaluate again the cortisol and IL-1B variations after some structure organizational modifications and after training that will teach the workers

  3. Participatory Design in Emergency Medical Service: Designing for Future Practice

    DEFF Research Database (Denmark)

    Kristensen, Margit; Kyng, Morten; Palen, Leysia Ann

    2006-01-01

    address challenges identified by disaster sociologists when designing for major incidents. Through qualitative research and participatory design, we have ex-amined the features of EMS work and technology use in different emergency situations from the perspective of mul-tiple actors. We conceptualize......We describe our research—its approach, results and prod-ucts—on Danish emergency medical service (EMS) field or “pre-hospital” work in minor and major incidents. We dis-cuss how commitments to participatory design and attention to the qualitative differences between minor and major incidents...

  4. 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...... interacted through e-mail. We asked these experts to define data variables and rank which were most important to report during an immediate prehospital medical response to a major incident. Five rounds were conducted. RESULTS: In the first round, the experts suggested 98 variables. After 5 rounds, 21...

  5. International Federation for Emergency Medicine Model curriculum for medical student education in emergency medicine

    Directory of Open Access Journals (Sweden)

    Cherri Hobgood

    2011-09-01

    The curriculum is designed with a focus on the basic minimum emergency medicine educational content that any medical school should be delivering to its students during their undergraduate years of training. It is designed, not to be prescriptive, but to assist educators and emergency medicine leadership in advancing physician education in basic emergency medicine content. The content would be relevant, not just for communities with mature emergency medicine systems, but also for developing nations or for nations seeking to expand emergency medicine within current educational structures. We anticipate that there will be wide variability in how this curriculum is implemented and taught, reflecting the existing educational milieu, the resources available, and the goals of the institutions’ educational leadership.

  6. Readiness for Radiological and Nuclear Events among Emergency Medical Personnel.

    Science.gov (United States)

    Dallas, Cham E; Klein, Kelly R; Lehman, Thomas; Kodama, Takamitsu; Harris, Curtis Andrew; Swienton, Raymond E

    2017-01-01

    Among medical providers, even though radiological and nuclear events are recognized as credible threats, there is a lack of knowledge and fear about the medical consequences among medical personnel which could significantly affect the treatment of patients injured and/or contaminated in such scenarios. This study was conducted to evaluate the relative knowledge, willingness to respond, and familiarity with nuclear/radiological contamination risks among U.S. and Japanese emergency medical personnel. An institutional review board-approved anonymous paper survey was distributed at various medical and disaster conferences and medicine courses in Japan and in the U.S. The surveys were written in Japanese and English and collected information on the following four categories: generalized demographics, willingness to manage, knowledge of disaster systems, and contamination risks. A total of 418 surveys were completed and collected. Demographics showed that physicians and prehospital responders were the prevalent survey responders. The majority of responders, despite self-professed disaster training, were still very uncomfortable with and unaware how to respond to a radiological/nuclear event. Despite some educational coverage in courses and a limited number of disaster events, it is concluded that there is a lack of comfort and knowledge regarding nuclear and radiological events among the medical community. It is recommended that considerable development and subsequent distribution is needed to better educate and prepare the medical community for inevitable upcoming radiological/nuclear events.

  7. 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.

  8. Expected Annual Emergency Miles per Ambulance: An Indicator for Measuring Availability of Emergency Medical Services Resources

    Science.gov (United States)

    Patterson, P. Daniel; Probst, Janice C.; Moore, Charity G.

    2006-01-01

    Context: To ensure equitable access to prehospital care, as recommended by the Rural and Frontier Emergency Medical Services (EMS) Agenda for the Future, policymakers will need a uniform measure of EMS infrastructure. Purpose and Methods: This paper proposes a county-level indicator of EMS resource availability that takes into consideration…

  9. 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…

  10. 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…

  11. Multidisciplinary team training reduces the decision-to-delivery interval for emergency Caesarean section

    DEFF Research Database (Denmark)

    Fuhrmann, Lone; Pedersen, T H; Atke, A

    2015-01-01

    to evaluate the effect of a simulation-based team training programme on the proportion of ECSs achieved within a 30-min time frame. METHOD: We performed an interventional before-and-after study. We evaluated a total of one hundred 30-min ECSs before and after the intervention. The primary outcome of interest......BACKGROUND: Emergency Caesarean section is performed when the life of the pregnant woman and/or the foetus is considered at risk. A 30-min standard for the decision-to-delivery interval (DDI) is a common practice and is supported by national organisations including The Danish Society of Obstetrics...... and Gynaecology. Danish obstetric departments report the DDI to a national database. A national arbitrarily set standard recommends that 95% of ECSs should be achieved within the 30-min DDI standard. In 2011, 34.4% of ECSs, performed at our hospital, were achieved within the 30-min time frame. This study aims...

  12. Automated electronic medical record sepsis detection in the emergency department

    OpenAIRE

    Su Q. Nguyen; Edwin Mwakalindile; Booth, James S.; Vicki Hogan; Jordan Morgan; Prickett, Charles T; Donnelly, John P; Wang, Henry E.

    2014-01-01

    Background. While often first treated in the emergency department (ED), identification of sepsis is difficult. Electronic medical record (EMR) clinical decision tools offer a novel strategy for identifying patients with sepsis. The objective of this study was to test the accuracy of an EMR-based, automated sepsis identification system. Methods. We tested an EMR-based sepsis identification tool at a major academic, urban ED with 64,000 annual visits. The EMR system collected vital sign and lab...

  13. 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.

  14. The experience of linking Victorian emergency medical service trauma data

    OpenAIRE

    Boyle Malcolm J

    2008-01-01

    Abstract Background The linking of a large Emergency Medical Service (EMS) dataset with the Victorian Department of Human Services (DHS) hospital datasets and Victorian State Trauma Outcome Registry and Monitoring (VSTORM) dataset to determine patient outcomes has not previously been undertaken in Victoria. The objective of this study was to identify the linkage rate of a large EMS trauma dataset with the Department of Human Services hospital datasets and VSTORM dataset. Methods The linking o...

  15. Automated electronic medical record sepsis detection in the emergency department

    OpenAIRE

    Nguyen, Su Q.; Edwin Mwakalindile; Booth, James S.; Vicki Hogan; Jordan Morgan; Prickett, Charles T; Donnelly, John P.; Wang, Henry E.

    2014-01-01

    Background. While often first treated in the emergency department (ED), identification of sepsis is difficult. Electronic medical record (EMR) clinical decision tools offer a novel strategy for identifying patients with sepsis. The objective of this study was to test the accuracy of an EMR-based, automated sepsis identification system. Methods. We tested an EMR-based sepsis identification tool at a major academic, urban ED with 64,000 annual visits. The EMR system collected vital sign and lab...

  16. Automated electronic medical record sepsis detection in the Emergency Department

    OpenAIRE

    Nguyen, Su; Mwakalindile, Edwin; Booth, James S.; Hogan, Vicki; Morgan, Jordan; Prickett, Charles T; Donnelly, John P.; Wang, Henry E.

    2014-01-01

    Background: While often first treated in the Emergency Department (ED), identification of sepsis is difficult. Electronic medical record (EMR) clinical decision tools offer a novel strategy for identifying patients with sepsis. The objective of this study was to test the accuracy of an EMR-based, automated sepsis identification system. Methods : We tested an EMR-based sepsis identification tool at a major academic, urban ED with 64,000 annual visits. The EMR system collected vital sign and la...

  17. Terrorism and the ethics of emergency medical care.

    Science.gov (United States)

    Pesik, N; Keim, M E; Iserson, K V

    2001-06-01

    The threat of domestic and international terrorism involving weapons of mass destruction-terrorism (WMD-T) has become an increasing public health concern for US citizens. WMD-T events may have a major effect on many societal sectors but particularly on the health care delivery system. Anticipated medical problems might include the need for large quantities of medical equipment and supplies, as well as capable and unaffected health care providers. In the setting of WMD-T, triage may bear little resemblance to the standard approach to civilian triage. To address these issues to the maximum benefit of our patients, we must first develop collective forethought and a broad-based consensus that these decisions must reach beyond the hospital emergency department. Critical decisions like these should not be made on an individual case-by-case basis. Physicians should never be placed in a position of individually deciding to deny treatment to patients without the guidance of a policy or protocol. Emergency physicians, however, may easily find themselves in a situation in which the demand for resources clearly exceeds supply. It is for this reason that emergency care providers, personnel, hospital administrators, religious leaders, and medical ethics committees need to engage in bioethical decision making before an acute bioterrorist event.

  18. Patients who leave the emergency department against medical advice

    Science.gov (United States)

    Lee, Choung Ah; Cho, Joon Pil; Choi, Sang Cheon; Kim, Hyuk Hoon; Park, Ju Ok

    2016-01-01

    Objective Discharge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients. Methods We reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group. We compared these groups with respect to age, gender, trauma or non-trauma status, type of hospital, health insurance, level of consciousness on admission, and diagnosis. Results Of 8,000,529 patients, 222,389 (2.78%) left against medical advice. The risk factors for DAMA across all age groups were as follows: no medical insurance (odds ratio [OR], 1.993), initial response to voice (OR, 2.753) or pain (OR, 2.101), trauma admission (OR, 1.126), admission to a local emergency medical center (OR, 1.215), and increased age. A high risk of DAMA was observed among patients with immune, endocrine, psychiatric, neurological, circulatory diseases, and external causes of morbidity and mortality. Conclusion Although DAMA cases account for only a small percentage of hospital discharges, they are important because DAMA patients have high readmission and mortality rates. It is therefore important to understand the general characteristics and predictors of DAMA in order to improve patient outcome and minimize the economic burden on the healthcare system.

  19. Effectiveness and student perspective of a pilot effort in team based learning in pharmacology for medical undergraduate

    Directory of Open Access Journals (Sweden)

    Nayana K. Hashilkar

    2016-08-01

    Conclusions: Team-Based Learning is an effective teaching-learning method to teach pharmacology to medical undergraduates. It encourages pre-class preparation, student's participation in small teams and improves their basic knowledge as well as skills of critical thinking. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1413-1416

  20. 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.

  1. 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.

  2. 3D medical collaboration technology to enhance emergency healthcare

    DEFF Research Database (Denmark)

    Welch, Gregory F; Sonnenwald, Diane H.; Fuchs, Henry

    2009-01-01

    of the dynamic reconstructions. We call this idea remote 3D medical collaboration. In this article we motivate and explain the vision for 3D medical collaboration technology; we describe the relevant computer vision, computer graphics, display, and networking research; we present a proof-of-concept prototype...... these problems, we are exploring the use of a small array of cameras to reconstruct dynamic three-dimensional (3D) views of a remote environment and of events taking place within. The 3D views could be sent across wired or wireless networks to remote healthcare professionals equipped with fixed displays...... system; and we present evaluation results supporting the general hypothesis that 3D remote medical collaboration technology could offer benefits over conventional 2D videoconferencing in emergency healthcare....

  3. Determining the composition and benefit of the pre-hospital medical response team in the conflict setting.

    Science.gov (United States)

    Davis, P R; Rickards, A C; Ollerton, J E

    2007-12-01

    To determine the optimal composition o f the pre-hospital medical response team (MERT) and the value of pre-hospital critical care interventions in a military setting, and specifically to determine both the benefit of including a doctor in the pre-hospital response team and the relevance of the time and distance to definitive care. A comprehensive review of the literature incorporating a range of electronic search engines and hand searches of key journals. There was no level 1 evidence on which to base conclusions. The 15 most relevant articles were analysed in detail. There was one randomized controlled trial (level 2 evidence) that supports the inclusion of a doctor on MERT. Several cohort studies were identified that analysed the benefits of specific critical care interventions in the pre-hospital setting. A doctor with critical care skills deployed on the MERT is associated with improved survival in victims of major trauma. Specific critical care interventions including emergency endotracheal intubation and ventilation, and intercostal drainage are associated with improved survival and functional recovery in certain patients. These benefits appear to be more easily demonstrated for the rural and remote setting than for the urban setting.

  4. 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).

  5. Concussion knowledge and management practices among coaches and medical staff in Irish professional rugby teams.

    Science.gov (United States)

    Fraas, M R; Coughlan, G F; Hart, E C; McCarthy, C

    2015-06-01

    Self-reported concussion rates among U-20 and elite rugby union players in Ireland are 45-48%. Half of these injuries go unreported. Accurate knowledge of concussion signs and symptoms and appropriate management practices among coaches and medical staff is important to improve the welfare of players. Examine concussion knowledge among coaches, and management techniques among medical staff of professional Irish rugby teams. Surveys were administered to 11 coaches and 12 medical staff at the end of the 2010-2011 season. Coaches demonstrated an accurate knowledge of concussion with a good understanding of concussion-related symptoms. Medical staff reported using a variety of methods for assessing concussion and making return-to-play decisions. Reliance on subjective clinical methods was evident, with less reliance on objective postural stability performance. Overall, the coaches in this investigation have accurate knowledge of concussion and medical staff use effective techniques for managing this injury. On-going education is needed to assist coaches in identifying concussion signs and symptoms. It is recommended that medical staff increase their reliance on objective methods for assessment and return-to-play decision making.

  6. Medical clearance of the psychiatric patient in the emergency department.

    Science.gov (United States)

    Janiak, Bruce D; Atteberry, Suzanne

    2012-11-01

    As part of the emergency department (ED) evaluation of patients with psychiatric complaints, emergency physicians are often asked to perform screening laboratory tests prior to admitting psychiatric patients, the value of which is questionable. To determine if routine screening laboratory studies performed in the ED on patients with a psychiatric chief complaint would alter ED medical clearance (evaluation, management or disposition) of such patients. In this retrospective chart review, the patient charts were reviewed for triage notes, history and physical examination, laboratory study results, and patient disposition. The study investigators subjectively determined if any of the laboratory abnormalities identified after admission would have changed ED management or disposition of the patient had they been identified in the ED. Subjects were 519 consecutive adult patients (18 years of age and older) admitted to the Medical College of Georgia's inpatient psychiatric ward through the ED. There were 502 patients who met inclusion criteria, and 50 of them had completely normal laboratory studies. Laboratory studies were performed in the ED for 148 patients. The most common abnormalities identified were positive urine drug screen (n = 221), anemia (n = 136), and hyperglycemia (n = 139). There was one case (0.19%) identified in which an abnormal laboratory value would have changed ED management or disposition of the patient had it been found during the patient's ED visit. Patients presenting to the ED with a psychiatric chief complaint can be medically cleared for admission to a psychiatric facility by qualified emergency physicians using an appropriate history and physical examination. There is no need for routine medical screening laboratory tests. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. 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.

  8. Contemporary management of uterine fibroids: focus on emerging medical treatments.

    Science.gov (United States)

    Singh, Sukhbir Sony; Belland, Liane

    2015-01-01

    This review provides an overview of therapeutic options, with a specific focus on the emerging role of medical options for UF management. PubMed, Google Scholar, and Cochrane Systematic Reviews were searched for articles published between 1980 and 2013. Relevant articles were identified using the following terms: 'uterine fibroids', 'leiomyoma', 'heavy menstrual bleeding', and 'menorrhagia'. The reference lists of articles identified were also searched for other relevant publications. Because of the largely benign nature of UFs, the most conservative options that minimize morbidity/risk and optimize outcomes should be considered. Watchful waiting, or no immediate intervention combined with regular follow-up, is an appropriate option for the majority of UF patients who experience no symptoms. For women with symptomatic UFs, the optimal treatment should restore quality of life through rapid relief of UF signs and symptoms, reduce tumor size for a sustained period, and maintain or improve fertility. Invasive surgical treatments, such as hysterectomy, have historically been the mainstay of UF treatment. Less invasive surgical and interventional techniques, such as myomectomy, uterine artery embolization, endometrial ablation, and myolysis provide alternatives to hysterectomy. Until recently, medical management of UFs was characterized by short-term treatments and therapies that provided symptomatic control. In addition to controlling abnormal uterine bleeding, newer medical therapies, including the recently Health-Canada-approved ulipristal acetate, act directly to shrink the tumor. Although no agent is currently approved for such use, emerging evidence suggests the potential for long-term medical management of UFs. The advent of novel medical therapies may diminish the long-held reliance on more invasive surgical UF treatment options.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. Carbon dioxide as a potential danger to medical rescue teams at work - A case study.

    Science.gov (United States)

    Podlewski, Roland; Płotek, Włodzimierz; Grześkowiak, Małgorzata; Małkiewicz, Tomasz; Frydrysiak, Krystyna; Żaba, Zbigniew

    2017-02-28

    Medical rescue teams might be exposed to the risk of accidental poisoning while performing rescue procedures. Exposure to the risk of lethal carbon dioxide (CO2) concentrations is a rare situation. This case study describes rescuing a patient who suffered from sudden cardiac arrest due to accidental CO2 poisoning. The victim was finally evacuated and resuscitated, but the circumstances of the rescue operation point to the need to equip ambulances with carbon dioxide detectors and hermetic oxygen masks. Med Pr 2017;68(1):135-138.

  14. 76 FR 72750 - Meeting Notice-Federal Interagency Committee on Emergency Medical Services

    Science.gov (United States)

    2011-11-25

    ..., Director, Office of Emergency Medical Services, National Highway Traffic Safety Administration, 1200 New... of several officials from Federal agencies as well as a State emergency medical services director... and Human Services and the Director of the Preparedness Division, Directorate of...

  15. Ambulance response time and emergency medical dispatcher program: a study in Kelantan, Malaysia.

    Science.gov (United States)

    Shah, C H Mohd Shaharudin; Ismail, I Mohd; Mohsin, S S J Syed

    2008-11-01

    This study provided data by a simple method of acquiring information related to ambulance response time (ART) and determined whether it met the international standards of ART. Additionally, this paper also compared the duration of ART at this hospital before and after the implementation of an Emergency Medical Dispatcher (EMD) program. The ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint were received and ended when the emergency team arrived at the scene of the incident. The parameters recorded include call processing time, time taken to prepare the team and time taken to travel to the scene. The results of the study revealed that the ART for the university hospital (HUSM) was at 913.2 +/- 276.5 seconds (mean +/- SD) and it was far below the international standard of ART as a benchmark of a good ambulance service. However, the study suggested that the EMD program that was recently implemented at the HUSM gave a significantly improvement to the ART score.

  16. Effect of emergency medicine pharmacists on medication-error reporting in an emergency department.

    Science.gov (United States)

    Weant, Kyle A; Humphries, Roger L; Hite, Kimberly; Armitstead, John A

    2010-11-01

    The effect of an emergency medicine (EM) clinical pharmacist on medication-error reporting in an emergency department (ED) was studied. The medication-error reports for patients seen at a university's ED between September 1, 2005, and February 28, 2009, were retrospectively reviewed. Errors reported before the addition of an EM pharmacist (from September 1, 2005, through February 28, 2006) were compared with those reported after the addition of two EM pharmacists (from September 1, 2008, through February 28, 2009). The severity of errors and the provider who reported the errors were characterized. A total of 402 medication errors were reported over the two time periods. Pharmacy personnel captured significantly more errors than did other health care personnel (94.5% versus 5.7%, p pharmacists resulted in 14.8 times as many medication-error reports as were made when no EM pharmacist was in the ED. More errors that actually occurred were captured with two pharmacists providing care (95.7% versus 4.3%, p errors documented were ordering errors (79.8%). Of these, 73.7% were captured after the addition of two EM pharmacists. Performance (40.0%) and knowledge (27.9%) deficits were the most common contributing factors to medication errors. During the study period after the addition of two EM pharmacists in the ED, 371 medication-error reports were completed, compared with 31 reports during the study period before the addition of the pharmacists. Pharmacy personnel reported the majority of medication errors during both study periods.

  17. How fun are your meetings? How and when humor patterns emerge and impact team performance.

    OpenAIRE

    Lehmann-Willenbrock, N.K.; Allen, J A

    2014-01-01

    Research on humor in organizations has rarely considered the social context in which humor occurs. One such social setting that most of us experience on a daily basis concerns the team context. Building on recent theorizing about the humor–performance link in teams, this study seeks to increase our understanding of the function and effects of humor in team interaction settings. We examined behavioral patterns of humor and laughter in real teams by videotaping and coding humor and laughter dur...

  18. The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand.

    Science.gov (United States)

    Jespersen, Sean; Lawman, Bronwyn; Reed, Fiona; Hawke, Kari; Plummer, Virginia; Gaskin, Cadeyrn J

    2016-12-01

    This investigation focused on the impact of integrating crisis team members into community mental health services on emergency department and adult mental health inpatient unit demand within an Australian public health service. Mixed methods were used including (a) the comparison of service use data with that of two other comparable services (both of which had community-based crisis teams), (b) surveys of (i) patients and carers and (ii) staff, and (c) focus groups with staff. The numbers of emergency department presentations with mental health conditions and adult mental health inpatient separations increased 13.9 and 5.7 %, respectively, from FY2006/07 to FY2012/13. Between the three services, there were minimal differences in the percentages of presentations with mental health conditions, the distribution of mental health presentations across a 24-h period, and the triage categories assigned to these patients. Survey participants reported that patients used the emergency department due to the urgency of situations, perceptions that gaining access to mental health services would take less time, and the unavailability of mental health services when help is needed. Staff identified several issues (e.g. inappropriate referrals) that may be unnecessary in increasing emergency department demand. The integration of crisis team members into community mental health services does not seem to have produced an increase in emergency department admissions or inpatient separations beyond what might be expected from population growth. The potential may exist, however, to reduce emergency department admissions through addressing the issue of inappropriate referrals.

  19. 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 (EMT-Paramedics earned significantly more than EMT-Basics, with differentials of $11,000-$18,000 over the course of the study. The major source of earnings disparity was type of organization: respondents employed by fire-based EMS agencies reported significantly higher earnings than other respondents, at both the EMT-Basic and EMT-Paramedic levels. Males also earned significantly more than females, with annual earnings differentials ranging from $7,000 to $15,000. There are a number of factors associated with compensation disparities within the EMS profession. These include type of service (ie, fire-based vs. other types of agencies) and gender. The reasons for these disparities warrant further investigation. Studnek JR . Compensation of Emergency Medical Technician (EMT)-Basics and Paramedics. Prehosp Disaster Med. 2016;31(Suppl. 1):s87-s95.

  20. Behavioral emergency in the elderly: a descriptive study of patients referred to an Aggression Response Team in an acute hospital

    Directory of Open Access Journals (Sweden)

    Simpkins D

    2016-10-01

    Full Text Available Daniel Simpkins,1 Carmelle Peisah,2,3 Irene Boyatzis1 1Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Hospital, 2School of Psychiatry, University of New South Wales, 3Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia Aim: The management of severely agitated elderly patients is not easy, and limited guidelines are available to assist practitioners. At a Sydney hospital, an Aggression Response Team (ART comprising clinical and security staff can be alerted when a staff member has safety concerns. Our aims were to describe the patient population referred for ART calls, reasons for and interventions during ART calls, and complications following them.Methods: Patients 65 years and older referred for ART calls in the emergency department or wards during 2014 were identified using the Incident Information Management System database and medical records were reviewed. Demographic and clinical data were collected. Results: Of 43 elderly patients with ART calls, 30 had repeat ART calls. Thirty-one patients (72% had underlying dementia, and 22 (51% were agitated at the time of admission. The main reasons for ART calls were wandering and physical aggression. Pharmacological sedation was used in 88% of the ART calls, with a range of psychotropics, doses, and routes of administration, including intravenous (19% and, most commonly, midazolam (53%. Complications were documented in 14% of cases where sedation was used. Conclusion: We observed a high frequency of pharmacological sedation among the severely agitated elderly, with significant variance in the choice and dose of sedation and a high rate of complications arising from sedation, which may be an underestimate given the lack of post-sedation monitoring. We recommend the development of guidelines on the management of behavioral emergency in the elderly patients, including de-escalation strategies and standardized psychotropic guidelines. Keywords: aged, aggression

  1. The impact of a pre-hospital medical response unit on patient care and emergency department attendances.

    LENUS (Irish Health Repository)

    Deasy, C

    2012-02-03

    A rapid response team was instigated in Cork to improve prehospital care and reduce unnecessary Emergency Department (ED) visits. This consisted of a Specialist Registrar (SpR) in Emergency Medicine and a Paramedic who attended all "999" calls in a designated rapid response vehicle on the allotted study days. Two hundred and sixty-three patients were seen on designated days between Jan 2004 and March 2006. Presentations seen included; road traffic accident (23%) collapse (12%), fall (10%) and seizure (8%). The majority of calls were to houses (36%). The most common medical intervention was intravenous cannulation (25%). Intravenous medications were administered in 21% of these patients--morphine sulphate was the most common drug given. It was possible to safely discharge 31% of patients on scene. In our experience skilled Emergency Medicine doctors attending at scene could provide advanced care and reduce ambulance transportation and patient attendance.

  2. Clinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross-sectional study.

    Science.gov (United States)

    Siassakos, D; Bristowe, K; Draycott, T J; Angouri, J; Hambly, H; Winter, C; Crofts, J F; Hunt, L P; Fox, R

    2011-04-01

    To identify specific aspects of teamworking associated with greater clinical efficiency in simulated obstetric emergencies. Cross-sectional secondary analysis of video recordings from the Simulation & Fire-drill Evaluation (SaFE) randomised controlled trial. Six secondary and tertiary maternity units. A total of 114 randomly selected healthcare professionals, in 19 teams of six members. Two independent assessors, a clinician and a language communication specialist identified specific teamwork behaviours using a grid derived from the safety literature. Relationship between teamwork behaviours and the time to administration of magnesium sulfate, a validated measure of clinical efficiency, was calculated. More efficient teams were likely to (1) have stated (recognised and verbally declared) the emergency (eclampsia) earlier (Kendall's rank correlation coefficient τ(b) = -0.53, 95% CI from -0.74 to -0.32, P=0.004); and (2) have managed the critical task using closed-loop communication (task clearly and loudly delegated, accepted, executed and completion acknowledged) (τ(b) = 0.46, 95% CI 0.17-0.74, P=0.022). Teams that administered magnesium sulfate within the allocated time (10 minutes) had significantly fewer exits from the labour room compared with teams who did not: a median of three (IQR 2-5) versus six exits (IQR 5-6) (P=0.03, Mann-Whitney U-test). Using administration of an essential drug as a valid surrogate of team efficiency and patient outcome after a simulated emergency, we found that more efficient teams were more likely to exhibit certain team behaviours relating to better handover and task allocation. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  3. Time for order in chaos! A health system framework for foreign medical teams in earthquakes.

    Science.gov (United States)

    Lind, Karin; Gerdin, Martin; Wladis, Andreas; Westman, Lina; von Schreeb, Johan

    2012-02-01

    The number of reported natural disasters is increasing, as is the number of foreign medical teams (FMTs) sent to provide relief. Studies show that FMTs are not coordinated, nor are they adapted to the medical needs of victims. Another key challenge to the response has been the lack of common terminologies, definitions, and frameworks for FMTs following disasters.In this report, a conceptual health system framework that captures two essential components of health care response by FMTs after earthquakes is presented. This framework was developed using expert panels and personal experience, as well as an exhaustive literature review.The framework can facilitate decisions for deployment of FMTs, as well as facilitate coordination in disaster-affected countries. It also can be an important tool for registering agencies that send FMTs to sudden onset disasters, and ultimately for improving disaster response.

  4. 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.

  5. Facilities and regionalization--emergency medical services systems.

    Science.gov (United States)

    Stewart, R D

    1990-02-01

    Advanced life support and the modern EMS system were born out of the hope that by extending hospital emergency facilities outside the bounds of the hospital, earlier and more intensive care could be provided to those patients requiring it. EMS systems have since left the nest and only recently, following a turbulent adolescence, is prehospital care returning as a partner with the medical facilities and physicians that presided over their modern origins. The next decade will see the continuing trend toward hospitals and practitioners regaining some influence in the design and direction of prehospital care.

  6. 76 FR 17485 - Meeting Notice Correction-Federal Interagency Committee on Emergency Medical Services; Correction...

    Science.gov (United States)

    2011-03-29

    ... Emergency Medical Services; Correction to Meeting Notice To Clarify Time Zone AGENCY: National Highway... on Emergency Medical Services; Correction to Meeting Notice to clarify time zone. SUMMARY: NHTSA is... on Emergency Medical Services (FICEMS) to be held as a stakeholder input call-in session to...

  7. 78 FR 49332 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2013-08-13

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... nationally recognized council of emergency medical services representatives and consumers, is to advise and... Transportation, Office of Emergency Medical Services, 1200 New Jersey Avenue SE., NTI-140, Washington, DC...

  8. 48 CFR 1852.242-78 - Emergency Medical Services and Evacuation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Emergency Medical Services... Provisions and Clauses 1852.242-78 Emergency Medical Services and Evacuation. As prescribed in 1842.7003, insert the following clause: Emergency Medical Services and Evacuation—April 2001 The Contractor...

  9. 78 FR 36300 - Federal Interagency Committee on Emergency Medical Services; Meeting

    Science.gov (United States)

    2013-06-17

    ... National Highway Traffic Safety Administration Federal Interagency Committee on Emergency Medical Services...--Federal Interagency Committee on Emergency Medical Services. SUMMARY: NHTSA announces a meeting of the Federal Interagency Committee on Emergency Medical Services (FICEMS) to be held in the Washington, DC...

  10. 76 FR 36174 - Federal Interagency Committee on Emergency Medical Services; Meeting

    Science.gov (United States)

    2011-06-21

    ... National Highway Traffic Safety Administration Federal Interagency Committee on Emergency Medical Services...--Federal Interagency Committee on Emergency Medical Services. SUMMARY: NHTSA announces a meeting of the Federal Interagency Committee on Emergency Medical Services (FICEMS) to be held in the Washington, DC...

  11. 75 FR 71792 - Federal Interagency Committee on Emergency Medical Services Meeting Notice

    Science.gov (United States)

    2010-11-24

    ... National Highway Traffic Safety Administration Federal Interagency Committee on Emergency Medical Services...--Federal Interagency Committee on Emergency Medical Services. SUMMARY: NHTSA announces a meeting of the Federal Interagency Committee on Emergency Medical Services (FICEMS) to be held in Washington, DC...

  12. 75 FR 34201 - Meeting Notice-Federal Interagency Committee on Emergency Medical Services

    Science.gov (United States)

    2010-06-16

    ... Notice--Federal Interagency Committee on Emergency Medical Services. SUMMARY: NHTSA announces a meeting of the Federal Interagency Committee on Emergency Medical Services (FICEMS) to be held in Washington... INFORMATION CONTACT: Drew Dawson, Director, Office of Emergency Medical Services, National Highway...

  13. 77 FR 14590 - National Emergency Medical Services Advisory Council (NEMSAC); Correction to the Notice of...

    Science.gov (United States)

    2012-03-12

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... Emergency Medical Services Advisory Council Meeting on March 29, 2012, to alter the start time from 1 p.m... recognized council of emergency medical services (EMS) representatives and consumers to provide advice...

  14. Emergency intraosseous access in a helicopter emergency medical service: a retrospective study

    Directory of Open Access Journals (Sweden)

    Heradstveit Bård E

    2010-10-01

    Full Text Available Abstract Background Intraosseous access (IO is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS. Methods We reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed, manual bone marrow aspiration needle (Inter V - Medical Device Technologies and EZ-IO® (Vidacare, used on both adults and paediatric patients. Results During this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p Conclusions Newer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric patients in critical situations. We believe that all emergency services that handle critically ill or injured paediatric and adult patients should be familiar with intraosseous techniques.

  15. Educational assessment of medical student rotation in emergency ultrasound.

    Science.gov (United States)

    Fox, J Christian; Cusick, Seric; Scruggs, William; Henson, Travis W; Anderson, Craig L; Barajas, Graciela; Zlidenny, Alexander; McDonough, Joanne; Langdorf, Mark I

    2007-08-01

    Medical student ultrasound education is sparse. In 2002, we began the first medical student rotation in emergency ultrasound. To evaluate if medical students can learn and retain sonographic skills during a two- or four-week elective. We gave students an exam on the first and last days of the rotation. Six months later, students took the exam a third time. A control group was used for comparison. Over a 19-month period, we enrolled 45 students (25 on the two-week and 20 on the four-week elective). The four-week student post-test score was significantly better than the two- week post-test score (81% vs 72%, p=0.003). On the six-month exam, the four-week student post-test score was significantly better than the two-week post-test score (77% vs 69%, p=0.008). The control group did not statistically improve. Medical students can learn bedside ultrasound interpretation with clinical integration and retain the knowledge six months later.

  16. Educational Assessment of Medical Student Rotation in Emergency Ultrasound

    Directory of Open Access Journals (Sweden)

    Fox, J Christian

    2007-08-01

    Full Text Available Background: Medical student ultrasound education is sparse. In 2002, we began the first medical student rotation in emergency ultrasound. Objective: To evaluate if medical students can learn and retain sonographic skills during a two- or four-week elective. Methods: We gave students an exam on the first and last days of the rotation. Six months later, students took the exam a third time. A control group was used for comparison. Results: Over a 19-month period, we enrolled 45 students (25 on the two-week and 20 on the four-week elective. The four-week student post-test score was significantly better than the two- week posttest score (81% vs. 72%, p=0.003. On the six-month exam, the four-week student post-test score was significantly better than the two-week post-test score (77% vs 69%, p=0.008. The control group did not statistically improve. Conclusion: Medical students can learn bedside ultrasound interpretation with clinical integration and retain the knowledge six months later.

  17. Emerging paradigms of cognition in medical decision-making.

    Science.gov (United States)

    Patel, Vimla L; Kaufman, David R; Arocha, Jose F

    2002-02-01

    The limitations of the classical or traditional paradigm of decision research are increasingly apparent, even though there has been a substantial body of empirical research on medical decision-making over the past 40 years. As decision-support technology continues to proliferate in medical settings, it is imperative that "basic science" decision research develop a broader-based and more valid foundation for the study of medical decision-making as it occurs in the natural setting. This paper critically reviews both traditional and recent approaches to medical decision making, considering the integration of problem-solving and decision-making research paradigms, the role of conceptual knowledge in decision-making, and the emerging paradigm of naturalistic decision-making. We also provide an examination of technology-mediated decision-making. Expanding the scope of decision research will better enable us to understand optimal decision processes, suitable coping mechanisms under suboptimal conditions, the development of expertise in decision-making, and ways in which decision-support technology can successfully mediate decision processes.

  18. 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.

  19. 24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

    Science.gov (United States)

    2010-04-01

    ... 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... medical technicians. 291.530 Section 291.530 Housing and Urban Development Regulations Relating to......

  20. Protocol of the DENIM study: a Delphi-procedure on the identification of trauma patients in need of care by physician-staffed Mobile Medical Teams in the Netherlands.

    Science.gov (United States)

    Harmsen, Annelieke Maria Karien; Geeraedts, Leo Maria George; Giannakopoulos, Georgios Fredericus; Terra, Maartje; Christiaans, Herman Martinus Timotheus; Mokkink, Lidwine Brigitta; Bloemers, Frank Willem

    2015-02-08

    In The Netherlands, standard prehospital trauma care is provided by emergency medical services and can be supplemented with advanced trauma care by Mobile Medical Teams. Due to observed over and undertriage in the dispatch of the Mobile Medical Team for major trauma patients, the accuracy of the dispatch criteria has been disputed. In order to obtain recommendations to invigorate the dispatch criteria, this study aimed at reaching consensus in expert opinion on the question; which acute trauma patient is in need of care by a Mobile Medical Team? In this paper we describe the protocol of the DENIM study (a Delphi-procedure on the identification of prehospital trauma patients in need of care by Mobile Medical Teams). A national three round digital Delphi study will be conducted to reach consensus. Literature was explored for relevant topics. After agreement on the themes of interest, the steering committee will construct questions for the first round. In total, 120 panellists with the following backgrounds; Mobile Medical Team physicians and nurses, trauma surgeons, ambulance nurses, emergency medical operators will be invited to participate. Group opinion will be fed back between each round that follows, allowing the panellists to revise their previous opinions and so, converge towards group consensus. Successful prehospital treatment of trauma patients greatly depends on the autonomous decisions made by the different professionals along the chain of prehospital trauma care. Trauma patients in need of care by the Mobile Medical Team need to be identified by those professionals in order to invigorate deployment criteria and improve trauma care. The Delphi technique is used because it allows for group consensus to be reached in a systematic and anonymous fashion amongst experts in the field of trauma care. The anonymous nature of the Delphi allows all experts to state their opinion whilst eliminating the bias of dominant and/or hierarchical individuals on group

  1. Emergency Department Wounds Managed by Combat Medics: A Case Series.

    Science.gov (United States)

    Schauer, Steven G; Pfaff, James A

    2017-03-01

    Combat medics are an integral part of their unit helping to conserve the fighting strength. Minor wounds are a common problem in the deployed settings that affect a soldier's ability to partake in operations. While the medics often manage wound care, there is very little data on the outcomes. Cases were acquired as part of a quality assurance project providing training feedback to medics on wound management. Laceration management is delegated to the medic at the direction of the provider. Follow-up included a series of short questions regarding wound outcomes: infection, revision, and cosmetic outcome (extremely satisfied = 1, unsatisfied = 5). Chart review was used when direct follow-up with the patient was not available for the remainder of the wounds. The project period was from May 2014 to June 2015. During this time there were 30 wound repairs documented. Direct contact follow-up was available for 57% of the encounters, the remainder was via chart review. The location of the wounds were as follows: facial 5, head/neck 0, upper extremity (excluding hand) 3, hand 16, lower extremity 5, and trunk 1. The average wound length was 2.98 cm (range, 0.8-8.0 cm). No wounds became infected. No wounds required revision. The average cosmetic rating was 1.8 (95% confidence interval = 1.48-2.12). In this series of wounds closed by medics in the emergency department no complications or revisions were necessary. Further research is needed to determine if this can be extrapolated to other military settings. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  2. Mobile-Based Medical Emergency Ambulance Scheduling System

    Directory of Open Access Journals (Sweden)

    Bassey Isong

    2016-11-01

    Full Text Available Effective and efficient public service delivery like healthcare services are very important in today's society, especially in the rural areas. People in rural areas are expected to have access to public facilities at all times. However, these services are not always available when they are needed. This paper discusses the problems faced by rural areas of Mafikeng in South Africa (SA when public and basic healthcare facilities like medical ambulance transports are needed during emergency situation. The challenges ranges from poor communication, poor road network and unstructured address to non-arrival of ambulances leading loss of lives that are preventable. This paper designed and implemented a system prototype using mobile application technologies to offer cost-effective services to patients during emergencies. It is intended to reduce long queues in hospitals and long waiting periods for an ambulance via location-based services. By using this application, lives in the rural areas can be made easier and loss of lives prevented by providing timely response from the appropriate healthcare providers during emergencies.

  3. Variation in emergency medical services workplace safety culture.

    Science.gov (United States)

    Patterson, P Daniel; Huang, David T; Fairbanks, Rollin J; Simeone, Scott; Weaver, Matthew; Wang, Henry E

    2010-01-01

    Workplace attitude, beliefs, and culture may impact the safety of patient care. This study characterized perceptions of safety culture in a nationwide sample of emergency medical services (EMS) agencies. We conducted a cross-sectional survey involving 61 advanced life support EMS agencies in North America. We administered a modified version of the Safety Attitudes Questionnaire (SAQ), a survey instrument measuring dimensions of workplace safety culture (Safety Climate, Teamwork Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition). We included full-time and part-time paramedics and emergency medical technicians. We determined the variation in safety culture scores across EMS agencies. Using hierarchical linear models, we determined associations between safety culture scores and individual and EMS agency characteristics. We received 1,715 completed surveys from 61 EMS agencies (mean agency response rate 47%; 95% confidence interval [CI] 10%, 83%). There was wide variation in safety culture scores across EMS agencies [mean (minimum, maximum)]: Safety Climate 74.5 (min 49.9, max 89.7), Teamwork Climate 71.2 (min 45.1, max 90.1), Perceptions of Management 67.2 (min 31.1, max 92.2), Job Satisfaction 75.4 (min 47.5, max 93.8), Working Conditions 66.9 (min 36.6, max 91.4), and Stress Recognition 55.1 (min 31.3, max 70.6). Air medical EMS agencies tended to score higher across all safety culture domains. Lower safety culture scores were associated with increased annual patient contacts. Safety Climate domain scores were not associated with other individual or EMS agency characteristics. In this sample, workplace safety culture varies between EMS agencies.

  4. Relationship between depression and medication adherence in cardiovascular disease: the perfect challenge for the integrated care team

    Science.gov (United States)

    Goldstein, Carly M; Gathright, Emily C; Garcia, Sarah

    2017-01-01

    Many individuals with cardiovascular disease (CVD) experience depression that is associated with poor health outcomes, which may be because of medication nonadherence. Several factors influence medication adherence and likely influence the relationship between depression and medication adherence in CVD patients. This comprehensive study reviews the existing literature on depression and medication adherence in CVD patients, addresses the methods of and problems with measuring medication adherence, and explains why the integrated care team is uniquely situated to improve the outcomes in depressed CVD patients. This paper also explores how the team can collaboratively target depressive symptoms and medication-taking behavior in routine clinical care. Finally, it suggests the limitations to the integrated care approach, identifies targets for future research, and discusses the implications for CVD patients and their families. PMID:28352161

  5. [Elemental status of the medical personnel of the emergency medical services in the city of Khanty-Mansiysk].

    Science.gov (United States)

    Korchina, T Ya; Kuzmenko, A P; Korchina, I V

    2014-01-01

    Spectrometric analysis of hair from 110 medical workers (54--from the Emergency medical services and 56--from polyclinics) was performed with the use of atomic emission spectrometry and mass spectrometry, inductively coupled argon plasma spectrometry (AES-ISP) methods. There were revealed features of the elemental status of the medical personnel of the Emergency medical services: a deficiency of Mg, K and Li was typical for this group (presented more then in half of cases).

  6. Improving acute medical management: Junior Doctor Emergency Prescription Cards.

    Science.gov (United States)

    Hutton, Joe; Gingell, Megan; Hutchinson, Lisa

    2016-01-01

    Doctors commencing Foundation Year (FY) training face many stresses and challenges. FY doctors are often the first point of contact for acutely unwell and deteriorating patients. Trust guidelines are used to aid acute medical management. Accessing guidelines is often fraught with barriers. Evidence suggests aide-memoire cards can provide easier access to guidelines and management pathways. We aimed to improve prescribing accuracy and efficiency of FY doctors for acute medical conditions within Gloucestershire trust by improving access to and usability of trust guidelines. Questionnaires were distributed to FY doctors to identify acute medical conditions to include on the emergency prescription cards (EPCs). Two small double-sided cards were created containing bullet pointed trust guidelines for: hyper/hypokalaemia, status epilepticus, diabetic emergencies, arrhythmias, myocardial infarction, acute asthma, pulmonary oedema, anaphylaxis and a ward-round checklist. Feedback was used to improve EPCs prior to distribution. Pre (N=53) and post-intervention (N=46) written questionnaires were completed by FY doctors. These assessed acute clinical management including use of guidance, confidence in management, speed of prescribing and EPC "usability". To assess prescribing accuracy, prescriptions for acute medical conditions were reviewed pre (N=8) and post-intervention (N=12). The EPCs were well received (80% quite/very useful) and found "easy to use" (83%). The introduction of EPCs increased guidance use (pre-intervention 58.8%, post-intervention 71.7%), increased confidence (pre-intervention 79%, post-intervention 89%) and significantly improved prescribing speed (p=0.05). There was a significant correlation with confidence and prescribing speed (p = 0.023). The accuracy of prescribed doses improved (pre-intervention 62.5%, post-intervention 87.5% accurate) as did details regarding route / additional required information (pre-intervention 75%, post-intervention 97

  7. Healthcare information technology and medical-surgical nurses: the emergence of a new care partnership.

    Science.gov (United States)

    Moore, An'Nita; Fisher, Kathleen

    2012-03-01

    Healthcare information technology in US hospitals and ambulatory care centers continues to expand, and nurses are expected to effectively and efficiently utilize this technology. Researchers suggest that clinical information systems have expanded the realm of nursing to integrate technology as an element as important in nursing practice as the patient or population being served. This study sought to explore how medical surgical nurses make use of healthcare information technology in their current clinical practice and to examine the influence of healthcare information technology on nurses' clinical decision making. A total of eight medical surgical nurses participated in the study, four novice and four experienced. A conventional content analysis was utilized that allowed for a thematic interpretation of participant data. Five themes emerged: (1) healthcare information technology as a care coordination partner, (2) healthcare information technology as a change agent in the care delivery environment, (3) healthcare information technology-unable to meet all the needs, of all the people, all the time, (4) curiosity about healthcare information technology-what other bells and whistles exist, and (5) Big Brother is watching. The results of this study indicate that a new care partnership has emerged as the provision of nursing care is no longer supplied by a single practitioner but rather by a paired team, consisting of nurses and technology, working collaboratively in an interdependent relationship to achieve established goals.

  8. Emergency department crowding and risk of preventable medical errors.

    Science.gov (United States)

    Epstein, Stephen K; Huckins, David S; Liu, Shan W; Pallin, Daniel J; Sullivan, Ashley F; Lipton, Robert I; Camargo, Carlos A

    2012-04-01

    The objective of the study is to determine the association between emergency department (ED) crowding and preventable medical errors (PME). This was a retrospective cohort study of 533 ED patients enrolled in the National ED Safety Study (NEDSS) in four Massachusetts EDs. Individual patients' average exposure to ED crowding during their ED visit was compared with the occurrence of a PME (yes/no) for the three diagnostic categories in NEDSS: acute myocardial infarction, asthma exacerbation, and dislocation requiring procedural sedation. To accommodate site-to-site differences in available administrative data, ED crowding was measured using one of three previously validated crowding metrics (ED Work Index, ED Workscore, and ED Occupancy). At each site, the continuous measure was placed into site-specific quartiles, and these quartiles then were combined across sites. We found that 46 (8.6%; 95% confidence interval, 6.4-11.3%) of the 533 patients experienced a PME. For those seen during higher levels of ED crowding (quartile 4 vs. quartile 1), the occurrence of PMEs was more than twofold higher, both on unadjusted analysis and adjusting for two potential confounders (diagnosis, site). The association appeared non-linear, with most PMEs occurring at the highest crowding level. We identified a direct association between high levels of ED crowding and risk of preventable medical errors. Further study is needed to determine the generalizability of these results. Should such research confirm our findings, we would suggest that mitigating ED crowding may reduce the occurrence of preventable medical errors.

  9. Team cohesiveness, team size and team performance in team-based learning teams.

    Science.gov (United States)

    Thompson, Britta M; Haidet, Paul; Borges, Nicole J; Carchedi, Lisa R; Roman, Brenda J B; Townsend, Mark H; Butler, Agata P; Swanson, David B; Anderson, Michael P; Levine, Ruth E

    2015-04-01

    The purpose of this study was to explore the relationships among variables associated with teams in team-based learning (TBL) settings and team outcomes. We administered the National Board of Medical Examiners (NBME) Psychiatry Subject Test first to individuals and then to teams of Year three students at four medical schools that used TBL in their psychiatry core clerkships. Team cohesion was analysed using the Team Performance Scale (TPS). Bivariate correlation and linear regression analysis were used to analyse the relationships among team-level variables (mean individual TPS scores for each team, mean individual NBME scores of teams, team size, rotation and gender make-up) and team NBME test scores. A hierarchical linear model was used to test the effects of individual TPS and individual NBME test scores within each team, as well as the effects of the team-level variables of team size, team rotation and gender on team NBME test scores. Individual NBME test and TPS scores were nested within teams and treated as subsampling units. Individual NBME test scores and individual TPS scores were positively and statistically significantly (p team NBME test scores, when team rotation, team size and gender make-up were controlled for. Higher team NBME test scores were associated with teams rotating later in the year and larger teams (p teams at four medical schools suggest that larger teams on later rotations score higher on a team NBME test. Individual NBME test scores and team cohesion were positively and significantly associated with team NBME test scores. These results suggest the need for additional studies focusing on team outcomes, team cohesion, team size, rotation and other factors as they relate to the effective and efficient performance of TBL teams in health science education. © 2015 John Wiley & Sons Ltd.

  10. 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.

  11. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module I. The Emergency Medical Technician, His Role, Responsibility, and Training.

    Science.gov (United States)

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

    This instructor's lesson plan guide is one of fifteen modules designed for use in the training of emergency medical technicians (EMT). Four units are presented: (1) role of the EMT, including the operation of an emerging medical services system; (2) the laws relevant to EMTs functioning in the field; (3) activities and responsibilities of an EMT…

  12. Educational impact of an assessment of medical students' collaboration in health care teams.

    Science.gov (United States)

    Olupeliyawa, Asela; Balasooriya, Chinthaka; Hughes, Chris; O'Sullivan, Anthony

    2014-02-01

    This paper explores how structured feedback and other features of workplace-based assessment (WBA) impact on medical students' learning in the context of an evaluation of a workplace-based performance assessment: the teamwork mini-clinical evaluation exercise (T-MEX). The T-MEX enables observation-based measurement of and feedback on the behaviours required to collaborate effectively as a junior doctor within the health care team. The instrument is based on the mini-clinical evaluation exercise (mini-CEX) format and focuses on clinical encounters such as consultations with medical and allied health professionals, discharge plan preparation, handovers and team meetings. The assessment was implemented during a 6-week period in 2010 with 25 medical students during their final clinical rotation. Content analysis was conducted on the written feedback provided by 23 assessors and the written reflections and action plans proposed by the 25 student participants (in 88 T-MEX forms). Semi-structured interviews with seven assessors and three focus groups with 14 student participants were conducted and the educational impact was explored through thematic analysis. The study enabled the identification of features of WBA that promote the development of collaborative competencies. The focus of the assessment on clinical encounters and behaviours important for collaboration provided opportunities for students to engage with the health care team and highlighted the role of teamwork in these encounters. The focus on specific behaviours and a stage-appropriate response scale helped students identify learning goals and facilitated the provision of focused feedback. Incorporating these features within an established format helped students and supervisors to engage with the instrument. Extending the format to include structured reflection enabled students to self-evaluate and develop plans for improvement. The findings illuminate the mechanisms by which WBA facilitates learning. The

  13. Challenges implementing bar-coded medication administration in the emergency room in comparison to medical surgical units.

    Science.gov (United States)

    Glover, Nancy

    2013-03-01

    Bar-coded medication administration has been successfully implemented and utilized to decrease medication errors at a number of hospitals in recent years. The purpose of this article was to discuss the varying success in utilization of bar-coded medication administration on medical-surgical units and in the emergency department. Utilization reports were analyzed to better understand the challenges between the units. Many factors negatively impacted utilization in the emergency department, including the inability to use bar-coded medication administration for verbal orders or to document medications distributed by the prescribing providers, unique aspects of emergency department nursing workflow, additional steps to chart when using bar-coded medication administration, and alert fatigue. Hardware problems affected all users. Bar-coded medication administration in its current form is more suitable for use on medical-surgical floors than in the emergency department. New solutions should be developed for bar-coded medication administration in the emergency department, keeping in mind requirements to chart medications when there is no order in the system, document medications distributed by prescribing providers, adapt to unpredictable nursing workflow, minimize steps to chart with bar-coded medication administration, limit alerts to those that are clinically meaningful, and choose reliable hardware with adequate bar-code scanning capability.

  14. The Mobile Team of Parasitology-Mycology, a medical entity for educational purposes to serve sick patients.

    Science.gov (United States)

    Desoubeaux, G; Simon, E G; Perrotin, D; Chandenier, J

    2014-06-01

    The Mobile Team of Parasitology-Mycology is a movable entity of the Parasitology-Mycology laboratory of Tours University Hospital, France. In contrast to the usual prerogatives of biomedical laboratories, the Mobile Team of Parasitology-Mycology is requested to intervene directly at bedside in various clinical departments, or even outside the hospital facility. Although its actions are of course primarily devoted to specialized diagnostic and therapeutic purposes, the Mobile Team also plays an important educational role in the medical training of undergraduate or graduate students.

  15. 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.

  16. The Federal Oil Spill Team for Emergency Response Remote Sensing (FOSTERRS)

    Science.gov (United States)

    Stough, T.; Jones, C. E.; Leifer, I.; Lindsay, F. E.; Murray, J. J.; Ramirez, E. M.; Salemi, A.; Streett, D.

    2014-12-01

    Oil spills can cause enormous ecological and economic devastation, necessitating application of the best science and technology available, for which remote sensing plays a critical role in detection and monitoring of oil spills. The FOSTERRS interagency working group seeks to ensure that during an oil spill, remote sensing assets (satellite/aircraft) and analysis techniques are quickly, effectively and seamlessly available to oil spills responders. FOSTERRS enables cooperation between agencies with core environmental remote sensing assets and capabilities and academic and industry experts to act as an oil spill remote sensing information clearinghouse. The US government and its collaborators have a broad variety of aircraft and satellite sensors, imagery interrogation techniques and other technology that can provide indispensable remote sensing information to agencies, emergency responders and the public during an oil spill. Specifically, FOSTERRS will work to ensure that (1) suitable aircraft and satellite imagery and radar observations are quickly made available in a manner that can be integrated into oil spill detection and mitigation efforts, (2) existing imagery interrogation techniques are in the hands of those who will provide the 24 x 7 operational support and (3) efforts are made to develop new technology where the existing techniques do not provide oil spills responders with important information they need. The FOSTERRS mission goal places it in an ideal place for identification of critical technological needs, and identifying bottlenecks in technology acceptance. The core FOSTERRS team incorporates representation for operations and science for agencies with relevant instrumental and platform assets (NASA, NOAA, USGS, NRL). FOSTERRS membership will open to a wide range of end-user agencies and planned observer status from industry and academic experts, and eventually international partners. Through these collaborations, FOSTERRS facilitates interagency

  17. [Antenatal emergency call. Indications. Role of the SAMU (Medical Emergency Care Services)].

    Science.gov (United States)

    Lallemand, E; Drouet, N; Faudemay, C; Lacroute, J M; Menthonnex, P

    1989-01-01

    The increased incidence of antenatal distress calls to the SAMU (emergency medical squad) by pediatric obstetricians in maternity departments (6 times in 5 years) poses the problem of recognizing their indications. Based on case reports of 128 newborns who profited from antenatal assistance, the authors attempt to define the indications. The elimination of student physicians in training for anesthesiology-intensive care, additional participants during SAMU transportation of patients, makes it even more necessary to define these indications accurately so that a single language of communication and procedure may be instituted for all who are involved in this effort.

  18. [Outcomes of Infection Control Team Inspections at the Dental Hospital, Tokyo Medical and Dental University].

    Science.gov (United States)

    Sunakawa, Mitsuhiro; Matsumoto, Hiroyuki; Okihata, Rie; Tsuruoka, Hiromi; Yamada, Yuichi; Adachi, Toshiko; Izumi, Yuichi

    2015-07-01

    In the Dental Hospital, Tokyo Medical and Dental University, an infection control team (ICT) has been formed to inspect each diagnosis department of clinics and wards in order to identify problems regarding nosocomial infection control. In this study, we analyzed the inspection reports and highlighted the following serious problems: 1) inadequate hygienic hand-washing for out- and in-patient treatment, 2) incomplete wearing of personal protective equipment (PPE) by dental health care workers, 3) necessity of environmental improvement in the clinics, and 4) cross-infection risk induced by. the continuous use of treatment devices without appropriate disinfection. The ICT provided feedback to the inspected departments, suggesting solutions to problems regarding nosocomial infection control. In order to enhance infection control in our hospital, dental healthcare practitioners must make further efforts on nosocomial infection control and prevention, and act according to their position by continuously educating students and enlightening hospital staff about the importance of infection control.

  19. How fun are your meetings? How and when humor patterns emerge and impact team performance.

    NARCIS (Netherlands)

    Lehmann-Willenbrock, N.K.; Allen, J.A.

    2014-01-01

    Research on humor in organizations has rarely considered the social context in which humor occurs. One such social setting that most of us experience on a daily basis concerns the team context. Building on recent theorizing about the humor–performance link in teams, this study seeks to increase our

  20. Emergent team roles in organizational meetings: Identifying communication patterns via cluster analysis.

    NARCIS (Netherlands)

    Lehmann-Willenbrock, N.K.; Beck, S.J.; Kauffeld, S.

    2016-01-01

    Previous team role taxonomies have largely relied on self-report data, focused on functional roles, and described individual predispositions or personality traits. Instead, this study takes a communicative approach and proposes that team roles are produced, shaped, and sustained in communicative beh

  1. Naegleria fowleri: a free living amoeba of emerging medical importance.

    Science.gov (United States)

    Parija, S C; Jayakeerthee, S R

    1999-09-01

    Naegleria fowleri, a free-living amoeba is ubiquitous and word-wide in distribution. Infection is due to inhalation or aspiration of aerosols containing cysts found in the environment. Of late, the amoeba is emerging as a pathogen of medical importance causing primary amoebic meningoencephalitis (PAM) in humans. The diagnosis of the condition is mainly parasitic which depends on the detection and identification of Naegleria trophozoites in the cerebro-spinal fluid (CSF) or biopsied brain tissue. Serological tests are not useful in the diagnosis of PAM. Most cases are fatal and various amoebicidal agents have been tried unsuccessfully. The present paper provides a review of the recent information on the biology and epidemiology of the disease caused by the amoeba Approaches in the diagnosis, pathophysiology and treatment of the condition are also discussed.

  2. Simulation and optimization models for emergency medical systems planning.

    Science.gov (United States)

    Bettinelli, Andrea; Cordone, Roberto; Ficarelli, Federico; Righini, Giovanni

    2014-01-01

    The authors address strategic planning problems for emergency medical systems (EMS). In particular, the three following critical decisions are considered: i) how many ambulances to deploy in a given territory at any given point in time, to meet the forecasted demand, yielding an appropriate response time; ii) when ambulances should be used for serving nonurgent requests and when they should better be kept idle for possible incoming urgent requests; iii) how to define an optimal mix of contracts for renting ambulances from private associations to meet the forecasted demand at minimum cost. In particular, analytical models for decision support, based on queuing theory, discrete-event simulation, and integer linear programming were presented. Computational experiments have been done on real data from the city of Milan, Italy.

  3. Correlates of team effectiveness: An exploratory study of firefighter's operations during emergency situations.

    Science.gov (United States)

    Jouanne, Elise; Charron, Camilo; Chauvin, Christine; Morel, Gaël

    2017-05-01

    This paper examines elements contributing to the effectiveness of firefighting teams carrying out typical tasks. Fourteen firefighter crews were filmed during nineteen real operations and answered questionnaires relating to psychosocial dimensions. Results have shown that "enriched closed-loops" of communication, positive emotional interactions and a "gamma" type of adaptation are positively related to team effectiveness. Conversely, open and incomplete loops of communication, negative emotional interactions, "beta" and "alpha" types of adaptation are negatively related to team effectiveness. Furthermore, there is a mediated link between organisational trust and motivation on the one hand and team effectiveness on the other. These findings highlight the necessity to consider both cognitive and psychosocial variables to account for team effectiveness in the firefighting profession. They also emphasize the need to expand firefighter training to the "non-technical" aspects of the competence.

  4. Emergency Medicine: On the Frontlines of Medical Education Transformation

    Directory of Open Access Journals (Sweden)

    Eric S. Holmboe

    2015-10-01

    Full Text Available 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.

  5. Perception of stroke symptoms and utilization of emergency medical services

    Directory of Open Access Journals (Sweden)

    Maximiliano A. Hawkes

    Full Text Available ABSTRACT Lack of stroke awareness and slow activation of emergency medical services (EMS are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population. Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results Seventy patients (75% arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02. Nineteen patients (20% were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001. Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

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

    Directory of Open Access Journals (Sweden)

    James R. Langabeer II

    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.

  7. Features of an Emerging Practice and Professional Development in a Science Teacher Team Collaboration with a Researcher Team

    Science.gov (United States)

    Olin, Anette; Ingerman, Åke

    2016-10-01

    This study concerns teaching and learning development in science through collaboration between science teachers and researchers. At the core was the ambition to integrate research outcomes of science education—here `didactic models'—with teaching practice, aligned with professional development. The phase where the collaboration moves from initial establishment towards a stable practice is investigated. The study aims to identifying features of formation and exploring consequences for the character of contact between research and teaching. Specific questions are "What may be identified as actions and arrangements impacting the quality and continuation of the emerging practice?" and "What and in what ways may support teacher growth?" The analysis draws on practice architectures as a theoretical framework and specifically investigates the initial meetings as a practice-node for a new practice, empirically drawing on documented reflections on science teaching, primarily from meetings and communication. The results take the form of an analytical-narrative account of meetings that focused planning, enactment and reflection on teaching regarding the human body. We identify enabling actions such as collaborative work with concrete material from the classroom and arrangements such as the regular meetings and that the collaborative group had a core of shared competence—in science teaching and learning. Constraining were actions such as introducing research results with weak connection to practical action in the school practice and arrangements such as differences between school and university practice architectures and the general `oppression' of teachers' classroom practice. The discussion includes reflections on researchers' roles and on a research and practice base for school development.

  8. Features of an Emerging Practice and Professional Development in a Science Teacher Team Collaboration with a Researcher Team

    Science.gov (United States)

    Olin, Anette; Ingerman, Åke

    2016-06-01

    This study concerns teaching and learning development in science through collaboration between science teachers and researchers. At the core was the ambition to integrate research outcomes of science education—here `didactic models'—with teaching practice, aligned with professional development. The phase where the collaboration moves from initial establishment towards a stable practice is investigated. The study aims to identifying features of formation and exploring consequences for the character of contact between research and teaching. Specific questions are "What may be identified as actions and arrangements impacting the quality and continuation of the emerging practice?" and "What and in what ways may support teacher growth?" The analysis draws on practice architectures as a theoretical framework and specifically investigates the initial meetings as a practice-node for a new practice, empirically drawing on documented reflections on science teaching, primarily from meetings and communication. The results take the form of an analytical-narrative account of meetings that focused planning, enactment and reflection on teaching regarding the human body. We identify enabling actions such as collaborative work with concrete material from the classroom and arrangements such as the regular meetings and that the collaborative group had a core of shared competence—in science teaching and learning. Constraining were actions such as introducing research results with weak connection to practical action in the school practice and arrangements such as differences between school and university practice architectures and the general `oppression' of teachers' classroom practice. The discussion includes reflections on researchers' roles and on a research and practice base for school development.

  9. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Science.gov (United States)

    2010-01-01

    ....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... assignment, for hospital emergency medical evacuation service helicopter operations unless that assignment... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Helicopter hospital emergency...

  10. Emergency Medical Technician-Ambulance: National Standard Curriculum. Student Study Guide (Third Edition).

    Science.gov (United States)

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

    This student study guide is one of three documents prepared for the Emergency Medical Technician (EMT), National Standard Curriculum. The course is designed to develop skills in symptom recognition and in all emergency care procedures and techniques currently considered to be within the responsibilities of an EMT providing emergency medical care…

  11. Optimizing Simulated Multidisciplinary Team Training of Pediatric Emergencies: An Evaluation of Prerequisites for Transfer of Skills to Clinical Practice

    Directory of Open Access Journals (Sweden)

    E. H. A. J. Coolen

    2015-01-01

    Full Text Available Introduction. Multidisciplinary simulation-based team training (STT provides a powerful training method to train technical and team skills during emergencies. Effectiveness of STT depends on transfer of learned skills to clinical practice. In this study we examined three important prerequisites to enhance transfer from STT into clinical practice, intervention readiness, realism, and performance self-efficacy. Methods. For the quantitative part of the study, 131 participants (pediatric nurses and physicians were asked to fill out an online questionnaire before and after training. For the qualitative part of the study we organized three one-hour focus group sessions in which participants were interviewed on attitude, realism, and self-efficacy. Results. Providing adequate preparation material and extensive debriefing of scenarios is important in creating this positive learning experience. The perspective of realism depends strongly on setting and learning goals. During STT team assembly and role playing can become more important to participants, while physical aspects become less important. Performance self-efficacy for all participants increases significantly (P<0.05 regarding team skills. Conclusions. STT can be a very positive multidisciplinary learning experience, which creates the possibility of enhancing confidence, skills, and team performance within the clinical context. STT combines three important prerequisites for transfer of training to take place.

  12. Cost analysis of strategies to reduce blood culture contamination in the emergency department: sterile collection kits and phlebotomy teams.

    Science.gov (United States)

    Self, Wesley H; Talbot, Thomas R; Paul, Barbara R; Collins, Sean P; Ward, Michael J

    2014-08-01

    Blood culture collection practices that reduce contamination, such as sterile blood culture collection kits and phlebotomy teams, increase up-front costs for collecting cultures but may lead to net savings by eliminating downstream costs associated with contamination. The study objective was to compare overall hospital costs associated with 3 collection strategies: usual care, sterile kits, and phlebotomy teams. Cost analysis. This analysis was conducted from the perspective of a hospital leadership team selecting a blood culture collection strategy for an adult emergency department (ED) with 8,000 cultures drawn annually. Total hospital costs associated with 3 strategies were compared: (1) usual care, with nurses collecting cultures without a standardized protocol; (2) sterile kits, with nurses using a dedicated sterile collection kit; and (3) phlebotomy teams, with cultures collected by laboratory-based phlebotomists. In the base case, contamination rates associated with usual care, sterile kits, and phlebotomy teams were assumed to be 4.34%, 1.68%, and 1.10%, respectively. Total hospital costs included costs of collecting cultures and hospitalization costs according to culture results (negative, true positive, and contaminated). Compared with usual care, annual net savings using the sterile kit and phlebotomy team strategies were $483,219 and $288,980, respectively. Both strategies remained less costly than usual care across a broad range of sensitivity analyses. EDs with high blood culture contamination rates should strongly consider evidence-based strategies to reduce contamination. In addition to improving quality, implementing a sterile collection kit or phlebotomy team strategy is likely to result in net cost savings.

  13. Emergency response teams training in public health crisis: The seriousness of serious games

    Directory of Open Access Journals (Sweden)

    Stanojević Vojislav

    2016-01-01

    Full Text Available Introduction. The rapid development of multimedia technologies in the last twenty years has lead to the emergence of new ways of learning academic and professional skills, which implies the application of multimedia technology in the form of a software -“serious computer games”. Three-Dimensional Virtual Worlds. The basis of this game-platform is made of the platform of three-dimensional virtual worlds that can be described as communication systems in which participants share the same three-dimensional virtual space within which they can move, manipulate objects and communicate through their graphical representativesavatars. Medical Education and Training. Arguments in favor of these computer tools in the learning process are accessibility, repeatability, low cost, the use of attractive graphics and a high degree of adaptation to the user. Specifically designed avatars allow students to get adapted to their roles in certain situations, especially to those which are considered rare, dangerous or unethical in real life. Discussion. Drilling of major incidents, which includes the need to create environments for training, cannot be done in the real world due to high costs and necessity to utilize the extensive resources. In addition, it is impossible to engage all the necessary health personnel at the same time. New technologies intended for conducting training, which are also called “virtual worlds”, make the following possible: training at all times depending on user’s commitments; simultaneous simulations on multiple levels, in several areas, in different circumstances, including dozens of unique victims; repeated scenarios and learning from mistakes; rapid feedback and the development of non-technical skills which are critical for reducing errors in dynamic, high-risk environments. Conclusion. Virtual worlds, which should be the subject of further research and improvements, in the field of hospital emergency response training for mass

  14. 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…

  15. Emergency department clinical redesign, team-based care and improvements in hospital performance: A time series analysis.

    Science.gov (United States)

    Dinh, Michael M; Green, Timothy C; Bein, Kendall J; Lo, Serigne; Jones, Aaron; Johnson, Terence

    2015-08-01

    The objective was to evaluate the impact of an ED clinical redesign project that involved team-based care and early senior assessment on hospital performance. This was an interrupted time series analysis performed using daily hospital performance data 6 months before and 8 months after the implementation of the clinical redesign intervention that involved Emergency Consultant-led team-based care, redistribution of ED beds and implementation of a senior nursing coordination roles in the ED. The primary outcome was the daily National Emergency Access Target (NEAT) performance (proportion of total daily ED presentations that were admitted to an inpatient ward or discharged from ED within 4 h of arrival). Secondary outcomes were daily ALOS in ED, inpatient Clinical Emergency Response System (CERS) calls and hospital mortality. Autoregressive Integrated Moving Average analysis was used to model NEAT performance. Hospital mortality was modelled using negative binomial regression. After adjusting for patient volume, inpatient admissions, ambulance, hospital occupancy, weekends ED Consultant numbers, weekends and underlying trends, there was a 17% improvement in NEAT associated with the post-intervention period (95% CI 12, 19% P performance with no evidence of an increase in clinical deterioration on inpatient wards and evidence for an improvement in hospital mortality. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  16. Why people do, or do not, immediately contact emergency medical services following the onset of acute stroke: qualitative interview study.

    Directory of Open Access Journals (Sweden)

    Joan E Mackintosh

    Full Text Available OBJECTIVES: To identify the reasons why individuals contact, or delay contacting, emergency medical services in response to stroke symptoms. DESIGN: Qualitative interview study with a purposive sample of stroke patients and witnesses, selected according to method of accessing medical care and the time taken to do so. Data were analysed using the Framework approach. SETTING: Area covered by three acute stroke units in the north east of England. PARTICIPANTS: Nineteen stroke patients and 26 witnesses who had called for help following the onset of stroke symptoms. RESULTS: Factors influencing who called emergency medical services and when they called included stroke severity, how people made sense of symptoms and their level of motivation to seek help. Fear of the consequences of stroke, including future dependence or disruption to family life, previous negative experience of hospitals, or involving a friend or relations in the decision to access medical services, all resulted in delayed admission. Lack of knowledge of stroke symptoms was also an important determinant. Perceptions of the remit of medical services were a major cause of delays in admission, with many people believing the most appropriate action was to telephone their GP. Variations in the response of primary care teams to acute stroke symptoms were also evident. CONCLUSIONS: The factors influencing help-seeking decisions are complex. There remains a need to improve recognition by patients, witnesses and health care staff of the need to treat stroke as a medical emergency by calling emergency medical services, as well as increasing knowledge of symptoms of stroke among patients and potential witnesses. Fear, denial and reticence to impose on others hinders the process of seeking help and will need addressing specifically with appropriate interventions. Variability in how primary care services respond to stroke needs further investigation to inform interventions to promote best

  17. Chinese military medical teams in the Ebola outbreak of Sierra Leone.

    Science.gov (United States)

    Lu, Yinying; Rong, G; Yu, S P; Sun, Z; Duan, X; Dong, Z; Xia, H; Zhan, N; Jin, C; Ji, J; Duan, H

    2016-06-01

    The 2014-2015 Ebola virus disease (EVD) epidemic in West Africa was the largest in history. The three most affected countries, Guinea, Liberia and Sierra Leone, have faced enormous challenges in controlling transmission and providing clinical care for patients with EVD. The Chinese government, in response to the requests of the WHO and the governments of the affected countries, responded rapidly by deploying Chinese military medical teams (CMMTs) to the areas struck by the deadly epidemic. A total of three CMMTs, comprising 115 military medical professionals, were rotationally deployed to Freetown, Sierra Leone to assist with infection prevention and control, clinical care and health promotion and training. Between 1 October 2014 and 22 March 2015, the CMMTs in Sierra Leone admitted and treated a total of 773 suspected and 285 confirmed EVD cases. Among the 285 confirmed cases, 146 (51.2%) patients survived after treatment. In addition, the CMMTs maintained the record of zero infections among healthcare workers and zero cross-infections between quarantined patients. In this manuscript, we aim to give an overview of the mission, and share our best practices experience on predeployment preparedness, EVD holding and treatment centre building and EVD case management. 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/

  18. Modified use of team-based learning for effective delivery of medical gross anatomy and embryology.

    Science.gov (United States)

    Vasan, Nagaswami S; DeFouw, David O; Holland, Bart K

    2008-01-01

    Team-based learning (TBL) is an instructional strategy that combines independent out-of-class preparation for in-class discussion in small groups. This approach has been successfully adopted by a number of medical educators. This strategy allowed us to eliminate anatomy lectures and incorporate small-group active learning. Although our strategy is a modified use of classical TBL, in the text, we use the standard terminology of TBL for simplicity. We have modified classical TBL to fit our curricular needs and approach. Anatomy lectures were replaced with TBL activities that required pre-class reading of assigned materials, an individual self-assessment quiz, discussion of learning issues derived from the reading assignments, and then the group retaking the same quiz for discussion and deeper learning. Students' performances and their educational experiences in the TBL format were compared with the traditional lecture approach. We offer several in-house unit exams and a final comprehensive subject exam provided by the National Board of Medical Examiners. The students performed better in all exams following the TBL approach compared to traditional lecture-based teaching. Students acknowledged that TBL encouraged them to study regularly, allowed them to actively teach and learn from peers, and this served to improve their own exam performances. We found that a TBL approach in teaching anatomy allowed us to create an active learning environment that helped to improve students' performances. Based on our experience, other preclinical courses are now piloting TBL.

  19. Prehospital electronic patient care report systems: early experiences from emergency medical services agency leaders.

    Directory of Open Access Journals (Sweden)

    Adam B Landman

    Full Text Available BACKGROUND: As the United States embraces electronic health records (EHRs, improved emergency medical services (EMS information systems are also a priority; however, little is known about the experiences of EMS agencies as they adopt and implement electronic patient care report (e-PCR systems. We sought to characterize motivations for adoption of e-PCR systems, challenges associated with adoption and implementation, and emerging implementation strategies. METHODS: We conducted a qualitative study using semi-structured in-depth interviews with EMS agency leaders. Participants were recruited through a web-based survey of National Association of EMS Physicians (NAEMSP members, a didactic session at the 2010 NAEMSP Annual Meeting, and snowball sampling. Interviews lasted approximately 30 minutes, were recorded and professionally transcribed. Analysis was conducted by a five-person team, employing the constant comparative method to identify recurrent themes. RESULTS: Twenty-three interviewees represented 20 EMS agencies from the United States and Canada; 14 EMS agencies were currently using e-PCR systems. The primary reason for adoption was the potential for e-PCR systems to support quality assurance efforts. Challenges to e-PCR system adoption included those common to any health information technology project, as well as challenges unique to the prehospital setting, including: fear of increased ambulance run times leading to decreased ambulance availability, difficulty integrating with existing hospital information systems, and unfunded mandates requiring adoption of e-PCR systems. Three recurring strategies emerged to improve e-PCR system adoption and implementation: 1 identify creative funding sources; 2 leverage regional health information organizations; and 3 build internal information technology capacity. CONCLUSION: EMS agencies are highly motivated to adopt e-PCR systems to support quality assurance efforts; however, adoption and

  20. Risks to emergency medical responders at terrorist incidents: a narrative review of the medical literature.

    Science.gov (United States)

    Thompson, Julian; Rehn, Marius; Lossius, Hans Morten; Lockey, David

    2014-09-24

    As the threat of international terrorism rises, there is an increasing requirement to provide evidence-based information and training for the emergency personnel who will respond to terrorist incidents. Current major incident training advises that emergency responders prioritize their own personal safety above that of the 'scene and survivors'. However, there is limited information available on the nature of these threats and how they may be accurately evaluated. This study reviews the published medical literature to identify the hazards experienced by emergency responders who have attended previous terrorist incidents. A PubMed literature search identified 10,894 articles on the subject of 'terrorism', and there was a dramatic increase in publications after the 9/11 attacks in 2001. There is heterogeneity in the focus and quality of this literature, and 307 articles addressing the subject of scene safety were assessed for information regarding the threats encountered at terrorist incidents. These articles demonstrate that emergency responders have been exposed to both direct terrorist threats and environmental scene hazards, including airborne particles, structural collapse, fire, and psychological stress. The emphasis of training and preparedness for terrorist incidents has been primarily on the direct threats, but the published literature suggests that the dominant causes of mortality and morbidity in responders after such incidents are the indirect environmental hazards. If the medical response to terrorist incidents is to be based on evidence rather than anecdote, analysis of the current literature should be incorporated into major incident training, and consistent collection of key data from future incidents is required.

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

    Science.gov (United States)

    Bashir, Talha

    2014-01-01

    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.

  2. AN OVERVIEW OF ELASTOGRAPHY - AN EMERGING BRANCH OF MEDICAL IMAGING.

    Science.gov (United States)

    Sarvazyan, Armen; Hall, Timothy J; Urban, Matthew W; Fatemi, Mostafa; Aglyamov, Salavat R; Garra, Brian S

    2011-11-01

    From times immemorial manual palpation served as a source of information on the state of soft tissues and allowed detection of various diseases accompanied by changes in tissue elasticity. During the last two decades, the ancient art of palpation gained new life due to numerous emerging elasticity imaging (EI) methods. Areas of applications of EI in medical diagnostics and treatment monitoring are steadily expanding. Elasticity imaging methods are emerging as commercial applications, a true testament to the progress and importance of the field.In this paper we present a brief history and theoretical basis of EI, describe various techniques of EI and, analyze their advantages and limitations, and overview main clinical applications. We present a classification of elasticity measurement and imaging techniques based on the methods used for generating a stress in the tissue (external mechanical force, internal ultrasound radiation force, or an internal endogenous force), and measurement of the tissue response. The measurement method can be performed using differing physical principles including magnetic resonance imaging (MRI), ultrasound imaging, X-ray imaging, optical and acoustic signals.Until recently, EI was largely a research method used by a few select institutions having the special equipment needed to perform the studies. Since 2005 however, increasing numbers of mainstream manufacturers have added EI to their ultrasound systems so that today the majority of manufacturers offer some sort of Elastography or tissue stiffness imaging on their clinical systems. Now it is safe to say that some sort of elasticity imaging may be performed on virtually all types of focal and diffuse disease. Most of the new applications are still in the early stages of research, but a few are becoming common applications in clinical practice.

  3. Emergency Department Patients' Perceptions of Radiation From Medical Imaging.

    Science.gov (United States)

    Repplinger, Michael D; Li, Annabel J; Svenson, James E; Ehlenbach, William J; Westergaard, Ryan P; Reeder, Scott B; Jacobs, Elizabeth A

    2016-02-01

    To evaluate emergency department patients' knowledge of radiation exposure and subsequent risks from computed tomography (CT) and magnetic resonance imaging (MRI) scans. This is a cross-sectional survey study of adult, English-speaking patients from June to August 2011 at 2 emergency departments--1 academic and 1 community-based--in the upper Midwest. The survey consisted of 2 sets of 3 questions evaluating patients' knowledge of radiation exposure from medical imaging and subsequent radiation-induced malignancies and was based on a previously published survey. The question sets paralleled each other, but one pertained to CT and the other to MRI. Questions in the survey ascertained patients' understanding of (1) the relative amount of radiation exposed from CT/MRI compared with a single chest x-ray; (2) the relative amount of radiation exposed from CT/MRI compared with a nuclear power plant accident; and (3) the possibility of radiation-induced malignancies from CT/MRl. Sociodemographic data also were gathered. The primary outcome measure was the proportion of correct answers to each survey question. Multiple logistic regression then was used to examine the relationship between the percentage correct for each question and sociodemographic variables, using odds ratios with 95% confidence intervals. P-values less than 0.05 were considered statistically significant. There were 500 participants in this study, 315 from the academic center and 185 from the community hospital. Overall, 14.1% (95% CI, 11.0%-17.2%) of participants understood the relative radiation exposure of a CT scan compared with a chest x-ray, while 22.8% (95% CI, 18.9%-26.7%) of respondents understood the lack of ionizing radiation use with MRI. At the same time, 25.6% (95% CI, 21.8%- 29.4%) believed that there was an increased risk of developing cancer from repeated abdominal CTs, while 55.6% (95% CI, 51.1%-60.1%) believed this to be true of abdominal MRI. Higher educational level and identification

  4. Chaplains on the Medical Team: A Qualitative Analysis of an Interprofessional Curriculum for Internal Medicine Residents and Chaplain Interns.

    Science.gov (United States)

    Hemming, Patrick; Teague, Paula J; Crowe, Thomas; Levine, Rachel

    2016-04-01

    Improved collaboration between physicians and chaplains has the potential to improve patient experiences. To better understand the benefits and challenges of learning together, the authors conducted several focus groups with participants in an interprofessional curriculum that partnered internal medicine residents with chaplain interns in the clinical setting. The authors derived four major qualitative themes from the transcripts: (1) physician learners became aware of effective communication skills for addressing spirituality. (2) Chaplain interns enhanced the delivery of team-based patient-centered care. (3) Chaplains were seen as a source of emotional support to the medical team. (4) The partnership has three keys to success: adequate introductions for team members, clear expectations for participants, and opportunities for feedback. The themes presented indicate several benefits of pairing physicians and chaplains in the setting of direct patient care and suggest that this is an effective approach to incorporating spirituality in medical training.

  5. Medical identity theft: an emerging problem for informatics.

    Science.gov (United States)

    Gillette, William; Patrick, Timothy B

    2007-10-11

    This poster reports a preliminary review of medical identity theft. Financial identity theft has received a great deal of media attention. Medical identity theft is a particular kind of identity theft that has received little attention. There are two main subtypes of medical identity theft. In the first type the stolen medical identity is used to receive medical services, and in the second type the stolen medical identity is used to commit healthcare fraud.

  6. Why and when citizens call for emergency help: an observational study of 211,193 medical emergency calls.

    Science.gov (United States)

    Møller, Thea Palsgaard; Ersbøll, Annette Kjær; Tolstrup, Janne Schurmann; Østergaard, Doris; Viereck, Søren; Overton, Jerry; Folke, Fredrik; Lippert, Freddy

    2015-11-04

    A medical emergency call is citizens' access to pre-hospital emergency care and ambulance services. Emergency medical dispatchers are gatekeepers to provision of pre-hospital resources and possibly hospital admissions. We explored causes for access, emergency priority levels, and temporal variation within seasons, weekdays, and time of day for emergency calls to the emergency medical dispatch center in Copenhagen in a two-year study period (December 1(st), 2011 to November 30(th), 2013). Descriptive analysis was performed for causes for access and emergency priority levels. A Poisson regression model was used to calculate adjusted ratio estimates for the association between seasons, weekdays, and time of day overall and stratified by emergency priority levels. We analyzed 211,193 emergency calls for temporal variation. Of those, 167,635 calls were eligible for analysis of causes and emergency priority level. "Unclear problem" was the most frequent category (19%). The five most common causes with known origin were categorized as "Wounds, fractures, minor injuries" (13%), "Chest pain/heart disease" (11%), "Accidents" (9%), "Intoxication, poisoning, drug overdose" (8%), and "Breathing difficulties" (7%). The highest emergency priority levels (Emergency priority level A and B) were assigned in 81% of calls. In the analysis of temporal variation, the total number of calls peaked at wintertime (26%), Saturdays (16%), and during daytime (39%). The pattern of citizens' contact causes fell into four overall categories: unclear problems, medical problems, intoxication and accidents. The majority of calls were urgent. The magnitude of unclear problems represents a modifiable factor and highlights the potential for further improvement of supportive dispatch priority tools or educational interventions at dispatch centers. Temporal variation was identified within seasons, weekdays and time of day and reflects both system load and disease occurrence. Data on contact patterns

  7. Partnership for Diversity: A Multidisciplinary Approach to Nurturing Cultural Competence at an Emerging Medical School.

    Science.gov (United States)

    Swanberg, Stephanie M; Abuelroos, Dena; Dabaja, Emman; Jurva, Stephanie; Martin, Kimberly; McCarron, Joshua; Reed-Hendon, Caryn; Yeow, Raymond Y; Harriott, Melphine M

    2015-01-01

    Fostering cultural competence in higher education institutions is essential, particularly in training future health care workers to care for diverse populations. The opportunity to explore techniques to address diversity and cultural competence at a new medical school was undertaken by a multidisciplinary team of librarians, faculty, staff, and medical students. From 2011 to 2015, the team sponsored a voluntary programming series to promote cultural competence and raise awareness of health care disparities for the medical school. Thirteen events were hosted with 562 participants across all. This approach to diversity proved effective and could be adapted in any higher education setting.

  8. Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics

    Directory of Open Access Journals (Sweden)

    Janice Halpern

    2014-01-01

    Full Text Available Effective workplace-based interventions after critical incidents (CIs are needed for emergency medical technicians (EMT/paramedics. The evidence for a period out of service post-CI (downtime is sparse; however it may prevent posttraumatic stress disorder (PTSD and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores. Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

  9. Hand Washing Practices Among Emergency Medical Services Providers

    Directory of Open Access Journals (Sweden)

    Joshua Bucher

    2015-10-01

    Full Text Available Introduction: Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS workers, respectively. Methods: We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results: There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003. Providers who brought their own sanitizer were more likely to clean their hands. Conclusion: Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.

  10. The 2012 derecho: emergency medical services and hospital response.

    Science.gov (United States)

    Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B

    2014-10-01

    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.

  11. Downtime after critical incidents in emergency medical technicians/paramedics.

    Science.gov (United States)

    Halpern, Janice; Maunder, Robert G; Schwartz, Brian; Gurevich, Maria

    2014-01-01

    Effective workplace-based interventions after critical incidents (CIs) are needed for emergency medical technicians (EMT)/paramedics. The evidence for a period out of service post-CI (downtime) is sparse; however it may prevent posttraumatic stress disorder (PTSD) and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores). Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

  12. 3D medical collaboration technology to enhance emergency healthcare

    DEFF Research Database (Denmark)

    Welch, Gregory F; Sonnenwald, Diane H.; Fuchs, Henry

    2009-01-01

    Two-dimensional (2D) videoconferencing has been explored widely in the past 15-20 years to support collaboration in healthcare. Two issues that arise in most evaluations of 2D videoconferencing in telemedicine are the difficulty obtaining optimal camera views and poor depth perception. To address...... system; and we present evaluation results supporting the general hypothesis that 3D remote medical collaboration technology could offer benefits over conventional 2D videoconferencing in emergency healthcare.......Two-dimensional (2D) videoconferencing has been explored widely in the past 15-20 years to support collaboration in healthcare. Two issues that arise in most evaluations of 2D videoconferencing in telemedicine are the difficulty obtaining optimal camera views and poor depth perception. To address...... these problems, we are exploring the use of a small array of cameras to reconstruct dynamic three-dimensional (3D) views of a remote environment and of events taking place within. The 3D views could be sent across wired or wireless networks to remote healthcare professionals equipped with fixed displays...

  13. Collegiate-Based Emergency Medical Service: Impact on Alcohol-Related Emergency Department Transports at a Small Liberal Arts College

    Science.gov (United States)

    Rosen, Joshua B.; Olson, Mark H.; Kelly, Marianne

    2012-01-01

    Objective: The authors examined the impact of a collegiate-based emergency medical service (CBEMS) on the frequency of emergency department (ED) transports. Participants: Students transported to the ED for acute alcohol intoxication during the Fall 2008 and the Fall 2009 semesters (N = 50). Methods: The frequency of students receiving…

  14. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 4. Vital Signs, Patient Assessment. Revised.

    Science.gov (United States)

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

    This student manual, the fourth 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: vital signs (temperature, pulse, respirations, and blood pressure) and patient assessment at the scene of an emergency. Each section contains objectives,…

  15. Experience, awareness, and perceptions about medical emergencies among dental interns of Chennai city, India

    Directory of Open Access Journals (Sweden)

    L Leelavathi

    2016-01-01

    Full Text Available Introduction: Every dental health professional should have the essential knowledge to identify, assess and manage a potentially life-threatening situation. Aim: To assess the experience, awareness, and perceptions about medical emergencies among dental interns in Chennai city, India. Materials and Methods: A cross-sectional study carried out in four randomly selected dental colleges of Chennai city. Data were collected using a self-administered, structured, closed-ended 20-item questionnaire. It consists of questions on experience of medical emergencies encountered by interns during their graduation, awareness of the essential drugs and equipment, the amount of medical emergencies training undertaken by participants, preparedness of interns in handling medical emergencies. Descriptive statistics, independent sample t-test, were used. Results: Out of 335 interns, 157 (47% said that syncope was the most common medical emergency event encountered by the interns. Regarding awareness about essential drugs, about 161 (48% study participants answered oxygen, epinephrine, nitroglycerin, antihistamine, salbutamol, and aspirin as emergency drugs. About half of the study participants, 187 (56% were aware that pressure should be given to the affected site, with or without suturing if the greater palatine artery is inadvertently cut. The majority of the interns (93% preferred to have a specified training on the handling of medical emergencies in dental practice. Conclusions: Syncope was the most common medical emergency event. Awareness about the essential drugs, equipment, and preparedness of dental interns in handling medical emergencies was low.

  16. Building Trusting Relationships in the Medical Practice Team: Thirty Rules to Live By for You and Your Staff.

    Science.gov (United States)

    Hills, Laura

    2015-01-01

    A medical practice team without trust isn't really a team; it's just a group of individuals who work together in a medical practice, often making disappointing progress. This is true no matter how capable or talented the individuals are. Your staff may never reach its full potential if trust is not present. This article offers medical practice managers 30 rules for building trust in their practices: 15 rules that will help them in their leadership roles, and 15 rules to teach and discuss with their employees. It suggests a trust-building screening question to include in job interviews to determine if applicants have a high capacity for trust. It also describes Reina and Reina's "Three C's of Trust," a model that practice managers may find useful as they develop trust competencies in their staffs. This article also includes 10 inspiring quotes that will help medical practice employees build trust and five easy-to-facilitate trust-building exercises that managers can use with the medical practice team.

  17. Developing a grounded theory for interprofessional collaboration acquisition using facilitator and actor perspectives in simulated wilderness medical emergencies.

    Science.gov (United States)

    Smith, Heather A; Reade, Maurianne; Marr, Marion; Jeeves, Nicholas

    2017-01-01

    Interprofessional collaboration is a complex process that has the potential to transform patient care for the better in urban, rural and remote healthcare settings. Simulation has been found to improve participants' interprofessional competencies, but the mechanisms by which interprofessionalism is learned have yet to be understood. A rural wilderness medicine conference (WildER Med) in northern Ontario, Canada with simulated medical scenarios has been demonstrated to be effective in improving participants' collaboration without formal interprofessional education (IPE) curriculum. Interprofessionalism may be taught through rural and remote medical simulation, as done in WildER Med where participants' interprofessional competencies improved without any formal IPE curriculum. This learning may be attributed to the informal and hidden curriculum. Understanding the mechanism by which this rural educational experience contributed to participants' learning to collaborate requires insight into the events before, during and after the simulations. The authors drew upon feedback from facilitators and patient actors in one-on-one interviews to develop a grounded theory for how collaboration is taught and learned. Sharing emerged as the core concept of a grounded theory to explain how team members acquired interprofessional collaboration competencies. Sharing was enacted through the strategies of developing common goals, sharing leadership, and developing mutual respect and understanding. Further analysis of the data and literature suggests that the social wilderness environment was foundational in enabling sharing to occur. Medical simulations in other rural and remote settings may offer an environment conducive to collaboration and be effective in teaching collaboration. When designing interprofessional education, health educators should consider using emergency response teams or rural community health teams to optimize the informal and hidden curriculum contributing to

  18. Patient safety culture at neonatal intensive care units: perspectives of the nursing and medical team

    Directory of Open Access Journals (Sweden)

    Andréia Tomazoni

    2014-10-01

    Full Text Available OBJECTIVE: to verify the assessment of the patient safety culture according to the function and length of experience of the nursing and medical teams at Neonatal Intensive Care Units.METHOD: quantitative survey undertaken at four Neonatal Intensive Care Units in Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected between February and April 2013 through the application of the Hospital Survey on Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and Cronbach's Alpha coefficient were used. Approval for the research project was obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121.RESULTS: differences in the number of positive answers to the Hospital Survey on Patient Safety Culture, the safety grade and the number of reported events were found according to the professional characteristics. A significant association was found between a shorter Length of work at the hospital and Length of work at the unit and a larger number of positive answers; longer length of experience in the profession represented higher grades and less reported events. The physicians and nursing technicians assessed the patient safety culture more positively. Cronbach's alpha demonstrated the reliability of the instrument.CONCLUSION: the differences found reveal a possible relation between the assessment of the safety culture and the subjects' professional characteristics at the Neonatal Intensive Care Units.

  19. Teaching neurology to medical students with a simplified version of team-based learning.

    Science.gov (United States)

    Brich, Jochen; Jost, Meike; Brüstle, Peter; Giesler, Marianne; Rijntjes, Michel

    2017-08-08

    To compare the effect of a simplified version of team-based learning (sTBL), an active learning/small group instructional strategy, with that of the traditionally used small group interactive seminars on the acquisition of knowledge and clinical reasoning (CR) skills. Third- and fourth-year medical students (n = 122) were randomly distributed into 2 groups. A crossover design was used in which 2 neurologic topics were taught by sTBL and 2 by small group interactive seminars. Knowledge was assessed with a multiple-choice question examination (MCQE), CR skills with a key feature problem examination (KFPE). Questionnaires were used for further methodologic evaluation. No group differences were found in the MCQE results. sTBL instruction of the topic "acute altered mental status" was associated with a significantly better student performance in the KFPE (p = 0.008), with no differences in the other 3 topics covered. Although both teaching methods were highly rated by the students, a clear majority voted for sTBL as their preferred future teaching method. sTBL served as an equivalent alternative to small group interactive seminars for imparting knowledge and teaching CR skills, and was particularly advantageous for teaching CR in the setting of a complex neurologic topic. Furthermore, students reported a strong preference for the sTBL approach, making it a promising tool for effectively teaching neurology. © 2017 American Academy of Neurology.

  20. Comparison of medical students' learning approaches between electronic and hard copy team-based learning.

    Science.gov (United States)

    Sharaf, Fawzy; Alnohair, Sultan

    2017-01-01

    To compare the students' perception of team-based learning (TBL): The paper (hard copy) compared with the e-copy (electronic copy) in the family medicine course of the fifth year medical students, Qassim University College of Medicine. A cross-sectional study was conducted during the family medicine course in 2015-2016 to compare the hard copy and the e-copy TBL sessions. We used Google drive to distribute, collect and analyze the questionnaire. The results of the e-copy TBL are shown and displayed directly with each session to the students, which was not the same as practiced with hard copy. We used also SPSS (version 17 for Windows) for more statistical analysis. The total number of respondents of students in each was 96; a phase of TBL phase 1 (hard copy) and phase 2 (e-copy). Male were 64 (66.7%) and females 32 (33.3%). The first three knowledge questions showed no difference between the mean score between paper and e-copy TBL, but of the perception questions showed a significant difference between the paper and e-copy TBL. The results of the survey showed that the students prefer e-copy TBL as a course format, as it was an attraction for most of the students and making them even more successful in the key exam and e-copy TBL develop the skills needed to work productively in task-groups.

  1. Mobile learning module improves knowledge of medical shock for forward surgical team members.

    Science.gov (United States)

    Schulman, Carl I; Garcia, George D; Wyckoff, Mary M; Duncan, Robert C; Withum, Kelly F; Graygo, Jill

    2012-11-01

    Acute trauma care is characterized by dynamic situations that require adequate preparation to ensure success for military health professionals. The use of mobile learning in this environment can provide a solution that standardizes education and replaces traditional didactic lectures. A comparative evaluation with a pre-post test design regarding medical shock was delivered via either a didactic lecture or a mobile learning video module to U.S. Army Forward Surgical Team (FST) members. Participants completed a pretest, were randomly assigned to treatment group by FST, and then completed the post-test and scenario assessment. One-hundred and thirteen FST members participated with 53 in the mobile learning group and 60 in the lecture group (control). The percent mean score for the mobile learning group increased from 43.6 to 70 from pretest to post-test, with a scenario mean score of M = 56.2. The percent mean score for the control group increased from 41.5 to 72.5, with a scenario mean score of M = 59.7. The two-way analysis of variance mean score difference was 26.4 for the mobile learning group and 31.0 for the control, F = 2.18, (p = 0.14). Mobile learning modules, coupled with a structured assessment, have the potential to improve educational experiences in civilian and military settings.

  2. Total simulation of operator team behavior in emergencies at nuclear power plants.

    Science.gov (United States)

    Takano, K; Sunaoshi, W; Suzuki, K

    2000-09-01

    In a large and complex system (i.e., a space aeronautics and nuclear power plant) it would be valuable to conduct operator training and support to demonstrate standard operators' behavior in coping with an anomaly caused by multiple malfunctions in which procedures would not have been stipulated previously. A system simulating operator team behavior including individual operator's cognitive behavior, his operations and physical behavior, and even verbal communication among team members, has been developed for a typical commercial nuclear power plant. This simulation model is not a scenario-based system but a complete knowledge-based system, based on the mental model that was envisaged by detailed analyses of experimental results obtained in the full-scope plant simulator. This mental model is composed of a set of knowledge bases and rules able to generate both diagnosis and prognosis depending on the observed situation even for multiple malfunctions. Simulation results of operator team behavior and plant dynamics were compared with corresponding experiments in several anomalies of multiple malfunctions. The comparison showed a reasonable agreement, so the simulation conditions were varied on cognitive task processing speed of individual operators, on team role sharing scheme, and on human machine interface (1st generation to 2nd generation control panel) to assess the sensitivity of this simulation model. Finally, it was shown that this simulation model has applications for the use of training standards and computer aided operator support systems.

  3. Factors predicting adherence with psychiatric follow-up appointments for patients assessed by the liaison psychiatric team in the emergency department.

    LENUS (Irish Health Repository)

    Agyapong, Vincent I O

    2010-01-01

    Several factors may predict adherence with psychiatric follow-up appointment for patients seen in the emergency department (ED) by liaison psychiatric teams. Awareness of these factors would allow for interventions targeted at vulnerable groups.

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

    Science.gov (United States)

    Hinkelbein, Jochen; Neuhaus, Christopher; Böhm, Lennert; Kalina, Steffen; Braunecker, Stefan

    2017-01-01

    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. 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 (pairline 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 undertaken in 10.6% of the cases. Although using a different method of data acquisition, this survey confirms previous data on the nature of emergencies and gives plausible numbers. Our data strongly argue for the establishment of a standardized database for recording the incidence and nature of in-flight medical emergencies. Such a database could inform on required medical equipment and cabin crew training.

  5. Preventable deaths following emergency medical dispatch--an audit study.

    Science.gov (United States)

    Andersen, Mikkel S; Johnsen, Søren Paaske; Hansen, Andreas Ernst; Skjaerseth, Eivinn; Hansen, Christian Muff; Sørensen, Jan Nørtved; Jepsen, Søren Bruun; Hansen, Jesper Bjerring; Christensen, Erika Frischknecht

    2014-12-19

    Call taker triage of calls to the 112 emergency number, can be error prone because rapid decisions must be made based on limited information. Here we investigated the preventability and common characteristics of same-day deaths among patients who called 112 and were not assigned an ambulance with lights and sirens by the Emergency Medical Communication Centre (EMCC). An audit was performed by an external panel of experienced prehospital consultant anaesthesiologists. The panel focused exclusively on the role of the EMCC, assessing whether same-day deaths among 112 callers could have been prevented if the EMCC had assessed the situations as highly urgent. The panels' assessments were based on review of patient charts and voice-log recordings of 112 calls. All patient related material was reviewed by the audit panel and all cases where then scored as preventable, potentially preventable or non-preventable during a two day meeting. The study setting was three of five regions in Denmark with a combined population of 4,182,613 inhabitants, which equals 75% of the Danish population. The study period was 18 months, from mid-2011 to the end of 2012. Linkage of prospectively collected EMCC data with population-based registries resulted in the identification of 94,488 non-high-acuity 112 callers. Among these callers, 152 (0.16% of all) died on the same day as the corresponding 112 call, and were included in this study. The mean age of included patients was 74.4 years (range, 31-100 years) and 45.4% were female. The audit panel found no definitively preventable deaths; however, 18 (11.8%) of the analysed same-day deaths (0.02% of all non-high-acuity callers) were found to be potentially preventable. In 13 of these 18 cases, the dispatch protocol was either not used or not used correctly. Same-day death rarely occurred among 112 callers whose situations were assessed as not highly urgent. No same-day deaths were found to be definitively preventable by a different EMCC call

  6. Medication Overdoses at a Public Emergency Department in Santiago, Chile

    Directory of Open Access Journals (Sweden)

    Pablo Aguilera, MD

    2016-01-01

    Full Text Available Introduction: While a nationwide poison control registry exists in Chile, reporting to the center is sporadic and happens at the discretion of the treating physician or by patients’ self-report. Moreover, individual hospitals do not monitor accidental or intentional poisoning in a systematic manner. The goal of this study was to identify all cases of intentional medication overdose (MO that occurred over two years at a large public hospital in Santiago, Chile, and examine its epidemiologic profile. Methods: This study is a retrospective, explicit chart review conducted at Hospital Sótero del Rio from July 2008 until June 2010. We included all cases of identified intentional MO. Alcohol and recreational drugs were included only when they were ingested with other medications. Results: We identified 1,557 cases of intentional MO and analyzed a total of 1,197 cases, corresponding to 0.51% of all emergency department (ED presentations between July 2008 and June 2010. The median patient age was 25 years. The majority was female (67.6%. Two peaks were identified, corresponding to the spring of each year sampled. The rate of hospital admission was 22.2%. Benzodiazepines, selective serotonin reuptake inhibitors, and tricyclic antidepressants (TCA were the causative agents most commonly found, comprising 1,044 (87.2% of all analyzed cases. Acetaminophen was involved in 81 (6.8% cases. More than one active substance was involved in 35% of cases. In 7.3% there was ethanol co-ingestion and in 1.0% co-ingestion of some other recreational drug (primarily cocaine. Of 1,557 cases, six (0.39% patients died. TCA were involved in two of these deaths. Conclusion: Similar to other developed and developing nations, intentional MO accounts for a significant number of ED presentations in Chile. Chile is unique in the region, however, in that its spectrum of intentional overdoses includes an excess burden of tricyclic antidepressant and benzodiazepine overdoses, a

  7. Improving emergency department flow through Rapid Medical Evaluation unit.

    Science.gov (United States)

    Chartier, Lucas; Josephson, Timothy; Bates, Kathy; Kuipers, Meredith

    2015-01-01

    The Toronto Western Hospital is an academic hospital in Toronto, Canada, with an annual Emergency Department (ED) volume of 64,000 patients. Despite increases in patient volumes of almost six percent per annum over the last decade, there have been no commensurate increases in resources, infrastructure, and staffing. This has led to substantial increase in patient wait times, most specifically for those patients with lower acuity presentations. Despite requiring only minimal care, these patients contribute disproportionately to ED congestion, which can adversely impact resource utilization and quality of care for all patients. We undertook a retrospective evaluation of a quality improvement initiative aimed at improving wait times experienced by patients with lower acuity presentations. A rapid improvement event was organized by frontline workers to rapidly overhaul processes of care, leading to the creation of the Rapid Medical Evaluation (RME) unit - a new pathway of care for patients with lower acuity presentations. The RME unit was designed by re-purposing existing resources and re-assigning one physician and one nurse towards the specific care of these patients. We evaluated the performance of the RME unit through measurement of physician initial assessment (PIA) times and total length of stay (LOS) times for multiple groups of patients assigned to various ED care pathways, during three periods lasting three months each. Weekly measurements of mean and 90th percentile of PIA and LOS times showed special cause variation in all targeted patient groups. Of note, the patients seen in the RME unit saw their median PIA and LOS times decrease from 98min to 70min and from 165min to 130min, respectively, from baseline. Despite ever-growing numbers of patient visits, wait times for all patients with lower acuity presentations remained low, and wait times of patients with higher acuity presentations assigned to other ED care pathways were not adversely affected. By

  8. Can Team Triage Improve Patient Flow in the Emergency Department? A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ming, Thomas; Lai, Aaron; Lau, Pui-Man

    2016-01-01

    This systematic review was performed as a feasibility study for revamping the triage service of an emergency department (ED) in a district hospital. In view of the overcrowding problem that plagues EDs worldwide, we reviewed evidence from randomized controlled trials (RCTs) to determine whether ED team triage improves patient flow in comparison with single-nurse triage. We measured improvement in patient flow in terms of the reduction in length of stay (LOS) or wait time (WT) for all ED patients. Adopting the Cochrane methodology, we searched and evaluated data sources for RCTs comparing patients assessed by an ED triage team, with patients receiving single-nurse triage at the same site. The data extracted were independently reviewed by 2 authors for inclusion and quality assessment. As for risk of bias across studies, there was an overall assessment of every outcome across the included studies according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria for RCTs. In total, 2,164 studies were identified and 2,106 were excluded on the basis of title/abstract, leaving 58 articles for full assessment. Four trials (all cluster RCTs) involving 14,772 patients (165 clusters) met the inclusion criteria. On the basis of our analysis, there was no statistically significant or clinically relevant reduction of LOS and WT for all patients in these studies. One study reported death as an outcome: Relative risk was 0.34 (95% CI [0.01, 8.24]), which suggested that team triage might reduce mortality. Overall, although we have found no conclusive evidence from RCTs to support the use of team triage for improving patient flow in the ED, the results need not deter nursing managers intending to introduce team triage for improving the morale of the triage nurse. However, they may need to consider economic and organizational factors, such as resource reallocation and staff receptiveness, in implementing the new practice.

  9. The experience of linking Victorian emergency medical service trauma data

    Directory of Open Access Journals (Sweden)

    Boyle Malcolm J

    2008-11-01

    Full Text Available Abstract Background The linking of a large Emergency Medical Service (EMS dataset with the Victorian Department of Human Services (DHS hospital datasets and Victorian State Trauma Outcome Registry and Monitoring (VSTORM dataset to determine patient outcomes has not previously been undertaken in Victoria. The objective of this study was to identify the linkage rate of a large EMS trauma dataset with the Department of Human Services hospital datasets and VSTORM dataset. Methods The linking of an EMS trauma dataset to the hospital datasets utilised deterministic and probabilistic matching. The linking of three EMS trauma datasets to the VSTORM dataset utilised deterministic, probabilistic and manual matching. Results There were 66.7% of patients from the EMS dataset located in the VEMD. There were 96% of patients located in the VAED who were defined in the VEMD as being admitted to hospital. 3.7% of patients located in the VAED could not be found in the VEMD due to hospitals not reporting to the VEMD. For the EMS datasets, there was a 146% increase in successful links with the trauma profile dataset, a 221% increase in successful links with the mechanism of injury only dataset, and a 46% increase with sudden deterioration dataset, to VSTORM when using manual compared to deterministic matching. Conclusion This study has demonstrated that EMS data can be successfully linked to other health related datasets using deterministic and probabilistic matching with varying levels of success. The quality of EMS data needs to be improved to ensure better linkage success rates with other health related datasets.

  10. Fit testing respirators for public health medical emergencies.

    Science.gov (United States)

    Brosseau, Lisa M

    2010-11-01

    Concerns about limiting pandemic infectious disease transmission when vaccines are not yet available prompted the Food and Drug Administration (FDA) to develop guidance for marketing respirators for use in public health medical emergencies. This project describes the results of filtering facepiece fit tests using 35 untrained, inexperienced subjects meeting the face size criteria of the National Institute for Occupational Safety and Health bivariate panel, in preparation for an FDA 510(k) application. Quantitative fit factors were measured for each subject on two replicates of each of two N95 filtering facepiece respirators (A and B) using the TSI Portacount Plus with N95 Companion. Subjects received no training or assistance with donning and had no prior experience with wearing respirators. The panel consisted of 20 females and 15 males; 80% were between 18 and 34 years of age. Almost all subjects properly placed the respirator on the face and formed the nose clip. Straps were improperly placed 25% of the time. Users reviewed the donning instructions 73% of the time and performed a seal check 80% of the time. Leaks were observed during 80% of the fit tests, most frequently at the chin during the head up and down exercise. For Respirator A, all but one subject had a 95% fit factor greater than 2 (the minimum required by FDA); one subject had a 95% fit factor of 1.5. All subjects had a 95% fit factor greater than 2.5 for Respirator B. Geometric mean fit factors ranged from 19-28 for these two respirators, and a majority of subjects were able to achieve a fit factor of 10 most of the time. However, fewer than 25% of subjects received the fit factor of 100 expected in workplace settings.

  11. 'We didn't know anything, it was a mess!' Emergent structures and the effectiveness of a rescue operation multi-team system.

    Science.gov (United States)

    Fleştea, Alina Maria; Fodor, Oana Cătălina; Curşeu, Petru Lucian; Miclea, Mircea

    2017-01-01

    Multi-team systems (MTS) are used to tackle unpredictable events and to respond effectively to fast-changing environmental contingencies. Their effectiveness is influenced by within as well as between team processes (i.e. communication, coordination) and emergent phenomena (i.e. situational awareness). The present case study explores the way in which the emergent structures and the involvement of bystanders intertwine with the dynamics of processes and emergent states both within and between the component teams. Our findings show that inefficient transition process and the ambiguous leadership generated poor coordination and hindered the development of emergent phenomena within the whole system. Emergent structures and bystanders substituted leadership functions and provided a pool of critical resources for the MTS. Their involvement fostered the emergence of situational awareness and facilitated contingency planning processes. However, bystander involvement impaired the emergence of cross-understandings and interfered with coordination processes between the component teams. Practitioner Summary: Based on a real emergency situation, the present research provides important theoretical and practical insights about the role of bystander involvement in the dynamics of multi-team systems composed to tackle complex tasks and respond to fast changing and unpredictable environmental contingencies.

  12. Partnered medication review and charting between the pharmacist and medical officer in the Emergency Short Stay and General Medicine Unit.

    Science.gov (United States)

    Tong, Erica Y; Roman, Cristina P; Smit, De Villiers; Newnham, Harvey; Galbraith, Kirsten; Dooley, Michael J

    2015-08-01

    A partnered medication review and charting model involving a pharmacist and medical officer was implemented in the Emergency Short Stay Unit and General Medicine Unit of a major tertiary hospital. The aim of the study was to describe the safety and effectiveness of partnered medication charting in this setting. A partnered medication review and charting model was developed. Credentialed pharmacists charted pre-admission medications and venous thromboembolism prophylaxis in collaboration with the admitting medical officer. The pharmacist subsequently had a clinical discussion with the treating nurse regarding the medication management plan for the patient. A prospective audit was undertaken of all patients from the initiation of the service. A total of 549 patients had medications charted by a pharmacist from the 14th of November 2012 to the 30th of April 2013. A total of 4765 medications were charted by pharmacists with 7 identified errors, corresponding to an error rate of 1.47 per 1000 medications charted. Partnered medication review and charting by a pharmacist in the Emergency Short Stay and General Medicine unit is achievable, safe and effective. Benefits from the model extend beyond the pharmacist charting the medications, with clinical value added to the admission process through early collaboration with the medical officer. Further research is required to provide evidence to further support this collaborative model. Copyright © 2015. Published by Elsevier Ltd.

  13. 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

  14. Emergency Medical Care. A Manual for the Paramedic in the Field.

    Science.gov (United States)

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

    This document is a textbook of emergency medical procedures to be used for training emergency medical technicians. The book is organized into 15 modules, each containing 1 to 10 units. Each module contains information illustrated with line drawings, a glossary, and references. The modules cover the following topics: the role of the emergency…

  15. The overall concordance of triage level between emergency medical technicians, triage nurses and instructor

    Directory of Open Access Journals (Sweden)

    Sabzevari S

    2015-08-01

    Full Text Available Background and Objective : Triage is essential for classification of patients in order to providing the best treatment and their transport to medical centers. The concordance of triage level between emergency medical technicians and triage nurses increases the accuracy and reduce of delivery time of patients, however the results of some studies demonstrated the poor triage of patients. This study was conducted aimed to determine the overall concordance of triage level between emergency medical technicians, triage nurses and instructor. Materials and Method: In this descriptive study, one instructor, 5 triage nurses and 30 emergency medical technicians participated through census in Iranshahr in 2014. Data collection tools were the demographic information form and “Emergency Severity Index" triage form. 78 patients were triaged separately by emergency medical technicians, triage nurses and instructor (as criteria. The overall concordance was assessed by kappa coefficient using SPSS 16. Results: The Kappa coefficient about the overall concordance of triage between emergency medical technicians and triage nurses was 0.20, between emergency medical technicians and instructor was 0.10 and between triage nurse and instructor was 0.19 Conclusion: According to the results, the overall concordance in triage level between triage nurse, emergency medical technicians and instructor was poor. Therefore, triage training courses and implementation of common triage is suggested for increase the agreement rate and reduce the time of patient transfer.

  16. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module XV. Telemetry and Communications.

    Science.gov (United States)

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

    This instructor's lesson plan guide on telemetry and communications is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Two units of study are presented: (1) emergency medical services communications systems (items of equipment and such radio communications concepts as frequency allocation,…

  17. Correlates of Intent to Leave Job and Profession for Emergency Medical Technicians and Paramedics

    Science.gov (United States)

    Chapman, Susan A.; Blau, Gary; Pred, Robert; Lopez, Andrea B.

    2009-01-01

    Purpose: A very limited number of studies have explored factors related to emergency medical services (EMS) workers leaving their jobs and the profession. This paper aims to investigate the correlates of intent to leave EMS jobs and the profession and compared two types of workers: emergency medical technicians (EMTs) and paramedics.…

  18. 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. Each operator shall make arrangements in advance for obtaining... provided to the nearest point of assistance. Selected agents of the operator shall be trained in...

  19. Emergency Medical Technician-Ambulance: National Standard Curriculum. Instructor's Lesson Plans (Third Edition).

    Science.gov (United States)

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

    This set of instructor's lesson plans is one of three documents prepared for the Emergency Medical Technician (EMT) National Standard Curriculum. It contains detailed outlines of course content and guidance for teaching each course lesson. The training course contains 33 lessons covering all emergency medical techniques currently considered to be…

  20. Course Guide and Course Coordinator Orientation Program. Basic Training Program for Emergency Medical Technician. Ambulance.

    Science.gov (United States)

    Dunlap and Associates, Inc., Darien, CT.

    To assist the States in implementing Federal standards for emergency medical services (under the Highway Safety Act of 1966), this guide has been prepared to aid in organizing, conducting, and standardizing a basic training course for emergency medical technicians (EMT's). Part I is a guide for a course designed to develop or upgrade the skill…