Sample records for accident and emergency services

  1. [Accidents and violence among women attended in Sentinel Emergency Services--Brazil, 2009].

    PubMed

    Rodrigues, Celeste de Souza; Malta, Deborah Carvalho; Godinho, Tatau; Mascarenhas, Márcio Dênis Medeiros; da Silva, Marta Maria Alves; Silva, Rurany Ester

    2012-09-01

    Accidents from external causes affect the human population in different ways. This article seeks to analyze emergency care for women who are victims of accidents and violence. Data from the Surveillance System for Violence and Accidents were analyzed. This study was carried out in 74 emergency units of 23 state capitals and the Federal District in 2009 and included 6,965 women aged from 20-59 years. The age groups of 20-39 and 40-59 years were compared for the occurrence of accidents and violence. Accidents were more frequent among young black women (20-39 years) with more than nine years of schooling. The occurrence of violence was also prevalent in young black women but with less schooling. Falls were the most frequent accidents (38.6%), followed by traffic accidents. The occurrence of violence was more frequent in the home (p <0.000) and the mention of alcohol abuse among victims of violence was predominant. The most frequent type of violence was aggression (84.6%), in which the aggressor was male (79.1%) and identified as an intimate partner (44.1%). It is increasingly important that services are able to provide comprehensive and humanized care to the victims of this important public health problem.

  2. A spatial analysis of urban transit accidents assisted by Emergency Mobile Care Services: an analysis of space and time.

    PubMed

    Mendonça, Marcela Franklin Salvador de; Silva, Amanda Priscila de Santana Cabral; Castro, Claudia Cristina Lima de

    2017-01-01

    Urban transit accident are a global public health problem. The objective of this study was to describe the profile of the victims and the occurrences of urban transit accidents attended to by emergency mobile care services (Serviço de Atendimento Móvel de Urgência- SAMU) in Recife, and their distribution based on spatial analysis. An ecological study, developed through secondary data from emergency mobile care services in Recife, referring to the total number of occurrences of urban transit accidents attended to from January 1 to June 30, 2015. The spatial analysis was performed using the Moran index. Basic support units performed most of the emergency services (89.2%). Among the victims, there was a predominance of males (76.8%) and an age group of 20 - 29 years old (31.5%). Collisions were responsible for 59.9% of the transit accidents, and motorcycles for 61.6% of the accidents among all means of transportation. Friday was the day that showed the highest risk for treatment, and there was a concentration of events between 6:00 am - 8:59am and 6:00pm - 8:59pm. The MoranMap identified critical areas where calls came from traffic accidents during the period analyzed. The records of the mobile service from the spatial analysis are an important source of information for health surveillance. The spatial analysis of urban transit accidents identified regions with a positive spatial correlation, providing subsidies to the logistical planning of emergency mobile care services. This study is groundbreaking in that it offers such information about the region.

  3. Occupant Injury Severity and Accident Causes in Helicopter Emergency Medical Services (1983-2014).

    PubMed

    Boyd, Douglas D; Macchiarella, Nickolas D

    2016-01-01

    Helicopter emergency medical services (HEMS) transport critically ill patients to/between emergency care facilities and operate in a hazardous environment: the destination site is often encumbered with obstacles, difficult to visualize at night, and lack instrument approaches for degraded visibility. The study objectives were to determine 1) HEMS accident rates and causes; 2) occupant injury severity profiles; and 3) whether accident aircraft were certified to the more stringent crashworthiness standards implemented two decades ago. The National Transportation Safety Board (NTSB) aviation accident database was used to identify HEMS mishaps for the years spanning 1983-2014. Contingency tables (Pearson Chi-square or Fisher's exact test) were used to determine differences in proportions. A generalized linear model (Poisson distribution) was used to determine if accident rates differed over time. While the HEMS accident rate decreased by 71% across the study period, the fraction of fatal accidents (36-50%) and the injury severity profiles were unchanged. None of the accident aircraft fully satisfied the current crashworthiness standards. Failure to clear obstacles and visual-to-instrument flight, the most frequent accident causes (37 and 26%, respectively), showed a downward trend, whereas accidents ascribed to aircraft malfunction showed an upward trend over time. HEMS operators should consider updating their fleet to the current, more stringent crashworthiness standards in an attempt to reduce injury severity. Additionally, toward further mitigating accidents ascribed to inadvertent visual-to-instrument conditions, HEMS aircraft should be avionics-equipped for instrument flight rules flight.

  4. Helicopter emergency medical services response to equestrian accidents.

    PubMed

    Lyon, Richard M; Macauley, Ben; Richardson, Sarah; de Coverly, Richard; Russell, Malcolm

    2015-04-01

    Horse riding is a common leisure activity associated with a significant rate of injury. Helicopter emergency medical services (HEMS) may be called to equestrian accidents. Accurate HEMS tasking is important to ensure appropriate use of this valuable medical resource. We sought to review HEMS response to equestrian accidents and identify factors associated with the need for HEMS intervention or transport of the patient to a major trauma centre. Retrospective case review of all missions flown by Kent, Surrey & Sussex Air Ambulance Trust over a 1-year period (1 July 2011 to 1 July 2012). All missions were screened for accidents involving a horse. Call details, patient demographics, suspected injuries, clinical interventions and patient disposition were all analysed. In the 12-month data collection period there were 47 equestrian accidents, representing ∼3% of the total annual missions. Of the 42 cases HEMS attended, one patient was pronounced life extinct at the scene. In 15 (36%) cases the patient was airlifted to hospital. In four (10%) cases, the patient underwent prehospital anaesthesia. There were no specific predictors of HEMS intervention. Admission to a major trauma centre was associated with the rider not wearing a helmet, a fall onto their head or the horse falling onto the rider. Equestrian accidents represent a significant proportion of HEMS missions. The majority of patients injured in equestrian accidents do not require HEMS intervention, however, a small proportion have life-threatening injuries, requiring immediate critical intervention. Further research is warranted, particularly regarding HEMS dispatch, to further improve accuracy of tasking to equestrian accidents.

  5. Accidents involving Brazilian indigenous treated at urgent and emergency services of the Unified Health System.

    PubMed

    Souza, Edinilsa Ramos de; Njaine, Kathie; Mascarenhas, Márcio Dênis Medeiros; Oliveira, Maria Conceição de

    2016-12-01

    Abstract We analyzed the accidents with Brazilian indigenous treated at urgent and emergency services of the Unified Health System (SUS). Data were obtained from the 2014 Viva Survey, which included 86 services from 24 capitals and the Federal District. The demographic profile of the indigenous, the event and the attendance were characterized. Most of the attended people were male in the 20-39 years age group. Falls and traffic accidents were the main reasons for attendance. Alcohol use was informed by 5.6% of the attended people, a figure that increases to 19.1% in traffic accidents, 26.1% among drivers and 22.8% among motorcyclists. There was a statistical difference between genders in relation to age, disability, place of occurrence of the event, work-related event and victim's condition in the traffic accident. We emphasize the importance of providing visibility to accidents with indigenous and engage them in the prevention of such events. Data reliability depends on the adequate completion in indigenous health information systems.

  6. Characteristics of motorcyclists involved in road traffic accidents attended at public urgent and emergency services.

    PubMed

    Mascarenhas, Márcio Dênis Medeiros; Souto, Rayone Moreira Costa Veloso; Malta, Deborah Carvalho; Silva, Marta Maria Alves da; Lima, Cheila Marina de; Montenegro, Marli de Mesquita Silva

    2016-12-01

    Injuries resulting from motorcycle road traffic accidents are an important public health issue in Brazil. This study aimed to describe the characteristics of motorcyclists involved in traffic accidents attended in public urgent and emergency services in the state capitals and the Federal District. This is a cross-sectional study based on data from the Violence and Accident Surveillance System (VIVA Survey) in 2014. Data were analyzed according to sociodemographic, event and attendance characteristics. Proportional differences between genders were analyzed by chi-square test (Rao-Scott) with 5% significance level. Motorcyclist-related attendances (n = 9,673) reported a prevalence of men (gender ratio = 3.2), young people aged 20-39 years (65.7%), black / brown (73.6%), paid work (76.4%). Helmet use was reported by 79.1% of the victims, 13.3% had consumed alcohol in the six hours prior to the accident, 41.4% of the events were related to the victim's work. Accidents were more frequent on weekends, in the morning and late afternoon. These characteristics can support the development of public accident prevention policies and health promotion.

  7. Pilot Domain Task Experience in Night Fatal Helicopter Emergency Medical Service Accidents.

    PubMed

    Aherne, Bryan B; Zhang, Chrystal; Newman, David G

    2016-06-01

    In the United States, accident and fatality rates in helicopter emergency medical service (HEMS) operations increase significantly under nighttime environmentally hazardous operational conditions. Other studies have found pilots' total flight hours unrelated to HEMS accident outcomes. Many factors affect pilots' decision making, including their experience. This study seeks to investigate whether pilot domain task experience (DTE) in HEMS plays a role against likelihood of accidents at night when hazardous operational conditions are entered. There were 32 flights with single pilot nighttime fatal HEMS accidents between 1995 and 2013 with findings of controlled flight into terrain (CFIT) and loss of control (LCTRL) due to spatial disorientation (SD) identified. The HEMS DTE of the pilots were compared with industry survey data. Of the pilots, 56% had ≤2 yr of HEMS experience and 9% had >10 yr of HEMS experience. There were 21 (66%) accidents that occurred in non-visual flight rules (VFR) conditions despite all flights being required to be conducted under VFR. There was a statistically significant increase in accident rates in pilots with <2 and <4 yr HEMS DTE and a statistically significant decrease in accident rates in pilots with >10 yr HEMS DTE. HEMS DTE plays a preventive role against the likelihood of a night operational accident. Pilots with limited HEMS DTE are more likely to make a poor assessment of hazardous conditions at night, and this will place HEMS flight crew at high risk in the VFR night domain.

  8. [Accidents by external causes in adolescents: care in sentinel urgency and emergency services in the Brazilian State Capitals--2009].

    PubMed

    Malta, Deborah Carvalho; Mascarenhas, Márcio Dênis Medeiros; Bernal, Regina Tomie Ivata; Andrade, Silvania Suely Caribé de Araújo; das Neves, Alice Cristina Medeiros; de Melo, Elza Machado; da Silva Junior, Jarbas Barbosa

    2012-09-01

    Adolescents are seeking new references and experiences, which may involve attitudes of risk and exposure to accidents and violence from external causes. These events constitute a serious Public Health problem. The scope of this study was to analyze the occurrence of accidents by external causes in adolescents from 10 to 19 years of age attended at sentinel urgency and emergency services in Brazil. Data from the 2009 Surveillance System for Violence and Accidents (VIVA 2009) was analyzed in 74 emergency units in 23 state capitals and the Federal District. The findings revealed that 6,434 adolescents (89.8%) were victims of accidents and 730 (10.2 %) were victims of violence. The main causes of the accidents were falls and traffic accidents, and assaults were predominant in violence. For both accidents and violence, non-white male adolescents were predominant and the events occurred most frequently on the public highways. A marked increase was detected, with hospitalization of victims of violence between 15 and 19 years of age. Understanding the epidemiological reality of external causes among adolescents represents an important tool for health prevention and promotion policies and the culture of peace seeking to reduce morbidity and mortality.

  9. Road traffic accident related morbidity as seen in an accident and emergency department.

    PubMed

    Galloway, D J; Patel, A R

    1981-04-01

    This paper describes some of the findings of a prospective study of victims of road traffic accidents arriving at the Western Infirmary's Accident and Emergency Department over a period of 12 months. More than half the accidents occurred during leisure hours thus likely to stretch the resource of the hospital services. More than a third of the total number of patients were young male drivers. Serious injuries were significantly more often sustained among pedestrians who were often older. Victims of motor-cycle accidents less often escaped serious injuries. Blood ethanol studies on a small sample suggested that male pedestrians were often highly intoxicated. A public health education programme is regarded as a primary measure in preventing a large proportion of serious morbidity and mortality especially amongst pedestrians.

  10. Uncertainty analysis of accident notification time and emergency medical service response time in work zone traffic accidents.

    PubMed

    Meng, Qiang; Weng, Jinxian

    2013-01-01

    Taking into account the uncertainty caused by exogenous factors, the accident notification time (ANT) and emergency medical service (EMS) response time were modeled as 2 random variables following the lognormal distribution. Their mean values and standard deviations were respectively formulated as the functions of environmental variables including crash time, road type, weekend, holiday, light condition, weather, and work zone type. Work zone traffic accident data from the Fatality Analysis Report System between 2002 and 2009 were utilized to determine the distributions of the ANT and the EMS arrival time in the United States. A mixed logistic regression model, taking into account the uncertainty associated with the ANT and the EMS response time, was developed to estimate the risk of death. The results showed that the uncertainty of the ANT was primarily influenced by crash time and road type, whereas the uncertainty of EMS response time is greatly affected by road type, weather, and light conditions. In addition, work zone accidents occurring during a holiday and in poor light conditions were found to be statistically associated with a longer mean ANT and longer EMS response time. The results also show that shortening the ANT was a more effective approach in reducing the risk of death than the EMS response time in work zones. To shorten the ANT and the EMS response time, work zone activities are suggested to be undertaken during non-holidays, during the daytime, and in good weather and light conditions.

  11. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 12. Water Accidents, Electrical Emergencies, Hazardous Materials and Radiation Accidents. Revised.

    ERIC Educational Resources Information Center

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

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers water accidents, electrical emergencies, and hazardous materials and radiation accidents. Objectives stated for the three chapters are for the students to be able to describe: emergency care for specified water…

  12. Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents.

    PubMed

    de Freitas, Mariana Gonçalves; Bonolo, Palmira de Fátima; de Moraes, Edgar Nunes; Machado, Carla Jorge

    2015-03-01

    The article aims to describe the profile of elderly victims of falls and traffic accidents from the data of the Surveillance Survey of Violence and Accidents (VIVA). The VIVA Survey was conducted in the emergency health-services of the Unified Health System in the capitals of Brazil in 2011. The sample of elderly by type of accident was subjected to the two-step cluster procedure. Of the 2463 elderly persons in question, 79.8% suffered falls and 20.2% were the victims of traffic accidents. The 1812 elderly who fell were grouped together into 4 clusters: Cluster 1, in which all had disabilities; Cluster 2, all were non-white and falls took place in the home; Cluster 3, younger and active seniors; and Cluster 4, with a higher proportion of seniors 80 years old or above who were white. Among cases of traffic accidents, 446 seniors were grouped into two clusters: Cluster 1 of younger elderly, drivers or passengers; Cluster 2, with higher age seniors, mostly pedestrians. The main victims of falls were women with low schooling and unemployed; traffic accident victims were mostly younger and male. Complications were similar in victims of falls and traffic accidents. Clusters allow adoption of targeted measures of care, prevention and health promotion.

  13. Helicopter emergency medical services accident rates in different international air rescue systems

    PubMed Central

    Hinkelbein, J; Schwalbe, M; Genzwuerker, HV

    2010-01-01

    Aim Each year approximately two to four helicopter emergency medical services (HEMS) crashes occur in Germany. The aim of the present study was to compare crash rates and fatal crash rates in Germany to rates in other countries. Materials and methods A MEDLINE search from 1970 to 2009 was performed using combinations of the keywords “HEMS”, “rescue helicopter”, “accident”, “accident rate”, “crash”, and “crash rate”. The search was supplemented by additional published data. Data were compared on the basis of 10,000 missions and 100,000 helicopter flying hours. These data were allocated to specific time frames for analyis. Results Eleven relevant studies were identified. Five studies (three from Germany, one from the US, one from Australia) analyzing HEMS accidents on the basis of 10,000 missions were identified. Crash rates per 10,000 missions ranged between 0.4 and 3.05 and fatal crash rates between 0.04 and 2.12. In addition, nine studies (six from the US, two from Germany, one from Australia) used 100,000 flying hours as a denominator. Here, crash rates ranged between 1.7 and 13.4 and fatal crash rates between 0.91 and 4.7. Conclusions Data and accident rates were inhomogeneous and differed significantly. Data analysis was impeded by publication of mean data, use of different time frames, and differences in HEMS systems. PMID:27147837

  14. Elderly patients discharged from an accident and emergency department--their dependency and support.

    PubMed Central

    Currie, C T; Lawson, P M; Robertson, C E; Jones, A

    1984-01-01

    One hundred elderly patients who had attended an accident and emergency department and had been discharged were visited at home shortly afterwards. Compared to their previous level of function, 52 showed a minor or major increase in dependency, usually related to trauma. Scrutiny of accident and emergency records showed only scanty documentation of dependency, function and support arrangements. Available statutory services for dependent elderly in the community were under-utilized by these patients. In 39 of the 52 cases with increased dependency relatives had provided additional support. PMID:6100354

  15. [Accidents and violence in childhood: survey evidence of emergency care for external causes--Brazil, 2009].

    PubMed

    Malta, Deborah Carvalho; Mascarenhas, Márcio Dênis Medeiros; Bernal, Regina Tomie Ivata; Viegas, Anna Paula Bise; de Sá, Naiza Nayla Bandeira; da Silva Junior, Jarbas Barbosa

    2012-09-01

    Understanding the characteristics and magnitude of accidents and violence due to external causes in children from 0 to 9 years of age is becoming ever more important in Public Health. The scope of this paper was to analyze emergency care for accidents due to external causes in children. The Sentinel Urgency and Emergency Services of the Violence and Accident Vigilance System (VIVA Survey), performed in 74 urgency services in the Federal District and 23 State capitals in 2009 was used. Data of 7,123 children were analyzed: 6,897 (96.7%) victims of accidents and 226 (3.3%) of violence. In comparison with victims of violence, the visits for accidents were more frequent among white children from 2 to 5 years old occurring in the home (p < 0.05). Among the accidents, falls and burns predominated in the 0 to 1group, while traffic accidents were most frequent in the 6 to 9-year-old age group (p < 0.001). With respect to violence, the visits for neglect and physical assault predominated, respectively, in extreme age groups, with someone in the family being the perpetrator (p < 0.001). Information on the occurrence of external causes in children may support health promotion policies, besides guiding health professionals, teachers and families in the prevention of such causes.

  16. Complaints against doctors in an accident and emergency department: a 10-year analysis.

    PubMed Central

    Kadzombe, E A; Coals, J

    1992-01-01

    We carried out an analysis of complaints against doctors in our Accident and Emergency Department received from 1 January 1979 to 31 December 1988. There were 66 complainants in all, comprising 37 relatives, 21 patients and eight persons acting in a professional capacity. The majority of complaints (80 out of 125) were about poor communication and dissatisfaction with diagnosis and treatment. A small number of complainants had unrealistic expectations of the Accident and Emergency service. A total of 83.3% of complaints were against Senior House Officers who saw 61.3% of all patients. We concluded that an improvement in the communicative, diagnostic and therapeutic skills of doctors would minimize justified complaints. PMID:1388487

  17. Emergency Responses and Health Consequences after the Fukushima Accident; Evacuation and Relocation.

    PubMed

    Hasegawa, A; Ohira, T; Maeda, M; Yasumura, S; Tanigawa, K

    2016-04-01

    The Fukushima accident was a compounding disaster following the strong earthquake and huge tsunami. The direct health effects of radiation were relatively well controlled considering the severity of the accident, not only among emergency workers but also residents. Other serious health issues include deaths during evacuation, collapse of the radiation emergency medical system, increased mortality among displaced elderly people and public healthcare issues in Fukushima residents. The Fukushima mental health and lifestyle survey disclosed that the Fukushima accident caused severe psychological distress in the residents from evacuation zones. In addition to psychiatric and mental health problems, there are lifestyle-related problems such as an increase proportion of those overweight, an increased prevalence of hypertension, diabetes mellitus and dyslipidaemia and changes in health-related behaviours among evacuees; all of which may lead to an increased cardiovascular disease risk in the future. The effects of a major nuclear accident on societies are diverse and enduring. The countermeasures should include disaster management, long-term general public health services, mental and psychological care, behavioural and societal support, in addition to efforts to mitigate the health effects attributable to radiation. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  18. Are mental health problems associated with use of Accident and Emergency and health-related harm?

    PubMed

    Keene, J; Rodriguez, J

    2007-08-01

    Previous findings indicate that mental health problems are common in Emergency departments; however, there are few studies of the extent of health-related problems and emergency service use in mental health populations as a whole. Record linkage methods were used to map the association between mental health, age, gender, and health-related harm across total health and mental health care populations in one geographical area, over three years. By examining patterns of health-related harm, an accurate profile of mentally ill Emergency patients was generated enabling identification of factors that increased vulnerability to harm. Of the total population of 625 964 individuals, 10.7% contacted Accident and Emergency (A&E) over three years, this proportion rose to 28.6% among the total secondary care mental health population. Young men and older women were more likely to contact A&E, both overall and within mental health populations and were also more likely to be frequent attendees at A&E. Four distinct groups (typologies) of mental health patients attending A&E emerged: young, male frequent attendees with self-inflicted and other traumatic injuries; young females also presenting with self-harm; older patients with multiple medical conditions; and very old patients with cardiac conditions and fractures. The study indicates increased A+E service use and unmet health-related need within a total mental health population. It identifies specific 'care populations' particularly vulnerable to accidents and self-harm and highlights the need for targeted services for mentally ill groups who may not access traditional health and social care services effectively.

  19. [Emergency care for victims of violence and accidents: differences in the epidemiological profile between the public and private health services. VIVA--Campinas, São Paulo, Brazil, 2009].

    PubMed

    Belon, Ana Paula; da Silveira, Naoko Yanagizawa Jardim; Barros, Marilisa Berti de Azevedo; Baldo, Caroline; da Silva, Marta Maria Alves

    2012-09-01

    The scope of this study is to analyze the differences in the profile of emergency care for external causes between public and private emergency departments. With data come from VIVA-Campinas 2009, the association between the nature of healthcare and the characteristics of the victims was verified using the chi-square test. Using Poisson regression, proportion ratios of care in the public and private network were estimated. In the sample of 1094 victims, 67.8% were treated by public health. Traffic accidents, animal-related accidents, and assaults were 2 times higher in public units, whereas collisions with objects and sprains were 75% and 2.7 times higher in private units. Cranium-encephalic trauma/polytrauma and cuts/lacerations were 3.8 times and 61% more frequent in public care, while victims with no injuries, with dislocations/sprains or fractures being predominant in private care. Head and multiple organ injuries, road accident and work-related injuries, the use of public transport or mobile emergency care services/ambulances were predominant in public care. Revealing significant differences in care in public and private care can contribute to the organization of healthcare.

  20. Mortality patterns in the accident and emergency department of an urban hospital in Nigeria.

    PubMed

    Ekere, A U; Yellowe, B E; Umune, S

    2005-06-01

    The accident and emergency (A & E) department of any hospital provides an insight to the quality of care available in the institution. The University of Port Harcourt Teaching Hospital (UPTH) is a foremost institution in the South-South geopolitical region of Nigeria, servicing a core population of about 5 million people. The aim of this review was to highlight the demographic patterns of mortality, time spent before death in the emergency room. A 3 year retrospective review, covering April 2000 - March 2003, of patients attended to in the Accident & Emergency department of University of Port Harcourt Teaching Hospital was carried out. Casualty records including attendance registers, Nurses' report books and death certificates were used to extract demographic indices, causes of death and time from arrival to death in the Accident and Emergency Unit. Multiway frequency tables were used for analysis. Of the 22,791 patients seen during the study period, 446 died, giving a crude mortality rate of 2 percent. The male to female ratio was 1.5:1; the trauma subset and the non-traumatic subset being 4.6:1 and 1.2:1 respectively. Most of the cases were of non-traumatic origin (79.8%), with the 20-49 age group being the most affected when all the cases were taken into consideration. However, the overall mean age was 33+/-9.4 years. The peak age in trauma deaths was 20-29 year, while that in non-traumatic deaths was 40-49 years. Some of the deaths (3.4%) could not be traced to any cause. Probably due to incomplete records or ignorance to the cause of death. Road traffic accidents and assaults were the commonest causes of traumatic death, accounting for 57.8% and 11.1% respectively. Bulk of the non traumatic deaths (25.2%) was from cardiovascular diseases. Most of the patients (70.9%) died within six hours of arrival in the accident and emergency, while 3.6% (16) were dead on arrival. The average time in the casualty before death was about 22.0 hours. Contributing factors to

  1. Industrial accident-related ocular emergencies in a tertiary hospital in Singapore.

    PubMed

    Ngo, C S; Leo, S W

    2008-04-01

    We present a review of industrial accident-related ocular trauma, from the perspective of the emergency setting of a tertiary hospital in Singapore. A retrospective analysis of patients seen by Tan Tock Seng Hospital's emergency ophthalmology service over a six-month period was performed. Data on clinical presentation, cause of injury, use of protective eyewear and subsequent losses of days-of-work were collected via a standardised telephone interview and review of case-sheets. A total of 300 persons presented with a diagnosis of industrial accident-related ocular trauma, out of the 1,460 patients seen during the study period. 95.7 percent were non-residents and the average age was 31 years. 99.3 percent were males. 66.0 percent were provided with protective eyewear, while 44.7 percent of those were non-compliant. The most common types of injuries were superficial foreign body (71.3 percent), chemical injury (10 percent) and blunt trauma (4 percent), while severe injury requiring admission and emergency surgery occurred in 15 cases. Average loss of days of work was 3.4 days. Industrial accident-related ocular trauma comprises a relatively large proportion of the patients requiring ophthalmic review at the emergency service level in Singapore. These patients are mainly young, non-resident men and the injuries were generally minor. These are largely preventable with the use of well-fitting protective eyewear and strict compliance. This would greatly reduce the unnecessary loss of workdays. Therefore, there is a need to review the design, and reinforce the strict implementation of occupational eye safety programmes, especially among non-resident workers.

  2. Use of emergency care services by immigrants—a survey of walk-in patients who attended the Oslo Accident and Emergency Outpatient Clinic.

    PubMed

    Ruud, Sven Eirik; Aga, Ruth; Natvig, Bård; Hjortdahl, Per

    2015-10-07

    The Oslo Accident and Emergency Outpatient Clinic (OAEOC) experienced a 5-6% annual increase in patient visits between 2005 and 2011, which was significantly higher than the 2-3% annual increase among registered Oslo residents. This study explored immigrant walk-in patients' use of both the general emergency and trauma clinics of the OAEOC and their concomitant use of regular general practitioners (RGPs) in Oslo. A cross-sectional survey of walk-in patients attending the OAEOC during 2 weeks in September 2009. We analysed demographic data, patients' self-reported affiliation with the RGP scheme, self-reported number of OAEOC and RGP consultations during the preceding 12 months. The first approach used Poisson regression models to study visit frequency. The second approach compared the proportions of first- and second-generation immigrants and those from the four most frequently represented countries (Sweden, Pakistan, Somalia and Poland) among the patient population, with their respective proportions within the general Oslo population. The analysis included 3864 patients: 1821 attended the Department of Emergency General Practice ("general emergency clinic"); 2043 attended the Section for Orthopaedic Emergency ("trauma clinic"). Both first- and second-generation immigrants reported a significantly higher OAEOC visit frequency compared with Norwegians. Norwegians, representing 73% of the city population accounted for 65% of OAEOC visits. In contrast, first- and second-generation immigrants made up 27% of the city population but accounted for 35% of OAEOC visits. This proportional increase in use was primarily observed in the general emergency clinic (42% of visits). Their proportional use of the trauma clinic (29%) was similar to their proportion in the city. Among first-generation immigrants only 71% were affiliated with the RGP system, in contrast to 96% of Norwegians. Similar finding were obtained when immigrants were grouped by nationality. Compared to

  3. A major sporting event does not necessarily mean an increased workload for accident and emergency departments. Euro96 Group of Accident and Emergency Departments

    PubMed Central

    Cooke, M. W.; Allan, T. F.; Wilson, S.

    1999-01-01

    AIM: To determine whether there were any changes in attendance at accident and emergency departments that could be related to international football matches (Euro96 tournament). METHOD: Fourteen accident and emergency departments (seven adjacent to and seven distant from a Euro96 venue) provided their daily attendance figures for a nine week period: three weeks before, during, and after the tournament. The relation between daily attendance rates and Euro96 football matches was assessed using a generalised linear model and analysis of variance. The model took into account underlying trends in attendance rates including day of the week. RESULTS: The 14 hospitals contributed 172 366 attendances (mean number of daily attendances 195). No association was shown between the number of attendances at accident and emergency departments and the day of the football match, whether the departments were near to or distant from stadia or the occurrence of a home nation match. The only observed independent predictors of variation were day of the week and week of the year. Attendance rates were significantly higher on Sunday and/or Monday; Monday was about 9% busier than the daily average. Increasing attendance was observed over time for 86% of the hospitals. CONCLUSION: Large sports tournaments do not increase the number of patients attending accident and emergency departments. Special measures are not required for major sporting events over and above the capacity of an accident and emergency department to increase its throughput on other days. 


 PMID:10522636

  4. Paediatric consultation patterns in general practice and the accident and emergency department.

    PubMed

    Bradley, T; McCann, B; Glasgow, J F; Patterson, C C

    1995-04-01

    The age, sex, source of referral and diagnosis of children brought to a paediatric accident and emergency department by their parents were compared to those consulting their general practitioner. A simultaneous, prospective review of these consultations was carried out over a six-week period in an inner-city paediatric teaching hospital and a group practice in a socially deprived urban area. 730 children less than 13 years of age who presented for a new consultation were seen. 629 (86%) presented initially to the general practitioner, who dealt with all but 25 (4.0%) without onward referral to the accident and emergency department. 127 consultations took place at the accident and emergency department, of which 104 (82%) were parental referrals. There was no sex difference in children seen by the general practitioner. There was a decreasing trend with increasing age in the proportion of children who consulted the general practitioner, perhaps due to the higher frequency of injury in the older children. Over three quarters (77%) of injured children were brought directly to the accident and emergency department, compared with only 4% of children without injuries (p < 0.001). Of 22 children with injuries who presented to the general practitioner, only 4 (18%) required onward referral. General practitioners met the great majority of the paediatric workload generated by the practice. Audit between primary and secondary care gives a more reliable picture than data from only one source. Injured children are more likely to be taken to the accident and emergency department. Further study of the severity of injury in children is required to determine if there is potential to reduce parental referrals to accident and emergency departments.

  5. [Occupational accidents due to exposure to biological material in the multidisciplinary team of the emergency service].

    PubMed

    Oliveira, Adriana Cristina; Lopes, Aline Cristine Souza; Paiva, Maria Henriqueta Rocha Siqueira

    2009-09-01

    This transversal, survey-based research was carried out with a multiprofessional emergency care team in Belo Horizonte, between June and December 2006. The study aimed at estimating the incidence of occupational accidents by exposure to biological material, post-accidents conducts and demographic determinant factors. The study applied a structured questionnaire and descriptive analyses, as well as incidence calculations and logistic regression. The incidence of accidents with biological material reached 20.6%, being 40.8% by sharp materials and 49.0% by body fluids; 35.3% of the accidents took place among physicians and 24.0% among nurses. Post-accidents procedures: no medical assessment, 63.3%; under-notification, 81.6%; no conduct, 55.0%; and no serological follow-up, 61.2%. Factors associated with accidents: working time in the institution (Odds Ratio--OR, 2.84; Credible Interval--CI 95%-1.22-6.62); working in advanced support units (OR = 4.18; CI 95%--1.64-10.64); and interaction between working time in the institution and working in Basic Support Unit (OR 0.27; CI 95%--0.07-1.00). In order to reduce accidents, the implementation of post-accident protocols and follow-up, as well as under-notification norms, are suggested.

  6. Designing the accident and emergency system: lessons from manufacturing

    PubMed Central

    Walley, P

    2003-01-01

    Objectives: To review the literature on manufacturing process design and demonstrate applicability in health care. Methods: Literature review and application of theory using two years activity data from two healthcare communities and extensive observation of activities over a six week period by seven researchers. Results: It was possible to identify patient flows that could be used to design treatment processes around the needs of the patient. Some queues are built into existing treatment processes and can be removed by better process design. Capacity imbalance, not capacity shortage, causes some unnecessary waiting in accident and emergency departments. Conclusions: Clinicians would find that modern manufacturing theories produce more acceptable designs of systems. In particular, good quality is seen as a necessary pre-requisite of fast, efficient services. PMID:12642523

  7. Designing the accident and emergency system: lessons from manufacturing.

    PubMed

    Walley, P

    2003-03-01

    To review the literature on manufacturing process design and demonstrate applicability in health care. Literature review and application of theory using two years activity data from two healthcare communities and extensive observation of activities over a six week period by seven researchers. It was possible to identify patient flows that could be used to design treatment processes around the needs of the patient. Some queues are built into existing treatment processes and can be removed by better process design. Capacity imbalance, not capacity shortage, causes some unnecessary waiting in accident and emergency departments. Clinicians would find that modern manufacturing theories produce more acceptable designs of systems. In particular, good quality is seen as a necessary pre-requisite of fast, efficient services.

  8. Major incidents in Kenya: the case for emergency services development and training.

    PubMed

    Wachira, Benjamin W; Smith, Wayne

    2013-04-01

    Kenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality. This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.

  9. Risk analysis of emergent water pollution accidents based on a Bayesian Network.

    PubMed

    Tang, Caihong; Yi, Yujun; Yang, Zhifeng; Sun, Jie

    2016-01-01

    To guarantee the security of water quality in water transfer channels, especially in open channels, analysis of potential emergent pollution sources in the water transfer process is critical. It is also indispensable for forewarnings and protection from emergent pollution accidents. Bridges above open channels with large amounts of truck traffic are the main locations where emergent accidents could occur. A Bayesian Network model, which consists of six root nodes and three middle layer nodes, was developed in this paper, and was employed to identify the possibility of potential pollution risk. Dianbei Bridge is reviewed as a typical bridge on an open channel of the Middle Route of the South to North Water Transfer Project where emergent traffic accidents could occur. Risk of water pollutions caused by leakage of pollutants into water is focused in this study. The risk for potential traffic accidents at the Dianbei Bridge implies a risk for water pollution in the canal. Based on survey data, statistical analysis, and domain specialist knowledge, a Bayesian Network model was established. The human factor of emergent accidents has been considered in this model. Additionally, this model has been employed to describe the probability of accidents and the risk level. The sensitive reasons for pollution accidents have been deduced. The case has also been simulated that sensitive factors are in a state of most likely to lead to accidents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. [IMSS in numbers: demand of services in the emergency room, 2004].

    PubMed

    2006-01-01

    The emergency room is one of the most productive services in any medical institution, where the demand of health services is diverse and complex in nature. Around 15 % of all the medical attentions provided at IMSS were done at the emergency room. There was an important increase in the number of consultations provided from 1995 to 2004; the death rate in the service also increased but the incapacity rate decreased. Adult and elderly women were among the most frequent users of emergency services. The main problems seen were respiratory infections (19.4%), trauma and poisoning (18.8%) and diarrheas (8%). Cholelithiasis, migraine, urinary infections and diabetes were more frequent in women, while trauma, accidents and conjunctivitis were more frequent in men. In relation to mortality, around 21% of all deaths registered at IMSS occurred in the emergency room. Diabetes and cardiovascular diseases appeared among the main death causes, especially in the adult and elderly population. Mortality was higher in men than in women.

  11. Recommended Procedures for Handling Emergency Illnesses and Accidents at School.

    ERIC Educational Resources Information Center

    North Dakota State Dept. of Health, Bismarck.

    Recommended procedures for handling emergency illnesses and accidents are provided in this guide for school personnel prepared by the North Dakota State Department of Health. Following five general recommendations for steps to take in emergency situations, advice and techniques are given for handling: nose bleeds; abdominal pain; toothaches and…

  12. Utilisation of a Helicopter Emergency Medical Service (HEMS) for equestrian accidents in a regional major trauma network in the United Kingdom.

    PubMed

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

    2015-05-01

    The utilisation of Helicopter Emergency Medical Services (HEMS) in response to equestrian accidents has been an integral part of operations for many years throughout the UK. The recent establishment of major trauma networks in the UK has placed great emphasis on the appropriate tasking of HEMS units to cases where added benefit can be provided and the incidence of time critical injury in cases of equestrian accidents has been shown to be low. This study assesses the impact made on the utilisation of the different HEMS resources for cases of equestrian accidents within the West Midlands following the launch of the regional trauma network. We present a retrospective analysis of all equestrian accidents attended by Midlands Air Ambulance (MAA) between 1 April 2012 and 1 April 2013. Data were abstracted from the MAA operational database relating to mission activations/scene attendances; team configuration (physician led and Critical Care Paramedic (CCP) led); on-scene interventions; mission timings and patient conveyance by helicopter. A total of 114 activations involved equestrian accidents (6% of overall workload). The contribution of equestrian accidents to overall workload was similar for physician led and CCP-led (69/1069) platforms (5% vs. 6%, p=0.50). Only three patients (3%) required pre-hospital RSI during the period analysed and there were no recorded cases of ketamine administration for analgesia/conscious sedation. In approximately half of all scene attendances patients did not require any medication to be administered by the HEMS team. The vast majority of incidents occurred in rural locations with over 80% of patients conveyed to hospital by helicopter. The average mission time for scene attendances resulting in conveyance by helicopter was in excess of 90 min on both types of platform. There is a clear requirement for the design and implementation of informed and intelligent tasking models to respond to the need for assistance in equestrian accidents

  13. Radiation protection issues on preparedness and response for a severe nuclear accident: experiences of the Fukushima accident.

    PubMed

    Homma, T; Takahara, S; Kimura, M; Kinase, S

    2015-06-01

    Radiation protection issues on preparedness and response for a severe nuclear accident are discussed in this paper based on the experiences following the accident at Fukushima Daiichi nuclear power plant. The criteria for use in nuclear emergencies in the Japanese emergency preparedness guide were based on the recommendations of International Commission of Radiological Protection (ICRP) Publications 60 and 63. Although the decision-making process for implementing protective actions relied heavily on computer-based predictive models prior to the accident, urgent protective actions, such as evacuation and sheltering, were implemented effectively based on the plant conditions. As there were no recommendations and criteria for long-term protective actions in the emergency preparedness guide, the recommendations of ICRP Publications 103, 109, and 111 were taken into consideration in determining the temporary relocation of inhabitants of heavily contaminated areas. These recommendations were very useful in deciding the emergency protective actions to take in the early stages of the Fukushima accident. However, some suggestions have been made for improving emergency preparedness and response in the early stages of a severe nuclear accident. © The Chartered Institution of Building Services Engineers 2014.

  14. Interpreter use in an inner city accident and emergency department.

    PubMed Central

    Leman, P

    1997-01-01

    OBJECTIVE: To determine the extent of communication problems that arose from patients whose primary language was non-English presenting to an inner city accident and emergency (A&E) department. METHODS: A prospective survey over seven consecutive days during September 1995. All adult patients other than those directly referred by their general practitioner to an inpatient team had a questionnaire completed by the A&E doctor first seeing the patient. The doctor recorded language ability and form of interpreter used, and estimated any prolongation of the consultation and ability to improve communication by the use of additional services. RESULTS: 103 patients (17%) did not speak English as their primary language; 55 patients (9.1% of the study population) had an English language ability rated as other than good, and 16 (29%) of these consultations could have been improved by the use of additional interpreter services; 28 patients overall (4.6% of the study population) required the use of an interpreter, who was usually a relative. CONCLUSIONS: A significant number of patients presenting to A&E have difficulty in communicating in English. These consultations could often have been improved by the use of additional interpreter services. Telephone interpreter services may provide the answer for use in A&E departments because of their instant and 24 hour availability. Images p99-a PMID:9132201

  15. A 26-year comparative review of United Kingdom helicopter emergency medical services crashes and serious incidents.

    PubMed

    Chesters, Adam; Grieve, Phillip H; Hodgetts, Timothy J

    2014-04-01

    The use of helicopter emergency medical services (HEMS) has increased substantially in the United Kingdom since 1987. There are currently no data on the rate of crashes and serious incidents related to HEMS in the United Kingdom. The aims of this article were to present data from a 26-year period since the start of HEMS operations in the United Kingdom and to compare them with published data from Germany, Australia, and the United States. Factors identified as affecting the safety of HEMS operations will also be discussed. A PubMed search was performed to retrieve published data on accident rates and safety discussions for international HEMS using the key words HEMS, helicopter, emergency medical services, accident, incident, and crash. The details of every helicopter crash in the United States since the beginning of HEMS operations was obtained and reviewed to identify those that involved HEMS aircraft. This novel UK information was compared with published data from three international systems. A total of 13 accidents or serious incidents involving HEMS aircraft were identified from Civil Aviation Authority records, only 1 of which was a fatal accident. It was estimated that approximately 230,000 HEMS missions occurred in the United Kingdom between 1987 and 2013, giving an absolute accident incidence of approximately 0.0057% and a fatal accident incidence of approximately 0.00043%. The accident and fatal accident rate per 10,000 missions in the United Kingdom was 0.57 and 0.04, respectively. This compares with published rates from Germany, Australia, and the United States with accident rate per 10,000 missions ranging between 0.57 and 0.75 and fatal accident rates per 10,000 missions ranging between 0.04 and 0.23. Accidents and serious incidents relating to HEMS operations in the United Kingdom have been comprehensively identified for the first time, allowing an estimation of overall accident and fatal accident rates and comparison with other countries' HEMS

  16. Preparedness of Finnish Emergency Medical Services for Chemical Emergencies.

    PubMed

    Jama, Timo J; Kuisma, Markku J

    2016-08-01

    Introduction The preparedness level of Finnish Emergency Medical Services (EMS) for treating chemical emergencies is unknown. The aim of this study was to survey the preparedness level of EMS systems for managing and handling mass-casualty chemical incidents in the prehospital phase in Finland. Hypothesis The study hypothesis was that university hospital districts would have better clinical capability to treat patients than would central hospital districts in terms of the number of patients treated in the field within one hour after dispatching as well as patients transported to hospital within one hour or two hours after dispatching. This cross-sectional study was conducted as a Webropol (Wuppertal, Germany) survey. All hospital districts (n=20) in continental Finland were asked about their EMS preparedness level in terms of capability of treating and transporting chemically affected patients in the field. Their capability for decontamination of affected patients in the field was also inquired. University hospital district-based EMS systems had at least 20% better absolute clinical capacity than central hospital-based EMS systems for treating chemically affected patients concerning all treatments inquired about, except the capacity for non-invasive ventilation (NIV)/continuous positive airway pressure (CPAP) treatment in the field. Overall, there was a good level of preparedness for treating chemical accident patients with supplemental oxygen, bronchodilators, and inhaled corticosteroids. Preparedness for providing antidote therapy in cases of cyanide gas exposure was, in general, low. The variation among the hospital districts was remarkable. Only nine of 15 central hospital district EMS had a mobile decontamination unit available, whereas four of five university hospital districts had one. Emergency Medical Services capacity in Finland for treating chemically affected patients in the field needs to be improved, especially in terms of antidote therapy. Mobile

  17. [Treatment of childhood injuries and violence in public emergency services].

    PubMed

    Malta, Deborah Carvalho; Mascarenhas, Márcio Denis Medeiros; Neves, Alice Cristina Medeiros das; Silva, Marta Alves da

    2015-05-01

    This study aimed to analyze the profile of treatment for accidents and violence involving children under 10 years of age in Brazil in the year 2011. This was a cross-sectional descriptive study in 71 emergency services in the Brazilian Unified National Health System (SUS), located in the national capital and 24 state capitals. Data were obtained from the Ministry of Health's system of sentinel surveillance services for Violence and Accidents (VIVA Survey). The highest proportion of injuries (67.4%) occurred inside the child's home. Among unintentional injuries, falls were the most frequent (52.4%), followed by running into objects or persons (21.8%) and traffic injuries (10.9%), especially as passengers (bicycles were an important means of transportation involved in the injuries). The vast majority of unintentional injuries are avoidable, and educational measures should be adopted, especially with parents, teachers, the community, and health workers, calling attention to the risks and the adoption of safe behaviors in the home, at school, and in leisure-time activities. Cases of violence are subject to mandatory reporting, and prompt measures should be taken to protect victims.

  18. Health impact of the Buncefield oil depot fire, December 2005: study of accident and emergency case records.

    PubMed

    Hoek, M R; Bracebridge, S; Oliver, I

    2007-09-01

    On Sunday 11th of December 2005, an explosion occurred at the Buncefield oil depot, Hertfordshire, resulting in a large fire that blazed for several days. Two Accident and Emergency (A&E) departments were placed on stand-by to receive casualties. A simple surveillance system was put in place during the acute phase of the incident, but this was not adequate to fully examine the health impact of the fire. Retrospective study of A&E records at Hemel Hempstead and Watford A&E departments for the period that the fire burnt. Two hundred and forty-four people attended A&E as a result of the fire: 187 were members of the emergency services; 17 were oil depot workers; and 40 were members of the public. The most common presenting complaints were respiratory symptoms (n = 66) and injuries (n = 38). Twenty-five (21%) individuals were referred for medical follow-up. There were no fatalities. There was a significant impact on local health services, with many emergency service personnel attending A&E asymptomatically. Alternative health service provision for these individuals, possibly near to the scene of the incident, should be considered. This incident has also highlighted an urgent need to develop surveillance systems that enable real-time monitoring of the acute public health impact of major incidents.

  19. Is the named nurse a reality in accident and emergency?

    PubMed

    Pryce, C

    1994-07-01

    Previous articles have looked at particular aspects of the named nurse concept, but few have addressed the perceived difficulties in the speciality of Accident and Emergency (A & E) nursing. This paper seeks to promote discussion with other specialist areas/departments/units.

  20. Stress and the student nurse in accident and emergency nursing.

    PubMed

    Scullion, P

    Accident and emergency (A and E) nursing is assumed to be very stressful. This article will briefly examine the concept of stress before exploring the literature on stressors associated with A and E nursing and in particular those associated with student nurses. The implications are explored and important questions posed.

  1. Emergency drinking water treatment during source water pollution accidents in China: origin analysis, framework and technologies.

    PubMed

    Zhang, Xiao-Jian; Chen, Chao; Lin, Peng-Fei; Hou, Ai-Xin; Niu, Zhang-Bin; Wang, Jun

    2011-01-01

    China has suffered frequent source water contamination accidents in the past decade, which has resulted in severe consequences to the water supply of millions of residents. The origins of typical cases of contamination are discussed in this paper as well as the emergency response to these accidents. In general, excessive pursuit of rapid industrialization and the unreasonable location of factories are responsible for the increasing frequency of accidental pollution events. Moreover, insufficient attention to environmental protection and rudimentary emergency response capability has exacerbated the consequences of such accidents. These environmental accidents triggered or accelerated the promulgation of stricter environmental protection policy and the shift from economic development mode to a more sustainable direction, which should be regarded as the turning point of environmental protection in China. To guarantee water security, China is trying to establish a rapid and effective emergency response framework, build up the capability of early accident detection, and develop efficient technologies to remove contaminants from water.

  2. Communication in Hong Kong Accident and Emergency Departments

    PubMed Central

    Chandler, Eloise; Pun, Jack; Lock, Graham; Matthiessen, Christian M. I. M.; Espindola, Elaine; Ng, Carman

    2015-01-01

    In this article, we report findings from the first qualitatively driven study of patient–clinician communication in Hong Kong Accident and Emergency Departments (AEDs). In light of the Hong Kong Hospital Authority’s policy emphasis on patient-centered care and communication in the public hospitals it oversees, we analyze clinicians’ perceptions of the role and relevance of patient-centered communication strategies in emergency care. Although aware of the importance of effective communication in emergency care, participants discussed how this was frequently jeopardized by chronic understaffing, patient loads, and time pressures. This was raised in relation to the absence of spoken interdisciplinary handovers, the tendency to downgrade interpersonal communication with patients, and the decline in staff attendance at communication training courses. Participants’ frequent descriptions of patient-centered communication as dispensable from, and time-burdensome in, AEDs highlight a discrepancy between the stated Hong Kong Hospital Authority policy of patient-centered care and the reality of contemporary Hong Kong emergency practice. PMID:28462303

  3. Building of communication system for nuclear accident emergency disposal based on IP multimedia subsystem

    NASA Astrophysics Data System (ADS)

    Wang, Kang; Gao, Guiqing; Qin, Yuanli; He, Xiangyong

    2018-05-01

    The nuclear accident emergency disposal must be supported by an efficient, real-time modularization and standardization communication system. Based on the analysis of communication system for nuclear accident emergency disposal which included many functions such as the internal and external communication, multiply access supporting and command center. Some difficult problems of the communication system were discussed such as variety access device type, complex composition, high mobility, set up quickly, multiply business support, and so on. Taking full advantages of the IP Multimedia Subsystem (IMS), a nuclear accident emergency communication system was build based on the IMS. It was studied and implemented that some key unit and module functions of communication system were included the system framework implementation, satellite access, short-wave access, load/vehicle-mounted communication units. The application tests showed that the system could provide effective communication support for the nuclear accident emergency disposal, which was of great practical value.

  4. Emergency Medical Services

    MedlinePlus

    ... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

  5. The challenges for nurses communicating with and gaining valid consent from adults with intellectual disabilities within the accident and emergency care service.

    PubMed

    Sowney, Margaret; Barr, Owen

    2007-09-01

    This paper reports the challenges experienced by nurses within accident and emergency departments in communicating with and gaining valid consent from adults with intellectual disabilities. Consent is both a legal requirement and an ethical principle required to be obtained by health-care professionals, prior to the start of any examination, treatment and/or care. Central to the process of seeking consent is effective communication. However, evidence shows that people with intellectual disabilities are not viewed by professionals within acute general hospitals as a vital source of information, neither are they often communicated with directly, nor involved in discussions or decisions about their health care and are frequently not directly asked for their consent. A purposive sample of nurses working within the accident and emergency departments of five general hospitals was recruited to participate in this qualitative study. Data were collected from five focus groups. Effective communication was identified as the most challenging aspect in caring for adults with intellectual disabilities within this environment, having an impact on the assessment of needs, informing patients of their health status and seeking valid consent. Fundamental to the provision of quality care are the concepts communication, choice and control. However, these issues are perceived to be more challenging in the provision of health care to people with intellectual disabilities. Communication and consent, therefore, require further consideration within the educational and clinical areas to strengthen nurses' competence in caring for people with intellectual disabilities, with an emphasis and understanding that choice and control are key principles for all people, being central aspects to the provision of an inclusive service for people with intellectual disabilities. All nurses need to have a greater awareness of learning disability, how to increase opportunities for effective communication and

  6. French policy for managing the post-accident phase of a nuclear accident.

    PubMed

    Gallay, F; Godet, J L; Niel, J C

    2015-06-01

    In 2005, at the request of the French Government, the Nuclear Safety Authority (ASN) established a Steering Committee for the Management of the Post-Accident Phase of a Nuclear Accident or a Radiological Emergency, with the objective of establishing a policy framework. Under the supervision of ASN, this Committee, involving several tens of experts from different backgrounds (e.g. relevant ministerial offices, expert agencies, local information commissions around nuclear installations, non-governmental organisations, elected officials, licensees, and international experts), developed a number of recommendations over a 7-year period. First published in November 2012, these recommendations cover the immediate post-emergency situation, and the transition and longer-term periods of the post-accident phase in the case of medium-scale nuclear accidents causing short-term radioactive release (less than 24 h) that might occur at French nuclear facilities. They also apply to actions to be undertaken in the event of accidents during the transportation of radioactive materials. These recommendations are an important first step in preparation for the management of a post-accident situation in France in the case of a nuclear accident. © The Chartered Institution of Building Services Engineers 2014.

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

    PubMed Central

    Garg, Rajesh H

    2012-01-01

    In India, the healthcare delivery system starts up from the sub-center at the village level and reaches up to super specialty medical centers providing state of the art emergency medical services (EMS). These highest centers, located in big cities, are considered the last referral points for the patients from nearby cities and states. As the incidents of rail and road accidents have increased in recent years, the role of EMS becomes critical in saving precious lives. But when the facilities and management of these emergency centers succumbs before the patient, then the question arises regarding the adequate availability and quality of EMS. The death of an unknown common man, Rambhor, for want of EMS in three big hospitals in the national capital of India put a big question on the “health” of the emergency health services in India. The emergency services infrastructure seems inadequate and quality and timely provision of EMS to critical patients appears unsatisfactory. There is lack of emergency medicine (EM) specialists in India and also the postgraduation courses in EM have not gained foot in our medical education system. Creation of a Centralized Medical Emergency Body, implementation of management techniques, modification of medical curriculum, and fixing accountability are some of the few steps which are required to improve the EMS in India. PMID:22416155

  8. Comparison of perceived and modelled geographical access to accident and emergency departments: a cross-sectional analysis from the Caerphilly Health and Social Needs Study.

    PubMed

    Fone, David L; Christie, Stephen; Lester, Nathan

    2006-04-13

    Assessment of the spatial accessibility of hospital accident and emergency departments as perceived by local residents has not previously been investigated. Perceived accessibility may affect where, when, and whether potential patients attend for treatment. Using data on 11,853 respondents to a population survey in Caerphilly county borough, Wales, UK, we present an analysis comparing the accessibility of accident and emergency departments as reported by local residents and drive-time to the nearest accident and emergency department modelled using a geographical information system (GIS). Median drive-times were significantly shorter in the lowest perceived access category and longer in the best perceived access category (p < 0.001). The perceived access and GIS modelled drive-time variables were positively correlated (Spearman's rank correlation coefficient, r = 0.38, p < 0.01). The strongest correlation was found for respondents living in areas in which nearly all households had a car or van (r = 0.47, p < 0.01). Correlations were stronger among respondents reporting good access to public transport and among those reporting a recent accident and emergency attendance for injury treatment compared to other respondents. Correlation coefficients did not vary substantially by levels of household income. Drive-time, road distance and straight-line distance were highly inter-correlated and substituting road distance or straight-line distance as the GIS modelled spatial accessibility measure only marginally decreased the magnitude of the correlations between perceived and GIS modelled access. This study provides evidence that the accessibility of hospital-based health care services as perceived by local residents is related to measures of spatial accessibility modelled using GIS. For studies that aim to model geographical separation in a way that correlates well with the perception of local residents, there may be minimal advantage in using sophisticated measures

  9. The epidemiology and cost analysis of patients presented to Emergency Department following traffic accidents.

    PubMed

    Akgül Karadana, Gökçe; Metin Aksu, Nalan; Akkaş, Meltem; Akman, Canan; Üzümcügil, Akın; Özmen, M Mahir

    2013-12-09

    Traffic accidents are ranked first as the cause of personal injury throughout the world. The high number of traffic accidents yielding injuries and fatalities makes them of great importance to Emergency Departments. Patients admitted to Hacettepe University Faculty of Medicine Adult Emergency Department due to traffic accidents were investigated epidemiologically. Differences between groups were evaluated by Kruskall-Wallis, Mann-Whitney, and Wilcoxon tests. A value of p<0.05 was accepted as statistically significant. We included 2003 patients over 16 years of age. The mean age was 39.6 ± 16.1 and 55% were males. Admissions by ambulance and due to motor vehicle accidents were the most common. In 2004 the rate of traffic accidents (15.3%) was higher than the other years, the most common month was May (10.8%), and the most common time period was 6 pm to 12 am (midnight). About half of the patients (51.5%) were admitted in the first 30 minutes. Life-threatening condition was present in 9.6% of the patients. Head trauma was the most common type of trauma, with the rate of 18.3%. Mortality rate was 81.8%. The average length of hospital stay was 403 minutes (6.7 hours) and the average cost per patient was 983 ± 4364 TL. Further studies are needed to compare the cost found in this study with the mean cost for Turkey. However, the most important step to reduce the direct and indirect costs due to traffic accidents is the prevention of these accidents.

  10. [Investigation of emergency capacities for occupational hazard accidents in silicon solar cell producing enterprises].

    PubMed

    Yang, D D; Xu, J N; Zhu, B L

    2016-11-20

    Objective: To investigate and analyze the influential factors of occupational hazard acci-dents, emergency facilities and emergency management in Silicon solar cell producing enterprises, then to pro-vide scientific strategies. Methods: The methods of occupationally healthy field investigating, inspecting of ven-tilation effectiveness, setup of emergency program and wearing chemical suit were used. Results: The mainly occupational hazard accidents factors in the process of Silicon solar cell producing included poisoning chemi-cals, high temperature, onizing radiation and some workplaces. The poisoning chemicals included nitric acid, hydrofluoric acid, sulfuric acid, hydrochloric acid, sodium hydroxide, potassium hydroxide, chlorine, phos-phorus oxychloride, phosphorus pentoxide, nitrogen dioxide, ammonia, silane, and so on; the workplaces in-cluded the area of producing battery slides and auxiliary producing area. Among the nine enterprises, gas detec-tors were installed in special gas supplying stations and sites, but the height, location and alarmvalues of gas detectors in six enterprises were not according with standard criteria; emergency shower and eyewash equip-ment were installed in workplaces with strong corrosive chemicals, but the issues of waste water were not solved; ventilation systems were set in the workplaces with ammonia and silane, but not qualified with part lo-cations and parameters in two enterprises; warehouses with materials of acid, alkali, chemical ammonia and phosphorus oxychloride were equipped with positive - pressure air respirator resuscitator and emergency cabi-nets, but with insufficient quantity in seven enterprises and expiration in part of products. The error rate of set-up emergency program and wearing chemical cloth were 30%~100% and 10%~30%, respectively. Among the nine enterprises, there were emergency rescue plans for dangerous chemical accidents, but without profession-al heatstroke and irradiation accident emergency plans

  11. [Violence and accidents among older and younger adults: evidence from the Surveillance System for Violence and Accidents (VIVA), Brazil].

    PubMed

    Luz, Tatiana Chama Borges; Malta, Deborah Carvalho; Sá, Naíza Nayla Bandeira de; Silva, Marta Maria Alves da; Lima-Costa, Maria Fernanda

    2011-11-01

    Data from the Brazilian Surveillance System for Violence and Accidents (VIVA) in 2009 were used to examine socio-demographic characteristics, outcomes, and types of accidents and violence treated at 74 sentinel emergency services in 23 Brazilian State capitals and the Federal District. The analysis included 25,201 individuals aged > 20 years (10.1% > 60 years); 89.3% were victims of accidents and 11.9% victims of violence. Hospitalization was the outcome in 11.1% of cases. Compared to the general population, there were more men and non-white individuals among victims of accidents, and especially among victims of violence. As compared to younger adults (20-59 years), accidents and violence against elderly victims showed less association with alcohol, a higher proportion of domestic incidents, more falls and pedestrian accidents, and aggression by family members. Policies for the prevention of accidents and violence should consider the characteristics of these events in the older population.

  12. Double take--fracture fishing in accident and emergency practice.

    PubMed

    Hyland-McGuire, P; Guly, H R; Hughes, P M

    1997-03-01

    To investigate conditions where, after initially negative plain x rays following trauma, there subsequently proves to be fracture, and to explore ways in which the management might be improved. A 16 month prospective study. Patient details were collected from accident and emergency (A&E) review clinics and returns, A&E ward admissions, correspondence from other services, and discussions at a weekly clinicoradiological conference. The inclusion criteria comprised A&E trauma patients with normal initial plain x rays and proven fractures on subsequent imaging for the same patient event. A large A&E department seeing 65,000 new attendances per annum with full back up services. 55 cases were identified: 41 fractures were identified on subsequent plain x ray, six on bone scan, six on CAT scan, and two on MRI scan. The commonest regions involved were the wrist, pelvis/hip, ankle/foot, and leg. Follow up had not been arranged at the initial attendance in 17 instances and between two and 135 days were required for definitive fracture recognition. All but nine patients required alteration in treatment because of fracture detection. Clinical suspicion of fracture at initial A&E attendance should prompt organised follow up even in the face of normal plain x rays. Consideration should be given to alternative imaging techniques which may have a higher resolution than plain x rays. Close corroboration between A&E and radiology departments has benefits in patient care in this group of patients and may lead to a reduction in functional disability and litigation.

  13. Administration of medicines by emergency nurse practitioners according to protocols in an accident and emergency department.

    PubMed Central

    Marshall, J; Edwards, C; Lambert, M

    1997-01-01

    OBJECTIVE: To present the legal and professional issues related to nurse administration of drugs according to protocols, and describe the implementation and initial audit findings of such a scheme. SETTING: Accident and emergency (A&E) department of a district general hospital. METHODS: Analysis of legal and professional opinion. Protocols acceptable to the medical, nursing, and pharmacy professions were developed across a wide range of drugs appropriate for administration by accident and emergency nurse practitioners (ENPs). The first six months of the scheme were audited. Audit initially addressed general compliance with protocols and later the specific areas of tetanus immunisation and emergency contraception. RESULTS: ENPs assessed 2925 patients in six months (10.9% of all new patients); 455 patients (15.5% of the ENP patients) were given drugs according to protocols. There were no breaches of the protocols. Subsequent audit of tetanus immunisation showed 94-100% compliance with protocol standards and 71-100% compliance for emergency contraception. CONCLUSIONS: There are no legal or professional obstacles to the development of protocols for the administration of drugs to patients by nurses without reference to a doctor, providing the protocols meet all the requirements of the UKCC and have the support of consultant medical staff. Such a system must be subject to regular audit to promote a dynamic approach to protocols and training. The system safely enhanced the quality of care of patients treated by ENPs in A&E. Images Figure 1 PMID:9248912

  14. [Polytrauma following a truck accident : How to save lives by guideline-oriented emergency care].

    PubMed

    Kippnich, M; Jelting, Y; Markus, C; Kredel, M; Wurmb, T; Kranke, P

    2017-12-01

    Identification and immediate treatment of life-threatening conditions is fundamental in patients with multiple trauma. In this context, the S3 guidelines on polytrauma and the S1 guidelines on emergency anesthesia provide the scientific background on how to handle these situations. This case report deals with a seriously injured driver involved in a truck accident. The inaccessible patient showed a scalping injury of the facial skeleton with massive bleeding and partially blocked airway but with spontaneous breathing as well as centralized cardiovascular circulation conditions and an initial Glasgow coma scale (GCS) of 8. An attempt was made to stop the massive bleeding by using hemostyptic-coated dressings. In addition, the patient was intubated via video laryngoscopy and received a left and right thoracic drainage as well as two entry points for intraosseous infusion. In modern emergency medical services, treatment based on defined algorithms is recommended and also increasingly established in dealing with critical patients. The guideline-oriented emergency care of patients with polytrauma requires invasive measures, such as intubation and thoracic decompression in the preclinical setting. The foundation for this procedure includes training in theory and practice both of the non-medical and medical rescue service personnel.

  15. Psychosocial assistance after environmental accidents: a policy perspective.

    PubMed Central

    Becker, S M

    1997-01-01

    There is a substantial body of literature on psychosocial impacts of chemical and nuclear accidents. Less attention, however, has been focused on the program and policy issues that are connected with efforts to provide psychosocial assistance to the victims of such accidents. Because psychosocial assistance efforts are certain to be an essential part of the response to future environmental emergencies, it is vital that relevant program and policy issues by more fully considered. This article discusses the highly complex nature of contamination situations and highlights some of the key policy issues that are associated with the provision of psychosocial services after environmental accidents. One issue concerns the potential for assistance efforts to become objects of conflict. In the context of the intense controversy typically associated with chemical or nuclear accidents, and with debates over the causation of illness usually at the center of environmental accidents, psychosocial assistance services may themselves become contested terrain. Other significant program and policy issues include determining how to interface with citizen self-help and other voluntary groups, addressing the problem of stigma, and deciding how to facilitate stakeholder participation in the shaping of service provision. This article offers a series of policy proposals that may help smooth the way for psychosocial assistance programs in future environmental emergencies. PMID:9467082

  16. Emergency Medical Service

    NASA Technical Reports Server (NTRS)

    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.

  17. Respiratory Emergencies and Management of Mining Accidents

    PubMed Central

    Özmen, İpek; Aksoy, Emine

    2015-01-01

    The rapid detection of the reasons for mining accidents that lead to emergency situations is vital for search and rescue work. The control of fire and gas leakage provides an immediate approach for rescue works for deaths or injuries and the detection of who needs resuscitation outside of the mine. The evacuation and recovery operations should be directed by continuous monitoring of the mine environment due to fire and explosion risks. The main toxic gases in mines are carbon monoxide (CO) and carbon dioxide (CO2); the flammable gases are methane (CH4), CO, and hydrogen (H2); the suffocating gases are CO2, nitrogen (N20), and CH4; and the toxic gases are CO, nitrogen oxides (NOx), and hydrogen sulfide (H2S). PMID:29404110

  18. Characteristic variation and original analysis of emergent water source pollution accidents in China between 1985 and 2013.

    PubMed

    Qu, Jianhua; Meng, Xianlin; Ye, Xiuqing; You, Hong

    2016-10-01

    China has suffered various water source pollution incidents in the past decades, which have resulted in severe threats to the safety of the water supply for millions of residents. From the aspects of quantity fluctuation, temporal volatility, regional inequality, pollutant category variation, and accident type differences, this study first characterizes the current status of water source contaminations in China by analyzing 340 pollution events for the period spanning from 1985 to 2013. The results show a general increase in the number of accidents during the period 1985-2006 and then a rapid decline starting in 2007. Spring and summer are high-incidence seasons for pollution, and the accident rate in developed southeastern coastal areas is far higher than that in the northwestern regions. Hazardous chemicals and petroleum are the most frequently occurring pollutants, whereas heavy metals and tailings are becoming emerging contaminants during occasional pollutions. Most of the accidents that occurred before 2005 were blamed on illegal emissions or traffic accidents; however, leakage in production has gradually become a major accident type in the past decade. Then, in combination with government actions and policy constraints, this paper explores the deep inducements and offers valuable insight into measures that should be taken to ensure future prevention and mitigation of emergent source water pollution.

  19. Decision support system for emergency management of oil spill accidents in the Mediterranean Sea

    NASA Astrophysics Data System (ADS)

    Liubartseva, Svitlana; Coppini, Giovanni; Pinardi, Nadia; De Dominicis, Michela; Lecci, Rita; Turrisi, Giuseppe; Cretì, Sergio; Martinelli, Sara; Agostini, Paola; Marra, Palmalisa; Palermo, Francesco

    2016-08-01

    This paper presents an innovative web-based decision support system to facilitate emergency management in the case of oil spill accidents, called WITOIL (Where Is The Oil). The system can be applied to create a forecast of oil spill events, evaluate uncertainty of the predictions, and calculate hazards based on historical meteo-oceanographic datasets. To compute the oil transport and transformation, WITOIL uses the MEDSLIK-II oil spill model forced by operational meteo-oceanographic services. Results of the modeling are visualized through Google Maps. A special application for Android is designed to provide mobile access for competent authorities, technical and scientific institutions, and citizens.

  20. Can primary care and community-based models of emergency care substitute for the hospital accident and emergency (A & E) department?

    PubMed

    Roberts, E; Mays, N

    1998-06-01

    This systematic review assesses the extent to which primary-secondary substitution is possible in the field of emergency care where the range of options for the delivery of care is increasing in the UK and elsewhere. Thirty-four studies were located which met the review inclusion criteria, covering a range of interventions. This evidence suggested that broadening access to primary care and introducing user charges or other barriers to the hospital accident and emergency (A & E) department can reduce demand for expensive secondary care, although the relative cost-effectiveness of these interventions remains unclear. On a smaller scale, employing primary care professionals in the hospital A & E department to treat patients attending with minor illness or injury seems to be a cost-effective method of substituting primary for secondary care resources. Interventions that addressed both sides of the primary-secondary interface and recognised the importance of patient preferences in the largely demand-driven emergency service were more likely to succeed in complementing rather than duplicating existing services. The evidence on other interventions such as telephone triage, minor injuries units and general practitioner out of hours co-operatives was sparse despite the fact that these interventions are growing rapidly in the UK. Quantifying the scope for substitution in any one health system is difficult since the evidence comes from international research studies undertaken in a variety of very different health settings. Simply transferring interventions which succeed in one setting without understanding the underlying process of change is likely to result in unexpected consequences locally. Nevertheless, the review findings clearly demonstrate that shifting the balance of care is possible. It also highlights a persistent gap in professional and lay perceptions of appropriate sources of care for minor illness and injury.

  1. The Fukushima Dai-ichi accident: additional lessons from a radiological emergency assistance mission.

    PubMed

    Becker, Steven M

    2013-11-01

    In response to the March 2011 earthquake-tsunami disaster and the Fukushima Dai-ichi nuclear accident, a special nongovernmental Radiological Emergency Assistance Mission flew to Japan from the United States. Invited by one of Japan's largest hospital and healthcare groups and facilitated by a New York-based international disaster relief organization, the mission included an emergency physician, a health physicist, and a disaster management specialist. During the 10 d mission, team members conducted fieldwork in areas affected by the earthquake, tsunami, and nuclear accident; went to cities and towns in the 20-30 km Emergency Evacuation Preparation Zone around the damaged nuclear plant; visited other communities affected by the nuclear accident; went to evacuation shelters; met with mayors and other local officials; met with central government officials; exchanged observations, experiences, and information with Japanese medical, emergency response, and disaster management colleagues; and provided radiological information and training to more than 1,100 Japanese hospital and healthcare personnel and first responders. The mission produced many insights with potential relevance for radiological/nuclear emergency preparedness and response. The first "lessons learned" were published in December 2011. Since that time, additional broad insights from the mission and mission followup have been identified. Five of these new lessons, which focus primarily on community impacts and responses and public communication issues, are presented and discussed in this article.

  2. Pre-flight risk assessment in Emergency Medical Service (EMS) helicopters

    NASA Technical Reports Server (NTRS)

    Shively, R. J.

    1992-01-01

    The Emergency Medical Service (EMS) industry has been the subject of several television and newspaper articles (Harvey and Jensen, 1987) which emphasized the negative aspects, (e.g., fatalities and high accident rates), rather than the life saving services performed. Until recently, the accident rate of the EMS industry has been five times as high as that of other civil helicopters. This high accident rate has been coupled with the dramatic rise in the number of programs. The industry has built from a single service at its inception in 1972, to over 180 in 1987 (Spray, 1987), to the point that 93 percent of the contiguous U.S. is now covered by some type of EMS service. These factors prompted the National Transportation Safety Board (NTSB) to study the accidents that occurred between May 11, 1978 and December 3, 1986 (NTSB, 1988). The NTSB report concluded that 'Sound pilot judgment is central to safe flight operations.' They further stated that '... factors unique to EMS helicopter operations--such as the influence of the mission itself, program competition, and EMS program management perspectives--can drastically influence pilot judgment during the EMS mission.' One of the most difficult decisions that a pilot must make is whether to accept or decline a mission. A pre-flight risk assessment system (SAFE) was developed at NASA-Ames Research Center for civil EMS operations to aid pilots in making this decision objectively. The ability of the SAFE system to predict mission risk profiles was tested at an EMS facility. The results of this field study demonstrated that the usefulness of SAFE was highly dependent on the type of mission flown. SAFE is now being modified so that it can 'learn' with each mission flown. For example, after flying a mission to a particular site, an EMS pilot would input information about this mission into the system, such as new buildings, wires, or approach procedures. Then, the next time a pilot flew a similar mission or one to the same

  3. Civilian Helicopter Search and Rescue Accidents in the United States: 1980 Through 2013.

    PubMed

    Worley, Gordon H

    2015-12-01

    Helicopters are commonly used in search and rescue operations, and accidents have occurred during helicopter search and rescue (HSAR) missions. The purposes of this study were to investigate whether the HSAR accident rate in the United States could be determined and whether any common contributing factors or trends could be identified. Searches were conducted of the National Transportation Safety Board aviation accident database, the records of the major search and rescue and air medical organizations, and the medical and professional literature for reports of HSAR accidents. A total of 47 civilian HSAR accidents were identified during the study. Of these, 43% involved fatal injuries, compared with a 19% fatality rate for US helicopter general aviation accidents during the same time period and a 40% rate for helicopter emergency medical services. The HSAR accidents carried a significantly higher risk of fatal outcomes when compared with helicopter general aviation accidents (2-tailed Fisher's exact test, P < .0005). Accidents that occurred at night and under instrument meteorological conditions did not have a statistically significant increase in percentage of fatal outcomes (P > .05). The number of HSAR missions conducted annually could not be established, so an overall accident rate could not be calculated. Although the overall number of HSAR accidents is small, the percentage of fatal outcomes from HSAR accidents is significantly higher than that from general helicopter aviation accidents and is comparable to that seen for helicopter emergency medical services operations. Further study could help to improve the safety of HSAR flights. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  4. Construction of a technique plan repository and evaluation system based on AHP group decision-making for emergency treatment and disposal in chemical pollution accidents.

    PubMed

    Shi, Shenggang; Cao, Jingcan; Feng, Li; Liang, Wenyan; Zhang, Liqiu

    2014-07-15

    The environmental pollution resulting from chemical accidents has caused increasingly serious concerns. Therefore, it is very important to be able to determine in advance the appropriate emergency treatment and disposal technology for different types of chemical accidents. However, the formulation of an emergency plan for chemical pollution accidents is considerably difficult due to the substantial uncertainty and complexity of such accidents. This paper explains how the event tree method was used to create 54 different scenarios for chemical pollution accidents, based on the polluted medium, dangerous characteristics and properties of chemicals involved. For each type of chemical accident, feasible emergency treatment and disposal technology schemes were established, considering the areas of pollution source control, pollutant non-proliferation, contaminant elimination and waste disposal. Meanwhile, in order to obtain the optimum emergency disposal technology schemes as soon as the chemical pollution accident occurs from the plan repository, the technique evaluation index system was developed based on group decision-improved analytical hierarchy process (AHP), and has been tested by using a sudden aniline pollution accident that occurred in a river in December 2012. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Emergency Medical Services Program Guide.

    ERIC Educational Resources Information Center

    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:…

  6. Transport accidents among children and adolescents at the emergency service of a teaching hospital in the southern zone of the city of São Paulo☆☆☆

    PubMed Central

    Gorios, Carlos; de Souza, Renata Maia; Gerolla, Viviane; Maso, Bruno; Rodrigues, Cintia Leci; Armond, Jane de Eston

    2014-01-01

    Objective to describe the victim profile and circumstances of transport accidents involving children and adolescents who were attended at a teaching hospital in the southern zone of the city of São Paulo. Methods this was an individual observational case series study among patients up to the age of 19 years who were attended at a hospital in the southern zone of the city of São Paulo, state of São Paulo, Brazil, due to traffic accidents. The files notifying suspected or confirmed cases of violence and accidents (SIVVA files) covering January to December 2012 were analyzed. Results among the 149 cases notified, 64.4% related to males and 35.6% to females. The transport accidents were predominantly among males, irrespective of age. The main injury diagnoses were superficial head trauma (24.8%) followed by multiple non-specified trauma (36.4%), in both sexes. Conclusion transport accidents among children and adolescents occurred more often among males. The main transport accidents among the children and adolescents attended as emergency cases were caused by motor vehicles and motorcycles. Among the accident victims, the largest proportion was attended because of being run over. PMID:26229833

  7. A one-year review of maxillofacial sports injuries treated at an accident and emergency department.

    PubMed

    Hill, C M; Burford, K; Martin, A; Thomas, D W

    1998-02-01

    To assess the aetiology and demand for oral and maxillofacial surgery services associated with sports injuries, a prospective study was undertaken. Data were collected from consecutive patients (with maxillofacial injuries associated with sports) attending the accident and emergency department at the Cardiff Royal Infirmary in the UK during a 12-month period and analysed. Data relating to demography, aetiology, site and extent of injury, treatment and outcome were collected. There were 790 attendances (695M:85F) arising principally from injuries related to rugby (n = 206), cycling (n = 189) and football (n = 109) but few from recognized contact sports (n = 26). The principal causes of these injuries were direct bodily contact (n = 260) and falls (n = 219). The commonest injury was soft-tissue laceration (n = 604); 80 patients had dentoalveolar fractures and 64 patients had fractures of the facial skeleton. Injuries were located in the upper- (n = 257), middle- (n = 201) and lower third of the face (n = 124) with 188 lip/intraoral injuries. Repair of lacerations (n = 600) was the commonest treatment; only 46 fractures required interventive treatment. Follow-up was performed for most of these patients at the Department of Oral and Maxillofacial Surgery at the Dental Hospital (n = 404) and general medical/dental practitioners (n = 258). These data highlight the importance of oral and maxillofacial surgery staff in the management of sports injuries in accident and emergency departments. Moreover, they suggest the need for prioritization of rule and legislation changes and the continuing need to improve safety standards to prevent maxillofacial injuries.

  8. Family presence preference when patients are receiving resuscitation in an accident and emergency department.

    PubMed

    Hung, Maria S Y; Pang, Samantha M C

    2011-01-01

    This paper is a report of a study to illuminate the experience of family members whose relatives survived the resuscitation in an accident and emergency department, and their preferences with regard to being present. Family presence during resuscitation can offer benefits to both patient and family members, and large healthcare organizations support and recommend offering the option for their presence. However, many staff believe that this is too distressing or traumatic for families and that they would interfere with the resuscitation process. An interpretive phenomenological approach was used to collect data in 2007-2008 with 18 family members of patients who survived life-sustaining interventions in an accident and emergency department in Hong Kong. Audio-recorded interviews were transcribed verbatim for thematic analysis and verified with the participants in second interviews. None of the family members was present in resuscitation room during the life-sustaining interventions, and five entered the room after the patients' condition was stable. The majority indicated a strong preference to be present if given the option. Three interrelated themes emerged: (i) emotional connectedness, (ii) knowing the patient, and (iii) perceived (in)appropriateness, with 10 subthemes representing affective, rational and contextual determinants of family presence preferences. The interplay of these determinants and how they contributed to strong or weak preference for family presence was analysed. Variations among the contributing determinants to each family member's preference to be present were revealed. Appropriate nursing interventions, policy and guidelines should be developed to meet individualized needs during such critical and life-threatening moments in accident and emergency departments. © 2010 Blackwell Publishing Ltd.

  9. 22 CFR 102.13 - Protective services with respect to deceased victims of accidents.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... victims of accidents. 102.13 Section 102.13 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United States Aircraft Accidents Abroad § 102.13 Protective services with respect to deceased victims of accidents. (a) Interim disposition of remains. Generally, local authorities...

  10. 22 CFR 102.13 - Protective services with respect to deceased victims of accidents.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... victims of accidents. 102.13 Section 102.13 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS CIVIL AVIATION United States Aircraft Accidents Abroad § 102.13 Protective services with respect to deceased victims of accidents. (a) Interim disposition of remains. Generally, local authorities...

  11. Towards emergency management of natural disasters and critical accidents: the Greek experience.

    PubMed

    Nivolianitou, Zoe; Synodinou, Barbara

    2011-10-01

    This paper presents the findings of a prototype study which sought to identify factors that contribute to effective emergency management in Greece and other European states regarding both natural disasters and critical accidents. The parameters for proper action and successful intervention in operational and logistical are identified based on the document analysis and interviews with emergency responders. The interviews are conducted between state-owned and voluntary organizations. They were asked to rate in terms of their importance for effective emergency response efforts. This paper offers useful information of the organization and management of emergency response in Greece, as well as provides interesting responders' opinions data concerning important priorities in the emergency management area. Despite the fact that the data come from the Greek experience, the conclusions may be applied for a broader use in the emergency planning of disasters. The whole study has been undertaken within the European Pre-Emergencies (PreEm) project. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Evaluation of emergency department nursing services and patient satisfaction of services.

    PubMed

    Mollaoğlu, Mukadder; Çelik, Pelin

    2016-10-01

    To identify nursing services and assess patient satisfaction in patients who present to the emergency department. Emergency nursing care is a significant determinant of patient satisfaction. Patient satisfaction is often regarded as a reliable indicator of the quality of services provided in the emergency department. This is a descriptive study. Eighty-four patients who presented to the university emergency department were included in the study. The study data were collected by the Patient Information Form and the Satisfaction Level Form. Emergency nursing services, including history taking, assessing vital signs, preparing the patient for an emergency intervention, oxygen therapy, drug delivery and blood-serum infusion were shown to be more commonly provided compared with other services such as counselling the patients and the relatives about their care or delivering educational and psychosocial services. However, 78·6% of the patients were satisfied with their nursing services. The highest satisfaction rates were observed in the following sub-dimensions of the Satisfaction Level Form: availability of the nurse (82·1%), behaviour of the nurse towards the patient (78·6%) and the frequency of nursing rounds (77·4%). The most common practices performed by nurses in the emergency department were physical nursing services. Patient satisfaction was mostly associated with the availability of nurses when they were needed. Our results suggest that in addition to the physical care, patients should also receive education and psychosocial care in the emergency department. We believe that this study will contribute to the awareness and understanding of principles and concepts of emergency nursing, extend the limits of nursing knowledge and abilities, and improve and maintain the quality of clinical nursing education and practice to train specialist nurses with high levels of understanding in ethical, intellectual, administrative, investigative and professional issues.

  13. Medical Emergencies in Goa

    PubMed Central

    Saddichha, Sahoo; Saxena, Mukul Kumar

    2010-01-01

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

  14. [Emergency service utilization and athletic injuries--data collection from the Fulda district].

    PubMed

    Raschka, C; Witzel, K

    1996-06-01

    Throughout the period of one year all sports accidents, which implied the need of medical services (n = 59), in the district of Fulda with 195,000 inhabitants were analysed. The bulk of the accidents took place during soccer matches (37.3%). The share of women was 25.4%. A repeated trauma was registered in 69.5% of the cases. 16% of the casualties received outpatient treatment. The ambulance was already at the site of the accident in 35.6% of the cases. The greater part of the accidents happened in the afternoon (57.6%). The accident was caused due to another athlete in 44.1% of the accidents. An ambulance with a doctor on board was needed four times, because the injury demanded treatment by an internist. The principle measure of first aid, taken by the ambulance men, was the positioning of the injured limb on a splint (n = 44). The incidence of sports accidents with need for medical service is 30/100,000 inhabitants. The part of sports accidents in relation to all ambulance actions is 2.3% (internal medicine only 0.18% and surgery only 15.3%). The percentage of sports accidents demanding a doctor in relation to all rescues with the need for a doctor is 0.3%.

  15. A two-stage optimization model for emergency material reserve layout planning under uncertainty in response to environmental accidents.

    PubMed

    Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Liu, Rentao; Wang, Peng

    2016-06-05

    In the emergency management relevant to pollution accidents, efficiency emergency rescues can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, a two-stage optimization framework is developed for emergency material reserve layout planning under uncertainty to identify material warehouse locations and emergency material reserve schemes in pre-accident phase coping with potential environmental accidents. This framework is based on an integration of Hierarchical clustering analysis - improved center of gravity (HCA-ICG) model and material warehouse location - emergency material allocation (MWL-EMA) model. First, decision alternatives are generated using HCA-ICG to identify newly-built emergency material warehouses for risk sources which cannot be satisfied by existing ones with a time-effective manner. Second, emergency material reserve planning is obtained using MWL-EMA to make emergency materials be prepared in advance with a cost-effective manner. The optimization framework is then applied to emergency management system planning in Jiangsu province, China. The results demonstrate that the developed framework not only could facilitate material warehouse selection but also effectively provide emergency material for emergency operations in a quick response. Copyright © 2016. Published by Elsevier B.V.

  16. Home accidents in elderly patients presenting to an emergency department.

    PubMed

    Lee, V M; Wong, T W; Lau, C C

    1999-04-01

    A prospective study was carried out in an Accident and Emergency department (A&E) to (1) examine the pattern of home accidents in elderly patients presenting to the A&E; (2) determine the nature and mechanisms of the accidents; and (3) investigate the associated factors in these accidents. All patients aged 65 or above with a history of injury at home within one week were included. Patients who needed immediate resuscitation and patients with mental illness or violent behaviour were excluded. A convenient sample was chosen during an 8-week period. A standardized questionnaire was used to collect data on (1) demographics; (2) nature of the accident and injury; and (3) health status. Health status assessment involved three components: physical status, drug history and past health. A total of 100 subjects were included giving an average occurrence of 3.3 cases per shift. The mean age of the group was 75 with female patients (66) outnumbering the males by about two to one. The toilet was the most common site (29%) of home accident, followed by the sitting room (18%), the kitchen (14%), the bedroom (11%) and the dining room (10%). In 79 cases the patient was alone at home during the accident. Falls were the most common (75%) type of accident. The remaining 25% of injuries were categorized as sharps injury (8%), foreign body ingestion (6%), crush injury (4%), burns/scald (3%), hit by/onto fallen objects (3%) and finally, electric shock (1%). Eighteen fractures were recorded. Thirty-two patients were admitted, 16 to the surgical ward and 16 to the orthopedic ward. In the functional assessment only 34 patients could perform the get-up-and-go test satisfactorily and only 61 patients had good hand grasp. Visual and hearing impairment were common. Over 45% of the patients had more than one disease and the majority of patients (80) were taking some medication. The roles of A&E staff in the prevention of home accidents in the elderly are discussed.

  17. Accidents with potentially hazardous biological material among workers in hospital supporting services.

    PubMed

    Canini, Silvia Rita Marin da Silva; Gir, Elucir; Machado, Alcyone Artiolli

    2005-01-01

    Descriptive study was carried out to characterize the occupational accidents involving potentially contaminated material among workers of hospital supporting services. The study reviewed records of workers involved in these accidents and attended at a specialized outpatient clinic of a large tertiary care hospital between January 1997 and October 2001. A total of 2814 workers from different professional categories were attended during this period. Of these, 147 (5.2%) belonged to the hospital supporting services and were the victims of 156 accidents, auxiliary cleaning personnel (80.2%), and over a third of the workers had not received any dose of hepatitis B vaccine (35.4%). Most accidents were due to sharp injuries (96.8%) caused by inadequately discarded hollow needles. Chemoprophylaxis for HIV was not indicated in only 23.1% of cases. We conclude that these workers are also exposed to the possibility of acquiring blood-borne pathogens and that periodical education programs are needed.

  18. Non-urgent accident and emergency department use as a socially shared custom: a qualitative study.

    PubMed

    Keizer Beache, Simone; Guell, Cornelia

    2016-01-01

    We explored attitudes of non-urgent accident and emergency department (AED) patients in the middle-income healthcare setting Saint Vincent and the Grenadines (SVG) in the Caribbean to understand how and why they decide to seek emergency care and resist using primary care facilities. In 2013, we conducted 12 semistructured interviews with a purposive sample of non-urgent AED users from a variety of social backgrounds. Verbatim transcripts were analysed with a grounded theory approach. In this study, we found, first, that participants automatically chose to visit the AED and described this as a locally shared custom. Second, the healthcare system in SVG reinforced this habitual use of the AED, for example, by health professionals routinely referring non-urgent cases to the AED. Third, there was also some deliberate use; patients took convenience and the systemic encouragement into account to determine that the AED was the most appropriate choice for healthcare. We conclude that the attitudes and habits of the Vincentian non-urgent patient are major determinants of their AED use and are intricately linked to local, socially shared practices of AED use. Findings show that health services research should reconsider rational choice behaviour models and further explore customs of health-seeking. 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/

  19. The Maurice Ellis lecture for 1986. The responsibility of emergency medicine towards the prevention of road accidents.

    PubMed Central

    Rutherford, W H

    1986-01-01

    It is argued that doctors who work in accident and emergency departments should play their part in road accident prevention. It is suggested that this might be done in the field of research, by direct action, through education of the public and by influencing legislation. Examples are given of both small and simple, and major national research projects based in accident and emergency departments. The type of direct action envisaged is modelled on the work of Dr Hayle Hadeson in preventing accidents to children. Examples of the education of the public are drawn from publicity work in the seat-belt campaign, and experiences of lobbying members of parliament in relation to seat-belt legislation are described. The relative under-funding of trauma research compared with cancer of heart disease research is seen as a measure of society's lack of interest in accident prevention, and colleagues unchallenged to do more to alter this situation. PMID:3768120

  20. Higher mortality rates amongst emergency patients admitted to hospital at weekends reflect a lower probability of admission.

    PubMed

    Meacock, Rachel; Anselmi, Laura; Kristensen, Søren Rud; Doran, Tim; Sutton, Matt

    2017-01-01

    Objective Patients admitted as emergencies to hospitals at the weekend have higher death rates than patients admitted on weekdays. This may be because the restricted service availability at weekends leads to selection of patients with greater average severity of illness. We examined volumes and rates of hospital admissions and deaths across the week for patients presenting to emergency services through two routes: (a) hospital Accident and Emergency departments, which are open throughout the week; and (b) services in the community, for which availability is more restricted at weekends. Method Retrospective observational study of all 140 non-specialist acute hospital Trusts in England analyzing 12,670,788 Accident and Emergency attendances and 4,656,586 emergency admissions (940,859 direct admissions from primary care and 3,715,727 admissions through Accident and Emergency) between April 2013 and February 2014.Emergency attendances and admissions to hospital and deaths in any hospital within 30 days of attendance or admission were compared for weekdays and weekends. Results Similar numbers of patients attended Accident and Emergency on weekends and weekdays. There were similar numbers of deaths amongst patients attending Accident and Emergency on weekend days compared with weekdays (378.0 vs. 388.3). Attending Accident and Emergency at the weekend was not associated with a significantly higher probability of death (risk-adjusted OR: 1.010). Proportionately fewer patients who attended Accident and Emergency at weekend were admitted to hospital (27.5% vs. 30.0%) and it is only amongst the subset of patients attending Accident and Emergency who were selected for admission to hospital that the probability of dying was significantly higher at the weekend (risk-adjusted OR: 1.054). The average volume of direct admissions from services in the community was 61% lower on weekend days compared to weekdays (1317 vs. 3404). There were fewer deaths following direct admission on

  1. Attendance at a hospital emergency department by drivers involved in automobile accidents in Italy.

    PubMed

    Pileggi, C; Nicotera, G; Angelillo, I F

    2005-04-01

    This study investigated the profile of drivers involved in automobile accidents attending a hospital emergency department (ED) in Catanzaro (Italy). Car drivers involved in automobile accidents who were registered for emergency care between May 2003 and February 2004 were included in the study. Demographics and details of the accident were collected immediately after admittance, before examination by the medical staff. For each patient, the medical staff completed a form including diagnostic investigations and medical/surgical examination in the ED. Of a total of 424 drivers included in the study 27.4% had conditions that were definitely non-urgent problems. Multiple logistic regression analysis indicated that the use of the ED as a source of non-urgent care was significantly higher among patients who were driving at a lower speed when the accident occurred, among those who presented to the ED before the implementation of the new Italian traffic code, and among those who underwent fewer diagnostic investigations and medical/surgical examinations in the ED. Most of the automobile related lesions occurred in the neck (43.9%) followed by multiple body regions (12.5%) and the upper extremities (10.4%). According to the nature of the injury a third were contusions (34%), followed by pain without physical signs and symptoms (28.8%), and dislocation, sprains, and strains (22.9%). Development of health promotion and education campaigns is required to prevent the use of the ED as a source of non-urgent care by those involved in automobile accidents.

  2. 76 FR 63353 - Proposed Information Collection (Payment and Reimbursement for Emergency Services for Non Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... (Payment and Reimbursement for Emergency Services for Non Service-Connected Conditions in Non-VA Facilities... to determine a claimant's eligibility for reimbursement or payment for emergency medical treatment at... information technology. Title: Payment and Reimbursement for Emergency Services for Non Service-Connected...

  3. Grief support in accident and emergency nursing: a literature review 1985-1993.

    PubMed

    McDonald, L; Butterworth, T; Yates, D W

    1995-07-01

    On completing a wide ranging review of literature related to Accident and Emergency (A & E) nursing, the authors chose to focus upon grief support. The literature ranges from personal experiences to large scale research. A table of studies is included to clarify major research findings in this area. The article concludes by recommending long term support for bereaved relatives and research to demonstrate the value of support for relatives in the community.

  4. Clinical supervision: from rhetoric to accident and emergency practice.

    PubMed

    Castille, K

    1996-01-01

    Clinical supervision is firmly on the nursing agenda and, when implemented, will affect every practising nurse. However, current literature offers little in the way of advice on the practical application in a setting like the Accident and Emergency department (A & E). The aim of this article is to encourage A & E nurses to consider how clinical supervision can best be implemented into their current practice. A framework is presented to show how one A & E department has embraced the concept of clinical supervision and incorporated in into their A & E nursing practice. The evaluation, to date, has been positive and A & E nurses have reported that they enjoy the sessions and consider clinical supervision to be a useful learning experience.

  5. Non-urgent accident and emergency department use as a socially shared custom: a qualitative study

    PubMed Central

    Keizer Beache, Simone; Guell, Cornelia

    2016-01-01

    Objective We explored attitudes of non-urgent accident and emergency department (AED) patients in the middle-income healthcare setting Saint Vincent and the Grenadines (SVG) in the Caribbean to understand how and why they decide to seek emergency care and resist using primary care facilities. Methods In 2013, we conducted 12 semistructured interviews with a purposive sample of non-urgent AED users from a variety of social backgrounds. Verbatim transcripts were analysed with a grounded theory approach. Results In this study, we found, first, that participants automatically chose to visit the AED and described this as a locally shared custom. Second, the healthcare system in SVG reinforced this habitual use of the AED, for example, by health professionals routinely referring non-urgent cases to the AED. Third, there was also some deliberate use; patients took convenience and the systemic encouragement into account to determine that the AED was the most appropriate choice for healthcare. Conclusions We conclude that the attitudes and habits of the Vincentian non-urgent patient are major determinants of their AED use and are intricately linked to local, socially shared practices of AED use. Findings show that health services research should reconsider rational choice behaviour models and further explore customs of health-seeking. PMID:25841166

  6. Were attendances to accident and emergency departments in England and Australia influenced by the Rugby World Cup Final 2003?

    PubMed

    Moody, William E; Hendry, Ross G; Muscatello, David

    2007-04-01

    To determine changes in volume and timing of accident and emergency (A&E) attendances associated with the Rugby World Cup Final 2003. Retrospective analysis of A&E attendance data from the West Midlands Surveillance Centre and the New South Wales Emergency Department Collection. West Midlands, England and New South Wales, Australia. Relative risk of accident and emergency attendance during a 18-h period in 2003 compared with the same 18-h period in the years 2000-2002. In the West Midlands, in the 2 h before kick-off there were 72 attendances compared with an expected 101 in 2000-2002 [relative risk (RR) 0.71, 95% confidence interval (CI) 0.55-0.89]. For New South Wales, there were 326 attendances compared with an expected 384 (RR 0.85, 95% CI 0.76-0.95). The West Midlands saw a significant increase in attendance peaking 6-8 h after the kick-off (RR 1.27, 95% CI 1.10-1.46). In the West Midlands, it appears that attendance was reduced in the hours immediately surrounding the final, but in subsequent hours attendances increased, potentially as a result of celebration of the win. In New South Wales, the final was associated with reduced attendance in the hours leading up to the final, but they quickly returned to normal. Major sporting events can influence accident and emergency workload.

  7. Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China

    PubMed Central

    Duan, Weili; He, Bin

    2015-01-01

    In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs) is a significant issue in China. An emergency response system (ERS) was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the domino effect, and fundamental requirements of ERS design were confirmed. The framework of ERS was composed mainly of a monitoring system, an emergency command center, an action system, and a supporting system. On this basis, six main emergency rescue steps containing alarm receipt, emergency evaluation, launched corresponding emergency plans, emergency rescue actions, emergency recovery, and result evaluation and feedback were determined. Finally, an example from the XiaoHu Chemical Industrial Park (XHCIP) was presented to check on the integrality, reliability, and maneuverability of the ERS, and the result of the first emergency drill with this ERS indicated that the developed ERS can reduce delays, improve usage efficiency of resources, and raise emergency rescue efficiency. PMID:26184260

  8. Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China.

    PubMed

    Duan, Weili; He, Bin

    2015-07-10

    In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs) is a significant issue in China. An emergency response system (ERS) was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the domino effect, and fundamental requirements of ERS design were confirmed. The framework of ERS was composed mainly of a monitoring system, an emergency command center, an action system, and a supporting system. On this basis, six main emergency rescue steps containing alarm receipt, emergency evaluation, launched corresponding emergency plans, emergency rescue actions, emergency recovery, and result evaluation and feedback were determined. Finally, an example from the XiaoHu Chemical Industrial Park (XHCIP) was presented to check on the integrality, reliability, and maneuverability of the ERS, and the result of the first emergency drill with this ERS indicated that the developed ERS can reduce delays, improve usage efficiency of resources, and raise emergency rescue efficiency.

  9. Idling Reduction for Emergency and Other Service Vehicles

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    2015-05-07

    This is a fact sheet about reducing idling for emergency and service vehicles. Emergency vehicles, such as police cars, ambulances, and fire trucks, along with other service vehicles such as armored cars, are often exempt from laws that limit engine idling. However, these vehicles can save fuel and reduce emissions with technologies that allow them to perform vital services without idling.

  10. Injuries caused by firearms treated at Brazilian urgent and emergency healthcare services.

    PubMed

    Ribeiro, Adalgisa Peixoto; Souza, Edinilsa Ramos de; Sousa, Carlos Augusto Moreira de

    2017-09-01

    This paper analyzes the medical care given at Brazilian urgent and emergency healthcare services to people injured by firearms in 2014. A cross-sectional study was carried out on care given to patients with firearms injuries in 24 capital cities of Brazilian states and in the Brazilian Federal District, included in the VIVA Survey. Simple and relative frequencies of the variables related to the patients and to the event were calculated, and a logistic model for complex samples was applied adopting care for firearms injuries patients as outcome. The results show the following percentages of care events as caused by firearms: 0.7% for the category 'other accidents (other than transport-related accidents)', 1.5% for self-inflicted injuries, 15.9% for injuries due to assault, and 65.1% of cases arising from legal intervention. The care given was predominantly to young male adults (age 20-39), of mixed race and with a low level of schooling. The most common injuries were: to arms and legs; and to multiple organs. The paper concludes by discussing the efforts to control firearms held by the public in Brazil, and how they can lead to severe and lethal outcomes in quarrels and interpersonal disputes.

  11. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Special rules for ambulance services, emergency and... § 422.113 Special rules for ambulance services, emergency and urgently needed services, and maintenance... equivalent, where other means of transportation would endanger the beneficiary's health. (b) Emergency and...

  12. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Special rules for ambulance services, emergency and... § 422.113 Special rules for ambulance services, emergency and urgently needed services, and maintenance... equivalent, where other means of transportation would endanger the beneficiary's health. (b) Emergency and...

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

    ERIC Educational Resources Information Center

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

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

  14. Disaster Monitoring and Emergency Response Services in China

    NASA Astrophysics Data System (ADS)

    Wu, J.; Han, X.; Zhou, Y.; Yue, P.; Wang, X.; Lu, J.; Jiang, W.; Li, J.; Tang, H.; Wang, F.; Li, X.; Fan, J.

    2018-04-01

    The Disaster Monitoring and Emergency Response Service(DIMERS) project was kicked off in 2017 in China, with the purpose to improve timely responsive service of the institutions involved in the management of natural disasters and man-made emergency situations with the timely and high-quality products derived from Space-based, Air-based and the in-situ Earth observation. The project team brought together a group of top universities and research institutions in the field of Earth observations as well as the operational institute in typical disaster services at national level. The project will bridge the scientific research and the response services of massive catastrophe in order to improve the emergency response capability of China and provide scientific and technological support for the implementation of the national emergency response strategy. In response to the call for proposal of "Earth Observation and Navigation" of 2017 National Key R&D Program of China, Professor Wu Jianjun, the deputy chairman of Faculty of Geographical Science of Beijing Normal University, submitted the Disaster Monitoring and Emergency Response Service (DIMERS) project, jointly with the experts and scholars from Institute of Remote Sensing and Digital Earth, Chinese Academy of Sciences, Wuhan University, China Institute of Earthquake Forecasting of China Earthquake Administration and China Institute of Water Resources and Hydropower Science. After two round evaluations, the proposal was funded by Ministry of Science and Technology of China.

  15. Business Models in Emerging Online Services

    NASA Astrophysics Data System (ADS)

    Lyons, Kelly; Playford, Corrie; Messinger, Paul R.; Niu, Run H.; Stroulia, Eleni

    Due to advances in technology and the rapid growth of online services, a significant number of new and inventive web-based service models and delivery methods have been introduced. Although online resources and services are having an impact on more traditional service delivery mechanisms, it is not yet clear how these emerging mechanisms for online service delivery will result in profitable business models. In this paper, we consider emerging business models for online services and their implications for how services are delivered, used, and paid for.We demonstrate the changing roles of user / consumer and provider / seller. We also discuss the applicability of different business models for various domains.

  16. An Examination of Safety Management Systems and Aviation Technologies in the Helicopter Emergency Medical Services Industry

    NASA Astrophysics Data System (ADS)

    Buckner, Steven A.

    The Helicopter Emergency Medical Service (HEMS) industry has a significant role in the transportation of injured patients, but has experienced more accidents than all other segments of the aviation industry combined. With the objective of addressing this discrepancy, this study assesses the effect of safety management systems implementation and aviation technologies utilization on the reduction of HEMS accident rates. Participating were 147 pilots from Federal Aviation Regulations Part 135 HEMS operators, who completed a survey questionnaire based on the Safety Culture and Safety Management System Survey (SCSMSS). The study assessed the predictor value of SMS implementation and aviation technologies to the frequency of HEMS accident rates with correlation and multiple linear regression. The correlation analysis identified three significant positive relationships. HEMS years of experience had a high significant positive relationship with accident rate (r=.90; p<.05); SMS had a moderate significant positive relationship to Night Vision Goggles (NVG) (r=.38; p<.05); and SMS had a slight significant positive relationship with Terrain Avoidance Warning System (TAWS) (r=.234; p<.05). Multiple regression analysis suggested that when combined with NVG, TAWS, and SMS, HEMS years of experience explained 81.4% of the variance in accident rate scores (p<.05), and HEMS years of experience was found to be a significant predictor of accident rates (p<.05). Additional quantitative regression analysis was recommended to replicate the results of this study and to consider the influence of these variables for continued reduction of HEMS accidents, and to induce execution of SMS and aviation technologies from a systems engineering application. Recommendations for practice included the adoption of existing regulatory guidance for a SMS program. A qualitative analysis was also recommended for future study SMS implementation and HEMS accident rate from the pilot's perspective. A

  17. Under-reporting of accidents involving biological material by nursing professionals at a Brazilian emergency hospital.

    PubMed

    Facchin, Luiza Tayar; Gir, Elucir; Pazin-Filho, Antonio; Hayashida, Miyeko; da Silva Canini, Silvia Rita Marin

    2013-01-01

    Pathogens can be transmitted to health professionals after contact with biological material. The exact number of infections deriving from these events is still unknown, due to the lack of systematic surveillance data and under-reporting. A cross-sectional study was carried out, involving 451 nursing professionals from a Brazilian tertiary emergency hospital between April and July 2009. Through an active search, cases of under-reporting of occupational accidents with biological material by the nursing team were identified by means of individual interviews. The Institutional Review Board approved the research project. Over half of the professionals (237) had been victims of one or more accidents (425 in total) involving biological material, and 23.76% of the accidents had not been officially reported using an occupational accident report. Among the underreported accidents, 53.47% were percutaneous and 67.33% were bloodborne. The main reason for nonreporting was that the accident had been considered low risk. The under-reporting rate (23.76%) was low in comparison with other studies, but most cases of exposure were high risk.

  18. Pattern and outcome of cases seen at the Adult Accident and Emergency Department of the Lagos University Teaching Hospital, Idi-Araba, Lagos.

    PubMed

    Uzoechina, N S; Abiola, A O; Akodu, B A; Mbakwem, A; Arogundade, A R; Tijani, H; Adegbesan-Omilabu, M A

    2012-01-01

    The accident and emergency department constitutes one of the vital entry points of patients into the healthcare facility of the hospital the world over. It responds to and manages variety of cases in all the clinical areas and thus pr vides an insight to the quality of care available in the health institution. The aim of this study is to determine the pattern of cases seen as well as the causes of deaths at the adult accident and emergency department of the Lagos UniversityTeaching Hospital, Idi-Araba, Lagos. Retrospective review of records of all patients attended to at the adult accident and emergency department of the Lagos University Teaching Hospital in 2009 and 2010 was carried out. Data spread sheet was used to collect data on demographic indices, diagnosis, outcome, date admitted, date discharged and amount paid from casualty attendance register and Nurses' report books. Data was collated and analysed using Epi-Info version 3.4.1 statistical software package. Out of the 5,427 available patients' records reviewed, 4,761(87.7%) were recorded as "discharged alive", 546 (10.1%) were recorded as "died", while 120 (2.2%) were recorded as "brought in dead". Of those discharged alive, male attendance was 2,376 (49.10%) while that of the female was 2,385 (50.10%). Majority of these patients were aged 20-39 years and the mean age of the patients was 39.96 +/- 18.22 yrs. Majority of cases seen were medical in origin (53.7%) and highest medical case seen was cerebrovascular accident, Commonest cause of death was from medical cases [69.2%] (cerebrovascular accident 22.0%). Male mortality was 55.3% while female mortality was 44.7%, mean age was 46.86 +/- 17.61. Most affected age group was 40 - 59 years (35.4%) and highest number of death was seen in December. The commonest case seen as well as commonest cause of death was cerebrovascular accident. A high number of heart failure, head injuries, road traffic accidents, upper gastrointestinal bleeding and post partum

  19. Accidents in the school environment: perspectives of staff concerned with data collection and reporting procedures.

    PubMed

    Williams, W R; Latif, A H; Cater, L

    2003-05-01

    School-accident reports document incidents that have resulted in children requiring assistance from staff in the education and healthcare sectors. This study was undertaken to investigate the collection and use of data by agencies concerned with the school-accident problem. Our aim was to determine if the annual collection and use of such a large body of data might be improved through better management procedures. Interviews were conducted with primary and secondary school staff in one education authority. Interviewees completed a questionnaire on accident activity and accident reporting in their school. In the healthcare sector, staff from the Schools' Office and the ambulance unit servicing the schools provided information on their collection and use of data. Our survey found that accident activity is usually a private matter for individual schools, shared to varying degrees with the education authority. Playgrounds, children's behaviour and footwear carried much of the blame for the injuries sustained. Staff generally accepted the current accident rates. The compilation of accident data by the Schools' Office, accident and emergency department, and ambulance service were compromised by deficiencies in computerization and computer software. The management and utilization of school-accident data could be improved by better collaboration within and between the education and healthcare agencies.

  20. Servant Leadership Theory and the Emergency Services Student

    ERIC Educational Resources Information Center

    Russell, Eric James

    2014-01-01

    This present case study explores the influence a servant leadership class had on a group of emergency service students' understanding of the roles and characteristics of a leader. The setting for the study was a state university in the Western United States. The six participants were undergraduate emergency services majors that underwent a 15-week…

  1. Nursing service innovation: A case study examining emergency nurse practitioner service sustainability.

    PubMed

    Fox, Amanda; Gardner, Glenn; Osborne, Sonya

    2018-02-01

    This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, ). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. © 2017 John Wiley & Sons Ltd.

  2. The role of the emergency physician in emergency medical services for children.

    PubMed

    Gausche-Hill, Marianne; Johnson, Ramon W; Warden, Craig R; Brennan, John A

    2003-08-01

    Emergency physicians have a duty to advance the care of pediatric patients in the emergency medical services (EMS) system. This policy resource and education paper, designed to support the American College of Emergency Physicians policy paper "The Role of the Emergency Physician in Emergency Medical Services for Children," describes the development of the federal EMS for Children Program, the importance of the integration of EMS for children into EMS systems, and the role of the emergency physician in EMS for children.

  3. The crisis in United States hospital emergency services.

    PubMed

    Harrison, Jeffrey P; Ferguson, Emily D

    2011-01-01

    Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.

  4. A Career in Professional Services: Accident, Serendipity or Something More?

    ERIC Educational Resources Information Center

    Regan, Julie-Anne; Graham, Carroll

    2018-01-01

    As part of a larger study, professional staff from two universities, Australian and British, were asked how they entered into a higher education career and what factors kept them in that career. Many participants reported that they found themselves in professional services almost by accident, or by a fortunate combination of circumstances.…

  5. Typical pedestrian accident scenarios for the development of autonomous emergency braking test protocols.

    PubMed

    Lenard, James; Badea-Romero, Alexandro; Danton, Russell

    2014-12-01

    An increasing proportion of new vehicles are being fitted with autonomous emergency braking systems. It is difficult for consumers to judge the effectiveness of these safety systems for individual models unless their performance is evaluated through track testing under controlled conditions. This paper aimed to contribute to the development of relevant test conditions by describing typical circumstances of pedestrian accidents. Cluster analysis was applied to two large British databases and both highlighted an urban scenario in daylight and fine weather where a small pedestrian walks across the road, especially from the near kerb, in clear view of a driver who is travelling straight ahead. For each dataset a main test configuration was defined to represent the conditions of the most common accident scenario along with test variations to reflect the characteristics of less common accident scenarios. Some of the variations pertaining to less common accident circumstances or to a minority of casualties in these scenarios were proposed as optional or supplementary test elements for an outstanding performance rating. Many considerations are incorporated into the final design and implementation of an actual testing regime, such as cost and the state of development of technology; only the representation of accident data lay within the scope of this paper. It would be desirable to ascertain the wider representativeness of the results by analysing accident data from other countries in a similar manner. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  7. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  8. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  9. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  10. 36 CFR 3.5 - Do I have to report an accident involving a vessel to the National Park Service?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... accident involving a vessel to the National Park Service? 3.5 Section 3.5 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.5 Do I have to report an accident involving a vessel to the National Park Service? (a) The operator of a vessel...

  11. Road Accident Prevention with Instant Emergency Warning Message Dissemination in Vehicular Ad-Hoc Network.

    PubMed

    Gokulakrishnan, P; Ganeshkumar, P

    2015-01-01

    A Road Accident Prevention (RAP) scheme based on Vehicular Backbone Network (VBN) structure is proposed in this paper for Vehicular Ad-hoc Network (VANET). The RAP scheme attempts to prevent vehicles from highway road traffic accidents and thereby reduces death and injury rates. Once the possibility of an emergency situation (i.e. an accident) is predicted in advance, instantly RAP initiates a highway road traffic accident prevention scheme. The RAP scheme constitutes the following activities: (i) the Road Side Unit (RSU) constructs a Prediction Report (PR) based on the status of the vehicles and traffic in the highway roads, (ii) the RSU generates an Emergency Warning Message (EWM) based on an abnormal PR, (iii) the RSU forms a VBN structure and (iv) the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF) and travels in High Risk Zone (HRZ). These vehicles might reside either within the RSU's coverage area or outside RSU's coverage area (reached using VBN structure). The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs) by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads.

  12. Road Accident Prevention with Instant Emergency Warning Message Dissemination in Vehicular Ad-Hoc Network

    PubMed Central

    P, Gokulakrishnan; P, Ganeshkumar

    2015-01-01

    A Road Accident Prevention (RAP) scheme based on Vehicular Backbone Network (VBN) structure is proposed in this paper for Vehicular Ad-hoc Network (VANET). The RAP scheme attempts to prevent vehicles from highway road traffic accidents and thereby reduces death and injury rates. Once the possibility of an emergency situation (i.e. an accident) is predicted in advance, instantly RAP initiates a highway road traffic accident prevention scheme. The RAP scheme constitutes the following activities: (i) the Road Side Unit (RSU) constructs a Prediction Report (PR) based on the status of the vehicles and traffic in the highway roads, (ii) the RSU generates an Emergency Warning Message (EWM) based on an abnormal PR, (iii) the RSU forms a VBN structure and (iv) the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF) and travels in High Risk Zone (HRZ). These vehicles might reside either within the RSU’s coverage area or outside RSU’s coverage area (reached using VBN structure). The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs) by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads. PMID:26636576

  13. New thinking needed for emergency services.

    PubMed

    Wankhade, Paresh

    2017-07-13

    Recent events in London and Manchester have highlighted the difficult and challenging role played by the emergency services. Their swift and professional response has drawn universal praise, but also raised concerns about reduced funding levels and job cuts against a heightened security threat. Transformational reforms are needed to improve our emergency services in a time of austerity.

  14. Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

    PubMed

    Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis

    2016-03-02

    In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.

  15. Analysis of occupational accidents with biological material among professionals in pre-hospital services.

    PubMed

    de Oliveira, Adriana Cristina; Paiva, Maria Henriqueta Rocha Siqueira

    2013-02-01

    To estimate the prevalence of accidents due to biological material exposure, the characteristics and post-accident conduct among professionals of pre-hospital services of the four municipalities of Minas Gerais, Brazil. A cross-sectional study, using a structured questionnaire that was developed to enable the calculation of prevalence, descriptive analysis and analytical analysis using logistic regression. The study included 228 professionals; the prevalence of accidents due to biological material exposure was 29.4%, with 49.2% percutaneous, 10.4% mucousal, 6.0% non-intact skin, and 34.4% intact skin. Among the professionals injured, those that stood out were nursing technicians (41.9%) and drivers (28.3%). Notification of the occurrence of the accident occurred in 29.8% of the cases. Percutaneous exposure was associated with time of work in the organization (OR=2.51, 95% CI: 1.18 to 5.35, p<0.017). Notification about accidents with biological material should be encouraged, along with professional evaluation/monitoring.

  16. Impact of triage in accident and emergency departments in Bahrain.

    PubMed

    Fateha, B E; Hamza, A Y

    2001-01-01

    We aimed to assess the impact of triage by physicians on the workload and expenditure of the Accident and Emergency (AE) Department of Salmaniya Medical Complex, Bahrain. We analysed three sets of data: patient visits to the AE Department over a 9-month period; patient visits 1 year previously; and forecast patient visits over 9 months starting from July 1999. The referral of patients to AE cubicles was reduced by 54.4% after the implementation of the triage, and reduction in the workload was statistically significant. The reduction in health care expenditure was estimated at between 15.3% and 17.3%. We conclude that triage by physicians can be cost-effective and can reduce the AE Department workload, freeing more time to manage life-threatening and urgent cases.

  17. A health visitor for older people in an accident and emergency department.

    PubMed

    Bridges, J; Meyer, J; McMahon, K; Bentley, J; Winter, J

    2000-02-01

    Published studies indicate that older people have special needs on discharge from accident and emergency (A&E) departments that are not always fully met. The literature reflects that although a significant proportion of older people have a decrease in functional independence and an increased need for services following discharge from A&E, social and functional assessment by A&E staff can be inadequate, as can the arrangement of follow-up community services. As part of a wider study into the organization of care for older people in A&E, a health visitor for older people was funded to work part-time in the A&E department of a large NHS Trust. The health visitor identified potential clients through reviewing the A&E documentation of patients aged 75 years or over discharged directly from A&E. Telephone calls or home visits were used to follow up those individuals deemed to be vulnerable by the health visitor. Interventions included health education, referral to other agencies and patient or family counselling. None of the clients followed up by the health visitor (n = 212) had been referred by A&E to a specialist in gerontology, which suggests that these clients would otherwise not have received the potential benefit of specialist intervention. The pilot study described here highlights a number of practical issues in relation to the health visitor post for older people in A&E, including the importance of dedicated office space and access to a telephone. Data collected during the study, plus the positive evaluation of the role by a small group of A&E staff confirm the claims made in other studies (e.g. Runciman et al, 1996) that health visitors for older people may be of value in meeting the post-discharge needs of these people.

  18. Cost-effectiveness analysis of telemedical devices for pre-clinical traffic accident emergency rescue in Germany.

    PubMed

    Auerbach, H; Schreyögg, J; Busse, R

    2006-01-01

    The purpose of this study is to assess the cost-effectiveness (net costs per life year gained) of telemedical devices for pre-clinical traffic accident emergency rescue in Germany. Two equipment versions of a telemedical device are compared from a societal perspective with the baseline in Germany, i.e. the non-application of telemedicine in emergency rescues. The analysis is based on retrospective statistical data covering a period of 10 years with discounted costs not adjusted for inflation. Due to the uncertainty of data, certain assumptions and estimates were necessary. The outcome is measured in terms of "life years gained" by reducing therapy-free intervals and improvements in first-aid provided by laypersons. The introduction of the basic equipment version, "Automatic Accident Alert", is associated with net costs per life year gained of euro 247,977 (at baseline assumptions). The full equipment version of the telemedical device would lead to estimated net costs of euro 239,524 per life year gained. Multi-way sensitivity-analysis with best and worst case scenarios suggests that decreasing system costs would disproportionately reduce total costs, and that rapid market penetration would largely increase the system's benefit, while simultaneously reducing costs. The net costs per life year gained in the application of the two versions of the telemedical device for pre-clinical emergency rescue of traffic accidents are estimated as quite high. However, the implementation of the device as part of a larger European co-ordinated initiative is more realistic.

  19. Motor Vehicle Accidents: The Family Practitioner's Role in Their Management

    PubMed Central

    Knight, Peter R.; Thomas, Edward J.

    1980-01-01

    The modern epidemic of motor vehicle accidents claims more lives, creates more morbidity and causes more property damage every successive year. Prevention is a responsibility of every family practitioner as he prescribes and counsels in his office. He has a limited role at an accident scene, but here he supports the patient and may assist personnel of ambulance, police or fire services. In the receiving hospital emergency room the priorities of emergency care, investigations and the indications for transfer of the patient to another facility are discussed. If the victim dies, the relatives' mourning is helped by organ donation and the initiative of the family practitioner in these circumstances may help many people. ImagesFig. 3 PMID:21293698

  20. Sports medicine and the accident and emergency medicine specialist.

    PubMed

    Abernethy, L; McNally, O; MacAuley, D; O'Neill, S

    2002-05-01

    Sport and exercise related injuries are responsible for about 5% of the workload in the accident and emergency (A&E) department, yet training in sports medicine is not a compulsory part of the curriculum for Higher Specialist Training. To determine how A&E medicine consultants and specialist trainees view their role and skill requirements in relation to sports medicine. A modified Delphi study, consisting of two rounds of a postal questionnaire. Participants were invited to rate the importance of statements relating to the role and training of the A&E specialist in relation to sports injuries (six statements) and the need for knowledge and understanding of defined skills of importance in sports medicine (16 statements). VALUE OF RESEARCH: This provides a consensus of opinion on issues in sport and exercise medicine that have educational implications for A&E specialists, and should be considered in the curriculum for Higher Specialist Training. There is also the potential for improving the health care provision of A&E departments, to the exercising and sporting population.

  1. ASME proposals for reform of SHO training: threat or opportunity for the specialty of accident and emergency?

    PubMed Central

    Reid, C

    2002-01-01

    A report is made on proposals for change in postgraduate medical training that may have profound implications for the specialty of accident and emergency (A&E). The proposals are detailed with their background and rationale, together with some of their possible effects on A&E. PMID:11971835

  2. An emergency dental service for students: 4-year findings.

    PubMed

    Sinclair, J; Wilson, N H

    1997-06-01

    To describe the arrangements for the provision of emergency dental services for students at the University of Manchester and to report data collected during the first four and a half years of the student emergency dental services (SEDS) unit based at the University Dental Hospital of Manchester. Data pertaining to every student attending SEDS since its inception were collected by means of questionnaire including provision to record diagnoses, treatment needs and the emergency care provided. The incidence of dental emergencies within the student population served by SEDS has been found to be 39 emergencies per 1000 students per annum, with the service being most heavily used by overseas students. Caries, pulpal pathology and failed restorations account for 46 per cent of the presenting emergencies, with pericoronitis (19 per cent) and other emergencies of periodontal origin (14 per cent) being common place. It is concluded that a student emergency dental service may be found to be an important element of student medical and related welfare services.

  3. [Health care for aged victims of accidents and violence: analysis of SUS health services in Recife (PE, Brazil)].

    PubMed

    de Lima, Maria Luiza Carvalho; de Souza, Edinilsa Ramos; de Lima, Maria Luiza Lopes Timóteo; Barreira, Alice Kelly; Bezerra, Eduardo Duque; Acioli, Raquel Moura Lins

    2010-09-01

    A situational diagnosis of the health services regarding the care of aged victims of accidents and violence (AVAV) was carried out in Recife, Pernambuco, Brazil. The National Policy for Reducing Accident and Violence Related Morbidity and Mortality and the National Policy for the Aged People Health were used as references. The methodology was based on the triangulation method, with both quantitative and qualitative approaches. Questionnaires and interviews were answered by managers and health staff of hospital, prehospital and rehabilitation services; and local aged health policy managers. In 2006, only the Family Health Program reported prehospital care for AVAV, 31 cases were due to violence and 18 to accidents. The hospital care for aged people was 7.2% of the total care, 27% from accidents and 10% from violence. In the same year, there was no record of rehabilitation care of AVAV. The directives of the policies studied are only partially followed. The health care is deficient in several aspects, such as: clinical protocols; notification devices; support to the aged, caregivers and aggressors; and also continuous training. This analysis can be such a contribution to the reorganization of the local health system, recognizing the aged person as vulnerable to accidents and violence.

  4. Chernobyl and Fukushima nuclear accidents: what has changed in the use of atmospheric dispersion modeling?

    PubMed

    Benamrane, Y; Wybo, J-L; Armand, P

    2013-12-01

    The threat of a major accidental or deliberate event that would lead to hazardous materials emission in the atmosphere is a great cause of concern to societies. This is due to the potential large scale of casualties and damages that could result from the release of explosive, flammable or toxic gases from industrial plants or transport accidents, radioactive material from nuclear power plants (NPPs), and chemical, biological, radiological or nuclear (CBRN) terrorist attacks. In order to respond efficiently to such events, emergency services and authorities resort to appropriate planning and organizational patterns. This paper focuses on the use of atmospheric dispersion modeling (ADM) as a support tool for emergency planning and response, to assess the propagation of the hazardous cloud and thereby, take adequate counter measures. This paper intends to illustrate the noticeable evolution in the operational use of ADM tools over 25 y and especially in emergency situations. This study is based on data available in scientific publications and exemplified using the two most severe nuclear accidents: Chernobyl (1986) and Fukushima (2011). It appears that during the Chernobyl accident, ADM were used few days after the beginning of the accident mainly in a diagnosis approach trying to reconstruct what happened, whereas 25 y later, ADM was also used during the first days and weeks of the Fukushima accident to anticipate the potentially threatened areas. We argue that the recent developments in ADM tools play an increasing role in emergencies and crises management, by supporting stakeholders in anticipating, monitoring and assessing post-event damages. However, despite technological evolutions, its prognostic and diagnostic use in emergency situations still arise many issues. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. [Fatal occupational accidents in Lombardy].

    PubMed

    Pianosi, G

    1995-01-01

    All fatal occupational accidents compensated in Lombardy from 1984 to 1989 were analyzed (1259 cases): significant differences between geographical distribution of fatal occupational accidents and workers were observed. Males accounted for about 95% of fatalities; an excess of cases was shown in both young and elderly workers. Death was the consequence of injuries involving most frequently the head, thorax and spinal cord. An excess of fatalities was observed in agriculture and, at a lower level, in manufacturing industries; small enterprises were involved in approximately 25% of fatalities occurring in the manufacturing industries and services. Employers were the victims of fatal accidents in 50% of cases in agriculture and in 70% of cases in craft industries. Construction, agriculture and transport accounted for about 50% of all fatalities. About 50% of fatal occupational accidents were related to vehicle use: the victim was the driver in the majority of cases, sometimes the victim was run over by a vehicle or fell from a vehicle. The results agree with some previous observations (e.g.: sex and age distribution; construction, agriculture and transport as working activities at high accident risk); but some original observations have emerged, in particular about the frequency of employers as victims and the role of vehicles in the genesis of fatal occupational accidents. If further studies confirm these latter observations, important developments could follow in preventive action design and implementation.

  6. Epidemiological profile of care for violence in public urgency and emergency services in Brazilian capital, Viva 2014.

    PubMed

    Souto, Rayone Moreira Costa Veloso; Barufaldi, Laura Augusta; Nico, Lucélia Silva; Freitas, Mariana Gonçalves de

    2017-09-01

    Injuries and deaths resulting from violence constitute a major public health problem in Brazil. The article aims to describe the profile of calls for violence in emergency departments and emergency Brazilian capitals. This is a descriptive study of Violence and Accident Surveillance System (VIVA), carried out in public emergencies Brazilian cities, from September to November 2014, a total of 4406 calls for aggression. We considered the following categories of analysis: 1) sociodemographic characteristics (gender, age, race / skin color, education, place of residence, vulnerability, alcohol intake); 2) Event feature (probable author, nature and means of aggression); and characteristics of care (getting to the hospital, prior service, evolution). Of the total calls for violence (n = 4406), the highest prevalence was among young people 20-39 years (50.2%), male, black and low education. As for the event characteristics it stands out that 87.8% were physical assaults; 46.3% cut/laceration and 13.7% involved a firearm. The results point to the need to strengthen intersectoral actions to expand the network of care and protection.

  7. Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention--a randomised controlled trial.

    PubMed

    Davison, John; Bond, John; Dawson, Pamela; Steen, I Nicholas; Kenny, Rose Anne

    2005-03-01

    To determine the effectiveness of multifactorial intervention to prevent falls in cognitively intact older persons with recurrent falls. Randomised controlled trial of multifactorial (medical, physiotherapy and occupational therapy) post-fall assessment and intervention compared with conventional care. Accident & Emergency departments in a university teaching hospital and associated district general hospital. 313 cognitively intact men and women aged over 65 years presenting to Accident & Emergency with a fall or fall-related injury and at least one additional fall in the preceding year; 159 randomised to assessment and intervention and 154 to conventional care. primary outcome was the number of falls and fallers in 1 year after recruitment. Secondary outcomes included injury rates, fall-related hospital admissions, mortality and fear of falling. There were 36% fewer falls in the intervention group (relative risk 0.64, 95% confidence interval 0.46-0.90). The proportion of subjects continuing to fall (65% (94/144) compared with 68% (102/149) relative risk 0.95, 95% confidence interval 0.81-1.12), and the number of fall-related attendances and hospital admissions was not different between groups. Duration of hospital admission was reduced (mean difference admission duration 3.6 days, 95% confidence interval 0.1-7.6) and falls efficacy was better in the intervention group (mean difference in Activities Specific Balance Confidence Score of 7.5, 95% confidence interval 0.72-14.2). Multifactorial intervention is effective at reducing the fall burden in cognitively intact older persons with recurrent falls attending Accident & Emergency, but does not reduce the proportion of subjects still falling.

  8. Nationwide Survey of Local Emergency Planning Committees

    EPA Pesticide Factsheets

    These 2008 and 1999 surveys track the progress of LEPCs by assessing their current activity; and probe current practices and preferences regarding issues such as communication, accident prevention, and Office of Emergency Management products and services.

  9. 75 FR 27917 - Emergency Medical Services Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... Part III The President Proclamation 8519--Emergency Medical Services Week, 2010 Executive Order... Medical Services Week, 2010 By the President of the United States of America A Proclamation Every day of... enhancing our country's preparedness and resilience. During Emergency Medical Services Week, we recommit to...

  10. Consent to treatment by minors attending accident and emergency departments: guidelines.

    PubMed Central

    Williams, L; Harris, A; Thompson, M; Brayshaw, A

    1997-01-01

    The absolute right to refuse medical treatment, even if the reasons are irrational, is confined to competent adults. Children under 16 years can give legal consent to treatment in the absence of consent from those with parental responsibility. Children under 18 years do not, however, have an absolute right to consent, or refuse to consent, to treatment. The views of children assume increasing importance with age and maturity. Accident and emergency medical and nursing staff may face difficult decisions when children, or those with parental responsibility, refuse to consent to medical treatment. This paper presents guidelines designed to guide the decision making process in immediately or potentially life threatening conditions and in non-life-threatening conditions. Images Figure 1 Figure 2 p289-a PMID:9315927

  11. Emergency medical services outcomes evaluation

    DOT National Transportation Integrated Search

    2003-07-01

    The provision of prehospital (Emergency Medical Services (EMS)) care has come under increased scrutiny in recent years. Many have questioned the value of the range of EMS services currently provided. There is a persistent concern about the lack of pr...

  12. [Elderly, poor, solitary and marginal patients: geriatric vulnerability in emergency services].

    PubMed

    Marín Gámez, N; Kessel Sardiñas, H; López Martínez, G; Barnosi Marín, A; Montoya Vergel, J; Navarro Corral, A; Delgado Rodríguez, M

    1998-07-01

    Status is a powerful determinant of health, and it may influence on the demand of Hospital emergency services. The aim of our investigation is to assess whether elderly patients usually wandering emergency services gather more negative socioeconomic conditions. A cross-sectional study on 800 randomised patients cared in emergency services was carried out. A questionnaire about economic, educational and professional levels, domestic violence, loneliness and life style was applied. A crude analysis was used to assess the age-factor (>/= 65 y.o.) by BMDP (PC 90). The trial was approved by the local Bioethics board. Low incomes, low educational level and loneliness were clinic and statistically related with age (65 and more). Data is offered as n (%), X2 and p < 0.0001 (Fisher exact Test two sided p value). Elderly patients frequently demanding hospital emergency services gather more vulnerability conditions, not merely medical. Low incomes, low educational level and loneliness are probably working as key factors on the geriatric demand of emergency services.

  13. [Research on accidents in a tire-producing plant].

    PubMed

    Mete, R; Sabatucci, A

    1989-09-30

    In the autumn of 1987 the U.S.L. health service (prevention, hygiene and occupational safety section) began a study about the accidents in a firm manufacturing tyres, placed in its own area. The retrospective enquiry starts from the analysis of typology, diffusion and seriousness of occupational accidents. The firm's accident register has been analyzed and integrated with other necessary information provided by the firm, by I.N.A.I.L. and by the air force metereological service. The study has been carried out on data concerning the following years: 1984-1985-1986. The accidents considered, implied absence from work and were divided as follows: for absence up till 3 days (in franchise), and more than 3 days (indemnified), applying the average value calculated on one year of the three analyzed. Every accident has been analyzed per year, month, day, hour of event. According to the classes: circumstances, kind of lesion, site of lesion, period of absence from work. The indices of: frequency, seriousness, incidence, mean duration have been calculated. The average monthly values of temperature: max and min. of the area and to the average monthly amount of processed elastomer (rate of production). The statistics we obtained, justified the study and showed the operative solution. The aspect of sanitary education and the general psychological aspect regarding the accident have been considered. Moreover the general operative solutions for the firm and specific ones for every department and for every position have been shown and faced up to. In this way, according to the risks that have emerged from the enquiries on previous accidents and thanks to direct inspection. it was possible to prevent accidents.

  14. Reliability of ophthalmic accident and emergency referrals: a new role for the emergency nurse practitioner?

    PubMed Central

    Ezra, D; Mellington, F; Cugnoni, H; Westcott, M

    2005-01-01

    Background and objectives: Annual attendances at the accident and emergency (A&E) department of St Bartholomew's and The Royal London NHS Trust exceed 100 000 people of which 6% are ophthalmic. This study evaluated the accuracy of eye referrals from A&E senior house officers (SHOs) and emergency nurse practitioners (ENPs) and the impact any inaccuracies may have had on out of hours work. Methods: Over a four week period a record of all referrals from the A&E department was made. The doctor receiving the referral made a note of clinical variables as reported by the referring clinician. When the patient was subsequently reviewed by an ophthalmologist, a record was again made of these findings. Any discrepancies were recorded. Results: A total of 67 patients were recruited. ENPs were found to be consistently more accurate than SHOs in every aspect of the assessment, most notably in visual acuity (p = 0.0029), and provisional diagnosis (p = 0.012). Furthermore, had the examination findings been accurate, 58% of all SHO referrals seen after hours would have been triaged to the next available clinic but only 10% of ENP referrals could have been seen at the next clinic session (p = 0.027). Conclusion: This study found ENPs to be more accurate than A&E SHOs in history taking, recording visual acuity, describing ocular anatomy, and making provisional diagnoses. A significant reduction in out of hours ophthalmic workload may be achieved in the authors' unit if ENPs were to see all eye emergencies. PMID:16189030

  15. Emergency medical service (EMS): A unique flight environment

    NASA Technical Reports Server (NTRS)

    Shively, R. Jay

    1993-01-01

    The EMS flight environment is unique in today's aviation. The pilots must respond quickly to emergency events and often fly to landing zones where they have never been before . The time from initially receiving a call to being airborne can be as little as two to three minutes. Often the EMS pilot is the only aviation professional on site, they have no operations people or other pilots to aid them in making decisons. Further, since they are often flying to accident scenes, not airports, there is often complete weather and condition information. Therefore, the initial decision that the pilot must make, accepting or declining a flight, can become very difficult. The accident rate of EMS helicopters has been relatively high over the past years. NASA-Ames research center has taken several steps in an attempt to aid EMS pilots in their decision making and situational awareness. A preflight risk assessment system (SAFE) was developed to aid pilots in their decision making, and was tested at an EMS service. The resutls of the study were promising and a second version incorporating the lessons learned is under development. A second line of research was the development of a low cost electronic chart display (ECD). This is a digital map display to help pilots maintain geographical orientation. Another thrust was undertaken in conjunction with the Aviation Safety Reporting System (ASRS). This involved publicizing the ASRS to EMS pilots and personnel, and calling each of the reporters back to gather additional information. This paper will discuss these efforts and how they may positively impact the safety of EMS operations.

  16. The Consumer Quality Index in an accident and emergency department: internal consistency, validity and discriminative capacity.

    PubMed

    Bos, Nanne; Sturms, Leontien M; Stellato, Rebecca K; Schrijvers, Augustinus J P; van Stel, Henk F

    2015-10-01

    Patients' experiences are an indicator of health-care performance in the accident and emergency department (A&E). The Consumer Quality Index for the Accident and Emergency department (CQI A&E), a questionnaire to assess the quality of care as experienced by patients, was investigated. The internal consistency, construct validity and discriminative capacity of the questionnaire were examined. In the Netherlands, twenty-one A&Es participated in a cross-sectional survey, covering 4883 patients. The questionnaire consisted of 78 questions. Principal components analysis determined underlying domains. Internal consistency was determined by Cronbach's alpha coefficients, construct validity by Pearson's correlation coefficients and the discriminative capacity by intraclass correlation coefficients and reliability of A&E-level mean scores (G-coefficient). Seven quality domains emerged from the principal components analysis: information before treatment, timeliness, attitude of health-care professionals, professionalism of received care, information during treatment, environment and facilities, and discharge management. Domains were internally consistent (range: 0.67-0.84). Five domains and the 'global quality rating' had the capacity to discriminate among A&Es (significant intraclass correlation coefficient). Four domains and the 'global quality rating' were close to or above the threshold for reliably demonstrating differences among A&Es. The patients' experiences score on the domain timeliness showed the largest range between the worst- and best-performing A&E. The CQI A&E is a validated survey to measure health-care performance in the A&E from patients' perspective. Five domains regarding quality of care aspects and the 'global quality rating' had the capacity to discriminate among A&Es. © 2013 John Wiley & Sons Ltd.

  17. A new approach to road accident rescue.

    PubMed

    Morales, Alejandro; González-Aguilera, Diego; López, Alfonso I; Gutiérrez, Miguel A

    2016-01-01

    This article develops and validates a new methodology and tool for rescue assistance in traffic accidents, with the aim of improving its efficiency and safety in the evacuation of people, reducing the number of victims in road accidents. Different tests supported by professionals and experts have been designed under different circumstances and with different categories of damaged vehicles coming from real accidents and simulated trapped victims in order to calibrate and refine the proposed methodology and tool. To validate this new approach, a tool called App_Rescue has been developed. This tool is based on the use of a computer system that allows an efficient access to the technical information of the vehicle and sanitary information of the common passengers. The time spent during rescue using the standard protocol and the proposed method was compared. This rescue assistance system allows us to make vital information accessible in posttrauma care services, improving the effectiveness of interventions by the emergency services, reducing the rescue time and therefore minimizing the consequences involved and the number of victims. This could often mean saving lives. In the different simulated rescue operations, the rescue time has been reduced an average of 14%.

  18. Consultant-based otolaryngology emergency service: a five-year experience.

    PubMed

    Barnes, M L; Hussain, S S M

    2011-12-01

    To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

  19. A Profile of Indian Health Service Emergency Departments.

    PubMed

    Bernard, Kenneth; Hasegawa, Kohei; Sullivan, Ashley; Camargo, Carlos

    2017-06-01

    The Indian Health Service provides health care to eligible American Indians and Alaskan Natives. No published data exist on emergency services offered by this unique health care system. We seek to determine the characteristics and capabilities of Indian Health Service emergency departments (EDs). All Indian Health Service EDs were surveyed about demographics and operational characteristics for 2014 with the National Emergency Department Inventory survey (available at http://www.emnet-nedi.org/). Of the forty eligible sites, there were 34 respondents (85% response rate). Respondents reported a total of 637,523 ED encounters, ranging from 521 to 63,200 visits per site. Overall, 85% (95% confidence interval 70% to 94%) had continuous physician coverage. Of all physicians staffing the ED, a median of 13% (interquartile range 0% to 50%) were board certified or board prepared in emergency medicine. Overall, 50% (95% confidence interval 34% to 66%) of respondents reported that their ED was operating over capacity. Indian Health Service EDs varied widely in visit volume, with many operating over capacity. Most were not staffed by board-certified or -prepared emergency physicians. Most lacked access to specialty consultation and telemedicine capabilities. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  20. On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues.

    PubMed

    Wang, Wei; Huang, Li; Liang, Xuedong

    2018-01-06

    This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks' statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies.

  1. On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues

    PubMed Central

    Wang, Wei; Huang, Li; Liang, Xuedong

    2018-01-01

    This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks’ statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies. PMID:29316614

  2. Epidemiological profile of work-related accidents with biological exposure among medical students in a surgical emergency room.

    PubMed

    Reis, Phillipe Geraldo Teixeira de Abreu; Driessen, Anna Luiza; da Costa, Ana Claudia Brenner Affonso; Nasr, Adonis; Collaço, Iwan Augusto; Tomasich, Flávio Daniel Saavedra

    2013-01-01

    To evaluate the accidents with biological material among medical students interning in a trauma emergency room and identify key related situations, attributed causes and prevention. we conducted a study with a quantitative approach. Data were collected through a questionnaire applied via internet, with closed, multiple-choice questions regarding accidents with biological material. The sample comprised 100 students. thirty-two had accidents with biological material. Higher-risk activities were local anesthesia (39.47%), suture (18.42%) and needle recapping (15.79%). The main routes of exposure to biological material were the eyes or mucosa, with 34%, and syringe needle puncture, with 45%. After contamination, only 52% reported the accident to the responsible department. The main causes of accidents and routes of exposure found may be attributed to several factors, such as lack of training and failure to use personal protective equipment. Educational and preventive actions are extremely important to reduce the incidence of accidents with biological materials and improve the conduct of post-exposure. It is important to understand the main causes attributed and situations related, so as general and effective measures can be applied.

  3. Farm accidents in children.

    PubMed Central

    Cameron, D.; Bishop, C.; Sibert, J. R.

    1992-01-01

    OBJECTIVE--To examine the problem of accidental injury to children on farms. DESIGN--Prospective county based study of children presenting to accident and emergency departments over 12 months with injuries sustained in a farm setting and nationwide review of fatal childhood farm accidents over the four years April 1986 to March 1990. SETTING--Accident and emergency departments in Aberystwyth, Carmarthen, Haverfordwest, and Llanelli and fatal accidents in England, Scotland, and Wales notified to the Health and Safety Executive register. SUBJECTS--Children aged under 16. MAIN OUTCOME MEASURE--Death or injury after farm related accidents. RESULTS--65 accidents were recorded, including 18 fractures. Nine accidents necessitated admission to hospital for a mean of two (range one to four) days. 13 incidents were related to tractors and other machinery; 24 were due to falls. None of these incidents were reported under the statutory notification scheme. 33 deaths were notified, eight related to tractors and allied machinery and 10 related to falling objects. CONCLUSIONS--Although safety is improving, the farm remains a dangerous environment for children. Enforcement of existing safety legislation with significant penalties and targeting of safety education will help reduce accident rates further. PMID:1638192

  4. Investigating the effect of Alcohol Brief Interventions within accident and emergency departments using a data informatics methodology.

    PubMed

    Baldacchino, Alex; O'Rourke, Louise; Humphris, Gerry

    2018-07-01

    Alcohol Brief Interventions (ABI) have been implemented throughout Scotland since 2008 and aim to reduce hazardous drinking through a Scottish Government funded initiative delivered in a range of settings, including Accident and Emergency (A and E) departments. To study the extent to which Alcohol Brief Interventions (ABI) are associated with later health service use. An opportunistic informatics approach was applied. A unique patient identifier was used to link patient data with core datasets spanning two years previous and two years post ABI. Variables included inpatient attendance, outpatient attendance, psychiatric admissions, and A and E attendance and prescribing. Patients (N = 1704) who presented at A and E departments who reported an average alcohol consumption of more than 8 units daily received the ABI. Fast Alcohol Screening Test (FAST) was used to assess patients for hazardous alcohol consumption. Multilevel linear modelling was employed to predict post-intervention utilisation using pre-ABI variables and controlling for person characteristics and venue. Significant decrease in A and E usage was found at one and two years following the ABI intervention. Previous health service use was predictive of later service use. A single question (Item 4) on the FAST was predictive of A and E attendance at one and two years. This investigation and methodology used provide support for the delivery of the ABI. However, it cannot be ascertained whether this is due to the ABI or simply is a result of making contact with a specialist in the addiction field. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. [When and where motorcyclists have accidents and die in Belo Horizonte, Minas Gerais State, Brazil].

    PubMed

    Diniz, Eugênio Paceli Hatem; Pinheiro, Letícia Cavalari; Proietti, Fernando Augusto

    2015-12-01

    The objective of this study was to analyze traffic accidents involving motorcycles in Belo Horizonte, Minas Gerais State, Brazil, from 2007 to 2011 and to identify clusters of high-risk and hazardous intersections in and around the city. Data were provided by the Military Police Brigade and the Emergency Medical Service (SAMU). Accident severity rates were used to identify critical intersections. Two techniques were used: kernel analysis and scan statistics (continuous Poisson model). High-risk clusters were located in the downtown area and on major thoroughfares. Surprisingly, the highest risk of accidents and death occurred not at intersections, but between them. Hazardous intersections are part of routes used to access regions around Greater Metropolitan Belo Horizonte. Two distinct trends in mortality rates and accidents were identified. Most motorcycle deaths occurred after 7:00 PM. The study concludes that there is an urgent need to improve motorcycle and public transportation routes.

  6. Psychosocial service needs of pediatric transport accident survivors: Using clinical data-mining to establish demographic and service usage characteristics.

    PubMed

    Manguy, Alys-Marie; Joubert, Lynette; Bansemer, Leah

    2016-09-01

    The objectives in this article are the exploration of demographic and service usage data gained through clinical data mining audit and suggesting recommendations for social work service delivery model and future research. The method is clinical data-mining audit of 100 sequentially sampled cases gathering quantitative demographic and service usage data. Descriptive analysis of file audit data raised interesting trends with potential to inform service delivery and usage; the key areas of the results included patient demographics, family involvement and impact, and child safety and risk issues. Transport accidents involving children often include other family members. Care planning must take into account psychosocial issues including patient and family emotional responses, availability of primary carers, and other practical needs that may impact on recovery and discharge planning. This study provides evidence to plan for further research and development of more integrated models of care.

  7. Emergency Health Services Informational and Educational Programs

    PubMed Central

    Pace, F. C.

    1967-01-01

    The development and present status of the Emergency Health Services (EHS) national and educational programs are discussed. Instituted in 1951 for medical and dental practitioners at a military school at Camp Borden, professional civilian indoctrination was later assumed by EHS at Canadian Emergency Measures College (CEMC). The federally sponsored courses there are now specialized; provincial EHS authorities undertake general indoctrination. Courses for graduates in pharmacy and nursing are also offered at CEMC. Hospital Disaster Institutes have been held across the country since 1954; Public Health Disaster Institutes, since 1966. Schools of Hygiene include the subject in graduate programs. Some years ago, three medical faculties introduced undergraduate teaching in mass casualty care; now, encouraged by the Association of Canadian Medical Colleges, a larger number are doing so. Several faculties of Dentistry, all faculties of Pharmacy, and 132 of 177 nursing schools teach apposite aspects. Professional journals have published many articles on this subject; this, for example, is the fourth Emergency Health Services Symposium presented by The Canadian Medical Association Journal. PMID:6015744

  8. Identifying barriers to emergency care services.

    PubMed

    Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

    2012-01-01

    This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

  9. [Substance related disorder in emergency services: Which attitudes?

    PubMed

    Rica, M; Principe, A; Le Reste, J-Y; Guillou Landreat, M

    2017-02-01

    Substance related disorders are more prevalent in emergency services than in the general population, about 20% of individuals in emergency care test positive for alcohol. Emergency services are strategic places to identify alcohol misuse. Attitudes to individuals presenting substance related disorders are important in developing therapeutic relationships and applying interventions. This study explores the attitudes of an emergency staff to these individuals across a range of roles, and evolution in face of an addictology care improvement. Data were gathered from an emergency service sample from the emergency department of a general hospital in Morlaix (France). We used a short questionnaire, adapted from previous similar French studies. Twenty-five persons answered the first questionnaire and 18 the second. A self-administrated attitudes questionnaire showed its interest in our study and helped us to identify attitudes and to initiate a reflection on behaviours in emergency care. Moreover, it helped to change attitudes towards individuals presenting substance related disorders. The daily setting of an addictive disorders specialized unit in emergency changed the point of view on addictive disorders of both physicians and nurses. We showed differences in addictive related disorders prevalence perception among patients attending emergency care between the two evaluations. But we also showed that physicians and nurses stressed that it was more difficult to ask patients in emergency care on the second evaluation, after and despite a daily addictive disorders specialized setting. We showed several limits in emergency staff care relationship with patients with substance related disorders. They identified difficulties to talk about addictive disorders, especially in younger and older patients. Regarding literature, we discuss our study limits and different ways of improving addictology care in emergency services. Copyright © 2015 L'Encéphale, Paris. Published by

  10. 47 CFR 97.407 - Radio amateur civil emergency service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 97.407 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AMATEUR RADIO SERVICE Providing Emergency Communications § 97.407 Radio amateur civil emergency... available to stations transmitting communications in RACES on a shared basis with the amateur service. In...

  11. 42 CFR 405.440 - Emergency and urgent care services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Emergency and urgent care services. 405.440 Section 405.440 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.440...

  12. 47 CFR 25.284 - Emergency Call Center Service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... service to the extent that they offer real-time, two way switched voice service that is interconnected... provider to reuse frequencies and/or accomplish seamless hand-offs of subscriber calls. Emergency Call Center personnel must determine the emergency caller's phone number and location and then transfer or...

  13. 47 CFR 25.284 - Emergency Call Center Service.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... service to the extent that they offer real-time, two way switched voice service that is interconnected... provider to reuse frequencies and/or accomplish seamless hand-offs of subscriber calls. Emergency Call Center personnel must determine the emergency caller's phone number and location and then transfer or...

  14. 47 CFR 25.284 - Emergency Call Center Service.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... service to the extent that they offer real-time, two way switched voice service that is interconnected... provider to reuse frequencies and/or accomplish seamless hand-offs of subscriber calls. Emergency Call Center personnel must determine the emergency caller's phone number and location and then transfer or...

  15. 47 CFR 25.284 - Emergency Call Center Service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... service to the extent that they offer real-time, two way switched voice service that is interconnected... provider to reuse frequencies and/or accomplish seamless hand-offs of subscriber calls. Emergency Call Center personnel must determine the emergency caller's phone number and location and then transfer or...

  16. Determinants of injuries and Road Traffic Accidents amongst service personnel in a large Defence station.

    PubMed

    Neelakantan, Anand; Kotwal, Brig Atul; Ilankumaran, Mookkiah

    2017-07-01

    Injuries are assuming epidemic proportions globally; and in India. Also, previous decade witnessed carnage on Indian roads, with nearly 12 lakh people killed and 55 lakhs disabled in road crashes. The trend in Armed Forces is reflective of the aforesaid patterns. Behaviour and socio-demographic background of the victims are significant determinants of injuries and road accidents. Community-based epidemiological information on these aspects is envisaged to contribute in their preventive strategy. Towards this direction, the present study was conducted with aim to generate socio-behavioural profile of injuries and Road Traffic Accidents (RTAs) amongst service personnel in a large defence station; and to evaluate their determinants. A cross sectional descriptive study was carried out among 796 Naval personnel onboard warships in large Naval station. Data on socio-behavioural aspects and determinants of injuries and road accidents was collected using a pre-validated questionnaire; and by scrutiny of relevant records. Data was analysed using MSExcel, Epi-info and SPSS 17. Young and middle-aged persons were predominantly involved in injuries and road accidents. Two-wheeler users sustained maximum road accidents. Human factor was a significant determinant in RTAs and injuries. A majority of victims admitted that human factors were the predominant cause of road accidents; and opined that the events were preventable. Age-specific Behavioural Change Communication strategies aimed at refining user outlook are imperative; tailored to sociodemographic milieu of user/victim. Incorporation of a dynamic feedback/reporting mechanism, creation of 'armed forces-specific road safety and injury prevention policy' and safety audits on injuries and road crashes are measures in this direction.

  17. [A guide to successful public relations for hospitals and emergency medical services].

    PubMed

    Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V

    2014-04-01

    Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you

  18. Emergency Medical Service (EMS): Rotorcraft Technology Workshop

    NASA Technical Reports Server (NTRS)

    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.

  19. [Development of medical emergency response system for accidents due to chemicals in Chongqing municipality].

    PubMed

    Ning, Xu; Dong, Zhao-jun; Mu, Ling; Zhai, Jian-cai

    2006-12-01

    To plan and develop a Chongqing chemical accident rescue command system. Based on the modes of leakage and diffusion of various poisonous gases and chemicals, different modes of injuries produced, and their appropriate rescue and treatments, also taking the following factors such as the condition of storage of chemicals, meteorological and geographic conditions, medical institutions and equipment, and their rescuing capacity into consideration, a plan was drafted to establish the rescue system. Real-time simulation technology, data analysis, evaluation technology and database technology were employed in the planning. Using Visual Studio 6.0 as the software development platform, this project aimed to design the software of an emergency command system for chemical accidents in Chongqing which could be operated with the Windows 2000/XP operating system. This system provided a dynamic scope of the endangered area, casualty number estimates, and recommendation of measures and a rescue plan for various chemical accidents. Furthermore, the system helped retrieve comprehensive information regarding the physical and chemical characteristics of more than 4 200 dangerous poisonous chemicals and their appropriate treatment modalities. This system is easy to operate with a friendly interface, functions rapidly and can provide real-time analysis with comparatively precise results. This system could satisfy the requirements of executing the command and the rescue of a chemical accident with good prospects of application.

  20. Geographic Discordance Between Patient Residence and Incident Location in Emergency Medical Services Responses.

    PubMed

    Hsia, Renee Y; Dai, Mengtao; Wei, Ran; Sabbagh, Sarah; Mann, N Clay

    2017-01-01

    The location of a patient's residence is often used for emergency medical services (EMS) system planning. Our objective is to evaluate the association between patient residence and emergency incident zip codes for 911 calls. We used data from the 2013 National Emergency Medical Services Information System (NEMSIS) Public-Release Research Dataset. We studied all 911 calls with a valid complaint by dispatch, identifying zip codes for both the residence and incident locations (n=12,376,784). The primary outcomes were geographic and distance discordances between patient residence and incident zip codes. We used a multivariate logistic regression model to determine geographic discordance between residence and incident zip codes by dispatch complaint, age, and sex. We also measured distances between locations with geospatial processing. The overall proportion of geographic discordance for all 911 calls was 27.7% (95% confidence interval [CI] 27.7% to 27.8%) and the median distance discordance was 11.5 miles (95% CI 11.5 to 11.5 miles). Lower geographic discordance rates were found among patients aged 65 to 79 years (20.2%; 95% CI 20.1% to 20.2%) and 80 years and older (14.5%; 95% CI 14.5% to 14.6%). Motor vehicle crashes (63.5%; 95% CI 63.5% to 63.6%), industrial accidents (59.3%; 95% CI 58.0% to 60.6%), and mass casualty incidents (50.6%; 95% CI 49.6% to 51.5%) were more likely to occur outside a patient's residence zip code. Median network distance between home and incident zip centroid codes ranged from 8.6 to 23.5 miles. In NEMSIS, there was geographic discordance between patient residence zip code and call location zip code in slightly more than one quarter of EMS responses records. The geographic discordance rates between residence and incident zip codes were associated with dispatch complaints and age. Although a patient's residence might be a valid proxy for incident location for elderly patients, this relationship holds less true for other age groups and among

  1. Attitudes towards general practice and primary care: a survey of senior house officers in accident and emergency.

    PubMed Central

    Dale, J; Williams, S

    1999-01-01

    OBJECTIVES: The attitudes and knowledge of hospital based staff about the capabilities of general practice may be important obstacles to continuity of care and the quality of communication at the primary-secondary care interface. However, little research has sought to investigate such factors or how they change over time. The study aims to assess how senior house officers (SHOs) in accident and emergency (A&E) departments perceive general practice, and to test how attitudes change during their six months' tenure. METHODS: Questionnaires were sent to all A&E SHOs working in the 27 A&E departments in South Thames region. At the end of the first month and at the end of the sixth months SHOs were asked to respond using 100 mm visual analogue scales to statements about the quality of general practitioner (GP) services in their area and their attitudes towards treating primary care patients in A&E. RESULTS: After sending reminders, 135 (79%) SHOs responded to the questionnaire at the end of the first month, and 115 (67%) responded to the questionnaire at the end of the sixth month; 104 (61%) responded to both. Statements relating to GP accessibility within and outside normal working hours, perceptions of patients' satisfaction with GP services, GPs' effectiveness in educating patients about use of services, and the frustrations and lack of reward of treating primary care patients scored most negatively. The overall trend was for attitudes to become more negative during SHOs' period of employment in A&E, particularly for those intent on hospital specialist careers or those working within London hospitals. CONCLUSIONS: The findings indicate the extent to which attitudes become more entrenched over time. This may lead to care that is more hospital focused. These issues need to be addressed if quality improvement is to occur across the A&E-primary care interface. PMID:9918286

  2. Occupational accidents among ambulance drivers in the emergency relief.

    PubMed

    Takeda, Elisabete; do Carmo Cruz Robazzi, Maria Lúcia

    2007-01-01

    We analyzed the occurrence of occupational accidents (OA) among ambulance drivers in Emergency Relief (ER), with a view to disclosing the types of events and their causes. A quantitative-qualitative study was carried out through the interview of 22 workers in a city in São Paulo, Brazil. The subjects were male, between 36 and 40 years old (40.9%), married (81.82%), with uncompleted primary education (40.9%), individual (90.9%) and family (54.55%) income between two and four Brazilian minimum wages, not performing any other paid occupation (45.45%). The majority of the OA were typical, due to an excess of exercises and vigorous and repeated movements (42.11%) and aggression through body strength and other means (26.33%). The OA occurs mainly because drivers carry out tasks that do not suit their professional formation.

  3. Highway Safety Program Manual: Volume 11: Emergency Medical Services.

    ERIC Educational Resources Information Center

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

    Volume 11 of the 19-volume Highway Safety Program Manual (which provides guidance to State and local governments on preferred highway safety practices) concentrates on emergency medical services. The purpose of the program, Federal authority in the area of medical services, and policies related to an emergency medical services (EMS) program are…

  4. Rural Emergency Medical Services (EMS) and Trauma

    MedlinePlus

    ... Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning Tools Testing New Approaches Rural Health IT ... to the 2015 WWAMI Rural Health Research Center report, Prehospital Emergency Medical Services Personnel in Rural Areas: ...

  5. [Resources and capacity of emergency trauma care services in Peru].

    PubMed

    Rosales-Mayor, Edmundo; Miranda, J Jaime; Lema, Claudia; López, Luis; Paca-Palao, Ada; Luna, Diego; Huicho, Luis

    2011-09-01

    The objectives of this study were to evaluate the resources and capacity of emergency trauma care services in three Peruvian cities using the WHO report Guidelines for Essential Trauma Care. This was a cross-sectional study in eight public and private healthcare facilities in Lima, Ayacucho, and Pucallpa. Semi-structured questionnaires were applied to the heads of emergency departments with managerial responsibility for resources and capabilities. Considering the profiles and volume of care in each emergency service, most respondents in all three cities classified their currently available resources as inadequate. Comparison of the health facilities showed a shortage in public services and in the provinces (Ayacucho and Pucallpa). There was a widespread perception that both human and physical resources were insufficient, especially in public healthcare facilities and in the provinces.

  6. Infections in traumatic wounds sutured at a Norwegian Accident and Emergency Department.

    PubMed

    Brudvik, Christina; Tariq, Hina; Bernardshaw, Soosaipillai V; Steen, Knut

    2015-05-05

    Different countries have different wound treatment traditions. We have studied the incidence and different factors related to infections in wound injuries sutured at a Norwegian A&E department. In this prospective study, clinical data were collected on 102 patients with traumatic wound injuries treated with sutures at Bergen Accident and Emergency Department between 30 February 2011 and 30 June 2011. Any wound infections in 97 of these patients at the time of suture removal were assessed and classified according to severity on a scale of grade 0 to grade 4. There were no serious infections, but mild clinical wound infections occurred in 15% of patients: 11% grade 1 and 4% grade 2 infections. Patients less than 65 years old had often cut themselves with knives (n = 33, 37%), and on their hands (n = 60, 67%), Men were most frequently injured at work (n = 38, 54%) and women most often at home (n = 18, 56%). No statistically significant correlation was found between the incidence of wound infections and the length of the wound, the time elapsed before suturing, the wound's location on the body, contamination or underlying chronic diseases. Two of the three self-inflictors in our study had clinical wound infections. Half of the bacteriological samples from ten of 15 wounds with clinical infection had plentiful growth of Staphylococcus aureus. One patient received oral antibiotic treatment for wound infection, and two had local antibiotic treatment. Mild clinical infections were found in almost one of six wounds sutured at a Norwegian A&E department. More studies are necessary to provide basic data to enable targeted improvements in wound treatment in the primary healthcare service.

  7. Positive Coping: A Unique Characteristic to Pre-Hospital Emergency Personnel

    PubMed Central

    Ebadi, Abbas; Froutan, Razieh

    2017-01-01

    Introduction It is important to gain a thorough understanding of positive coping methods adopted by medical emergency personnel to manage stressful situations associated with accidents and emergencies. Thus, the purpose of this study was to gain a better understanding of positive coping strategies used by emergency medical service providers. Methods This study was conducted using a qualitative content analysis method. The study participants included 28 pre-hospital emergency personnel selected from emergency medical service providers in bases located in different regions of the city of Mashhad, Iran, from April to November 2016. The purposive sampling method also was used in this study, which was continued until data saturation was reached. To collect the data, semistructured open interviews, observations, and field notes were used. Results Four categories and 10 subcategories were extracted from the data on the experiences of pre-hospital emergency personnel related to positive coping strategies. The four categories included work engagement, smart capability, positive feedback, and crisis pioneering. All the obtained categories had their own subcategories, which were determined based on their distinctly integrated properties. Conclusion The results of this study show that positive coping consists of several concepts used by medical emergency personnel, management of stressful situations, and ultimately quality of pre-hospital clinical services. Given the fact that efficient methods such as positive coping can prevent debilitating stress in an individual, pre-hospital emergency authorities should seek to build and strengthen “positive coping” characteristics in pre-hospital medical emergency personnel to deal with accidents, emergencies, and injuries through adopting regular and dynamic policies. PMID:28243409

  8. Positive Coping: A Unique Characteristic to Pre-Hospital Emergency Personnel.

    PubMed

    Ebadi, Abbas; Froutan, Razieh

    2017-01-01

    It is important to gain a thorough understanding of positive coping methods adopted by medical emergency personnel to manage stressful situations associated with accidents and emergencies. Thus, the purpose of this study was to gain a better understanding of positive coping strategies used by emergency medical service providers. This study was conducted using a qualitative content analysis method. The study participants included 28 pre-hospital emergency personnel selected from emergency medical service providers in bases located in different regions of the city of Mashhad, Iran, from April to November 2016. The purposive sampling method also was used in this study, which was continued until data saturation was reached. To collect the data, semistructured open interviews, observations, and field notes were used. Four categories and 10 subcategories were extracted from the data on the experiences of pre-hospital emergency personnel related to positive coping strategies. The four categories included work engagement, smart capability, positive feedback, and crisis pioneering. All the obtained categories had their own subcategories, which were determined based on their distinctly integrated properties. The results of this study show that positive coping consists of several concepts used by medical emergency personnel, management of stressful situations, and ultimately quality of pre-hospital clinical services. Given the fact that efficient methods such as positive coping can prevent debilitating stress in an individual, pre-hospital emergency authorities should seek to build and strengthen "positive coping" characteristics in pre-hospital medical emergency personnel to deal with accidents, emergencies, and injuries through adopting regular and dynamic policies.

  9. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical services. 115...

  10. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical services. 115...

  11. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical services. 115...

  12. Preliminary assessment of appropriateness of emergency care service use: actions taken and consultations obtained before emergency care presentation.

    PubMed

    Tzeng, Huey-Ming

    2011-01-01

    Inappropriate use of emergency care services can increase hospital readmissions and related costs. This pilot, cross-sectional survey project determined whether home health care patients who receive emergency care services during a Medicare-approved home care episode sought consultation from health care professionals before they made the emergency care visit. The two research questions were: (a) What actions were taken by the patient before making an emergency care visit?; (b) If prior consultation was obtained, what were the suggestions? Preliminary data were obtained from a Michigan-based, Medicare-certified, not-for-profit home health agency affiliated with a university health system. A two-page questionnaire recorded up to three emergency care visits. Volunteer participants were Medicare patients who had no cognitive deficits and were able to communicate with home health care providers (HHCPs) by themselves. Thirty-five emergency care visits were reported; 31 (88.6%) Medicare patients participated and 4 (11.4%) of them had two emergency care visits. Before the patients made an emergency care visit, they most often called their primary care physicians (PCPs; N = 20, 57.1%), followed by the HHCPs (N = 10, 28.6%). All 20 patients who contacted their PCPs and 7 patients who contacted their HHCPs were advised to seek emergency care services. In 20 emergency care visits the patient was admitted for an acute hospital stay; the other 15 patients went home. Most patients contacted their PCPs or HHCPs before they went to an emergency department or urgent care facility. These results implied that PCPs and HHCPs seemed to perceive that the need for emergency care should be determined at an emergency room or urgent care facility. This study was unable to differentiate the need for emergency care services or the appropriateness of the advice given by PCPs or HHCPs when the home care patients were under the care of a medical team.

  13. Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study.

    PubMed

    Ramacciati, Nicola; Ceccagnoli, Andrea; Addey, Beniamino; Rasero, Laura

    2018-05-01

    Physical and verbal aggression against health professionals, particularly nurses, is globally serious and widespread, with the most vulnerable being nurses working in the Accident and Emergency Department. Most international research into this issue focused on quantifying aggression, describing its nature, identifying perpetrators, stratifying risk and implementing preventive or mitigating interventions. Few studies investigated the nurses' subjective perceptions. As part of the 2016 Italian National Survey on Violence against Accident and Emergency Nurses, our research team collected qualitative data to explore their perceptions of Workplace Violence. From 19th July 2016 to 19th March 2017 we distributed online a 39-item validated questionnaire to 15,618 Emergency Nurses working in 668 Italian National Health Service Accident and Emergency Departments in all 20 Italian Regions. Answers were analysed using van Kaan's method. 1100 Emergency Nurses responded to the survey and 265 replied to our focus question. There were 144 Females, 119 Males, 2 not stated, average age 42 ± 9 years, average work experience 18 ± 9 years, average Accident and Emergency Department experience 11 ± 8 years. Four major themes emerged: the nurses' perception of physical and verbal aggression, precipitating factors, consequences, and solutions. These themes confirmed previous findings and showed that Italian nursing staff's perceptions of physical and verbal aggression is the same as emergency nurses working worldwide. How Italian Accident and Emergency nurses perceive Workplace Violence adds to our knowledge of the issue and contributes to finding shared solutions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Emergency medical services and congestion : urban sprawl and pre-hospital emergency care time.

    DOT National Transportation Integrated Search

    2009-01-01

    This research measured the association between urban sprawl and emergency medical service (EMS) response time. The purpose was to test the hypothesis that features of the built environment increase the probability of delayed ambulance arrival. Using ...

  15. [Bicycle accidents treated in emergency departments. A multicentre study].

    PubMed

    González Pacheco, N; Marañón Pardillo, R; Storch de Gracia Calvo, P; Campos Calleja, C; Mojica Muñoz, E; Rodríguez Sáez, M J; Crespo Rupérez, E; Panzino Occhiuzzo, F; Díez Sáez, C; Barea Martínez-Páis, V; Hernández González, A; Estopiñá Ferrer, G; Yagüe Torcal, F; Pociello Almiñana, N; García Peleteiro, P; Pizà Oliveras, A

    2014-04-01

    To describe epidemiological characteristics, types of injury, prognosis and medical management of bicycle-related Paediatric Emergency Department (ED) visits and to identify potential preventive measures. This multicentred, observational prospective study included all children between 3 and 16 years of age treated for bicycle-related injuries in the Emergency Departments of 15 Spanish Hospitals belonging to the «Unintentional Paediatric Injury Workshop» of the Spanish Paediatric Emergency Society between the 1(st) of June 2011 and the 31(st) of May 2012. Characteristics of all ED visits, as well as epidemiological data and accident-related information, were collected. A total of 846 patients were included in the study, with a male predominance (72.9%) and a median age of 9.6 ± 3.6 years. Head injury was the third most common injury (22.3%) and the main cause of admission to the Pediatric Intensive Care Unit (PICU) (68.4%). More than three-quarters (77.9%) of the patients did not wear a helmet, which was significantly associated to a higher incidence of head injury and admission to PICU. Older children (OR 1.063) and bicycle injuries involving motor vehicles (OR 2.431) were identified as independent risk factors for worse outcomes. Since helmet use reduces up to 88% of central nervous system lesions secondary to head injury, promotion of its use should be the main preventive measure, followed by restriction of bike-riding to cycling areas. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  16. DEVELOPMENT OF A NATIONAL EMERGENCY PLAN FOR MEDICAL DIAGNOSTICS AND THERAPY OF DETERMINISTIC EFFECTS AFTER RADIATION ACCIDENTS.

    PubMed

    Ziegler, Andreas

    2016-09-01

    The focus of nuclear emergency planning in Austria has been so far on mitigating effects of widespread contamination (e.g. after NPP accidents); however, these plans did not contain provisions on the medical management of an acute radiation syndrome. To close this gap, a 'Medical Radiation Emergency Plan' was created in 2009 and 2011. This paper describes the development of this plan (including the selection of consulted guidance) as well as its structure and main propositions and closes with an outlook on probable enhancements for the second edition. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. The work of the South Manchester Accident Rescue Team (SMART).

    PubMed

    Redmond, A D

    1990-01-01

    Skills acquired in the hospital do not necessarily translate to the scene of an accident. However, training in certain hospital specialties, particularly accident and emergency medicine, will expose doctors to dealing with very ill patients in a less rigidly structured environment. The operating theatre is a disciplined and controlled environment. Skill in anaesthesia, monitoring and operating, if tested only in these circumstances may be found to be gravely inadequate when exposed to the fluctuant and hostile environment at the site. Doctors who wish to do this sort of work or are designated to do it, must undergo regular and frequent training, especially if they are not trained in accident and emergency departments. This has long been recognised by the British Association for Immediate Care. In combination with the Royal College of Surgeons of Edinburgh they have now established a diploma in Immediate Medical Care. In urban areas the need for a doctor to attend at the scene of an accident is usually limited to entrapment. These occasions are likely to be infrequent and this can result in a lack of preparedness for such events. Interhospital transfer, primarily from peripheral hospitals to the specialist services of a teaching hospital, often involves critically ill and injured patients. The management of these cases by the mobile team provides regular, frequent exposure to working in a 'hostile' environment. Relationships with the rescue services are developed and staff become familiar with equipment and call-out procedures. The care of transported patients is improved. None of our patients have died in transit or within 6 h of arrival at base.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. A randomized controlled evaluation of specialist nurse education following accident and emergency department attendance for acute asthma.

    PubMed

    Levy, M L; Robb, M; Allen, J; Doherty, C; Bland, J M; Winter, R J

    2000-09-01

    We investigated whether hospital-based specialist asthma nurses improved recognition and self-treatment of asthma episodes by patients followed up after attending accident and emergency departments (A&E) for asthma exacerbations. We carried out a randomized prospective controlled trial of adult asthma self-management, following a hospital outpatient nurse consultation in two outer-London District General Hospitals (secondary care centres). The study included 211 adults, over 18 years old (mean age 40 years) who attended for asthma in two accident and emergency departments over 13 months. One hundred and eight evaluable patients were randomized into the control group who continued with their usual medical treatment and were not offered any intervention during the study period. One hundred and three evaluable patients were randomized into the intervention group. They were offered three 6-weekly outpatient appointments with one of two specialist asthma nurses for a structured asthma consultation, after attendance at the accident and emergency department. Following assessment of their asthma treatment and control, the nurses advised patients, through the use of self-management-plans, how to recognize and manage uncontrolled asthma and when to seek medical assistance. Medication and inhaler device type were altered if necessary The primary outcome was patient reported self-management of asthma exacerbations for 6 months. Secondary outcomes were assessed at baseline, 3 months and 6 months. These included home peak flow and symptom diaries, structured telephone questionnaires and audit of general practitioner records to determine utilization of services (6 months before and after A&E). Data were analysed on an intention to treat basis by multiple and logistic regression. The intervention group increased their use of inhaled topical steroids in 31/61 (51%) vs. 15/70 (21%) attacks in controls (OR 3.91 CI 1.8-8.4, P<0.001) and their use of rescue medication in 54/61 (89

  19. Multimedia Messaging Service teleradiology in the provision of emergency neurosurgery services.

    PubMed

    Ng, Wai Hoe; Wang, Ernest; Ng, Ivan

    2007-04-01

    Neurosurgical emergencies constitute a significant proportion of workload of a tertiary neurosurgical service. Prompt diagnosis and emergent institution of definitive treatment are critical to reduce neurological mortality and morbidity. Diagnosis is highly dependent on accurate interpretation of scans by experienced clinicians. This expertise may not be readily available especially after office hours because many neurosurgical units are manned by middle-level neurosurgical staff with varying levels of experience in scan interpretation. Multimedia Messaging Service mobile phone technology offers a simple, cheap, quick, and effective solution to the problem of scan interpretation. An MMS takes only a few minutes to send and receive and allows senior doctors to view important images and make important clinical decisions to enhance patient management in an emergency situation. A mobile phone (with VGA camera and MMS capabilities) was provided to the neurosurgery registrar on call. The on-call mobile phone is passed on to the corresponding registrar on-call the next day. All consultants had personal mobile phones that are MMS-enabled. Relevant representative CT/MRI images can be taken directly from the mobile phone from the PACS off the computer screen. When only hard copies are available, the images can be taken off the light box. After a 12-month trial period, a questionnaire was given to all staff involved in the project to ascertain the usefulness of the MMS teleradiology service. The survey on the use of the MMS service in a tertiary neurosurgical service demonstrated that the technology significantly improved the level of confidence of the senior-level staff in emergent clinical decision making. Significantly, the MMS images were of sufficient quality and resolution to obviate the need to view the actual scans. The impact of MMS is less pronounced in the middle-level staff, but there was a trend that most of the junior staff found the service more useful. The MMS

  20. Emergency residential care settings: A model for service assessment and design.

    PubMed

    Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

    2018-02-01

    There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Drug abuse-related accidents leading to emergency department visits at two medical centers.

    PubMed

    Chen, Isaac Chun-Jen; Hung, Dong-Zong; Hsu, Chi-Ho; Wu, Ming-Ling; Deng, Jou-Fang; Chang, Chin-Yu; Shih, Hsin-Chin; Liu, Chen-Chi; Wang, Chien-Ying; Wen, Yi-Szu; Wu, Jackson Jer-Kan; Huang, Mu-Shun; Yang, Chen-Chang

    2012-05-01

    Drug abuse is becoming more prevalent in Taiwan, as evidenced by increasing reports of drug trafficking and drug abuse-related criminal activity, and the wide use of more contemporary illicit drugs. Consequently, drug abuse-related accidents are also expected to occur with greater frequency. However, no study has yet specifically evaluated the prevalence, pattern, and outcomes of drug abuse-related accidents among patients visiting emergency departments (EDs) in Taiwan. We conducted an ambidirectional study with patients who visited the EDs of Taipei Veterans General Hospital (TVGH) and China Medical University Hospital (CMUH) due to drug abuse-related accidents from January 2007 through September 2009. Information on the patients' baseline characteristics and clinical outcomes was collected and analyzed. During the study period, a total of 166 patients visited the EDs of one of the two study hospitals due to drug abuse-related accidents. This yielded a prevalence of drug abuse of 0.1% among all patients visiting the ED due to accident and/or trauma. Fifty-six out of the 166 patients visited the ED at TVGH, most patients being between 21 and 40 years old. Opioids (41.1%) were the drugs most commonly abused by the patients, followed by benzodiazepines (32.1%). More than two-thirds of the patients (n=38, 67.9%) required hospitalization, and three patients died (5.4%). In contrast, 110 patients with drug abuse-related accidents visited the ED at CMUH during the study period. Most of these subjects had abused benzodiazepines (69.1%), were between 21 and 40 years old, and were female. Fewer than one-fifth of the patients (n=19, 17.3%) required hospitalization, with no deaths reported. There were significant between-hospital differences in terms of patient gender, drugs of choice, injury mechanisms, method and time of the ED visit, triage levels, and need for hospitalization. Although the prevalence of drug abuse-related accidents was low, and only three patient deaths

  2. Industrial Accidents Triggered by Natural Hazards: an Emerging Risk Issue

    NASA Astrophysics Data System (ADS)

    Renni, Elisabetta; Krausmann, Elisabeth; Basco, Anna; Salzano, Ernesto; Cozzani, Valerio

    2010-05-01

    Natural disasters such as earthquakes, tsunamis, flooding or hurricanes have recently and dramatically hit several countries worldwide. Both direct and indirect consequences involved the population, causing on the one hand a high number of fatalities and on the other hand so relevant economical losses that the national gross product may be affected for many years. Loss of critical industrial infrastructures (electricity generation and distribution, gas pipelines, oil refineries, etc.) also occurred, causing further indirect damage to the population. In several cases, accident scenarios with large releases of hazardous materials were triggered by these natural events, causing so-called "Natech events", in which the overall damage resulted from the simultaneous consequences of the natural event and of the release of hazardous substances. Toxic releases, large fires and explosions, as well as possible long-term environmental pollution, economical losses, and overloading of emergency systems were recognised by post-event studies as the main issues of these Natech scenarios. In recent years the increasing frequency and severity of some natural hazards due to climate change has slowly increased the awareness of Natech risk as an emerging risk among the stakeholders. Indeed, the iNTeg-Risk project, co-funded by the European Commission within the 7th Framework Program specifically addresses these scenarios among new technological issues on public safety. The present study, in part carried out within the iNTeg-Risk project, was aimed at the analysis and further development of methods and tools for the assessment and mitigation of Natech accidents. Available tools and knowledge gaps in the assessment of Natech scenarios were highlighted. The analysis mainly addressed the potential impact of flood, lightning and earthquake events on industrial installations where hazardous substances are present. Preliminary screening methodologies and more detailed methods based on

  3. Determinants of Demand in the Public Dental Emergency Service.

    PubMed

    Matsumoto, Maria Sa; Gatti, Marcia An; de Conti, Marta Hs; de Ap Simeão, Sandra F; de Oliveira Braga Franzolin, Solange; Marta, Sara N

    2017-02-01

    Although dental emergencies are primarily aimed at pain relief, in practice, dental emergency services have been overwhelmed by the massive inflow of patients with less complex cases, which could be resolved at basic levels of health care. They frequently become the main gateway to the system. We investigated the determinant factors of demand at the Central Dental Emergency Unit in Bauru, São Paulo, Brazil. The questionnaire was applied to 521 users to evaluate sociodemographic profile; factors that led users to seek the service at the central dental emergency; perception of service offered. About 80.4% of users went directly to the central dental emergency, even before seeking basic health units. The reasons were difficulty to be attended (34.6%) and incompatible time (9.8%). To the perception of the necessity of the service, responses were problem as urgent (78.3%) and pain was the main complaint (69.1%). The profile we found was unmarried (41.5%), male (52.2%), white (62.8%), aged 30 to 59 (52.2%), incomplete basic education (41.6%), family income up to 2 minimum wages (47.4%), and no medical/dental plan (88.9%). It was concluded that the users of central dental emergency come from all sectors of the city, due to difficult access to basic health units; they consider their complaint urgent; and they are satisfied with the service offered. To meet the profile of the user urgency's service so that it is not overloaded with demand that can be fulfilled in basic health units.

  4. The Fort McMurray, Alberta wildfires: Emergency and recovery management of healthcare services.

    PubMed

    Matear, David

    2017-01-01

    One of the largest wildfires in Canadian history raged through northern Alberta in May to July 2016, and prompted the largest emergency air evacuation in Canadian history. Central to the challenges were the evacuation of a regional hospital, and the emergency and recovery management associated with healthcare services. This paper describes multiple phases of emergency and recovery management, which employed and adapted the Incident Command System to healthcare services. There were no injuries reported throughout the medical evacuation and recovery of medical services. The leadership and management of healthcare services achieved the goals of evacuating patients and staff effectively, supporting emergency first responders and the re-entry of the population to Fort McMurray.

  5. Implementation of the Ottawa Ankle Rules by nurses working in an accident and emergency department.

    PubMed Central

    Salt, P; Clancy, M

    1997-01-01

    OBJECTIVE: To assess whether accident and emergency (A&E) nurses using the Ottawa Ankle Rules could detect all ankle fractures. DESIGN: Prospective observational study. SETTING: A&E department of a university teaching hospital. SUBJECTS: All patients who presented with ankle injuries who were initially assessed by a nurse taught the Ottawa Ankle Rules. OUTCOME MEASURES: (1) The numbers of patients referred by the nurse for ankle radiography; (2) of these, the number with ankle fractures; (3) of those not sent for radiography initially by the nurse, the number who subsequently had x rays (ordered by the doctor) and had a fracture; (4) of those having no x rays, the number who reattended later. RESULTS: 324 patients were eligible; 238 had x rays at the request of the nurse (73%); 48 of these (20%) were diagnosed as having a fracture. Of those 86 patients not sent for radiography by the nurse, 19 subsequently had x ray examinations at the request of a doctor and no fracture was detected. Of the 67 not sent for radiography, none returned within the subsequent eight weeks. CONCLUSIONS: Nurses can apply the Ottawa Ankle Rules safely without missing acute fractures; that is, of those who were not sent for radiography by nurses, none subsequently reattended the A&E department or the trauma service of the Bristol Royal Infirmary during the following two months. PMID:9413774

  6. Immigrants and borderline personality disorder at a psychiatric emergency service.

    PubMed

    Pascual, J C; Malagón, A; Córcoles, D; Ginés, J M; Soler, J; García-Ribera, C; Pérez, V; Bulbena, A

    2008-12-01

    Several studies have suggested that immigrants have higher rates of psychiatric emergency service use and a higher risk of mental disorders such as schizophrenia than indigenous populations. To compare the likelihood that immigrants (immigrant group) v. indigenous population (indigenous group) will be diagnosed with borderline personality disorder in a psychiatric emergency service and to determine differences according to area of origin. A total of 11 578 consecutive admissions over a 4-year period at a tertiary psychiatric emergency service were reviewed. The collected data included socio-demographic and clinical variables and the Severity of Psychiatric Illness rating score. Psychiatric diagnosis was limited to information available in the emergency room given that a structured interview is not usually feasible in this setting. The diagnosis of borderline personality disorder was based on DSM-IV criteria. Immigrants were divided into five groups according to region of origin: North Africa, sub-Saharan Africa, South America, Asia and Western countries. Multivariate statistical logistic regression analysis showed that all subgroups of immigrants had a lower likelihood of being diagnosed with borderline personality disorder than the indigenous population independently of age and gender. Furthermore, the rates of borderline personality disorder diagnosis were considerably lower in Asian and sub-Saharan subgroups than in South American, North African, Western or native subgroups. Our results showed that in the psychiatric emergency service borderline personality disorder was diagnosed less frequently in the immigrant group v. the indigenous group. Our results do not support the concept of migration as a risk factor for borderline personality disorder.

  7. The profile of women who seek emergency contraception from the family planning service.

    PubMed

    Lo, Sue S T; Ho, P C

    2012-08-01

    OBJECTIVES. To review the profile of emergency contraceptive users, their reasons for using emergency contraception, and whether they use it correctly. DESIGN. Retrospective analysis of medical records. SETTING. Six Birth Control Clinics and three Youth Health Care Centres of the Family Planning Association of Hong Kong. PARTICIPANTS. Women requesting emergency contraception between 2006 and 2008. MAIN OUTCOME MEASURES. Demographics of emergency contraception users, reasons for requesting emergency contraception, number of times the subject had unprotected intercourse before emergency contraception use, type of emergency contraception provided, coitus-treatment intervals, and outcomes. RESULTS. A total of 11 014 courses of emergency contraception were provided, which included 10 845 courses of levonorgestrel-only pills, 168 intrauterine contraceptive devices, and one course of pills plus an intrauterine contraceptive device. The mean age of the users was 30 years. Two thirds (65.6%) were nulliparous and 64.9% had not had a previous abortion. Their major reasons for requesting emergency contraception were: omission of contraceptive at the index intercourse (38.9%), condom accidents (38.0%), and non-use of any regular contraceptives (20.6%). Non-users of contraceptives were more likely to have had a previous abortion. In all, 97.9% of women took emergency contraception within 72 hours of their unprotected intercourse; 98% had had a single act of unprotected intercourse. None of the intrauterine contraceptive device users became pregnant. The failure rate for emergency contraceptive pills was 1.8%. CONCLUSIONS. Women requested emergency contraception because contraceptives were omitted or condom accidents. Health care providers should focus on motivating women with a history of abortion to use contraceptives, and ensure that condom users know how to use them correctly. Most women followed instructions on the use for emergency contraception and their outcomes were

  8. Utilization of emergency services for non-traumatic dental disease.

    PubMed

    Da Silva, Keith; Kunzel, Carol; Yoon, Richard K

    2013-01-01

    To identify and characterize children who utilize emergency dental services for non-traumatic dental disease. Caregivers of children under 12 years old who seek out emergency services for the treatment of non-traumatic dental disease will be surveyed regarding their child's current oral health status. Patient's clinical data will be obtained and they will be further followed for a period of 2 months to determine if they follow-up with recommendations for comprehensive dental care. One hundred and ninety-eight people participated in the study (97% response rate). Eighty-three percent of the children were diagnosed with dental caries. Seventy-four percent of patients of record presented with an emergency at least once before and 73% had a history of one or more broken appointments. Patients with a history of previous emergency visits (OR = 3.45, CI = 2.05, 5.81) or a history of missed appointments (OR = 2.21, CI = 1.42, 3.58) were significantly more likely to fail to return for comprehensive care (P < .01). This study shows that those who utilize emergency services more than once, or have a history of missed appointments are more likely to continue to utilize emergency dental services as their primary means for dental care.

  9. Research on sudden environmental pollution public service platform construction based on WebGIS

    NASA Astrophysics Data System (ADS)

    Bi, T. P.; Gao, D. Y.; Zhong, X. Y.

    2016-08-01

    In order to actualize the social sharing and service of the emergency-response information for sudden pollution accidents, the public can share the risk source information service, dangerous goods control technology service and so on, The SQL Server and ArcSDE software are used to establish a spatial database to restore all kinds of information including risk sources, hazardous chemicals and handling methods in case of accidents. Combined with Chinese atmospheric environmental assessment standards, the SCREEN3 atmospheric dispersion model and one-dimensional liquid diffusion model are established to realize the query of related information and the display of the diffusion effect under B/S structure. Based on the WebGIS technology, C#.Net language is used to develop the sudden environmental pollution public service platform. As a result, the public service platform can make risk assessments and provide the best emergency processing services.

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

    ERIC Educational Resources Information Center

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

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

  11. Public-private implementation of integrated emergency response services: Case study of GVK Emergency Management and Research Institute in Karnataka, India.

    PubMed

    Sriram, Veena M; Gururaj, Gopalkrishna; Hyder, Adnan A

    2017-12-01

    Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public-private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru. A case study methodology was used to explore systematically the organizational model of GVK Emergency Management and Research Institute in Karnataka. Qualitative data were collected through an in-person site visit to GVK Emergency Management and Research Institute headquarters in Bengaluru in July 2013. Three sources were used: in-depth, semistructured interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. The organization follows a standardized model across the states and union territories where they have contractual arrangements, including Karnataka. Processes for fleet maintenance, information systems/information technology and training, and deployment were well structured at the organizational level. The public-private partnership appears pro-poor in orientation; however, further demand-side research is required on the perspective of patients. Our study reveals a functional structure at the organizational level, which provides a key service at no cost to users. Detailed analyses of this nature can help inform global efforts for the development and strengthening of emergency medical services systems. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Traffic accidents on expressways: new threat to China.

    PubMed

    Zhao, Jinbao; Deng, Wei

    2012-01-01

    As China is building one of the largest expressway systems in the world, expressway safety problems have become serious concerns to China. This article analyzed the trends in expressway accidents in China from 1995 to 2010 and examined the characteristics of these accidents. Expressway accident data were obtained from the Annual Report for Road Traffic Accidents published by the Ministry of Public Security of China. Expressway mileage data were obtained from the National Statistics Yearbook published by the National Bureau of Statistics of China. Descriptive statistical analyses were conducted based on these data. Expressway deaths increased by 10.2-fold from 616 persons in 1995 to 6300 persons in 2010, and the average annual increase was 17.9 percent over the past 15 years, and the overall other road traffic deaths was -0.33 percent. China's expressway mileage accounted for only 1.85 percent of highway mileage driven in 2010, but expressway deaths made up 13.54 percent of highway traffic deaths. The average annual accident lethality rate [accident deaths/(accident deaths + accident injuries)] for China's expressways was 27.76 percent during the period 1995 to 2010, which was 1.33 times higher than the accident lethality rate of highway traffic accidents. China's government should pay attention to expressway construction and safety interventions during the rapid development period of expressways. Related causes, such as geographic patterns, speeding, weather conditions, and traffic flow composition, need to be studied in the near future. An effective and scientific expressway safety management services system, composed of a speed monitoring system, warning system, and emergency rescue system, should be established in developed and underdeveloped provinces in China to improve safety on expressway.

  13. Availability of pediatric services and equipment in emergency departments: United States, 2006.

    PubMed

    Schappert, Susan M; Bhuiya, Farida

    2012-03-01

    This report presents data on the availability of pediatric services, expertise, and supplies for treating pediatric emergencies in U.S. hospitals. Data in this report are from the Emergency Pediatric Services and Equipment Supplement (EPSES), a self-administered questionnaire added to the 2006 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS samples nonfederal short-stay and general hospitals in the United States. Sample data were weighted to produce annual estimates of pediatric services, expertise, and equipment availability in hospital emergency departments (EDs). In 2006, only 7.2 percent of hospital EDs had all recommended pediatric emergency supplies, and 45.6 percent had at least 85.0 percent of recommended supplies. EDs in children's hospitals and hospitals with pediatric intensive care units (PICUs) were more likely to meet guidelines for pediatric emergency department services, expertise, and supplies. About 74.0 percent of these facilities had at least 85.0 percent of recommended supplies, compared with 42.4 percent of other facilities. Among children's hospitals and hospitals with PICUs, 66.0 percent had 24 hours a day, 7 days a week access to a board-certified pediatric emergency medicine attending physician; such access was uncommon in other types of hospitals. In general, little change was noted in the availability of emergency pediatric supplies between 2002-2003, when the initial EPSES was conducted, and 2006.

  14. Integrating emergency services in an urban health system.

    PubMed

    Radloff, D; Blouin, A S; Larsen, L; Kripp, M E

    2000-03-01

    When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.

  15. Integrating geographical information and augmented reality techniques for mobile escape guidelines on nuclear accident sites.

    PubMed

    Tsai, Ming-Kuan; Lee, Yung-Ching; Lu, Chung-Hsin; Chen, Mei-Hsin; Chou, Tien-Yin; Yau, Nie-Jia

    2012-07-01

    During nuclear accidents, when radioactive materials spread into the environment, the people in the affected areas should evacuate immediately. However, few information systems are available regarding escape guidelines for nuclear accidents. Therefore, this study constructs escape guidelines on mobile phones. This application is called Mobile Escape Guidelines (MEG) and adopts two techniques. One technique is the geographical information that offers multiple representations; the other is the augmented reality that provides semi-realistic information services. When this study tested the mobile escape guidelines, the results showed that this application was capable of identifying the correct locations of users, showing the escape routes, filtering geographical layers, and rapidly generating the relief reports. Users could evacuate from nuclear accident sites easily, even without relief personnel, since using slim devices to access the mobile escape guidelines is convenient. Overall, this study is a useful reference for a nuclear accident emergency response. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Changing pattern of pediatric maxillofacial injuries at the Accident and Emergency Department of the University Teaching Hospital, Ibadan--a four-year experience.

    PubMed

    Okoje, Victoria N; Alonge, Temitope O; Oluteye, Olufemi A; Denloye, Obafunke O

    2010-01-01

    Maxillofacial injuries are common among polytraumatized patients, and in Nigeria, the incidence seems to be on the increase. This probably is related to the drive of industrialization and the increase in the number of road traffic accidents. Delays in attending to severe maxillofacial injuries can be grave because of concomitant injuries that can be life threatening. This is a prospective review of maxillofacial injuries in patients less than or equal to 16 years of age who were seen at the Accident and Emergency Department between October 2002 and December 2006. In all the patients, the accident and emergency physicians carried out initial resuscitation, and thereafter, they were referred to the maxillofacial unit on call. A total of 611 patients with maxillofacial injuries were seen during the study period and of this, 134 (22%) were less than or equal to 16 years old. The male:female ratio was 1.1:1.0. Road traffic accident (RTA) was the most common etiological factor in 73 (54.5%) cases, while gunshot injuries accounted for 6 (4.4%) cases. Soft tissue lacerations were the most common maxillofacial injuries occurring in 90 (55.9%) cases; mandibular fractures were the most common bony injury in 17 (13.4%). The upsurge in maxillofacial gunshot injuries in the pediatric age group is alarming and this may be a reflection of the global changes (westernization and drug-related offenses like armed robberies) and the harsh economic conditions in this community.

  17. Update of the Nuclear Criticality Slide Rule for the Emergency Response to a Nuclear Criticality Accident

    NASA Astrophysics Data System (ADS)

    Duluc, Matthieu; Bardelay, Aurélie; Celik, Cihangir; Heinrichs, Dave; Hopper, Calvin; Jones, Richard; Kim, Soon; Miller, Thomas; Troisne, Marc; Wilson, Chris

    2017-09-01

    AWE (UK), IRSN (France), LLNL (USA) and ORNL (USA) began a long term collaboration effort in 2015 to update the nuclear criticality Slide Rule for the emergency response to a nuclear criticality accident. This document, published almost 20 years ago, gives order of magnitude estimates of key parameters, such as number of fissions and doses (neutron and gamma), useful for emergency response teams and public authorities. This paper will present, firstly the motivation and the long term objectives for this update, then the overview of the initial configurations for updated calculations and preliminary results obtained with modern 3D codes.

  18. 1995 Kentucky traffic accident facts

    DOT National Transportation Integrated Search

    1995-01-01

    KENTUCKYS TRAFFIC ACCIDENT FACTS report for 1995 is based on accident reports submitted to the Accident Unit housed : in the Kentucky State Police Information Services Branch, Records Section. As required by Kentucky Revised statutes 189.635, : ...

  19. 1996 Kentucky traffic accident facts

    DOT National Transportation Integrated Search

    1996-01-01

    KENTUCKYS TRAFFIC ACCIDENT FACTS report for 1996 is based on accident reports submitted to the Accident Unit housed : in the Kentucky State Police Information Services Branch, Records Section. As required by Kentucky Revised statutes 189.635, : ...

  20. 1998 Kentucky traffic accident facts

    DOT National Transportation Integrated Search

    1998-01-01

    KENTUCKYS TRAFFIC ACCIDENT FACTS report for 1998 is based on accident reports submitted to the Accident Unit housed : in the Kentucky State Police Information Services Branch, Records Section. As required by Kentucky Revised statutes 189.635, : ...

  1. 1997 Kentucky traffic accident facts

    DOT National Transportation Integrated Search

    1997-01-01

    KENTUCKYS TRAFFIC ACCIDENT FACTS report for 1997 is based on accident reports submitted to the Accident Unit housed : in the Kentucky State Police Information Services Branch, Records Section. As required by Kentucky Revised statutes 189.635, : ...

  2. Assessing the physical service setting: a look at emergency departments.

    PubMed

    Steinke, Claudia

    2015-01-01

    To determine the attributes of the physical setting that are important for developing a positive service climate within emergency departments and to validate a measure for assessing physical service design. The design of the physical setting is an important and contributing factor for creating a service climate in organizations. Service climate is defined as employee perceptions of the practices, procedures, and behaviors that get rewarded, supported, and expected with regard to customer service and customer service quality. There has been research conducted which identifies antecedents within organization that promotes a positive service climate which in turn creates service-oriented behaviors by employees toward clients. The antecedent of the physical setting and its impact on perceptions of service climate has been less commonly explored. Using the concept of the physical service setting (which may be defined as aspects of the physical, built environment that facilitate the delivery of quality service), attributes of the physical setting and their relationship with service climate were explored by means of a quantitative paper survey distributed to emergency nurses (n = 180) throughout a province in Canada. The results highlight the validity and reliability of six scales measuring the physical setting and its relation to service. Respondents gave low ratings to the physical setting of their departments, in addition to low ratings of service climate. Respondents feel that the design of the physical setting in the emergency departments where they work is not conducive to providing quality service to clients. Certain attributes of the physical setting were found to be significant in influencing perceptions of service climate, hence service quality, within the emergency department setting. © The Author(s) 2015.

  3. Determining optimum flash patterns for emergency service vehicles: an experimental investigation using high definition film.

    PubMed

    Turner, Sally; Wylde, Julie; Langham, Martin; Morrow, Andrew

    2014-09-01

    An investigation of how emergency vehicle lighting (EVL) can be improved is reported with reference to an analysis of police vehicle road traffic accidents (Study 1). In Study 2, 37 regular drivers were shown film clips of a marked police vehicle, in which flash rate (1 Hz, 4 Hz) and pattern (single, triple pulse) were varied on the blue Light Emitting Diode (LED) roofbar. Results indicate a 4 Hz flash rate conveys greater urgency than a 1 Hz rate, while a 1 Hz, single flash combination was ranked the least urgent of all combinations. Participants claimed they would leave significantly more space before pulling out in front of an approaching police car (gap acceptance) in the 4 Hz single pulse condition in comparison to other EVL combinations. The preliminary implications for which flash characteristics could prove most optimal for emergency service use are discussed with regard to effects on driver perception and expected driving behaviour. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  4. Soil sampling and analytical strategies for mapping fallout in nuclear emergencies based on the Fukushima Dai-ichi Nuclear Power Plant accident.

    PubMed

    Onda, Yuichi; Kato, Hiroaki; Hoshi, Masaharu; Takahashi, Yoshio; Nguyen, Minh-Long

    2015-01-01

    The Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident resulted in extensive radioactive contamination of the environment via deposited radionuclides such as radiocesium and (131)I. Evaluating the extent and level of environmental contamination is critical to protecting citizens in affected areas and to planning decontamination efforts. However, a standardized soil sampling protocol is needed in such emergencies to facilitate the collection of large, tractable samples for measuring gamma-emitting radionuclides. In this study, we developed an emergency soil sampling protocol based on preliminary sampling from the FDNPP accident-affected area. We also present the results of a preliminary experiment aimed to evaluate the influence of various procedures (e.g., mixing, number of samples) on measured radioactivity. Results show that sample mixing strongly affects measured radioactivity in soil samples. Furthermore, for homogenization, shaking the plastic sample container at least 150 times or disaggregating soil by hand-rolling in a disposable plastic bag is required. Finally, we determined that five soil samples within a 3 m × 3-m area are the minimum number required for reducing measurement uncertainty in the emergency soil sampling protocol proposed here. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Use of geographic information systems to determine new helipad locations and improve timely response while mitigating risk of helicopter emergency medical services operations.

    PubMed

    Foo, Cheryl P Z; Ahghari, Mahvareh; MacDonald, Russell D

    2010-01-01

    Traumatic injury is a leading cause of morbidity and mortality, but these can be minimized by timely transport to definite care. Helicopter emergency medical services (HEMS) provide timely transport and can influence survival. However, accident analyses indicate that landing at an unsecured landing zone (LZ), particularly at night, increases the risk of aviation accidents. To ensure safety, some HEMS operations land only at designated, secured LZs. This study utilized geographic information systems (GISs) to compare locations of scene call requests and secure LZs. The goal was to determine the optimal placement of new helipads as a strategy to improve access while mitigating the risk of aviation accidents. Call request data from a large air medical transport service were used to determine the geographic locations of all requests for scene responses in 2006. Request locations were compared with the locations of existing helipads, and straight-line distances between scene and helipad were determined using the GIS application. The application was then used to determine potential locations for new helipads. During the study period, 748 requests for scene calls and 269 helipads were available. There were 476 (52.4%) requests at least 10 kilometers from a helipad and 356 (36.6%) requests at least 15 kilometers from a helipad. One particular region, Southwestern Ontario, was identified as having the highest number of requests >15 kilometers from the closest helipad. GISs can be used to determine potential locations for new helipad construction using historical call request data. This evidence-based approach can improve HEMS access while mitigating operational risk.

  6. Development, utilisation, and importance of accident and emergency department derived assault data in violence management

    PubMed Central

    Warburton, A; Shepherd, J

    2004-01-01

    Objectives: To develop formal processes for the collection, disclosure, and effective use of accident and emergency (A&E) department derived assault injury data for city violence reduction. Methods: Over a four year period, managed by a multi-agency steering group, A&E data collection, collation, and disclosure processes were developed, instituted, and refined. Consultations and negotiations between agencies identified the most effective and ethical methods, appropriate recipients, and the nature of the information of most use. Results: Disclosure of A&E data to city authorities, the police, and local media drew substantial attention and crime prevention resources to the locations of violence. As a result, a police task force responsible for targeting city street crime was funded, which analysed both A&E and police information. Monthly, electronic transfer of raw, anonymous data to the task force crime analyst informed and prompted violence prevention initiatives by several agencies. Police mounted overt and covert interventions targeted at violence hotspot licensed premises and used the data to oppose, on injury grounds, drinks/entertainment licence applications. Transport authorities established new half hourly night time city centre bus services. The local authority mounted an assault awareness campaign in schools and public libraries, and licensing magistrates used the data to measure, for example, the impact of continuous 36 hour drinks licensing on public safety. Conclusions: The principal finding of this evaluation was that judicious sharing of unique information about locations and times of violence derived from A&E patients was a powerful and effective means of targeting police and other local resource to bring about violence reduction. PMID:15208234

  7. Development, utilisation, and importance of accident and emergency department derived assault data in violence management.

    PubMed

    Warburton, A L; Shepherd, J P

    2004-07-01

    To develop formal processes for the collection, disclosure, and effective use of accident and emergency (A&E) department derived assault injury data for city violence reduction. Over a four year period, managed by a multi-agency steering group, A&E data collection, collation, and disclosure processes were developed, instituted, and refined. Consultations and negotiations between agencies identified the most effective and ethical methods, appropriate recipients, and the nature of the information of most use. Disclosure of A&E data to city authorities, the police, and local media drew substantial attention and crime prevention resources to the locations of violence. As a result, a police task force responsible for targeting city street crime was funded, which analysed both A&E and police information. Monthly, electronic transfer of raw, anonymous data to the task force crime analyst informed and prompted violence prevention initiatives by several agencies. Police mounted overt and covert interventions targeted at violence hotspot licensed premises and used the data to oppose, on injury grounds, drinks/entertainment licence applications. Transport authorities established new half hourly night time city centre bus services. The local authority mounted an assault awareness campaign in schools and public libraries, and licensing magistrates used the data to measure, for example, the impact of continuous 36 hour drinks licensing on public safety. The principal finding of this evaluation was that judicious sharing of unique information about locations and times of violence derived from A&E patients was a powerful and effective means of targeting police and other local resource to bring about violence reduction.

  8. Reassuring and reducing anxiety in seriously injured patients: a study of accident and emergency interventions.

    PubMed

    Jay, R

    1996-07-01

    This paper is an account of a qualitative study of significantly injured patients' experience in the Accident and Emergency department (A&E) and explores the question 'What A&E nursing interventions are effective in providing reassurance and reducing anxiety in patients with significant trauma?' A review of the limited literature available indicates that when a seriously injured patient is admitted to the A&E department, the medical and nursing staff often respond urgently to the physiological crisis without adequate consideration of psychological needs. The research design used a version of the Critical Incident Technique to interview 7 patients who had sustained serious injuries a few days previously. The findings indicate that central to the delivery of emergency care is the individual's transition from their normal independent existence through pre-hospital trauma and into the isolating experience of fear, dependence and the resuscitation room. Different methods of coping were required to meet their needs and regain some control. Methods such as touch, company and information became paramount as did the need to trust the people seen to be in control of their new environment.

  9. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... means of transportation would endanger the beneficiary's health. (b) Emergency and urgently needed... temporarily absent from the MA plan's service (or, if applicable, continuation) area (or, under unusual and... organization's provider network is temporarily unavailable or inaccessible) when the services are medically...

  10. Construction industry accidents in Spain.

    PubMed

    Camino López, Miguel A; Ritzel, Dale O; Fontaneda, Ignacio; González Alcantara, Oscar J

    2008-01-01

    This paper analyzed industrial accidents that take place on construction sites and their severity. Eighteen variables were studied. We analyzed the influence of each of these with respect to the severity and fatality of the accident. This descriptive analysis was grounded in 1,630,452 accidents, representing the total number of accidents suffered by workers in the construction sector in Spain over the period 1990-2000. It was shown that age, type of contract, time of accident, length of service in the company, company size, day of the week, and the remainder of the variables under analysis influenced the seriousness of the accident. IMPACT ON INJURY PREVENTION: The results obtained show that different training was needed, depending on the severity of accidents, for different age, length of service in the company, organization of work, and time when workers work. The research provides an insight to the likely causes of construction injuries in Spain. As a result of the analysis, industries and governmental agencies in Spain can start to provide appropriate strategies and training to the construction workers.

  11. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... equivalent, where other means of transportation would endanger the beneficiary's health. (b) Emergency and... enrollee is temporarily absent from the MA plan's service (or, if applicable, continuation) area (or, under... but the organization's provider network is temporarily unavailable or inaccessible) when the services...

  12. Production layout improvement in emergency services: a participatory approach.

    PubMed

    Zanatta, Mateus; Amaral, Fernando Gonçalves

    2012-01-01

    Volunteer fire department is a service that responds emergency situations in places where there are no military emergency services. These services need to respond quickly, because time is often responsible for the operation success besides work environment and setup time interfere with the prompt response to these calls and care efficiency. The layout design is one factor that interferes with the quick setup. In this case, the spaces arrangement can result in excessive or unnecessary movements; also the equipment provision may hinder the selection and collection of these or even create movement barriers for the workers. This work created a new layout for the emergency assistance service, considering the human factors related to work through the task analysis and workers participation on the alternatives of improvement. The results showed an alternate layout with corridors and minimization of unusable sites, allowing greater flexibility and new possibilities of requirements.

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

    PubMed

    Gałazkowski, Robert

    2010-01-01

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

  14. Factors Impacting Mortality in the Pre-Hospital Period After Road Traffic Accidents in Urban India.

    PubMed

    Chandrasekharan, Ananthnarayan; Nanavati, Aditya J; Prabhakar, Sandhya; Prabhakar, Subramaniam

    2016-07-01

    India currently has the dubious distinction of experiencing the highest number of road traffic accidents in the world. We believe that this study on road traffic accidents may help to identify factors in the pre-hospital setting that may influence mortality rates. A prospective observational study was carried out in a metro area in India over a period of one year. The study included consecutive patients admitted to the trauma service after road traffic accidents. Demographic information, time and place of accident, and details regarding the vehicle and the events leading up to the hospital admission were recorded. Injury severity, management in the hospital, and final outcomes in terms of mortality were noted. The data were analyzed with SPSS software. A total of 773 patients were enrolled. Of these, there were 197 deaths and 576 survivors. The majority of patients were aged 15 - 40 years (67%) and were male (87.84%). More accidents occurred at night (58.2%) than during the day (41.8%). Mortality was not significantly associated with age, sex, or time of accident. City roads (38.9%) saw more accidents than highways (26.13%), but highway accidents were more likely to be fatal. Two-wheeler riders (37.65%) and pedestrians (35.75%) formed the majority of our study population. Mortality was significantly associated with crossing the road on foot (P = 0.004). Pillion riders on two-wheeler vehicles were more likely to experience poor outcomes (relative risk [RR] = 1.9, P = 0.001). Front-seat occupants in four-wheeler vehicles were at an increased risk of not surviving the accident (61.98%; RR=2.56, P = 0.01). Lack of safety gear, such as helmets, seat belts, and airbags, was significantly associated with mortality (P = 0.05). Delays in transfers of patients to the hospital and a lack of pre-hospital emergency services was significantly associated with increased mortality (P = 0.000). A lack of respect for the law, weak legislation and law enforcement, disregard for

  15. Emergency and Disaster Information Service

    NASA Astrophysics Data System (ADS)

    Boszormenyi, Zsolt

    2010-05-01

    The Hungarian National Association of Radio Distress-Signalling and Infocommunications (RSOE) operates Emergency and Disaster Information Service (EDIS) within the frame of its own website which has the objective to monitor and document all the events on the Earth which may cause disaster or emergency. Our service is using the speed and the data spectrum of the internet to gather information. We are monitoring and processing several foreign organisation's data to get quick and certified information. The EDIS website operated together by the General-Directorate of National Disaster Management (OKF) and RSOE, in co-operation with the Crisis Management Centre of the Ministry of Foreign Affairs, provides useful information regarding emergency situations and their prevention. Extraordinary events happening in Hungary, Europe and other areas of the World are being monitored in 24 hours per day. All events processed by RSOE EDIS are displayed real time - for the sake of international compatibility - according to the CAP protocol on a secure website. To ensure clear transparency all events are categorized separately in the RSS directory (e.g. earthquake, fire, flood, landslide, nuclear event, tornado, vulcano). RSOE EDIS also contributes in dissemination of the CAP protocol in Hungary. Beside the official information, with the help of special programs nearly 900-1000 internet press publication will be monitored and the publication containing predefined keywords will be processed. However, these "news" cannot be considered as official and reliable information, but many times we have learnt critical information from the internet press. We are screening the incoming information and storing in a central database sorted by category. After processing the information we are sending it immediately via E-Mail (or other format) for the organisations and persons who have requested it (e.g. National Disaster Management, United Nations etc.). We are aspiring that the processed data

  16. Association between temperature and emergency room visits for cardiorespiratory diseases, metabolic syndrome-related diseases, and accidents in metropolitan Taipei.

    PubMed

    Wang, Yu-Chun; Lin, Yu-Kai

    2014-01-01

    This study evaluated risks of the emergency room visits (ERV) for cerebrovascular diseases, heart diseases, ischemic heart disease, hypertensive diseases, chronic renal failure (CRF), diabetes mellitus (DM), asthma, chronic airway obstruction not elsewhere classified (CAO), and accidents associated with the ambient temperature from 2000 to 2009 in metropolitan Taipei. The distributed lag non-linear model was used to estimate the cumulative relative risk (RR) and confidence interval (CI) of cause-specific ERV associated with daily temperature from lag 0 to lag 3 after controlling for potential confounders. This study identified that temperatures related to the lowest risk of ERV was 26 °C for cerebrovascular diseases, 18 °C for CRF, DM, and accidents, and 30 °C for hypertensive diseases, asthma, and CAO. These temperatures were used as the reference temperatures to measure RR for the corresponding diseases. A low temperature (14°C) increased the ERV risk for cerebrovascular diseases, hypertensive diseases, and asthma, with respective cumulative 4-day RRs of 1.56 (95% CI: 1.23, 1.97), 1.78 (95% CI: 1.37, 2.34), and 2.93 (95% CI: 1.26, 6.79). The effects were greater on, or after, lag one. At 32°C, the cumulative 4-day RR for ERV was significant for CRF (RR = 2.36; 95% CI: 1.33, 4.19) and accidents (RR = 1.23; 95% CI: 1.14, 1.33) and the highest RR was seen on lag 0 for CRF (RR = 1.69; 95% CI: 1.01, 3.58), DM (RR = 1.69; 95% CI: 1.09, 2.61), and accidents (RR = 1.19; 95% CI: 1.11, 1.27). Higher temperatures are associated with the increased ERV risks for CRF, DM, and accidents and lower temperatures with the increased ERV risks for cerebrovascular diseases, hypertensive diseases, and asthma in the subtropical metropolitan.

  17. Resilient National Security and Emergency Preparedness Communications: Service Metrics

    DTIC Science & Technology

    2015-10-01

    the East Coast of the United States after a tornado . Emergency management services are immediately called into duty to protect, provide, and secure...channel, radios that are vulnerable to congestion during heavy usage. During a tornado emergency prior to the hurricane, in a period of only 10...In terms of Survivability, the probability of a tornado occurring in any given year in this location is P( tornado ) = 0.05. The

  18. Print media representations of UK Accident and Emergency treatment targets: Winter 2014-2015.

    PubMed

    Grant, Aimee; Hoyle, Louise

    2017-12-01

    To undertake an analysis of UK national daily newspaper coverage of accident and emergency treatment targets, in order to understand whether the media could be seen to be creating a scandal. Emergency department treatment targets have become common in developed countries. In the UK, hospitals are required to treat and discharge patients within four hours, and statistics are published daily. Breaches of targets are regularly reported by the UK print media. Exploratory research of tabloid newspaper articles that reported on four-hour treatment targets in the UK during a seven-month period over the winter of 2014-2015 (n = 1,317). An interpretivist thematic approach was used during analysis. The main "problem" identified by newspapers was the failure to meet the target, rather than negative effects on patient care (where they existed). Proposed solutions were diverse. Many articles did not describe who was to blame for the failure. We conclude that the media created a feeling of scandal, and hypothesise that this is related to political reasons and the availability of data on a daily basis. It is important for nursing staff to understand the influence of the media on patients and how stories are reported. © 2017 John Wiley & Sons Ltd.

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

    PubMed

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

    2017-12-01

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

  20. 22 CFR 102.17 - Reports on accident.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Reports on accident. 102.17 Section 102.17... Accidents Abroad Foreign Aircraft Accidents Involving United States Persons Or Property § 102.17 Reports on accident. When an accident occurs to a foreign aircraft in the district of a Foreign Service post and...

  1. 22 CFR 102.17 - Reports on accident.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Reports on accident. 102.17 Section 102.17... Accidents Abroad Foreign Aircraft Accidents Involving United States Persons Or Property § 102.17 Reports on accident. When an accident occurs to a foreign aircraft in the district of a Foreign Service post and...

  2. The analysis outlining the occurrence and consequences of accidents in the work environment of the firefighters employed by the State Fire Service in Poland in 2008-2013.

    PubMed

    Pawlak, Agata; Gotlib, Joanna; Gałązkowski, Robert

    2016-01-01

    Due to the specifics of their work and to being exposed to a wide range of hazards, firefighters working for the State Fire Service (SFS) face the risk of work-related accidents more often than members of other occupational groups. The aim of this paper is to analyze the occurrence and consequences of accidents in the work environment of the SFS officers in Poland between the years 2008-2013. The material analyzed is based on aggregate data collected by the Headquarters of the State Fire Service. Figures regarding accidents in the period between 1 January 2008 and 31 December 2013 show that 8518 work-related accidents occurred in that period and 8635 people were injured. The data shows that neither the number of accidents nor their frequency indicator underwent any significant fluctuations over the 6 years under consideration. The group that is most exposed to accidents on duty in the profession includes active firefighters serving in rescue and fire extinguishment divisions. According to the data, the greatest number of trauma incidents in the SFS between the years 2008-2013 occurred during sporting activities. The predominant cause of these was inappropriate behavior or the lack of proper care. The most frequent injuries sustained during the accidents were broken or fractured bones and sprained joints. Accidents on duty occur significantly more often when firefighters are at their stations, during sporting classes, exercises or maneuvers, than in the course of actual rescue operations. The firefighters of the State Fire Services are insufficiently prepared for their sporting activities. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  3. Emergency healthcare process automation using mobile computing and cloud services.

    PubMed

    Poulymenopoulou, M; Malamateniou, F; Vassilacopoulos, G

    2012-10-01

    Emergency care is basically concerned with the provision of pre-hospital and in-hospital medical and/or paramedical services and it typically involves a wide variety of interdependent and distributed activities that can be interconnected to form emergency care processes within and between Emergency Medical Service (EMS) agencies and hospitals. Hence, in developing an information system for emergency care processes, it is essential to support individual process activities and to satisfy collaboration and coordination needs by providing readily access to patient and operational information regardless of location and time. Filling this information gap by enabling the provision of the right information, to the right people, at the right time fosters new challenges, including the specification of a common information format, the interoperability among heterogeneous institutional information systems or the development of new, ubiquitous trans-institutional systems. This paper is concerned with the development of an integrated computer support to emergency care processes by evolving and cross-linking institutional healthcare systems. To this end, an integrated EMS cloud-based architecture has been developed that allows authorized users to access emergency case information in standardized document form, as proposed by the Integrating the Healthcare Enterprise (IHE) profile, uses the Organization for the Advancement of Structured Information Standards (OASIS) standard Emergency Data Exchange Language (EDXL) Hospital Availability Exchange (HAVE) for exchanging operational data with hospitals and incorporates an intelligent module that supports triaging and selecting the most appropriate ambulances and hospitals for each case.

  4. Management of soft tissue knee injuries in an accident and emergency department: the effect of the introduction of a physiotherapy practitioner

    PubMed Central

    Jibuike, O; Paul-Taylor, G; Maulvi, S; Richmond, P; Fairclough, J

    2003-01-01

    Objective: To assess the effect of the introduction of a physiotherapist with an extended scope of practice in the management of acute soft tissue knee injuries in an accident and emergency (A&E) department. Methods: The A&E department established an Acute Knee Screening Service (AKSS) in 1998. An experienced physiotherapist was appointed to run the AKSS after additional training. Local guidelines and protocols were developed in conjunction with trauma knee surgeons, radiologists, physiotherapists, and A&E doctors. This study describes 100 consecutive patients managed by the AKSS over a three month period and comparisons are made over a similar period before the introduction of the AKSS. Results: The initial diagnosis of patients with acute knee injuries referred to the service showed meniscal injuries (38%), cruciate ligament injuries (18%), fractures (2%), patellofemoral joint injuries (10%), and others (32%). Ninety five per cent of patients referred to AKSS were seen within one week. Medical time was saved in both A&E and trauma clinic. Fifty nine per cent of patients were treated and discharged from the service without further medical review. Thirty nine per cent (39) were referred to trauma clinic and of these 44% (17) had MRI scans performed as requested by the physiotherapist. Eighty eight per cent (15) of these scans showed significant abnormality: (nine, anterior cruciate ligament tears, one, posterior cruciate ligament tears, and nine meniscal tears). Conclusions: A physiotherapy practitioner working with an extended role is a valuable addition to an A&E department. The AKSS improves the quality of care of acute knee injuries, saves medical time, and fosters cooperation across services within the NHS. PMID:12533365

  5. 47 CFR 25.284 - Emergency Call Center Service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... mobile satellite service to end-user customers (part 25, subparts A-D) must provide Emergency Call Center... Center personnel must determine the emergency caller's phone number and location and then transfer or otherwise redirect the call to an appropriate public safety answering point. Providers of mobile satellite...

  6. [Domestic and family violence against women: a case-control study with victims treated in emergency rooms].

    PubMed

    Garcia, Leila Posenato; Duarte, Elisabeth Carmen; Freitas, Lúcia Rolim Santana de; Silva, Gabriela Drummond Marques da

    2016-01-01

    This study aimed to identify factors associated with treatment of victims of domestic and family violence in emergency rooms in Brazil. This is a case-control study based on the Surveillance System for Violence and Accidents (VIVA), 2011. Women ≥ 18 years who were victims of family and domestic violence were selected as cases and compared to accident victims (controls). Adjusted odds ratios were estimated by unconditional logistic regression. 623 cases and 10,120 controls were included. Risk factors according to the adjusted analysis were younger age (18-29 years), low schooling, lack of paid work, alcohol consumption, having sought treatment in a different health service, and violence on weekends or at night or in the early morning hours. The study concludes that domestic and family violence shows alcohol consumption as a strongly associated factor. Days and hours with the highest ocurrence reveal the need to adjust emergency services to treat victims.

  7. Medical Emergency Workload of a Regional UK HEMS Service.

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2012-10-01

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

  9. 77 FR 10666 - Pipeline Safety: Post Accident Drug and Alcohol Testing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... operators of Liquefied Natural Gas (LNG) facilities to conduct post- accident drug and alcohol tests of... reviewed, along with other applicable sections of Part 199: Under Sec. 199.105, post-accident drug tests of... administering the test. Covered employees must remain available for post-accident testing, but emergency...

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

    ERIC Educational Resources Information Center

    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. 75 FR 71792 - Federal Interagency Committee on Emergency Medical Services Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

    ..., Directorate of Emergency Preparedness and Response of the Department of Homeland Security, to provide.... NHTSA-2010-0156] Federal Interagency Committee on Emergency Medical Services Meeting Notice AGENCY... Committee on Emergency Medical Services. SUMMARY: NHTSA announces a meeting of the Federal Interagency...

  12. Planning the content of a brief educational course in maxillofacial emergencies for staff in accident and emergency departments: a modified Delphi study.

    PubMed

    Elledge, Ross O C; McAleer, Sean

    2015-02-01

    It is well known that staff in accident and emergency (A&E) departments lack the knowledge and confidence needed to deal with maxillofacial emergencies, and that it is related to limited education at undergraduate and postgraduate levels. We therefore aimed to design a syllabus for a short course to educate staff about the most common emergencies. To find out which learning outcomes should be included and to reach a consensus, we did a 3-stage modified Delphi study of the opinions of members of the British Association of Oral and Maxillofacial Surgeons (BAOMS). Of a possible 890 members, 188 responded (21%) in the second round and 105 in the third (12%). Eighteen (37%) of the 49 proposed learning outcomes were rated very important and all of them were retained in the syllabus after the third round. Thirty (61%) items were retained with a consensus of 51% or above in the final round. The Delphi technique is a useful addition to the armamentarium of those involved in education, and has been used effectively in syllabus design. We achieved good consensus on the items to be included and the syllabus will be piloted locally. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Factors associated with prehospital death among traffic accident patients in Osaka City, Japan: A population-based study.

    PubMed

    Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Hayashida, Sumito; Ogura, Hiroshi; Shimazu, Takeshi

    2018-01-02

    Although it is important to assess the factors associated with traffic accident fatalities to decrease them as a matter of public health, such factors have not been fully identified. Using a large-scale data set of ambulance records in Osaka City, Japan, we retrospectively analyzed all traffic accident patients transported to hospitals by emergency medical service personnel from 2013 to 2014. In this study, prehospital death was defined as that occurring at the scene or in the emergency department immediately after hospital arrival. We assessed prehospital factors associated with prehospital death due to traffic accidents by logistic regression models. This study enrolled 28,903 emergency patients involved in traffic accidents, of whom 68 died prehospital. In a multivariate model, elderly patients aged ≥75 years (adjusted odds ratio [AOR] = 4.34; 95% confidence interval [CI], 2.29-8.23), nighttime (AOR = 2.75; 95% CI, 1.65-4.70), and type of injured person compared to bicyclists such as pedestrians (AOR = 9.58; 95% CI, 5.07-17.99), motorcyclists (AOR = 2.75; 95% CI, 1.21-6.24), and car occupants (AOR = 2.98; 95% CI, 1.39-6.40) were significantly associated with prehospital death due to traffic accidents. In addition, the AOR for automobile versus nonautomobile as the collision opponent was 4.76 (95% CI, 2.30-9.88). In this population, the factors associated with prehospital death due to traffic accidents were elderly people, nighttime, and pedestrian as the type of patient. The proportion of prehospital deaths due to traffic accidents was also high when the collision component was an automobile.

  14. 36 CFR 9.46 - Accidents and fires.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Accidents and fires. 9.46 Section 9.46 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Non-Federal Oil and Gas Rights § 9.46 Accidents and fires. The operator shall take...

  15. Information infrastructure for emergency medical services.

    PubMed

    Orthner, Helmuth; Mishra, Ninad; Terndrup, Thomas; Acker, Joseph; Grimes, Gary; Gemmill, Jill; Battles, Marcie

    2005-01-01

    The pre-hospital emergency medical and public safety information environment is nearing a threshold of significant change. The change is driven in part by several emerging technologies such as secure, high-speed wireless communication in the local and wide area networks (wLAN, 3G), Geographic Information Systems (GIS), Global Positioning Systems (GPS), and powerful handheld computing and communication services, that are of sufficient utility to be more widely adopted. We propose a conceptual model to enable improved clinical decision making in the pre-hospital environment using these change agents.

  16. A protocol for a pragmatic randomized controlled trial evaluating outcomes of emergency nurse practitioner service.

    PubMed

    Jennings, Natasha; Gardner, Glenn; O'Reilly, Gerard

    2014-09-01

    To evaluate emergency nurse practitioner service effectiveness on outcomes related to quality of care and service responsiveness. Increasing service pressures in the emergency setting have resulted in the adoption of service innovation models; the most common and rapidly expanding of these is the emergency nurse practitioner. The delivery of high quality patient care in the emergency department is one of the most important service indicators to be measured in health services today. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this model in outcomes related to safety and quality of patient care. Pragmatic randomized controlled trial at one site with 260 participants. This protocol describes a definitive prospective randomized controlled trial, which will examine the impact of emergency nurse practitioner service on key patient care and service indicators. The study control will be standard emergency department care. The intervention will be emergency nurse practitioner service. The primary outcome measure is pain score reduction and time to analgesia. Secondary outcome measures are waiting time, number of patients who did not wait, length of stay in the emergency department and representations within 48 hours. Scant research enquiry evaluating emergency nurse practitioner service on patient effectiveness and service responsiveness exists currently. This study is a unique trial that will test the effectiveness of the emergency nurse practitioner service on patients who present to the emergency department with pain. The research will provide an opportunity to further evaluate emergency nurse practitioner models of care and build research capacity into the workforce. Trial registration details: Australian and New Zealand Clinical Trials Registry dated 18th August 2013, ACTRN12613000933752. © 2014 John Wiley & Sons Ltd.

  17. 22 CFR 102.8 - Reporting accidents.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... probably be the first to be informed of the accident, in which event he will be expected to report the accident to the Foreign Service post, to the nearest Civil Aeronautics Administration office, and to his home office in the United States. If this is not the case, the Foreign Service post should report...

  18. 22 CFR 102.8 - Reporting accidents.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... probably be the first to be informed of the accident, in which event he will be expected to report the accident to the Foreign Service post, to the nearest Civil Aeronautics Administration office, and to his home office in the United States. If this is not the case, the Foreign Service post should report...

  19. 22 CFR 102.8 - Reporting accidents.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... probably be the first to be informed of the accident, in which event he will be expected to report the accident to the Foreign Service post, to the nearest Civil Aeronautics Administration office, and to his home office in the United States. If this is not the case, the Foreign Service post should report...

  20. 22 CFR 102.8 - Reporting accidents.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... probably be the first to be informed of the accident, in which event he will be expected to report the accident to the Foreign Service post, to the nearest Civil Aeronautics Administration office, and to his home office in the United States. If this is not the case, the Foreign Service post should report...

  1. 22 CFR 102.8 - Reporting accidents.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... probably be the first to be informed of the accident, in which event he will be expected to report the accident to the Foreign Service post, to the nearest Civil Aeronautics Administration office, and to his home office in the United States. If this is not the case, the Foreign Service post should report...

  2. Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data.

    PubMed

    Owens, Christabel; Hansford, Lorraine; Sharkey, Siobhan; Ford, Tamsin

    2016-03-01

    Presentation at an accident and emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood. To examine young people's perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter. Secondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16-25 with experience of self-harm. Participants reported avoiding A&E whenever possible, based on their own and others' previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further self-harm. Positive encounters were those in which they received 'treatment as usual', i.e. non-discriminatory care, delivered with kindness, which had the potential to challenge negative self-evaluation and break the cycle. The clinical needs of young people who self-harm continue to demand urgent attention. Further hypothesis testing and trials of different models of care delivery for this vulnerable group are warranted. © The Royal College of Psychiatrists 2016.

  3. Crash Injury Management for Traffic Law Enforcement Officers; Emergency Medical Services; Course Guide.

    ERIC Educational Resources Information Center

    Cleven, Arlene M.

    The course guide has been prepared to aid in planning and conducting a training program in emergency medical care for first responders to traffic accidents (expected to be patrolling law enforcement officers). This document contains a detailed description of the training program; suggestions for course planning including class size, scheduling…

  4. Research into Australian emergency services personnel mental health and wellbeing: An evidence map.

    PubMed

    Varker, Tracey; Metcalf, Olivia; Forbes, David; Chisolm, Katherine; Harvey, Sam; Van Hooff, Miranda; McFarlane, Alexander; Bryant, Richard; Phelps, Andrea J

    2018-02-01

    Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.

  5. Risk Assessment for Emergency Planning Related to Nuclear Weapons Accidents

    DTIC Science & Technology

    1985-09-25

    accidents is higher than many of the other accidents, several reviewers thought it appropriate to evaluate these accidents in more detail. In particular, it...consequences is presented in Table 2-5. The plutonium releases in the 1F-3F gram range are due to plutonium burning in Type A weapons, while the higher ...explosion given a tanker casualty varies from 0.05 (in harbor) to 0.16 (at pier) to 0.19 (at sea). Although these numbers are somewhat higher than the

  6. Aircraft accidents : method of analysis

    NASA Technical Reports Server (NTRS)

    1931-01-01

    The revised report includes the chart for the analysis of aircraft accidents, combining consideration of the immediate causes, underlying causes, and results of accidents, as prepared by the special committee, with a number of the definitions clarified. A brief statement of the organization and work of the special committee and of the Committee on Aircraft Accidents; and statistical tables giving a comparison of the types of accidents and causes of accidents in the military services on the one hand and in civil aviation on the other, together with explanations of some of the important differences noted in these tables.

  7. Improving European Wildfire Emergency Information Services

    NASA Astrophysics Data System (ADS)

    Bielski, Conrad; Whitmore, Ceri; O'Brien, Victoria; Zeug, Gunter; Kalas, Milan; Porras, Ignasi; Solé, Josep Maria; Gálvez, Pedro; Navarro, Maria; Nurmi, Pertti; Kilpinen, Juha; Ylinen, Kaisa; Furllanelo, Cesare; Maggio, Valerio; Alikadic, Azra; Dolci, Claudia

    2017-04-01

    European wildfires are a seasonal natural hazard that many regions must battle regularly. However, as European urbanization continues to encroach on natural areas and the climate changes it is likely that the frequency of wildfires will increase likewise the number of areas prone to wildfires. It is therefore paramount not only to increase public awareness of this natural hazard but also to be prepared by improving wildfire hazard forecasting, monitoring, and mapping. As part of the H2020 funded project entitled Improving Resilience to Emergencies through Advanced Cyber Technologies: I-REACT (Grant Agreement #700256) , there is a task with the goal to develop models and implement technologies to improve the support around the entire emergency management cycle with respect to wildfire hazards. Based on operational weather forecasts, pan-European geospatial data as well as regularly acquired Earth Observation imagery through the Copernicus program, and other sources of information such as social media channels a European wildfire service is being developed. This will be achieved by improving on the successes of the European Forest Fire Information Service (EFFIS) and the guidance of emergency managers experienced in wildfire hazards. Part of the research will be to reduce the number of false alarms. However, once a wildfire has been identified, the system focuses on the disaster region to provide situational information to the decision makers applying state-of-the-art approaches to improve disaster response. Post-wildfire information will continue to be produced for damage and recovery assessments. Ultimately, I-REACT expects to reduce wildfire costs to life, property and livelihood. This work will improve wildfire disaster emergency management through the development and integration of new data and technologies respectively as well as the knowledge from emergency managers who not only understand the hazard itself but also can provide insights into the information

  8. 31 CFR 594.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS... medical services. The provision of nonscheduled emergency medical services in the United States to persons...

  9. 50 CFR 401.17 - Safety and accident prevention.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Safety and accident prevention. 401.17 Section 401.17 Wildlife and Fisheries JOINT REGULATIONS (UNITED STATES FISH AND WILDLIFE SERVICE... FISHERIES CONSERVATION, DEVELOPMENT AND ENHANCEMENT § 401.17 Safety and accident prevention. In the...

  10. Profile of an accident flying squad.

    PubMed

    Little, K

    1972-09-30

    An analysis of 184 accident flying squad calls and of 280 patients injured in road accidents and treated by a flying squad based on an accident department inclusive from 1967 to 1971 has shown that such a service can provide an efficient system without disrupting the routine work of the hospital.

  11. Association between Temperature and Emergency Room Visits for Cardiorespiratory Diseases, Metabolic Syndrome-Related Diseases, and Accidents in Metropolitan Taipei

    PubMed Central

    Wang, Yu-Chun; Lin, Yu-Kai

    2014-01-01

    Objective This study evaluated risks of the emergency room visits (ERV) for cerebrovascular diseases, heart diseases, ischemic heart disease, hypertensive diseases, chronic renal failure (CRF), diabetes mellitus (DM), asthma, chronic airway obstruction not elsewhere classified (CAO), and accidents associated with the ambient temperature from 2000 to 2009 in metropolitan Taipei. Methods The distributed lag non-linear model was used to estimate the cumulative relative risk (RR) and confidence interval (CI) of cause-specific ERV associated with daily temperature from lag 0 to lag 3 after controlling for potential confounders. Results This study identified that temperatures related to the lowest risk of ERV was 26 °C for cerebrovascular diseases, 18 °C for CRF, DM, and accidents, and 30 °C for hypertensive diseases, asthma, and CAO. These temperatures were used as the reference temperatures to measure RR for the corresponding diseases. A low temperature (14°C) increased the ERV risk for cerebrovascular diseases, hypertensive diseases, and asthma, with respective cumulative 4-day RRs of 1.56 (95% CI: 1.23, 1.97), 1.78 (95% CI: 1.37, 2.34), and 2.93 (95% CI: 1.26, 6.79). The effects were greater on, or after, lag one. At 32°C, the cumulative 4-day RR for ERV was significant for CRF (RR = 2.36; 95% CI: 1.33, 4.19) and accidents (RR = 1.23; 95% CI: 1.14, 1.33) and the highest RR was seen on lag 0 for CRF (RR = 1.69; 95% CI: 1.01, 3.58), DM (RR = 1.69; 95% CI: 1.09, 2.61), and accidents (RR = 1.19; 95% CI: 1.11, 1.27). Conclusions Higher temperatures are associated with the increased ERV risks for CRF, DM, and accidents and lower temperatures with the increased ERV risks for cerebrovascular diseases, hypertensive diseases, and asthma in the subtropical metropolitan. PMID:24932702

  12. 7 CFR 3431.23 - Service to Federal government in emergency situations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23 Service to Federal government in emergency situations... 7 Agriculture 15 2014-01-01 2014-01-01 false Service to Federal government in emergency situations...

  13. 7 CFR 3431.23 - Service to Federal government in emergency situations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23 Service to Federal government in emergency situations... 7 Agriculture 15 2013-01-01 2013-01-01 false Service to Federal government in emergency situations...

  14. 7 CFR 3431.23 - Service to Federal government in emergency situations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23 Service to Federal government in emergency situations... 7 Agriculture 15 2012-01-01 2012-01-01 false Service to Federal government in emergency situations...

  15. 7 CFR 3431.23 - Service to Federal government in emergency situations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23 Service to Federal government in emergency situations... 7 Agriculture 15 2011-01-01 2011-01-01 false Service to Federal government in emergency situations...

  16. Notification: Administration of Emergency and Rapid Response Services Contracts

    EPA Pesticide Factsheets

    Project #OA-FY13-0046, October 23, 2012. The EPA OIG’s Office of Audit plans to begin the preliminary research phase of an audit evaluating Region 6’s administration and management of the Emergency and Rapid Response Services (ERRS) contracts.

  17. 78 FR 49332 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ...-0091] National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council. SUMMARY: The... emergency medical services representatives and consumers, is to advise and consult with DOT and the Federal...

  18. Does alcohol contribute to accident and emergency department attendance in elderly people?

    PubMed Central

    van der Pol, V; Rodgers, H; Aitken, P; James, O; Curless, R

    1996-01-01

    OBJECTIVE: To evaluate the possible contribution of alcohol to presentation of elderly subjects at a hospital accident and emergency (A&E) department. METHODS: 105 patients aged 70 years and over who attended the department were interviewed by a single observer using a structured questionnaire based on previously validated general population surveys. Details of alcohol consumption within the previous 24 hours were recorded. Usual consumption of alcohol in the preceding 12 months was estimated by the quantity frequency method. Alcohol dependence was screened for by the CAGE questionnaire. An assessment of disability was made using the Barthel index. Breath alcohol was measured. RESULTS: In only 2% of attenders was alcohol thought to be a contributory factor. Breath alcohol measurements were technically unsatisfactory in this age group. Regular drinkers were functionally and socially more independent than non-regular drinkers. Drinking patterns in this age group may partly be determined by the physical ability to obtain alcohol. CONCLUSIONS: Alcohol was not found to be a major factor in A&E attendance in elderly people. PMID:8832344

  19. Assessment of Emergency Medical Services in the Ashanti Region of Ghana.

    PubMed

    Mould-Millman, N K; Oteng, R; Zakariah, A; Osei-Ampofo, M; Oduro, G; Barsan, W; Donkor, P; Kowalenko, T

    2015-09-01

    We aimed to assess the structure, function and performance of Ashanti Region's emergency medical services system in the context of the regional need for prehospital emergency care. A mixed-methods approach was employed, using retrospective collection of quantitative data and prospectively gathered qualitative data. Setting - pertinent data were collected from Ghanaian and international sources; interviews and technical assessments were performed primarily in the Ashanti Region of Ghana. All stakeholders relevant to emergency medical services in the Ashanti Region of Ghana were assessed; there was a special focus on National Ambulance Service (NAS) and Ashanti Region healthcare personnel. This was an observational study using qualitative and quantitative assessment techniques. The structure, function and performance of the Ashanti emergency medical services system, guided by a relevant technical assessment framework. NAS is the premier and only true prehospital agency in the Ashanti Region. NAS has developed almost every essential aspect of an EMS system necessary to achieve its mission within a low-resource setting. NAS continues to increase its number of response units to address the overwhelming Ashanti region demand, especially primary calls. Deficient areas in need of development are governance, reliable revenue, public access, community integration, clinical care guidelines, research and quality assurance processes. The Ashanti Region has a growing and thriving emergency medical services system. Although many essential areas for development were identified, NAS is well poised to meet the regional demand for prehospital emergency care and transport.

  20. 78 FR 30727 - Emergency Medical Services Week, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ... Medical Services Week, 2013 By the President of the United States of America A Proclamation In every.... During Emergency Medical Services Week, we pause to offer our gratitude to these remarkable men and women, whose dedication is fundamental to our society's well-being. In recent weeks, we have again seen the...

  1. A new system for digital image acquisition, storage and presentation in an accident and emergency department

    PubMed Central

    Clegg, G; Roebuck, S; Steedman, D

    2001-01-01

    Objectives—To develop a computer based storage system for clinical images—radiographs, photographs, ECGs, text—for use in teaching, training, reference and research within an accident and emergency (A&E) department. Exploration of methods to access and utilise the data stored in the archive. Methods—Implementation of a digital image archive using flatbed scanner and digital camera as capture devices. A sophisticated coding system based on ICD 10. Storage via an "intelligent" custom interface. Results—A practical solution to the problems of clinical image storage for teaching purposes. Conclusions—We have successfully developed a digital image capture and storage system, which provides an excellent teaching facility for a busy A&E department. We have revolutionised the practice of the "hand-over meeting". PMID:11435357

  2. Profile of an Accident Flying Squad

    PubMed Central

    Little, Keith

    1972-01-01

    An analysis of 184 accident flying squad calls and of 280 patients injured in road accidents and treated by a flying squad based on an accident department inclusive from 1967 to 1971 has shown that such a service can provide an efficient system without disrupting the routine work of the hospital. PMID:5076258

  3. 77 FR 46802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ...-0100] National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council. SUMMARY: The... NEMSAC is to provide a nationally recognized council of emergency medical services representatives and...

  4. Cost of a roller skating rink to the local accident and emergency department.

    PubMed Central

    Nayeem, N; Shires, S E; Porter, J E

    1990-01-01

    A 14 month retrospective study was undertaken to determine the cost implications of the opening of a roller skating rink to the local hospital accident and emergency department (A and E). A total of 398 patients attended following injury at the roller skating rink, of whom 384 were included in the study. The estimated cost of their injuries was determined by the hospital accounts department. The average cost per patient attending the A and E department following roller skating injury was about 100 pounds. The total cost to the A and E department of all injuries sustained at the rink over this period was 38,412 pounds. The cost implications of opening a roller skating rink for the A and E department are considerable. If proposals for self-budgeting are applied, A and E departments will have to seek additional funding if such leisure facilities are opened in their vicinity. PMID:2097020

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

    PubMed

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

    2016-03-01

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

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

    PubMed

    Dick, W

    1994-01-01

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

  7. Acute stress reactions after submarine accidents.

    PubMed

    Eid, Jarle; Johnsen, Bjørn Helge

    2002-05-01

    The aim of the present study was to explore contextual and individual factors associated with acute stress reactions in three Norwegian submarine crews exposed to different significant peacetime maneuver accidents. Approximately 2 to 3 weeks after the accidents, crew members completed the Coping Style Questionnaire, the General Health Questionnaire, the Impact of Event Scale, and the Post-Traumatic Symptom Scale. Although exposed subjects (N = 47) revealed more posttraumatic stress symptoms than nonexposed crew members on shore leave (N = 7), they showed less acute stress reactions than survivors from a surface ship accident in the Norwegian Navy. Inspection of individual cases revealed that 4% of the exposed submariners showed high loads of acute stress symptoms. Unit cohesion and habitual coping styles emerged as resilience factors, whereas previous exposure to critical incidents and personal experience of not coping in the accident situation emerged as vulnerability factors, explaining 32% of the acute stress reactions reported by submarine crew members.

  8. 1999 Kentucky traffic accident facts

    DOT National Transportation Integrated Search

    1999-01-01

    KENTUCKYS TRAFFIC COLLISION FACTS report for 1999 is based on accident reports submitted to the Accident Unit housed in the Kentucky State Police Information Services Branch, Records Section. As required by Kentucky Revised statutes 189.635, ev...

  9. [Diagnosis and treatment of diving accidents. New German guidelines for diving accidents 2014-2017].

    PubMed

    Jüttner, B; Wölfel, C; Liedtke, H; Meyne, K; Werr, H; Bräuer, T; Kemmerer, M; Schmeißer, G; Piepho, T; Müller, O; Schöppenthau, H

    2015-06-01

    In 2015 the German Society for Diving and Hyperbaric Medicine (GTÜM) and the Swiss Underwater and Hyperbaric Medical Society (SUHMS) published the updated guidelines on diving accidents 2014-2017. These multidisciplinary guidelines were developed within a structured consensus process by members of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), the Sports Divers Association (VDST), the Naval Medical Institute (SchiffMedInst), the Social Accident Insurance Institution for the Building Trade (BG BAU), the Association of Hyperbaric Treatment Centers (VDD) and the Society of Occupational and Environmental Medicine (DGAUM). This consensus-based guidelines project (development grade S2k) with a representative group of developers was conducted by the Association of Scientific Medical Societies in Germany. It provides information and instructions according to up to date evidence to all divers and other lay persons for first aid recommendations to physician first responders and emergency physicians as well as paramedics and all physicians at therapeutic hyperbaric chambers for the diagnostics and treatment of diving accidents. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose and the following key action statements: on-site 100% oxygen first aid treatment, still patient positioning and fluid administration are recommended. Hyperbaric oxygen (HBO) recompression remains unchanged the established treatment in severe cases with no therapeutic alternatives. The basic treatment scheme recommended for diving accidents is hyperbaric oxygenation at 280 kPa. For quality management purposes there is a need in the future for a nationwide register of hyperbaric therapy.

  10. Barriers to formal emergency obstetric care services' utilization.

    PubMed

    Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

    2011-06-01

    Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be

  11. Real life safety benefits of increasing brake deceleration in car-to-pedestrian accidents: Simulation of Vacuum Emergency Braking.

    PubMed

    Jeppsson, Hanna; Östling, Martin; Lubbe, Nils

    2018-02-01

    The objective of this study is to predict the real-life benefits, namely the number of injuries avoided rather than the reduction in impact speed, offered by a Vacuum Emergency Brake (VEB) added to a pedestrian automated emergency braking (AEB) system. We achieve this through the virtual simulation of simplified mathematical models of a system which incorporates expected future advances in technology, such as a wide sensor field of view, and reductions in the time needed for detection, classification, and brake pressure build up. The German In-Depth Accident Study database and the related Pre Crash Matrix, both released in the beginning of 2016, were used for this study and resulted in a final sample of 526 collisions between passenger car fronts and pedestrians. Weight factors were calculated for both simulation model and injury risk curves to make the data representative of Germany as a whole. The accident data was used with a hypothetical AEB system in a simulation model, and injury risk was calculated from the new impact speed using injury risk curves to generate new situations using real accidents. Adding a VEB to a car with pedestrian AEB decreased pedestrian casualties by an additional 8-22%, depending on system setting and injury level, over the AEB-only system. The overall decrease in fatalities was 80-87%, an improvement of 8%. Collision avoidance was improved by 14-28%. VEB with a maximum deceleration in the middle of the modelled performance range has an effectiveness similar to that of an "early activation" system, where the AEB is triggered as early as 2 s before collision. VEB may therefore offer a substantial increase in performance without increasing false positive rates, which earlier AEB activation does. Most collisions and injuries can be avoided when AEB is supplemented by the high performance VEB; remaining cases are characterised by high pedestrian walking speed and late visibility due to view obstructions. VEB is effective in all analysed

  12. A Longitudinal Emergency Medical Services Track in Emergency Medicine Residency.

    PubMed

    Adams, Daniel; Bischof, Jason; Larrimore, Ashley; Krebs, William; King, Andrew

    2017-03-30

    Emergency medicine residency programs offer Emergency Medical Services (EMS) curricula to address Accreditation Council for Graduate Medical Education (ACGME) milestones. While some programs offer advanced clinical tracks in EMS, no standard curriculum exists. We sought to establish a well-defined EMS curriculum to allow interested residents to develop advanced clinical skills and scholarship within this subspecialty. Core EMS fellowship trained faculty were recruited to help develop the curriculum. Building on ACGME graduation requirements and milestones, important elements of EMS fellowship training were incorporated into the curriculum to develop the final document. The final curriculum focuses on scholarly activities relating to the four core areas of EMS identified by The American Board of Emergency Medicine and serves as an intermediary between ACGME graduation requirements for education in EMS and fellowship level training. Standardization of the EMS scholarly track can provide residents with the potential to obtain competency beyond ACGME requirements and prepare them for success in fellowship training and/or leadership within EMS on graduation.

  13. A Longitudinal Emergency Medical Services Track in Emergency Medicine Residency

    PubMed Central

    Bischof, Jason; Larrimore, Ashley; Krebs, William; King, Andrew

    2017-01-01

    Emergency medicine residency programs offer Emergency Medical Services (EMS) curricula to address Accreditation Council for Graduate Medical Education (ACGME) milestones. While some programs offer advanced clinical tracks in EMS, no standard curriculum exists. We sought to establish a well-defined EMS curriculum to allow interested residents to develop advanced clinical skills and scholarship within this subspecialty. Core EMS fellowship trained faculty were recruited to help develop the curriculum. Building on ACGME graduation requirements and milestones, important elements of EMS fellowship training were incorporated into the curriculum to develop the final document. The final curriculum focuses on scholarly activities relating to the four core areas of EMS identified by The American Board of Emergency Medicine and serves as an intermediary between ACGME graduation requirements for education in EMS and fellowship level training. Standardization of the EMS scholarly track can provide residents with the potential to obtain competency beyond ACGME requirements and prepare them for success in fellowship training and/or leadership within EMS on graduation. PMID:28465874

  14. [Suicidal behaviour and attempted suicide occurring during assessment by the outreach psychiatric emergency service].

    PubMed

    de Winter, R F P; de Groot, M H; van Dassen, M; Deen, M L; de Beurs, D P

    The outreach emergency psychiatric service plays an important role in recognising, arranging interventions and preventing suicide and suicidal behaviour. However, little is known about the assessments that members of the emergency team make when faced with patients showing suicidal behaviour.
    AIM: To describe the relationships that are revealed between patient characteristics, suicidal thoughts and attempted suicide during assessments made by the emergency psychiatric service in The Hague.
    METHOD: The emergency service kept a detailed record of 14,705 consultations. We compared the characteristics of patients who had suicidal thoughts with those of patients who had no such thoughts and we also compared the characteristics of patients who had attempted to commit suicide with those of patients who had not. We drew these comparisons by using logistic regression models, adjusting for clustering.
    RESULTS: 32.2% of the patients showed signs of suicidal behaviour and 9.2 % appeared likely to attempt suicide. Suicidal behaviour occurred most often in patients with depression. Suicidal patients were more often admitted to hospital than were non-suicidal patients and they were more likely to have been referred by a general practitioner or a general hospital. Medication was the most frequent means employed in attempts to commit suicide.
    CONCLUSION: In about one third of the consultations of the outreach emergency psychiatric service, the patient showed suicidal behaviour. The actions and the policy of the emergency psychiatric service with regard to suicidal behaviour were diverse and dependent on factors that could change over the course of time.

  15. Emergency health services informational and educational programs: development and present status.

    PubMed

    Pace, F C

    1967-01-28

    The development and present status of the Emergency Health Services (EHS) national and educational programs are discussed. Instituted in 1951 for medical and dental practitioners at a military school at Camp Borden, professional civilian indoctrination was later assumed by EHS at Canadian Emergency Measures College (CEMC). The federally sponsored courses there are now specialized; provincial EHS authorities undertake general indoctrination. Courses for graduates in pharmacy and nursing are also offered at CEMC. Hospital Disaster Institutes have been held across the country since 1954; Public Health Disaster Institutes, since 1966. Schools of Hygiene include the subject in graduate programs. Some years ago, three medical faculties introduced undergraduate teaching in mass casualty care; now, encouraged by the Association of Canadian Medical Colleges, a larger number are doing so. Several faculties of Dentistry, all faculties of Pharmacy, and 132 of 177 nursing schools teach apposite aspects. Professional journals have published many articles on this subject; this, for example, is the fourth Emergency Health Services Symposium presented by The Canadian Medical Association Journal.

  16. Effect of weather and time on trauma events determined using emergency medical service registry data.

    PubMed

    Lin, Li-Wei; Lin, Hsiao-Yu; Hsu, Chien-Yeh; Rau, Hsiao-Hsien; Chen, Ping-Ling

    2015-09-01

    Trauma admissions are associated with weather and temporal factors; however, previous study results regarding these factors are contradictory. We hypothesised that weather and temporal factors have different effects on specific trauma events in an emergency medical service (EMS) system. EMS data from January 1, 2009, to December 31, 2010, were obtained from the fire department of Taipei City and associated with the local weather data. EMS trauma events were categorised into total trauma, traffic accidents (TAs), motorbike accidents (MBAs), and falls. Hourly data on trauma patients were analysed using the zero-inflated Poisson model. The hourly incidence of total trauma increased with the magnitude of precipitation (incidence rate ratio [IRR]=1.06, 1.09, and 1.11 in light, moderate, and heavy rain, respectively), and this effect was more prominent in fall patients than in patients with other injuries (IRR=1.07, 1.21, and 1.32). However, the hourly incidence of TAs and MBAs was associated only with light rain (IRR=1.11 and 1.06, respectively). An hour of sunshine exposure was associated with an increase in the hourly incidence of all groups, and higher temperatures were associated with an increased hourly incidence of total trauma, TAs, and MBAs, but not falls. The hourly incidence of falls increased only in late fall and winter. Compared with the hourly incidence between 3 am and 7 am, the hourly incidence of all groups plateaued between 7 am and 11 pm and declined from 11 pm to 3 am. During the plateau period, 2 peaks in the incidence of TAs (IRR=5.03 and 5.07, respectively) and MBAs (IRR=5.81 and 5.51, respectively) were observed during 7-11 am and 3-7 pm. The hourly incidence of total trauma, TAs, and MBAs plateaued during workdays, peaked on Fridays, declined on Saturdays, and troughed on Sundays. The incidence of falls increased only on Mondays (IRR=1.09). Weather and temporal factors had different impacts on the incidence of traffic-related accidents and falls

  17. Beyond 'flood hotspots': Modelling emergency service accessibility during flooding in York, UK

    NASA Astrophysics Data System (ADS)

    Coles, Daniel; Yu, Dapeng; Wilby, Robert L.; Green, Daniel; Herring, Zara

    2017-03-01

    This paper describes the development of a method that couples flood modelling with network analysis to evaluate the accessibility of city districts by emergency responders during flood events. We integrate numerical modelling of flood inundation with geographical analysis of service areas for the Ambulance Service and the Fire & Rescue Service. The method was demonstrated for two flood events in the City of York, UK to assess the vulnerability of care homes and sheltered accommodation. We determine the feasibility of emergency services gaining access within the statutory 8- and 10-min targets for high-priority, life-threatening incidents 75% of the time, during flood episodes. A hydrodynamic flood inundation model (FloodMap) simulates the 2014 pluvial and 2015 fluvial flood events. Predicted floods (with depth >25 cm and areas >100 m2) were overlain on the road network to identify sites with potentially restricted access. Accessibility of the city to emergency responders during flooding was quantified and mapped using; (i) spatial coverage from individual emergency nodes within the legislated timeframes, and; (ii) response times from individual emergency service nodes to vulnerable care homes and sheltered accommodation under flood and non-flood conditions. Results show that, during the 2015 fluvial flood, the area covered by two of the three Fire & Rescue Service stations reduced by 14% and 39% respectively, while the remaining station needed to increase its coverage by 39%. This amounts to an overall reduction of 6% and 20% for modelled and observed floods respectively. During the 2014 surface water flood, 7 out of 22 care homes (32%) and 15 out of 43 sheltered accommodation nodes (35%) had modelled response times above the 8-min threshold from any Ambulance station. Overall, modelled surface water flooding has a larger spatial footprint than fluvial flood events. Hence, accessibility of emergency services may be impacted differently depending on flood mechanism

  18. Use of a virtual learning environment for training in maxillofacial emergencies: impact on the knowledge and attitudes of staff in accident and emergency departments.

    PubMed

    Elledge, Ross; McAleer, Sean; Thakar, Meera; Begum, Fathema; Singhota, Sanjeet; Grew, Nicholas

    2016-02-01

    Many graduates will take up junior roles in accident and emergency (A&E) departments to which a large proportion of patients present with facial injuries caused by interpersonal violence. However, it is widely recognised that undergraduates and postgraduates have few opportunities for training in oral and maxillofacial surgery. We aimed to assess the impact of a specifically designed maxillofacial emergencies virtual learning environment (VLE) on the knowledge and confidence of junior doctors in two A&E departments. They were given free access to the VLE for one month, and were asked to complete multiple choice questions and to rate their confidence to deal with 10 common situations on visual analogue scales (VAS) at baseline and one month after training. A total of 29 doctors agreed to pilot the website, 21 (72%) completed both sets of questions, and 18 (62%) completed both VAS assessments. The mean (SD) multiple choice score improved from 10 (2.52) to 13 (3.56) out of a maximum of 20 (p=0.004) and the mean (SD) VAS improved from 29.2 (19.2) mm to 45.7 (16.6) mm out of a maximum of 100 mm (p=0.007). This was a small pilot study with limited numbers, but it showed improvements in the knowledge of maxillofacial emergencies and in confidence, although the latter remained low. Further work is needed to examine how these brief educational interventions affect the attitudes of frontline staff to maxillofacial emergencies. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Patient expectations from an emergency medical service.

    PubMed

    Qidwai, Waris; Ali, Syed Sohail; Baqir, Muhammad; Ayub, Semi

    2005-01-01

    Patient expectation survey at the Emergency Medical Services can improve patient satisfaction. A need was established to conduct such a survey in order to recommend its use as a quality improvement tool. The study was conducted on patients visiting the Emergency Medical Services, Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and expectations of patients. The ethical requirements for conducting the study were met. A hundred patients were surveyed. The majority was relatively young, married men and women, well educated and better socio-economically placed. The majority of the patients expected a waiting time and a consultation time of less than 30 minutes and 20 minutes, respectively. The majority of respondents expected and agreed to be examined by a trainee but there were reluctant to be examined by the students. There was an expectation that the consultant will examine patients and not advice the attending team over the phone. The majority of the patients expected intravenous fluid therapy. There was a desire to have patient attendant present during the consultation process. The majority of the patients expected to pay less than three thousand rupees for the visit. An expectation exists for investigations and hospitalization. Involvement of patients in decisions concerning their treatment and written feedback on their visit was expected. We have documented the need and value of patient expectation survey at the Emergency Medical Services department. The use of such a tool is recommended in order to improve the satisfaction levels of patients visiting such facilities.

  20. 10-year evaluation of train accidents.

    PubMed

    Akkaş, Meltem; Ay, Didem; Metin Aksu, Nalan; Günalp, Müge

    2011-09-01

    Although less frequent than automobile accidents, train accidents have a major impact on victims' lives. Records of patients older than 16 years of age admitted to the Adult Emergency Department of Hacettepe University Medical Center due to train accidents were retrospectively evaluated. 44 patients (30 males, 14 females) with a mean age of 31.8±11.4 years were included in the study. The majority of the accidents occurred during commuting hours. 37 patients were discharged, 22 of them from the emergency department. The mortality rate was 7/44 (16%). Overall mean Revised Trauma Score (RTS) was 10.5 (3 in deaths and 11.9 in survivors). In 5 patients, the cause of death was pelvic trauma leading to major vascular injury and lower limb amputation. In 1 patient, thorax and abdomen trauma and in 1 patient head injury were the causes of mortality. Primary risk factors for mortality were alcohol intoxication (100%), cardiopulmonary resuscitation on admittance (100%), recurrent suicide attempt (75%), presence of psychiatric illness (60%), and low RTS. In this study, most train accidents causing minor injuries were due to falling from the train prior to acceleration. Nevertheless, train accidents led to a mortality rate of 16% and morbidity rate of 37%. These findings draw attention to the importance of developing preventive strategies.

  1. Visualization of Traffic Accidents

    NASA Technical Reports Server (NTRS)

    Wang, Jie; Shen, Yuzhong; Khattak, Asad

    2010-01-01

    Traffic accidents have tremendous impact on society. Annually approximately 6.4 million vehicle accidents are reported by police in the US and nearly half of them result in catastrophic injuries. Visualizations of traffic accidents using geographic information systems (GIS) greatly facilitate handling and analysis of traffic accidents in many aspects. Environmental Systems Research Institute (ESRI), Inc. is the world leader in GIS research and development. ArcGIS, a software package developed by ESRI, has the capabilities to display events associated with a road network, such as accident locations, and pavement quality. But when event locations related to a road network are processed, the existing algorithm used by ArcGIS does not utilize all the information related to the routes of the road network and produces erroneous visualization results of event locations. This software bug causes serious problems for applications in which accurate location information is critical for emergency responses, such as traffic accidents. This paper aims to address this problem and proposes an improved method that utilizes all relevant information of traffic accidents, namely, route number, direction, and mile post, and extracts correct event locations for accurate traffic accident visualization and analysis. The proposed method generates a new shape file for traffic accidents and displays them on top of the existing road network in ArcGIS. Visualization of traffic accidents along Hampton Roads Bridge Tunnel is included to demonstrate the effectiveness of the proposed method.

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

    PubMed

    Rayner, Clive; Ragan, Michael R

    2018-05-01

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

  3. Emergency Medical Services Instructor Training Program of the National Standard Curriculum Revised

    DOT National Transportation Integrated Search

    1996-05-01

    In 1986, the National Highway Traffic Safety Administration (NHTSA) developed the first edition of the "Emergency Medical Services Instructor Training Program" to teach instructor skills to Emergency Medical Services (EMS) experts. In 1990, NHTSA rev...

  4. Implementation of legislative requirements for emergency medical services in prepaid group practice organizations.

    PubMed Central

    Solomon, M A

    1977-01-01

    The Health Maintenance Organization Act of 1973, the Emergency Medical Services (EMS) Systems Act of 1973, and other laws are examined for their effects on the organization and management of emergency services in prepaid group practice plans (PPGP). The study was conducted in 1974-75 by the Group Health Association of America. The data were gathered through interviews with administrators and providers of seven PPGPs and with leaders of health planning agencies in the same communities, as well as through reviews of internal documents and a 1-month utilization survey of emergency and urgent care services in each PPGP. Effects of the laws were found to be limited, with the health maintenance legislation appearing to have the greastes effect on the design of emergency servide models. In most localities, two parallel systems may operate in offering round-the-clock emergency care and programs to educate members and the public about the appropriate use of emergency facilities. The EMS legislation has had minimal effects on the design of emergency services in the PPGPs. The emergency services component is the most transitional aspect of the PPGS nad the one most amenable to change. Revisions have come through changes in internal management policy and from demands of subscribers. A regulating inference in the operation of the PGP, in the area of emergency services as well as in the delivery of primary care services, is that the plans must compete, both in costs and benefits, with available indemnity insurance coverage. The market dictates premium levels without regard to associated benefits. Additional costs for broader coverage and administrative regulatory mechanisms must be borne by the subscriber in the form of increased premiums. As a result, the utilization of expensive emergency care must be carefully controlled, and this restraint is often accomplished by requirements specifying which health problems are appropriate for the provision of emergency care, rather than

  5. [Frequently accidents and injury at school].

    PubMed

    Gautier Vargas, María; Martínez González, Vanesa

    2011-01-01

    During the time we have been in a private company that provide schools with medical care, we were surprised by the frequent and constant phone calls received to ask for our services. This fact made us take the decision to carry out a survey to find out the accidents and the most frequent injuries. According to the retrospective study we realized throughout two different academic courses in several schools in Cantabria, the 3.23% of the students have any accidents or injuries. We found out children between 11 and 15 have the highest accident rate, being 10.8 % higher when boys (rather than girls) are involved. The most common injuries are contusions 42.85%, followed by sprains 23.45%, being blows the reason in 42% of the cases, and surprisingly acts of aggression in 1%. It was also unexpected to learn that gyms, where children are taught in physical education, have the highest percent on accident rate. All these inquiries lead us to think that age, play and sports are determinant factors in the accidents happened in the school area.

  6. Increased ICU resource needs for an academic emergency general surgery service*.

    PubMed

    Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

    2014-04-01

    ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all p< 0.01). Ventilator usage, defined by percentage of total ICU days patients required mechanical ventilation, was significantly higher for acute care emergency surgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p < 0.01). Continuous renal replacement therapy usage, defined as percent of patients requiring this service, was significantly higher in acute care emergency surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p < 0.01). Acute care emergency surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p < 0.001 for each) and more likely required emergent surgery (13.7% vs 6.7% and 3.5%, all p < 0

  7. The occurrence of external causes in childhood in emergency care: epidemiological aspects, Brazil, 2014.

    PubMed

    Malta, Deborah Carvalho; Mascarenhas, Márcio Dênis Medeiros; Silva, Marta Maria Alves da; Carvalho, Mércia Gomes Oliveira de; Barufaldi, Laura Augusta; Avanci, Jovina Quintes; Bernal, Regina Tomie Ivata

    2016-12-01

    To describe emergency care for external causes in childhood, age group 0-9 years, in Brazilian capitals, collected from the Violence and Accident Surveillance System (VIVA) Survey in 2014. To review data from the VIVA survey conducted in public emergency services in 24 Brazilian capitals. Variables analyzed were gender, age group (0-1 years, 2-5 years and 6-9 years), race/skin color, type of events and injuries, aggressors and other. Eight thousand five hundred eighty-eight children received care, of which 8,164 (95%) were victims of accidents and 424 (5%) of violence. Boys suffered more accidents, most events occurred at home (65%) and discharge was the most frequent outcome. Falls were the most frequent accidents, followed by other accidents, road injury and burns. Neglect prevailed among the types of violence, followed by physical violence. The perpetrator was a child's relative in 72% of the cases, and women were the most frequent aggressors for children under 1 year, and men for children aged 6 to 9 years. Childhood accidents occurred mainly at home, and falls were the most frequent events. Family members and acquaintances perpetrated violence against children. Data point to the implementation of public prevention and child protection policies.

  8. [Accidents with foreign bodies in children under 15 years of age: epidemiological analysis of first aid services, hospitalizations, and deaths].

    PubMed

    Martins, Christine Baccarat de Godoy; Andrade, Selma Maffei de

    2008-09-01

    This study aims to analyze accidents involving foreign bodies among children less than 15 years of age residing in Londrina, Paraná State, Brazil, in terms of first aid, hospitalization, and death (2001). Data were obtained from general hospital records and the Municipal Mortality Database. A total of 434 accidents were analyzed, with a 3.7% hospitalization rate and 0.7% mortality. Boys predominated (53.7%), and the incidence rate was highest among children one to three years of age (7.2 per 1,000 children). Foreign body penetration in natural orifices (eyes, nostrils, and ears) accounted for 94%, inhalation/ingestion of food 2.8%, inhalation/ingestion of objects 2.5%, and aspiration of gastric contents 0.7%, and these causes accounted for all the deaths. The results contribute to epidemiological knowledge on such accidents and indicate the need to restructure health services in order to decentralize care for less complex injuries, besides emphasizing the need for preventive measures.

  9. Speeding response, saving lives : automatic vehicle location capabilities for emergency services

    DOT National Transportation Integrated Search

    1999-01-01

    This brochure focuses on the application of automatic vehicle location systems to emergency services. It discusses how AVL works with emergency vehicles and how it accommodates a wide range of emergency situations, and the benefits of ITS use. (3 p.)

  10. [Estimating and reporting aggression in relation to personal characteristics of emergency service workers].

    PubMed

    Penterman, E J M; van der Staak, C P F; Nijman, H L I

    2014-01-01

    Research on aggression in mental health care has focused mainly on patient characteristics, whereas very little research has been done on the characteristics of the care providers in their reporting of aggression. To study the characteristics of the care providers of an emergency service in relation to the reporting of aggression. All emergency service workers( n = 21) in the Uden-Veghel region were asked to complete a neo-pi-r form. Before 576 outreach contacts had been made with patients in psychiatric crises, the Checklist of Risks in the Crisis-team (crc) was also completed and in cases where the patient exhibited aggressive behaviour, a soas-r form was filled in, following contact with the patient. Significant differences were found between the psychiatric emergency service workers with regard to the mean estimates of the likelihood that they would experience aggression during the consultation and with regard to the proportion of patient contacts for which emergency workers reported aggression. There were indications that the level of conscientiousness of the emergency service workers was positively associated with a higher chance that they would report aggressive behaviour following the consultation. Furthermore, altruism was found to be negatively associated with the likelihood, as predicted by the service workers, that they would be confronted with aggression during contact with the patient. Possibly, workers who scored high on conscientiousness and who work thoroughly and in a orderly and systematic manner and who keep to the rules are less flexible in their response to the patient during the interaction. As a result, the patient became irritated more quickly. On the other hand, it could be that conscientious workers completed the form-filling more carefully when aggression had to be reported and as a result they made higher preliminary estimates of the likelihood of aggression and a reported a larger number of incidents of actual aggression.

  11. Ambulance traffic accidents in Taiwan.

    PubMed

    Chiu, Po-Wei; Lin, Chih-Hao; Wu, Chen-Long; Fang, Pin-Hui; Lu, Chien-Hsin; Hsu, Hsiang-Chin; Chi, Chih-Hsien

    2018-04-01

    Ambulance traffic accidents (ATAs) are the leading cause of occupation-related fatalities among emergency medical service (EMS) personnel. We aim to use the Taiwan national surveillance system to analyze the characteristics of ATAs and to assist EMS directors in developing policies governing ambulance operations. A retrospective, cross-sectional and largely descriptive study was conducted using Taiwan national traffic accidents surveillance data from January 1, 2011 to October 31, 2016. Among the 1,627,217 traffic accidents during the study period, 715 ATAs caused 8 deaths within 24 h and 1844 injured patients. On average, there was one ATA for every 8598 ambulance runs. Compared to overall traffic accidents, ATAs were 1.7 times more likely to result in death and 1.9 times more likely to have injured patients. Among the 715 ATAs, 8 (1.1%) ATAs were fatal and 707 (98.9%) were nonfatal. All 8 fatalities were associated with motorcycles. The urban areas were significantly higher than the rural areas in the annual number of ATAs (14.2 ± 7.3 [7.0-26.7] versus 3.1 ± 1.9 [0.5-8.4], p = 0.013), the number of ATA-associated fatalities per year (0.2 ± 0.2 [0.0-0.7] versus 0.1 ± 0.1 [0.0-0.2], p = 0.022), and the annual number of injured patients (who needed urgent hospital visits) in ATAs (19.4 ± 7.3 [10.5-30.9] versus 5.2 ± 3.8 [0.9-15.3], p < 0.001). The ATA-associated fatality rate in Taiwan was high, and all fatalities were associated with motorcycles. ATAs in a highly motorcycle-populated area may require further investigation. An ambulance traffic accident reporting system should be built to provide EMS policy guidance for ATA reduction and outcome improvements. Copyright © 2018. Published by Elsevier B.V.

  12. World commercial aircraft accidents

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kimura, C.Y.

    1993-01-01

    This report is a compilation of all accidents world-wide involving aircraft in commercial service which resulted in the loss of the airframe or one or more fatality, or both. This information has been gathered in order to present a complete inventory of commercial aircraft accidents. Events involving military action, sabotage, terrorist bombings, hijackings, suicides, and industrial ground accidents are included within this list. Included are: accidents involving world commercial jet aircraft, world commercial turboprop aircraft, world commercial pistonprop aircraft with four or more engines and world commercial pistonprop aircraft with two or three engines from 1946 to 1992. Each accidentmore » is presented with information in the following categories: date of the accident, airline and its flight numbers, type of flight, type of aircraft, aircraft registration number, construction number/manufacturers serial number, aircraft damage, accident flight phase, accident location, number of fatalities, number of occupants, cause, remarks, or description (brief) of the accident, and finally references used. The sixth chapter presents a summary of the world commercial aircraft accidents by major aircraft class (e.g. jet, turboprop, and pistonprop) and by flight phase. The seventh chapter presents several special studies including a list of world commercial aircraft accidents for all aircraft types with 100 or more fatalities in order of decreasing number of fatalities, a list of collision accidents involving commercial aircrafts, and a list of world commercial aircraft accidents for all aircraft types involving military action, sabotage, terrorist bombings, and hijackings.« less

  13. Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review

    PubMed Central

    Cocker, Fiona; Joss, Nerida

    2016-01-01

    Compassion fatigue (CF) is stress resulting from exposure to a traumatized individual. CF has been described as the convergence of secondary traumatic stress (STS) and cumulative burnout (BO), a state of physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment. Professionals regularly exposed to the traumatic experiences of the people they service, such as healthcare, emergency and community service workers, are particularly susceptible to developing CF. This can impact standards of patient care, relationships with colleagues, or lead to more serious mental health conditions such as posttraumatic stress disorder (PTSD), anxiety or depression. A systematic review of the effectiveness of interventions to reduce CF in healthcare, emergency and community service workers was conducted. Thirteen relevant studies were identified, the majority of which were conducted on nurses (n = 10). Three included studies focused on community service workers (social workers, disability sector workers), while no studies targeting emergency service workers were identified. Seven studies reported a significant difference post-intervention in BO (n = 4) or STS (n = 3). This review revealed that evidence of the effectiveness of CF interventions in at-risk health and social care professions is relatively recent. Therefore, we recommend more research to determine how best to protect vulnerable workers at work to prevent not only CF, but also the health and economic consequences related to the ensuing, and more disabling, physical and mental health outcomes. PMID:27338436

  14. The epidemiology and type of injuries seen at the accident and emergency unit of a Nigerian referral center

    PubMed Central

    Adoga, Adeyi A.; Ozoilo, Kenneth N.

    2014-01-01

    Background: A plethora of injuries present at any accident and emergency unit, but the pattern of the injuries varies from region to region especially in ours with the increased ethno-religious clashes and terrorist attacks. This study aims to determine the epidemiology and type of injuries presenting to our center with the possibility of developing injury surveillance initiatives in our center and Nigeria as a whole. Materials and Methods: Injured patients consecutively presenting to the accident and emergency department of the Jos University Teaching Hospital within the period February 2011 to January 2012 were prospectively recorded. Results: A total of 720 injured patients admitted with an age range of 8 months to 75 years (mean = 37.9; SD = ±52.4), which consists of 544 males and 176 females giving a male to female ratio of 3.1:1. Patients aged 20-29 years were in the majority (n = 220, 30.6%) with peak incidences in the period of communal clashes. Injuries sustained from motorcycles were the highest (n = 248, 34.4%). Others were 160 (22.2%) in other vehicular and pedestrian injuries, machete (n = 128), gunshots (n = 92), burns (n = 36), bomb blast injuries (n = 16), fall from heights (n = 32) and miscellaneous (n = 8). Injuries sustained in communal clashes and terrorist attacks accounted for 236 (32.8%) presentations. The most common site of injury was the head (n = 30 4, 42.2%). Relatives, passersby and law enforcement agencies brought patients to the hospital with times between injury and presentation ranging from 1 h to 3 weeks. 40 (5.6%) patients were brought in dead. Conclusion: A collective effort - on the part of the government and the citizenry is required to ensure better outcomes and a safer society for all. PMID:24812451

  15. Pediatric mental health emergencies in the emergency medical services system. American College of Emergency Physicians.

    PubMed

    Dolan, Margaret A; Mace, Sharon E

    2006-10-01

    Emergency departments (EDs) are vital in the management of pediatric patients with mental health emergencies (MHE). Pediatric MHE are an increasing part of emergency medical practice because EDs have become the safety net for a fragmented mental health infrastructure which is experiencing critical shortages in services in all sectors. EDs must safely, humanely, and in a culturally and developmentally appropriate manner manage pediatric patients with undiagnosed and known mental illnesses including those with mental retardation, autistic spectrum disorders, attention deficit hyperactivity disorder (ADHD), and those experiencing a behavioral crisis. EDs also manage patients with suicidal ideation, depression, escalating aggression, substance abuse, post traumatic stress disorder, maltreatment, and those exposed to violence and unexpected deaths. EDs must address not only the physical but also the mental health needs of patients during and after mass casualty incidents and disasters. The American Academy of Pediatrics and the American College of Emergency Physicians support the following actions: advocacy for increased mental health resources, including improved pediatric mental health tools for the ED, increased mental health insurance coverage, adequate reimbursement at all levels; acknowledgment of the importance of the child's medical home, and promotion of education and research for mental health emergencies.

  16. Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

    PubMed

    Heggestad, Torhild; Børsheim, Knut Yngve

    2002-01-01

    To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998. The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases. The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS. Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.

  17. Burnout among nursing staff in accident and emergency and acute medicine: a comparative study.

    PubMed

    Gillespie, Mark; Melby, Vidar

    2003-11-01

    This study was designed to identify the prevalence of burnout among nurses working in Accident and Emergency (A & E) and acute medicine, to establish factors that contribute to stress and burnout, to determine the experiences of nurses affected by it and highlight its effects on patient care and to determine if stress and burnout have any effects on individuals outside the clinical setting. A triangulated research design was used incorporating quantitative and qualitative methods. Maslach Burnout Inventory was used. Nurses working in acute medicine experienced higher levels of emotional exhaustion than their A & E counterparts. The overall level of depersonalization was low. High levels of personal accomplishment were experienced less by junior members of staff. Stress and burnout have far reaching effects both for nurses in their clinical practice and personal lives. If nurses continue to work in their current environment without issues being tackled, then burnout will result. The science of nursing does not have to be painful, but by recognition of the existence of stress and burnout we can take the first steps towards their prevention.

  18. A seamless ubiquitous emergency medical service for crisis situations.

    PubMed

    Lin, Bor-Shing

    2016-04-01

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

  19. Modelling optimal location for pre-hospital helicopter emergency medical services.

    PubMed

    Schuurman, Nadine; Bell, Nathaniel J; L'Heureux, Randy; Hameed, Syed M

    2009-05-09

    Increasing the range and scope of early activation/auto launch helicopter emergency medical services (HEMS) may alleviate unnecessary injury mortality that disproportionately affects rural populations. To date, attempts to develop a quantitative framework for the optimal location of HEMS facilities have been absent. Our analysis used five years of critical care data from tertiary health care facilities, spatial data on origin of transport and accurate road travel time catchments for tertiary centres. A location optimization model was developed to identify where the expansion of HEMS would cover the greatest population among those currently underserved. The protocol was developed using geographic information systems (GIS) to measure populations, distances and accessibility to services. Our model determined Royal Inland Hospital (RIH) was the optimal site for an expanded HEMS - based on denominator population, distance to services and historical usage patterns. GIS based protocols for location of emergency medical resources can provide supportive evidence for allocation decisions - especially when resources are limited. In this study, we were able to demonstrate conclusively that a logical choice exists for location of additional HEMS. This protocol could be extended to location analysis for other emergency and health services.

  20. Emergency Psychiatric Services for Individuals with Intellectual Disabilities: Perspectives of Hospital Staff

    ERIC Educational Resources Information Center

    Lunsky, Yona; Gracey, Carolyn; Gelfand, Sara

    2008-01-01

    Strains on the mainstream mental health system can result in inaccessible services that force individuals with intellectual disabilities into the emergency room (ER) when in psychiatric crisis. The purpose of this study was to identify clinical and systemic issues surrounding emergency psychiatry services for people with intellectual disabilities,…

  1. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...

  2. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...

  3. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...

  4. Emergency Presentations to an Inner-City Psychiatric Service for Children and Adolescents

    ERIC Educational Resources Information Center

    Dil, L. M.; Vuijk, P. J.

    2012-01-01

    Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the…

  5. Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

    PubMed

    Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

    2014-12-01

    Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

  6. In-reach nursing services improve older patient outcomes and access to emergency care.

    PubMed

    Street, Maryann; Considine, Julie; Livingston, Patricia; Ottmann, Goetz; Kent, Bridie

    2015-06-01

    To identify the impact of in-reach services providing specialist nursing care on outcomes for older people presenting to the emergency department from residential aged care. Retrospective cohort study compared clinical outcomes of 2278 presentations from 2009 with 2051 presentations from 2011 before and after the implementation of in-reach services. Median emergency department length of stay decreased by 24 minutes (7.0 vs 6.6 hours, P < 0.001) and admission rates decreased by 23% (68 vs 45%, P < 0.001). The proportion of people with repeat emergency department visits within six months decreased by 12% (27 vs 15%). The proportion of admitted patients who were discharged with an end of life palliative care plan increased by 13% (8 vs 21%, P = 0.007). There was a significant reduction in the median length of stay, fewer hospital admissions and fewer repeat visits for people from residential aged care following implementation of in-reach services. © 2014 ACOTA.

  7. Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

    PubMed

    Rocha, T A H; da Silva, N C; Amaral, P V; Barbosa, A C Q; Rocha, J V M; Alvares, V; de Almeida, D G; Thumé, E; Thomaz, E B A F; de Sousa Queiroz, R C; de Souza, M R; Lein, A; Toomey, N; Staton, C A; Vissoci, J R N; Facchini, L A

    2017-12-01

    Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  8. An Introduction to Emergency Medical Services (EMS). Pre-Hospital Phase. Emergency Medical Services Orientation, Lesson Plan No. 9.

    ERIC Educational Resources Information Center

    Young, Derrick P.

    Designed for use with interested students at high schools, community colleges, and four-year colleges, this lesson plan was developed to provide an introduction to the pre-hospital phase of Emergency Medical Services (EMS) and to serve as a recruitment tool for the EMS Program at Kapiolani Community College (KCC) in Hawaii. The objectives of the…

  9. Effect of tele-emergency services on recruitment and retention of US rural physicians.

    PubMed

    Potter, Andrew J; Mueller, Keith J; Mackinney, A Clinton; Ward, Marcia M

    2014-01-01

    As competition for physicians intensifies in the USA, rural areas are at a disadvantage due to challenges unique to rural medical practice. Telemedicine improves access to care not otherwise available in rural settings. Previous studies have found that telemedicine also has positive effects on the work environment, suggesting that telemedicine may improve rural physician recruitment and retention, although few have specifically examined this. Using a mixed-method approach, clients of a single telemedicine service in the Upper Midwestern USA were surveyed and interviewed about their views of the impact of tele-emergency on physician recruitment and retention and the work environment. Surveys were completed by 292 clinical and administrative staff at 71 hospitals and semi-structured interviews were conducted with clinicians and administrators at 16 hospitals. Survey respondents agreed that tele-emergency had a positive effect on physician recruitment and retention and related workplace factors. Interviewees elucidated how the presence of tele-emergency played an important role in enhancing physician confidence, providing educational opportunities, easing burden, and supplementing care, workplace factors that interviewees believed would impact recruitment and retention. However, gains were limited by hospitals' interpretation of the Emergency Medical Treatment and Labor Act as requiring on-site physician coverage even if tele-emergency was used. Results indicate that, all other factors being equal, tele-emergency increases the likelihood of physicians entering and remaining in rural practice. New regulatory guidance by the Centers for Medicare and Medicaid Services related to on-site physician coverage will likely accelerate implementation of tele-emergency services in rural hospitals. Telemedicine may prove to be an increasingly valuable recruitment and retention tool for rural hospitals as competition for physicians intensifies.

  10. MDCT findings in sports and recreational accidents.

    PubMed

    Bensch, Frank V; Koivikko, Mika P; Koskinen, Seppo K

    2011-12-01

    Sports and recreational accidents involving critical areas of the body occur commonly in the general population. Reports on their demographics and recommendations for screening procedures are, however, few. To assess injuries of the craniofacial area, spine, and torso resulting from sports and recreational accidents with multidetector computed tomography (MDCT) as primary imaging method in a Level I trauma center. All emergency room CT requests over a time span of 105 months were reviewed retrospectively for trauma mechanism and injury. Patients were identified using an electronic picture archiving and communications system (PACS), and MDCT studies interpreted by two radiologists independently. Of a total of 5898 patients, 492 patients (301 boys/men, 191 girls/women, age range 2-76 years, mean 33.5 years, median 29.5 years) with sports or recreational accidents emerged. A total of 102 traumatic findings were diagnosed, thereof 72 (71%) serious. The three most commonly encountered serious injuries were intracranial injury, fractures of facial bones, and vertebral injuries. The three most common injury mechanisms were bicycling, horseback riding, and team ball sports. Patients from recreational activities were on average significantly younger (29.2 years) than those from sports accidents (36.9 years; P < 0.001). Only age groups <21 years and 41-50 years differed in injury severity from the other age groups (P = 0.004 and P = 0.063, respectively). Of all trauma mechanisms, only bicycling had a significantly increased risk of injury (P < 0.001). Injuries in sports and recreational accidents presented with an overall incidence of 21%, of which 71% are serious. The most common mechanisms of injury were bicycling, horseback riding, and team ball sports. The largest incidence of serious injury involved bicycling. Because of the high probability of a serious injury and the high energies that are often involved in these accidents, we recommend ruling out of internal injury

  11. Alcohol-control public service announcements (PSAs) and drunk-driving fatal accidents in the United States, 1996-2010.

    PubMed

    Niederdeppe, Jeff; Avery, Rosemary; Miller, Emily N

    2017-06-01

    Widespread concern regarding the detrimental effects of excessive alcohol consumption (especially by minors) and associated social problems (particularly drunk driving) continues to exist among policymakers, law enforcement officers, and the general public. Alcohol consumption is a leading contributor to death from injuries, which itself is one of the main causes of death for people under 21years of age in the United States. This study examines the relationship between the volume and timing of alcohol-control public service announcements (PSAs) and rates of drunk-driving fatal accidents in the U.S. We estimate ordinary least squares (OLS) regression models to predict rates of drunk-driving fatal accidents by state and month as a function of the volume of alcohol-control PSAs aired during the previous 8months. Models include controls for state anti-drunk-driving laws and regulations, state demographic characteristics, state taxes on alcohol, calendar year, and seasonality. Results indicate that higher volumes of anti-drunk driving PSAs airing in the preceding 2 to 3months are associated, albeit modest in magnitude, with reduced rates of drunk-driving fatal accidents. The regression coefficients are largest for adults (relative to underage drunk drivers) and when the PSAs air during prime time (relative to daytime or nighttime). We conclude that PSAs could play an important contributing role in reducing drunk-driving fatal accidents, although levels of exposure and potential effects likely remain modest due to reliance on donated air time. Well-funded anti-drunk driving campaigns could achieve higher levels of exposure and have a larger impact. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. [Implementation of the Mobile Emergency Medical Service in Brazil: action strategies and structural dimension].

    PubMed

    O'Dwyer, Gisele; Konder, Mariana Teixeira; Reciputti, Luciano Pereira; Macedo, Cesar; Lopes, Monica Guimarães Macau

    2017-08-07

    The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service. Structural difficulties included physician retention, poorly equipped dispatch centers, and shortage of ambulances. The North and Northeast were the country's most heavily affected regions. SAMU is formatted as a structuring strategy in the emergency care network, but its performance suffered the impact of limited participation by primary care in the emergency network and especially the lack of hospital beds.

  13. [Psychiatric Emergencies in the Preclinical Emergency Medicine Service in Ulm, Germany in 2000 and 2010, and Practical Consequences].

    PubMed

    Schönfeldt-Lecuona, Carlos; Gahr, Maximilian; Schütz, Stefan; Lang, Dirk; Pajonk, Frank Gerald Bernhard; Connemann, Bernhard J; Muth, Claus-Martin; Freudenmann, Roland W

    2017-07-01

    Background  Psychiatric emergencies (PE) in preclinical emergency medical services are about 5 - 10 % of all emergencies and represent often a source of difficulties in handling for the non-psychiatric professional helpers that deal with them. Studies informing about quantitative and qualitative changes of PEs in preclinical emergency medicine in Germany are scarce. Methods  Therefore, we conducted a retrospective cross-sectional study of PE in a preclinical emergency medical service based on the protocols of the emergency ambulance of the Section for Emergency Medicine at the University Hospital Ulm comparing the years 2000 and 2010. Results  We observed a significant increase of PEs from 8.8 % in the year 2000 (n = 285, from a total of n = 3227) to 10.3 % in 2010 (n = 454, from a total of n = 4425). In both years intoxications were the most common PE [2000: n = 116 (44.4 %); 2010: n = 171 (37.7 %)], followed by suicide-related behavior [2000: n = 59 (22.6 %); 2010: n = 78 (17.2 %)] and acute anxiety disorders [2000: n = 37 (13 %); 2010: n = 105 (23.1 %)]. The mentioned three conditions accounted for about 80 % of all PE. Most frequently PE occurred at the weekend and with the highest density in the evening and at night (18 - 24 h) in both years. Patients with PE were predominantly men, but the rate of women causing PE increased between 2000 and 2010. Discussion/Conclusion  This study provides preliminary data on current trends in PEs in preclinical emergency medicine in Germany and has implications for improving the medical care provided. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Time-to-collision analysis of pedestrian and pedal-cycle accidents for the development of autonomous emergency braking systems.

    PubMed

    Lenard, James; Welsh, Ruth; Danton, Russell

    2018-06-01

    The aim of this study was to describe the position of pedestrians and pedal cyclists relative to the striking vehicle in the 3 s before impact. This information is essential for the development of effective autonomous emergency braking systems and relevant test conditions for consumer ratings. The UK RAIDS-OTS study provided 175 pedestrian and 127 pedal-cycle cases based on in-depth, at-scene investigations of a representative sample of accidents in 2000-2010. Pedal cyclists were scattered laterally more widely than pedestrians (90% of cyclists within around ±80° compared to ±20° for pedestrians), however their distance from the striking vehicle in the seconds before impact was no greater (90% of cyclists within 42 m at 3 s compared to 50 m for pedestrians). This data is consistent with a greater involvement of slow moving vehicles in cycle accidents. The implication of the results is that AEB systems for cyclists require almost complete 180° side-to-side vision but do not need a longer distance range than for pedestrians. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

    PubMed

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

    2016-01-01

    Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

  16. Inappropriate--the patient or the service?

    PubMed

    Steel, J

    1995-07-01

    The inappropriate use of Accident and Emergency (A & E) departments by the public has been the subject of debate for many years. Patients often attend departments with problems which could equally have been treated by the primary care services in the community. However, despite much research into why patients choose to visit A & E departments rather than their general practitioners, efforts to reverse this trend have generally failed. If the professional view of what is appropriate cannot be enforced, perhaps the label 'inappropriate' belongs to the A & E services rather than the patient.

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

    PubMed

    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.

  18. Developing an operational capabilities index of the emergency services sector.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Collins, M.J.; Eaton, L.K.; Shoemaker, Z.M.

    2012-02-20

    In order to enhance the resilience of the Nation and its ability to protect itself in the face of natural and human-caused hazards, the ability of the critical infrastructure (CI) system to withstand specific threats and return to normal operations after degradation must be determined. To fully analyze the resilience of a region and the CI that resides within it, both the actual resilience of the individual CI and the capability of the Emergency Services Sector (ESS) to protect against and respond to potential hazards need to be considered. Thus, a regional resilience approach requires the comprehensive consideration of allmore » parts of the CI system as well as the characterization of emergency services. This characterization must generate reproducible results that can support decision making with regard to risk management, disaster response, business continuity, and community planning and management. To address these issues, Argonne National Laboratory, in collaboration with the U.S. Department of Homeland Security (DHS) Sector Specific Agency - Executive Management Office, developed a comprehensive methodology to create an Emergency Services Sector Capabilities Index (ESSCI). The ESSCI is a performance metric that ranges from 0 (low level of capabilities) to 100 (high). Because an emergency services program has a high ESSCI, however, does not mean that a specific event would not be able to affect a region or cause severe consequences. And because a program has a low ESSCI does not mean that a disruptive event would automatically lead to serious consequences in a region. Moreover, a score of 100 on the ESSCI is not the level of capability expected of emergency services programs; rather, it represents an optimal program that would rarely be observed. The ESSCI characterizes the state of preparedness of a jurisdiction in terms of emergency and risk management. Perhaps the index's primary benefit is that it can systematically capture, at a given point in time

  19. Suicide among emergency and protective service workers: A retrospective mortality study in Australia, 2001 to 2012.

    PubMed

    Milner, A; Witt, K; Maheen, H; LaMontagne, A D

    2017-01-01

    Emergency and protective services personnel (e.g., police, ambulance, fire-fighters, defence, prison and security officers) report elevated levels of job stress and health problems. While population-level research is lacking, there has been some research suggesting suicide rates may be elevated in emergency and protective services. This paper compares suicide rates between emergency and protective services occupational groups over a 12-year period (2001-2012) in Australia. Labour force data was obtained from the 2006 Australian Census. Suicide data was obtained from the National Coroners Information System (NCIS). Negative binomial regression was used to estimate the association between suicide and employment as an emergency or protective service worker (including prison and security officers) over the period 2001-2012, as compared to all other occupations. Information on suicide method was extracted from the NCIS. The age-adjusted suicide rate across all emergency and protective service workers was 22.4 (95% CI 19.5 to 25.2) per 100,000 in males and 7.8 in females (95% CI 4.6 to 11.00), compared to 15.5 per 100,000 (95% CI 15.2 to 15.9) for males and 3.4 (95% CI 3.2 to 3.6) for females in other occupations. The highest risk by subgroup was observed among those employed in the defence force, prison officers, and ambulance personnel. The major method of death for all occupational groups was hanging. Our results clearly highlight the need for suicide prevention among emergency and protective service occupations.

  20. [Mutual aid societies for industrial accidents and occupational diseases in the social security service within the framework of the Prevention of Occupational Risk Act].

    PubMed

    Albalá-Ortiz, M

    The passing of the Prevention of Industrial Risks Act, in force from 9 February 1996 has altered previous ideas on the subject, which is currently considered to be of utmost importance for national and community legislation. In this article we describe the preventive functions of the Mutual Aid Societies for Industrial Accidents and professional diseases of the National Health Service. We have analysed the current legislation so as to clarify the activities of the Mutual Aid Societies in the field of the prevention of industrial accidents, and have defined the actions which may be taken in this field according to the present laws. Two different types of preventive activities are considered: (1) Those which depend on contributions, included in the professional risks cover, and which are obliged to prepare an annual plan of the measures taken to prevent industrial accidents and professional illness, following the guidelines established by the Ministry of Labor and Social Services and according to certain priorities. (2) The functions corresponding to the services for third-party prevention exclusively for their associated companies when the Mutual Aid Society is approved as a service for third party cover. This requires a voluntary or professional contract and the financial cost is borne by the company which requests it. The objective of the current legislation is, amongst other things, to introduce the new preventive approach established by the Prevention of Industrial Risks Act in the workplace and through the Mutual Aid Societies as well as to foment a new culture of prevention.

  1. Understanding case mix across three paediatric services: could integration of primary and secondary general paediatrics alter walk-in emergency attendances?

    PubMed

    Steele, Lloyd; Coote, Nicky; Klaber, Robert; Watson, Mando; Coren, Michael

    2018-05-04

    To understand the case mix of three different paediatric services, reasons for using an acute paediatric service in a region of developing integrated care and where acute attendances could alternatively have been managed. Mixed methods service evaluation, including retrospective review of referrals to general paediatric outpatients (n=534) and a virtual integrated service (email advice line) (n=474), as well as a prospective survey of paediatric ambulatory unit (PAU) attendees (n=95) and review by a paediatric consultant/registrar to decide where these cases could alternatively have been managed. The case mix of outpatient referrals and the email advice line was similar, but the case mix for PAU was more acute.The most common parental reasons for attending PAU were referral by a community health professional (27.2%), not being able to get a general practitioner (GP) appointment when desired (21.7%), wanting to avoid accident and emergency (17.4%) and wanting specialist paediatric input (14.1%). More than half of PAU presentations were deemed most appropriate for community management by a GP or midwife. The proportion of cases suitable for community management varied by the reason for attendance, with it highestl for parents reporting not being able to get a GP appointment (85%), and lowest for those referred by community health professionals (29%). One in two attendances to acute paediatric services could have been managed in the community. Integration of paediatric services could help address parental reasons for attending acute services, as well as facilitating the community management of chronic conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. The capability of accident and emergency departments to safely decontaminate victims of chemical incidents

    PubMed Central

    Horby, P.; Murray, V.; Cummins, A.; Mackway-Jones, K.; Euripidou, R.

    2000-01-01

    Objectives—To evaluate the capability of accident and emergency (A&E) departments in six health regions of England to safely decontaminate casualties exposed to hazardous chemicals. Methods—In January 1999 a postal questionnaire was sent to the clinical director of all A&E departments in Trent, North and South Thames, South and West, North West and, Anglia and Oxford Health Regions. The questionnaire inquired about characteristics of the department, decontamination facilities and equipment, and staff training. Non-responders were sent a second questionnaire and contacted by telephone if they failed to respond to the second mailing. Results—308 of 326 departments identified (94%) returned a questionnaire. There was no significant difference in response rate by region (p = 0.99). Analysis was restricted to 154 major departments seeing more than 20 000 new attendances per year. Of these 154 departments, 109 (71%) had a written chemical incident plan but only 55 (36%) maintained a list of nearby industrial chemical sites. Fifty nine departments (38%) stated that members of staff had received training in the management of chemically contaminated casualties in the preceding year. Eighteen departments (12%) possessed the level of personal protective equipment (PPE) recommended for decontamination by the Ambulance Services Association. Ninety six departments (62%) had a designated decontamination room but only seven (7%) of them incorporated all the features generally considered necessary for safe decontamination. Forty one units (27%) had the capability to decontaminate casualties outside of the department either with warm water from a shower attachment or with a mobile decontamination unit. Thirty six departments (23%) had neither a decontamination room nor the ability to decontaminate casualties outside the department. Only 16 units (10%) had both adequate PPE and either a decontamination room or the capability to decontaminate outside the department. Conclusions

  3. Grouping of body areas affected in traffic accidents. A cohort study.

    PubMed

    León, Alba Luz; Ascuntar-Tello, Johana; Valderrama-Molina, Carlos Oliver; Giraldo, Nelson Darío; Constaín, Alfredo; Puerta, Andrés; Restrepo, Camilo; Jaimes, Fabián

    2018-03-01

    Traffic accidents are considered a public health problem and, according to the World Health Organization, currently is the eighth cause of death in the world. Specifically, pedestrians, cyclists and motorcyclists contribute half of the fatalities. Adequate clinical management in accordance with aggregation patterns of the body areas involved, as well as the characteristics of the accident, will help to reduce mortality and disability in this population. Secondary data analysis of a cohort of patients involved in traffic accidents and admitted to the emergency room (ER) of a high complexity hospital in Medellín, Colombia. They were over 15 years of age, had two or more injuries in different areas of the body and had a hospital stay of more than 24 h after admission. A cluster analysis was performed, using Ward's method and the linfinity similarity measure, to obtain clusters of body areas most commonly affected depending on the type of vehicle and the type of victim. Among 2445 patients with traffic accidents, 34% (n = 836) were admitted into the Intensive Care Unit (ICU) and the overall hospital mortality rate was 8% (n = 201). More than 50% of the patients were motorcycle riders but mortality was higher in pedestrian-car accidents (16%, n = 34). The clusters show efficient performance to separate the population depending on the severity of their injuries. Pedestrians had the highest mortality after having accidents with cars and they also had the highest number of body parts clustered, mainly on head and abdomen areas. Exploring the cluster patterns of injuries and body areas affected in traffic accidents allow to establish anatomical groups defined by the type of accident and the type of vehicle. This classification system will accelerate and prioritize ER-care for these population groups, helping to provide better health care services and to rationalize available resources.

  4. Predictors of Suicide and Accident Death in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

    PubMed Central

    Schoenbaum, Michael; Kessler, Ronald C.; Gilman, Stephen E.; Colpe, Lisa J.; Heeringa, Steven G.; Stein, Murray B.; Ursano, Robert J.; Cox, Kenneth L.

    2014-01-01

    IMPORTANCE The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multicomponent study designed to generate actionable recommendations to reduce Army suicides and increase knowledge of risk and resilience factors for suicidality. OBJECTIVES To present data on prevalence, trends, and basic sociodemographic and Army experience correlates of suicides and accident deaths among active duty Regular Army soldiers between January 1, 2004, and December 31, 2009, and thereby establish a foundation for future Army STARRS investigations. DESIGN, SETTING, AND PARTICIPANTS Analysis of trends and predictors of suicide and accident deaths using Army and Department of Defense administrative data systems. Participants were all members of the US Regular Army serving at any time between 2004 and 2009. MAIN OUTCOMES AND MEASURES Death by suicide or accident during active Army service. RESULTS The suicide rate rose between 2004 and 2009 among never deployed and currently and previously deployed Regular Army soldiers. The accident death rate fell sharply among currently deployed soldiers, remained constant among the previously deployed, and trended upward among the never deployed. Increased suicide risk was associated with being a man (or a woman during deployment), white race/ethnicity, junior enlisted rank, recent demotion, and current or previous deployment. Sociodemographic and Army experience predictors were generally similar for suicides and accident deaths. Time trends in these predictors and in the Army’s increased use of accession waivers (which relaxed some qualifications for new soldiers) do not explain the rise in Army suicides. CONCLUSIONS AND RELEVANCE Predictors of Army suicides were largely similar to those reported elsewhere for civilians, although some predictors distinct to Army service emerged that deserve more in-depth analysis. The existence of a time trend in suicide risk among never-deployed soldiers argues indirectly against the view

  5. New CPT codes: hospital, consultation, emergency and nursing facility services.

    PubMed

    Zuber, T J; Henley, D E

    1992-03-01

    New evaluation and management codes were created by the Current Procedural Terminology (CPT) Editorial Panel to ensure more accurate and consistent reporting of physician services. The new hospital inpatient codes describe three levels of service for both initial and subsequent care. Critical care services are reported according to the total time spent by a physician providing constant attention to a critically ill patient. Consultation codes are divided into four categories: office/outpatient, initial inpatient, follow-up inpatient and confirmatory. Emergency department services for both new and established patients are limited to five codes. In 1992, nursing facility services are described with either comprehensive-assessment codes or subsequent-care codes. Hospital discharge services may be reported in addition to the comprehensive nursing facility assessment. Since the 1992 CPT book will list only the new codes, and since all insurance carriers will not be using these codes in 1992, physicians are encouraged to keep their 1991 code books and contact their local insurance carriers to determine which codes will be used.

  6. Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS)

    PubMed Central

    Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

    2016-01-01

    Objectives To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Design Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. Setting North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Participants Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. Interventions NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Main outcome measures Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. Results NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014–7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. Conclusions NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community

  7. Evaluation of severe accident risks: Quantification of major input parameters: MAACS (MELCOR Accident Consequence Code System) input

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sprung, J.L.; Jow, H-N; Rollstin, J.A.

    1990-12-01

    Estimation of offsite accident consequences is the customary final step in a probabilistic assessment of the risks of severe nuclear reactor accidents. Recently, the Nuclear Regulatory Commission reassessed the risks of severe accidents at five US power reactors (NUREG-1150). Offsite accident consequences for NUREG-1150 source terms were estimated using the MELCOR Accident Consequence Code System (MACCS). Before these calculations were performed, most MACCS input parameters were reviewed, and for each parameter reviewed, a best-estimate value was recommended. This report presents the results of these reviews. Specifically, recommended values and the basis for their selection are presented for MACCS atmospheric andmore » biospheric transport, emergency response, food pathway, and economic input parameters. Dose conversion factors and health effect parameters are not reviewed in this report. 134 refs., 15 figs., 110 tabs.« less

  8. Interpreter services in emergency medicine.

    PubMed

    Chan, Yu-Feng; Alagappan, Kumar; Rella, Joseph; Bentley, Suzanne; Soto-Greene, Marie; Martin, Marcus

    2010-02-01

    Emergency physicians are routinely confronted with problems associated with language barriers. It is important for emergency health care providers and the health system to strive for cultural competency when communicating with members of an increasingly diverse society. Possible solutions that can be implemented include appropriate staffing, use of new technology, and efforts to develop new kinds of ties to the community served. Linguistically specific solutions include professional interpretation, telephone interpretation, the use of multilingual staff members, the use of ad hoc interpreters, and, more recently, the use of mobile computer technology at the bedside. Each of these methods carries a specific set of advantages and disadvantages. Although professionally trained medical interpreters offer improved communication, improved patient satisfaction, and overall cost savings, they are often underutilized due to their perceived inefficiency and the inconclusive results of their effect on patient care outcomes. Ultimately, the best solution for each emergency department will vary depending on the population served and available resources. Access to the multiple interpretation options outlined above and solid support and commitment from hospital institutions are necessary to provide proper and culturally competent care for patients. Appropriate communications inclusive of interpreter services are essential for culturally and linguistically competent provider/health systems and overall improved patient care and satisfaction. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  9. Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study.

    PubMed

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

    2015-12-01

    There is an increasing need to assess the performance of emergency ambulance services using measures other than the time taken for an ambulance to arrive on scene. In line with government policy, patients and carers can help to shape new measures of ambulance service performance. To investigate the aspects of emergency ambulance service care valued by users. Qualitative interview study. One of 11 ambulance services in England. Twenty-two users and eight of their spouses (n = 30). Users of the emergency ambulance service, experiencing different types of ambulance service response, valued similar aspects of their pre-hospital care. Users were often extremely anxious about their health, and the outcome they valued was reassurance provided by ambulance service staff that they were receiving appropriate advice, treatment and care. This sense of being reassured was enhanced by the professional behaviour of staff, which instilled confidence in their care; communication; a short wait for help; and continuity during transfers. A timely response was valued in terms of allaying anxiety quickly. The ability of the emergency ambulance service to allay the high levels of fear and anxiety felt by users is crucial to the delivery of a high quality service. Measures developed to assess and monitor the performance of emergency ambulance services should include the proportion of users reporting feeling reassured by the response they obtained. © 2014 John Wiley & Sons Ltd.

  10. Absence and Need for Fatigue Risk Management in Emergency Medical Services

    DOT National Transportation Integrated Search

    2018-01-11

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

  11. [Cerebrovascular accidents: risk factors, clinical course and prognosis in the Cardiology "B" Service of the du Point G University Hospital Center, Bamako].

    PubMed

    Coulibaly, S; Diakité, S; Diall, I B; Menta, I; Sacko, A K; Diallo, B

    2010-01-01

    Our study of series, futurology, descriptive and analytical proceeded in the service of Cardiology B of the CHU of the Point G of the 1(er) July at 31 Décember 2007 and related to 57 in-patients. It aimed to release the factors of risks, to evaluate under treatment the evolution and to determine the prognostic elements of the cerebral vascular accidents. All the patients hospitalized in the service of Cardiology G for the period of study for cerebral vascular accident documented by a cerebral TDM was included in the series. The cerebral vascular accidents represented more of the quarter (25,22 %) of the admissions. The sample counted 29 women (50,9 %) and 28 men (49,1 %) with a sex ratio of 1,03 in favour of the women. The average age was 61,17 years ± 13,71 there. Arterial hypertension (59,6 %) was the first factor of risk and in the series the ischaemic AVC constituted approximately three quarters (70,2 %) of the organic types. It was especially male and the rather female hemorrhagic lesion. The hemorrhagic AVC was noted before 30 years and the ischaemic AVC beyond. The complications were with female prevalence and identical lethality in the two sexes. The hospital death rate in the study was considerable (10,5 %). The found prognostic elements did not have statistical significance.

  12. A Hot-Line Emergency Service for the Ambulatory Frail Elderly.

    ERIC Educational Resources Information Center

    Wolf-Klein, Gisele P.; Silverstone, Felix A.

    1987-01-01

    Surveyed patients and families who used hotline emergency service in ambulatory day treatment center for frail elderly. Results revealed appropriate use of service: Most calls required medical intervention, including hospitalization in 31 percent of cases. Findings suggest that 24-hour medical coverage is necessary and cost efficient. (Author/NB)

  13. 76 FR 29131 - Emergency Medical Services Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-19

    ... Services Week, 2011 Proclamation 8675--National Defense Transportation Day and National Transportation Week, 2011 Proclamation 8676--Peace Officers Memorial Day and Police Week, 2011 Proclamation 8677--World Trade Week, 2011 Notice of May 17, 2011--Continuation of the National Emergency With Respect to the...

  14. Tethered Balloon Technology in Design Solutions for Rescue and Relief Team Emergency Communication Services.

    PubMed

    Alsamhi, Saeed Hamood; Ansari, Mohd Samar; Ma, Ou; Almalki, Faris; Gupta, Sachin Kumar

    2018-05-23

    The actions taken at the initial times of a disaster are critical. Catastrophe occurs because of terrorist acts or natural hazards which have the potential to disrupt the infrastructure of wireless communication networks. Therefore, essential emergency functions such as search, rescue, and recovery operations during a catastrophic event will be disabled. We propose tethered balloon technology to provide efficient emergency communication services and reduce casualty mortality and morbidity for disaster recovery. The tethered balloon is an actively developed research area and a simple solution to support the performance, facilities, and services of emergency medical communication. The most critical requirement for rescue and relief teams is having a higher quality of communication services which enables them to save people's lives. Using our proposed technology, it has been reported that the performance of rescue and relief teams significantly improved. OPNET Modeler 14.5 is used for a network simulated with the help of ad hoc tools (Disaster Med Public Health Preparedness. 2018;page 1 of 8).

  15. Emergency Mental Health Services for Children After the Terrorist Attacks of September 11, 2001.

    PubMed

    Bruckner, Tim A; Kim, Yonsu; Lubens, Pauline; Singh, Amrita; Snowden, Lonnie; Chakravarthy, Bharath

    2016-01-01

    Much literature documents elevated psychiatric symptoms among adults after the terrorist attacks of September 11, 2001 (9/11). We, however, know of no research in children that examines emergency mental health services following 9/11. We test whether children's emergency services for crisis mental health care rose above expected values in September 2001. We applied time-series methods to California Medicaid claims (1999-2003; N = 127,200 visits). Findings in California indicate an 8.7% increase of children's emergency mental health visits statistically attributable to 9/11. Non-Hispanic white more than African American children account for this acute rise in emergency services.

  16. Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS).

    PubMed

    Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

    2016-08-26

    To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014-7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community pharmacists supported integration into the NHS OOH services. Adopting lean thinking provided a

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

    PubMed

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

    2018-01-01

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

  18. Los Alamos National Laboratory emergency management plan. Revision 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents,more » transportation accidents, electrical accidents, and natural disasters.« less

  19. Audit of an emergency biochemistry service.

    PubMed Central

    Smellie, W S; Murphy, M J; Galloway, P J; Hinnie, J; McIlroy, J; Dryburgh, F J

    1995-01-01

    AIM--To examine a model for the evaluation of appropriateness of testing in an emergency biochemistry laboratory. METHODS--A model was devised in which incoming emergency test requests were categorised as appropriate or inappropriate. Explicit criteria were used to define eight minor categories, which were chosen to reflect accurately current working practice within the hospital and laboratory. Five junior medical staff each undertook a prospective 24 hour assessment, during which time all incoming requests were monitored and categorised according to these criteria. Concordance between monitors was evaluated before and during assessments. RESULTS--Of 509 requests, 384 (75%) were appropriate and 125 (25%) were inappropriate according to the criteria used to define categories. Inappropriate requests fell into three main groups: preoperative samples (43.2% (54/125) of all inappropriate requests), missed routine samples (33.6% (42/125)) and accelerated (priority) analyses (16% (20/125)). Various other reasons accounted for the remaining 7.2% (9/125). CONCLUSION--This model may be used to obtain valid information about current clinical and laboratory practice. Strategies to reduce the number of inappropriate requests have been identified in order to reserve the emergency service for situations of true need. PMID:8568000

  20. Enabling heterogenous multi-scale database for emergency service functions through geoinformation technologies

    NASA Astrophysics Data System (ADS)

    Bhanumurthy, V.; Venugopala Rao, K.; Srinivasa Rao, S.; Ram Mohan Rao, K.; Chandra, P. Satya; Vidhyasagar, J.; Diwakar, P. G.; Dadhwal, V. K.

    2014-11-01

    Geographical Information Science (GIS) is now graduated from traditional desktop system to Internet system. Internet GIS is emerging as one of the most promising technologies for addressing Emergency Management. Web services with different privileges are playing an important role in dissemination of the emergency services to the decision makers. Spatial database is one of the most important components in the successful implementation of Emergency Management. It contains spatial data in the form of raster, vector, linked with non-spatial information. Comprehensive data is required to handle emergency situation in different phases. These database elements comprise core data, hazard specific data, corresponding attribute data, and live data coming from the remote locations. Core data sets are minimum required data including base, thematic, infrastructure layers to handle disasters. Disaster specific information is required to handle a particular disaster situation like flood, cyclone, forest fire, earth quake, land slide, drought. In addition to this Emergency Management require many types of data with spatial and temporal attributes that should be made available to the key players in the right format at right time. The vector database needs to be complemented with required resolution satellite imagery for visualisation and analysis in disaster management. Therefore, the database is interconnected and comprehensive to meet the requirement of an Emergency Management. This kind of integrated, comprehensive and structured database with appropriate information is required to obtain right information at right time for the right people. However, building spatial database for Emergency Management is a challenging task because of the key issues such as availability of data, sharing policies, compatible geospatial standards, data interoperability etc. Therefore, to facilitate using, sharing, and integrating the spatial data, there is a need to define standards to build

  1. [Suspected child abuse in paediatric emergency service].

    PubMed

    Sabaté Rotés, A; Sancosmed Ron, M; Cebrián Rubio, R; Canet Ponsa, M; Martín González, M

    2009-07-01

    To describe the epidemiology of child abuse in an emergency department of a tertiary paediatric hospital. Descriptive and retrospective study from January 2008 to January 2006 including patients less than sixteen years of age who were suspected of being abused during the examination in the emergency department. Child maltreatment was 0.07% of all paediatric emergencies (45% physical abuse, 35% sexual abuse and 20% neglect). Mean age of 6 years old, with no gender differences. 86% were suspected of maltreatment. An adult living with the child was suspected in 67% of cases. Social and judicial procedures were activated. A total of 24 children were admitted, 14 under medical criteria and the rest in order to protect the child; 2 had serious neurological consequences and one died. Eight patients were discharged to social service care centres. We believe it is necessary to improve the pediatrician's knowledge of child abuse and to create specialized units.

  2. Innovations in Emergency Nursing: Transforming Emergency Care Through a Novel Nurse-Driven Emergency Department Telehealth Express Care Service.

    PubMed

    McHugh, Catherine; Krinsky, Rhonda; Sharma, Rahul

    2018-04-06

    Emergency department overcrowding and acuity are significant challenges to patients and staff. Low-acuity patients have extended wait times, and decreased satisfaction can have a negative effect on patient flow. A multidisciplinary ED team developed and launched the first ED-based Telehealth Express Care Service, where patients who present to the emergency department with minor complaints are offered a "virtual visit" with a board-certified emergency physician located remotely. More than 6 months into the program, more than 1,300 patients have been treated. These patients experienced decreased length of stay (2.5 hours to 38 minutes) and increased satisfaction. The program is very well received by staff members who appreciate its efficiency. Telehealth has the potential to optimize ED efficiency, increase patient satisfaction, and promote safe, high-quality provision of care. Copyright © 2018 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  3. Occupational accidents among mototaxi drivers.

    PubMed

    Amorim, Camila Rego; de Araújo, Edna Maria; de Araújo, Tânia Maria; de Oliveira, Nelson Fernandes

    2012-03-01

    The use of motorcycles as a means of work has contributed to the increase in traffic accidents, in particular, mototaxi accidents. The aim of this study was to estimate and characterize the incidence of occupational accidents among the mototaxis registered in Feira de Santana, BA. This is a cross-sectional study with descriptive and census data. Of the 300 professionals registered at the Municipal Transportation Service, 267 professionals were interviewed through a structured questionnaire. Then, a descriptive analysis was conducted and the incidence of accidents was estimated based on the variables studied. Relative risks were calculated and statistical significance was determined using the chi-square test and Fisher's exact test, considering p < 0.05. Logistic regression was used in order to perform simultaneous adjustment of variables. Occupational accidents were observed in 10.5% of mototaxis. There were mainly minor injuries (48.7%), 27% of them requiring leaves of absence from work. There was an association between the days of work per week, fatigue in lower limbs and musculoskeletal complaints, and accidents. Knowledge of the working conditions and accidents involved in this activity can be of great importance for the adoption of traffic education policies, and to help prevent accidents by improving the working conditions and lives of these professionals.

  4. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

  5. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

  6. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  7. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

  8. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

  9. 36 CFR 4.4 - Report of motor vehicle accident.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... accident. 4.4 Section 4.4 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR VEHICLES AND TRAFFIC SAFETY § 4.4 Report of motor vehicle accident. (a) The operator of a motor vehicle involved in an accident resulting in property damage, personal injury or death shall report the...

  10. 36 CFR 4.4 - Report of motor vehicle accident.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... accident. 4.4 Section 4.4 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR VEHICLES AND TRAFFIC SAFETY § 4.4 Report of motor vehicle accident. (a) The operator of a motor vehicle involved in an accident resulting in property damage, personal injury or death shall report the...

  11. Audit of thrombolysis initiated in an accident and emergency department.

    PubMed Central

    Nee, P A; Gray, A J; Martin, M A

    1994-01-01

    Early thrombolytic therapy after acute myocardial infarction is important in reducing mortality. To evaluate a system for reducing in-hospital delays to thrombolysis pain to needle and door to needle times to thrombolysis were audited in a major accident and emergency (A and E) department of a district general hospital and its coronary care unit (CCU), situated about 5 km away. Baseline performance over six months was assessed retrospectively from notes of 43 consecutive patients (group 1) transferred to the CCU before receiving thrombolysis. Subsequently, selected patients (23) were allowed to receive thrombolysis in the A and E department before transfer to the CCU. The agent was administered by medical staff in the department after receiving oral confirmation of myocardial infarction from the admitting medical officer in the CCU on receipt of fax transmission of the electrocardiogram. A second prospective audit during six months from the start of the new procedure established time intervals in 23 patients eligible to receive thrombolysis in the A and E department (group 2b) and 30 ineligible patients who received thrombolysis in the CCU (group 2a). The groups did not differ significantly in case mix, pre-hospital delay, or transfer time to the CCU. In group 2b door to needle time and pain to needle time were reduced significantly (geometric mean 38 min v 121 min (group 2a) and 128 min (group 1); 141 min v 237 min (group 2a) and 242 min (group 1) respectively, both p < 0.0001). The incidence of adverse effects was not significantly different. Nine deaths occurred (six in group 1, three in group 2b), an in-hospital mortality of 9.9%. Thrombolysis can be safely instituted in the A and E department in selected patients, significantly reducing delay to treatment. PMID:10136256

  12. 47 CFR 63.63 - Emergency discontinuance, reduction, or impairment of service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... impairment of service. 63.63 Section 63.63 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... AND IMPAIRMENT OF SERVICE BY COMMON CARRIERS; AND GRANTS OF RECOGNIZED PRIVATE OPERATING AGENCY STATUS Discontinuance, Reduction, Outage and Impairment § 63.63 Emergency discontinuance, reduction, or impairment of...

  13. An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario.

    PubMed

    Mew, E J; Ritchie, S D; VanderBurgh, D; Beardy, J L; Gordon, J; Fortune, M; Mamakwa, S; Orkin, A M

    2017-01-01

    Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. We aimed to understand emergency response systems, services, and training in remote NAN communities. We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

  14. Secondary school accident reporting in one education authority.

    PubMed

    Williams, W R; Latif, A H A; Sibert, J

    2002-01-01

    Secondary schools appear to have very different accident rates when they are compared on the basis of accident report returns. The variation may be as a result of real differences in accident rates or different reporting procedures. This study investigates accident reporting from secondary schools and, in particular, the role of the school nurse. Accident form returns covering a 2-year period were collected for statistical analysis from 13 comprehensive schools in one local education authority in Wales. School sites were visited in the following school year to obtain information about accident records held on site and accident reporting procedures. The main factors determining the number of school accident reports submitted to the education authority relate to differences in recording and reporting procedures, such as the employment of a nurse and the policy of the head teacher/safety officer on submitting accident returns. Accident and emergency department referrals from similar schools may show significant differences in specific injuries and their causes. The level of school accident activity cannot be gauged from reports submitted to the education authority. Lack of incentives for collecting good accident data, in conjunction with the degree of complacency in the current system, suggest that future accident rates and reporting activity are unlikely to change.

  15. The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: a systematic review.

    PubMed

    Jennings, Natasha; Clifford, Stuart; Fox, Amanda R; O'Connell, Jane; Gardner, Glenn

    2015-01-01

    To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools. Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis. Synthesis of the available research attempts to provide an

  16. 7 CFR 3431.23 - Service to Federal Government in emergency situations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Service to Federal Government in emergency situations...) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23...

  17. Emergency medical services

    NASA Technical Reports Server (NTRS)

    Billica, Roger; Chandler, Michael

    1994-01-01

    When NASA was established in 1958, it was known that space flight would require efforts beyond those of NASA to ensure the health and safety of our astronauts. On 10 Aug. 1958, a Secretary of Defense memorandum was signed that assigned the first Department of Defense (DOD) Manager to provide support to NASA for Project Mercury. This established a chain of command through the Joint Chiefs of Staff to the Secretary of Defense. The current charter is dated 19 Mar. 1986 and assigns the DOD Manager responsibilities to the Commander and Chief, US Space Command. The DOD Managers charter has many support areas and among them are recovery of astronauts and medical support. Today these efforts support the Space Shuttle and Space Station Programs. Briefly, the program works with each organization tasking the other through a requirements document. Level of care, communications, and recovery requirements are established; NASA and the DOD provide the capability to meet them. NASA is also responsible for the specialized training and equipment needed to meet these requirements. A Shuttle launch a KSC requires an Emergency Medical Services (EMS) coordinator on console to facilitate communications, ensure proper coverage, and coordinate with area hospitals. A contingent of NASA medical personnel are assembled to provide triage and medical support capabilities. The DOD provides medical evacuation (MEDEVAC) helicopters with surgeons and pararescue specialists (PJ's) or emergency medical technicians (EMT's). Each helicopter is equipped with at least one doctor and one PJ/EMT per astronaut crew member. Transoceanic abort landing (TAL) sites and end of mission (EOM) sites have similar structures, with TAL sites utilizing fixed wingg aircraft for MEDEVAC. The DOD also supports contingency planning for the support and return of crew members from the Space Station Freedom. Much of this support has been directed at the recovery of crew members following the landing of an Assured Crew Return

  18. ["Medical Emergency Services as Seen by Consumers". Health services research by CATI survey of the community].

    PubMed

    Rau, Rüdiger; Mensing, Monika; Brand, Helmut

    2006-01-15

    In the Wesel district (North Rhine-Westphalia), emergency ambulances have been called out with increasing frequency and hospitals report that their emergency departments (ED) are more and more being used outside consultation hours of panel doctors. Therefore, the district health conference put this issue on its agenda. The aim was to obtain data on the following questions: * What do people do when they need medical help outside consultation hours of panel doctors? * Do people know that there is an on-call duty by panel doctors? Do they know how to contact this service? Do people know the Emergency Medical Service and phone number 112 and the new phone number 19222 for Patient Transport Ambulances? The study population was defined as comprising all residents in the district of Wesel between 18 and 87 years of age (approximately 385,000 people). The sample contained 1,089 persons drawn in accordance with the Gabler-Häder method and in a second step the "birthday method" was used. The survey was carried out by the CATI Laboratory (Computer-Assisted Telephone Interviews) at the Institute of Public Health (lögd, Bielefeld, Germany) between February 18 and March 28, 2002. (1) Being asked: "How would you act in case of a non-life-threatening disease outside consultation hours of panel doctors?", 52.6% of the respondents gave at least one correct answer; 48.6 % of all given answers were "correct" (i. e., on-call duty of Statutory Health Insurance [SHI]-accredited physicians), the others were "incorrect", i. e., "I go to the hospital/emergency department" (24.3%) or "I call the phone number 112" (13%). (2) About 80% of respondents said they heard about the on-call duty of SHI physicians. (3) 95.6% of respondents stated they knew the emergency call of the fire department; 86% of these participants were able to name the correct phone number 112. (4) About 4% of the respondents said they knew the nationwide telephone number for patient transports, and 58% of these

  19. Notification: Audit of Region 6's Emergency and Rapid Response Services Contracts

    EPA Pesticide Factsheets

    Project #OA-FY13-0046, March 20, 2013. The Office of Inspector General plans to begin the fieldwork phase of our audit of Region 6’s management of the Emergency and Rapid Response Services contracts.

  20. Collegiate-Based Emergency Medical Service: Impact on Alcohol-Related Emergency Department Transports at a Small Liberal Arts College

    ERIC Educational Resources Information Center

    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…

  1. National Survey of Preventive Health Services in US Emergency Departments

    PubMed Central

    Delgado, M. Kit; Acosta, Colleen D.; Ginde, Adit A.; Wang, N. Ewen; Strehlow, Matthew C.; Khandwala, Yash S.; Camargo, Carlos A.

    2012-01-01

    Study objective We describe the availability of preventive health services in US emergency departments (EDs), as well as ED directors’ preferred service and perceptions of barriers to offering preventive services. Methods Using the 2007 National Emergency Department Inventory (NEDI)–USA, we randomly sampled 350 (7%) of 4,874 EDs. We surveyed directors of these EDs to determine the availability of (1) screening and referral programs for alcohol, tobacco, geriatric falls, intimate partner violence, HIV, diabetes, and hypertension; (2) vaccination programs for influenza and pneumococcus; and (3) linkage programs to primary care and health insurance. ED directors were asked to select the service they would most like to implement and to rate 5 potential barriers to offering preventive services. Results Two hundred seventy-seven EDs (80%) responded across 46 states. Availability of services ranged from 66% for intimate partner violence screening to 19% for HIV screening. ED directors wanted to implement primary care linkage most (17%) and HIV screening least (2%). ED directors “agreed/strongly agreed” that the following are barriers to ED preventive care: cost (74%), increased patient length of stay (64%), lack of follow-up (60%), resource shifting leading to worse patient outcomes (53%), and philosophical opposition (27%). Conclusion Most US EDs offer preventive services, but availability and ED director preference for type of service vary greatly. The majority of EDs do not routinely offer Centers for Disease Control and Prevention–recommended HIV screening. Most ED directors are not philosophically opposed to offering preventive services but are concerned with added costs, effects on ED operations, and potential lack of follow-up. PMID:20889237

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

    PubMed

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

    2015-07-01

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

  3. Association between knowledge and attitudes of school nurses towards epilepsy and the risk of accidents in Greek schools.

    PubMed

    Toli, Theodora; Sourtzi, Panagiota; Tsoumakas, Konstantinos; Kalokerinou-Anagnostopoulou, Athena

    2013-05-01

    School nurses have the ability to enhance the knowledge and tolerance of an entire community and to form more positive and sensitized attitudes to future adults. The aim of this study was to investigate the relationship between the knowledge and attitudes of nurses and the frequency of accidents caused by epilepsy in Greek schools. Our sample consisted of 306 school nurses from all over the country. It was observed that the knowledge of school nurses on epilepsy was quite high, although there were specific aspects that raise concerns on their preparedness to respond to seizure-related emergencies, while their attitudes, although positive, still need improvement. Accidents caused by epilepsy were reported by half of the nurses, and prevention was considered of major importance. Therefore, organized continuous education programs and clear guidelines by the responsible authorities would help school nurses provide better services to students with epilepsy. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Managing Emergency Situations in VANET Through Heterogeneous Technologies Cooperation.

    PubMed

    Santamaria, Amilcare Francesco; Tropea, Mauro; Fazio, Peppino; De Rango, Floriano

    2018-05-08

    Nowadays, the research on vehicular computing enhanced a very huge amount of services and protocols, aimed to vehicles security and comfort. The investigation of the IEEE802.11p, Wireless Access in Vehicular Environments (WAVE) and Dedicated Short Range Communication (DSRC) standards gave to the scientific world the chance to integrate new services, protocols, algorithms and devices inside vehicles. This opportunity attracted the attention of private/public organizations, which spent lot of resources and money to promote vehicular technologies. In this paper, the attention is focused on the design of a new approach for vehicular environments able to gather information during mobile node trips, for advising dangerous or emergency situations by exploiting on-board sensors. It is assumed that each vehicle has an integrated on-board unit composed of several sensors and Global Position System (GPS) device, able to spread alerting messages around the network, regarding warning and dangerous situations/conditions. On-board units, based on the standard communication protocols, share the collected information with the surrounding road-side units, while the sensing platform is able to recognize the environment that vehicles are passing through (obstacles, accidents, emergencies, dangerous situations, etc.). Finally, through the use of the GPS receiver, the exact location of the caught event is determined and spread along the network. In this way, if an accident occurs, the arriving cars will, probably, avoid delay and danger situations.

  5. Accident Prevention Subcommittee of the CAAAC

    EPA Pesticide Factsheets

    The Accident Prevention Subcommittee was established to provide the Chemical Emergency Preparedness and Prevention Office with stakeholder advice and counsel on scientific and technical aspects of the Clean Air Act. This committee is inactive.

  6. Designing and implementing E-health Applications in the UK's National Health Service.

    PubMed

    Bower, D Jane; Barry, Nessa; Reid, Margaret; Norrie, John

    2005-12-01

    Telemedicine/e-health applications have the potential to play an important role in Britain's National Health Service (NHS), including the NHS in Scotland. The Scottish Telemedicine Action Forum (STAF) was established by the Scottish Executive Department of Health in 1999 to take a range of applications, targeted on national priorities, into routine service. In the process it has provided insights into how advanced information and communication technologies (ICTs) can be moved from the research stage into routine service. In this article four of the projects are described and analysed focusing on the key issues that have emerged as critical for carrying projects successfully through to implementation in service as follows: 1. A multisite videoconferencing network linking 15 minor injury units to the main accident and emergency (A&E) centre. 2. A single-site neonatal intensive care "cotside" laptop system to assist communication between parents and clinical staff. 3. A single-site outpatient chronic disease management system. 4. A multisite software audit tool to support the care of cleft lip and palate patients from birth onward.

  7. Waiting room crowding and agitation in a dedicated psychiatric emergency service.

    PubMed

    El-Mallakh, Rif S; Whiteley, Amanda; Wozniak, Tanya; Ashby, McCray; Brown, Shawn; Colbert-Trowel, Danya; Pennington, Tammy; Thompson, Michael; Tasnin, Rokeya; Terrell, Christina L

    2012-05-01

    Emergency department crowding is a growing problem that impacts patient care and safety. The effect of crowding has not been examined in emergency psychiatric services. The association between patient census and use of restraints, seclusion, and anti-agitation medications as needed was examined for 1 month. A total of 689 patients were seen in 31 days. The average hourly census was 6.8 ± 2.8 (range 0 to 18). There were 33 incidences of seclusion or restraint and an additional 15 instances of medications administered for agitation. The use of seclusion, restraint, or medication for agitation was significantly associated with census (r2 = 0.3, F = 5.47, P = .036). Crowding in emergency psychiatric waiting rooms may increase the need for seclusion, restraint, or medications for agitation.

  8. The work of accident and emergency nurses: Part I. An introduction to the rules.

    PubMed

    Sbaih, L

    1997-01-01

    An ethnomethodological study was undertaken to explore the work of Accident and Emergency nurses, the aim of which was to analyse the ordinary, taken-for-granted and everyday work of those practising A & E nursing. This, the first of two papers, will examine the work of A & E nurses via a description of rules or maxims that underpin work and its everyday organization. Such a description will form the basis for part 2, which explores the specific rules of A & E nursing work. To understand the specific rules and the ways in which they contribute to organization and accomplishment of aspects of the work, the definition and use of rules should be put forward. Defining rules within the context of the work provides a means by which specific rules of work can then be explored. The rules of A & E work ensure that A & E nursing is seen and heard as a specific type of work with its own unique approach to talk and organization. This is tied in with peer and colleague views of what is deemed to be clinical competence within the A & E setting.

  9. Emergency department patient satisfaction: customer service training improves patient satisfaction and ratings of physician and nurse skill.

    PubMed

    Mayer, T A; Cates, R J; Mastorovich, M J; Royalty, D L

    1998-01-01

    Customer service initiatives in healthcare have become a popular way of attempting to improve patient satisfaction. This study investigates the effect of clinically focused customer service training on patient satisfaction in the setting of a 62,000-visit emergency department and level I trauma center. Analysis of patient complaints, patient compliments, and a statistically verified patient-satisfaction survey indicate that (1) all 14 key quality characteristics identified in the survey increased dramatically in the study period; (2) patient complaints decreased by over 70 percent from 2.6 per 1,000 emergency department (ED) visits to 0.6 per 1,000 ED visits following customer service training; and (3) patient compliments increased more than 100 percent from 1.1 per 1,000 ED visits to 2.3 per 1,000 ED visits. The most dramatic improvement in the patient satisfaction survey came in ratings of skill of the emergency physician, likelihood of returning, skill of the emergency department nurse, and overall satisfaction. These results show that clinically focused customer service training improves patient satisfaction and ratings of physician and nurse skill. They also suggest that such training may offer a substantial competitive market advantage, as well as improve the patients' perception of quality and outcome.

  10. Prehospital paediatric emergencies treated by an Australian helicopter emergency medical service.

    PubMed

    Barker, Claire L; Weatherall, Andrew D

    2014-04-01

    The aim of this study was to describe the mechanism and severity of injuries in the paediatric population treated by an Australian helicopter emergency medical service and to examine the frequency and nature of interventions performed. This information is important for planning education and continuing professional development in prehospital medicine. The study is a retrospective cohort analysis of 349 patients under the age of 16 treated by CareFlight in Sydney, Australia, between April 2007 and April 2012. Data collected included age, type of incident, medication and fluid administered, procedures performed, receiving hospital, 24 h and 30-day mortality and injuries sustained. Falls (33%), motor vehicle incidents (30%), sport injury (14%) and immersion injury (12%) were the most common mechanisms. A total of 27 children died within 30 days; nontrauma cases were proportionally overrepresented in the deaths. With respect to tasking, 59% cases involved a severely or significantly injured child. Among the children, 97% with a traumatic mechanism were transferred directly to a paediatric trauma centre.In addition, 81% of children had at least one intervention by the helicopter emergency medical services team at the incident scene, most commonly intravenous cannulation (61%), crystalloid bolus (29%), intubation (21%) and intravenous analgesia administration (15%). Paediatric prehospital patients can be of high dependency, requiring urgent critical care procedures. Training in prehospital medicine should include paediatrics. It is essential that practitioners maintain skills in venous access, airway management and provision of adequate analgesia in children.

  11. [Mortality in traffic accidents in Bayamo, Cuba 2011].

    PubMed

    Piña-Tornés, Arlines; González-Longoria, Lourdes; González-Pardo, Secundino; Acosta-González, Ariel; Vintimilla-Burgos, Patricio; Paspuel-Yar, Silvana

    2014-01-01

    With the objective of describing mortality from traffic accidents in Bayamo, Cuba, in 2011 a review was performed of injured and deceased patients due to traffic accidents, recorded in the Hospital Carlos M. de Céspedes. Of the 1,365 injured patients treated in the emergency room, the predominant groups were individuals aged 25 to 44 years comprising 372 patients (27.3%) and men comprising 1,071 (78.5%). 46 people died, most from the same age group and male. Multiple traumatisms (52.6%) and craniofacial trauma (34.2%) were the predominant injuries. Motor vehicle-pedestrian accidents stood out with a mortality of 26.3%. In conclusion, mortality from traffic accidents predominately occurs in young male adults, whose fatal consequences are due to multiple traumatisms from road accidents.

  12. Emergency Contraception Education for Health and Human Service Professionals: An Evaluation of Knowledge and Attitudes

    ERIC Educational Resources Information Center

    Colarossi, Lisa; Billowitz, Marissa; Breitbart, Vicki

    2010-01-01

    Objective: To assess the knowledge and attitudes of health care providers, health educators, and social service providers before and after a training session on emergency contraceptive pills. Design: A survey study using pre-post training measurements. Setting: Two hundred and twenty-three medical, social service, and health education providers in…

  13. Hurricane Hugo: Emergency Preparedness Planning and Response for Mental Health Services.

    ERIC Educational Resources Information Center

    Carter, Nancy C.; And Others

    This report describes how, in the aftermath of Hurricane Hugo, the South Carolina Department of Mental Health activated its Emergency Preparedness Plan to assist mental health centers and their staff in providing crisis counseling services to the general public. The first section explains the history and structure of the involvement by the…

  14. Investigating emergency room service quality using lean manufacturing.

    PubMed

    Abdelhadi, Abdelhakim

    2015-01-01

    The purpose of this paper is to investigate a lean manufacturing metric called Takt time as a benchmark evaluation measure to evaluate a public hospital's service quality. Lean manufacturing is an established managerial philosophy with a proven track record in industry. A lean metric called Takt time is applied as a measure to compare the relative efficiency between two emergency departments (EDs) belonging to the same public hospital. Outcomes guide managers to improve patient services and increase hospital performances. The patient treatment lead time within the hospital's two EDs (one department serves male and the other female patients) are the study's focus. A lean metric called Takt time is used to find the service's relative efficiency. Findings show that the lean manufacturing metric called Takt time can be used as an effective way to measure service efficiency by analyzing relative efficiency and identifies bottlenecks in different departments providing the same services. The paper presents a new procedure to compare relative efficiency between two EDs. It can be applied to any healthcare facility.

  15. Support for Interdisciplinary Approaches in Emergency Medical Services Education

    ERIC Educational Resources Information Center

    Leggio, William J., Jr.; D'Alessandro, Kenneth J.

    2015-01-01

    This article analyzes the need for Emergency Medical Services (EMS) educational programs and academicians to develop interdisciplinary educational and training opportunities with other healthcare disciplines. A literature review was conducted on EMS education and interdisciplinary approaches in healthcare education. In general, support for both…

  16. Demand and supply of emergency help: an economic analysis of Red Cross services.

    PubMed

    Hackl, Franz; Pruckner, Gerald Josef

    2006-08-01

    This paper analyzes supply and demand side characteristics of (voluntary) Red Cross services in Austria. The demand side analysis is based on a contingent valuation study on people's willingness to pay for emergency treatment, transportation services and disaster relief activities. The supply side is identified by a high percentage of volunteers in the Red Cross organization which makes the provision of emergency help at low cost possible. We find that aggregate benefits of Red Cross services exceed their cost of production. Policy conclusions are drawn with respect to future recruitment and funding: whereas intrinsic motivation is important for the decision to volunteer, and financial incentives play a minor role in general, the young Red Cross activists work voluntarily for self-realization reasons and to continue their education. Age-specific recruitment strategies accompanied by word-of-mouth advertising are recommended to address potential volunteers. As long as the volunteering character of Red Cross services will be maintained and cost of production will not go up an increase of funds does not seem necessary in the future. Moreover, a radical change in the structure of funding may crowd out both donations and voluntary labor supply.

  17. 49 CFR 234.7 - Accidents involving grade crossing signal failure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Accidents involving grade crossing signal failure..., STATE ACTION PLANS, AND EMERGENCY NOTIFICATION SYSTEMS Reports and Plans § 234.7 Accidents involving... railroad equipment and an automobile, bus, truck, motorcycle, bicycle, farm vehicle, or pedestrian at a...

  18. 49 CFR 234.7 - Accidents involving grade crossing signal failure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Accidents involving grade crossing signal failure..., STATE ACTION PLANS, AND EMERGENCY NOTIFICATION SYSTEMS Reports and Plans § 234.7 Accidents involving... railroad equipment and an automobile, bus, truck, motorcycle, bicycle, farm vehicle, or pedestrian at a...

  19. 49 CFR 234.7 - Accidents involving grade crossing signal failure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Accidents involving grade crossing signal failure..., STATE ACTION PLANS, AND EMERGENCY NOTIFICATION SYSTEMS Reports and Plans § 234.7 Accidents involving... railroad equipment and an automobile, bus, truck, motorcycle, bicycle, farm vehicle, or pedestrian at a...

  20. Building capacity in VA to provide emergency gynecology services for women.

    PubMed

    Cordasco, Kristina M; Huynh, Alexis K; Zephyrin, Laurie; Hamilton, Alison B; Lau-Herzberg, Amy E; Kessler, Chad S; Yano, Elizabeth M

    2015-04-01

    Visits to Veterans Administration (VA) emergency departments (EDs) are increasingly being made by women. A 2011 national inventory of VA emergency services for women revealed that many EDs have gaps in their resources and processes for gynecologic emergency care. To guide VA in addressing these gaps, we sought to understand factors acting as facilitators and/or barriers to improving VA ED capacity for, and quality of, emergency gynecology care. Semistructured interviews with VA emergency and women's health key informants. ED directors/providers (n=14), ED nurse managers (n=13), and Women Veteran Program Managers (n=13) in 13 VA facilities. Leadership, staff, space, demand, funding, policies, and community were noted as important factors influencing VA EDs building capacity and improving emergency gynecologic care for women Veterans. These factors are intertwined and cross multiple organizational levels so that each ED's capacity is a reflection not only of its own factors, but also those of its local medical center and non-VA community context as well as VA regional and national trends and policies. Policies and quality improvement initiatives aimed at building VA's emergency gynecologic services for women need to be multifactorial and aimed at multiple organizational levels. Policies need to be flexible to account for wide variations across EDs and their medical center and community contexts. Approaches that build and encourage local leadership engagement, such as evidence-based quality improvement methodology, are likely to be most effective.

  1. Appraisals and Cognitive Coping Styles Associated with Chronic Post-Traumatic Symptoms in Child Road Traffic Accident Survivors

    ERIC Educational Resources Information Center

    Stallard, Paul; Smith, Elisabeth

    2007-01-01

    Background: Comparatively little is known about the cognitive appraisals and coping styles of child road traffic accident (RTA) survivors that are associated with chronic post-traumatic reactions. Methods: Seventy-five children and young people aged 7-18 who were involved in a road traffic accident and attended an accident and emergency department…

  2. Risk Factors of Road Traffic Accidents Associated Mortality in Northern Iran; A Single Center Experience Utilizing Oaxaca Blinder Decomposition.

    PubMed

    Sherafati, Faranak; Homaie-Rad, Enayatollah; Afkar, Abolhassan; Gholampoor-Sigaroodi, Ramin; Sirusbakht, Soheil

    2017-04-01

    To investigate the differences in death after receiving emergency services in traffic accidents between urban and rural regions, and decompose factors of the gap in Langerood, Northern Iran. This cross-sectional study was conducted in Langrood, Northern Iran during a 1-year period from 2013 to 2014. The hospital data of traffic crashes were used. Data contained those patients who survived at the scene of accident. Injury severity score, time to admission, age, gender, season of crash and type of collision were variables used in this study. Oaxaca decomposition technique was used to show the amount of inequity. In addition, three regression models were used to show the reason of inequity. Overall 1520 patients with road traffic accidents were admitted to our center during the study period. The mean age of the patients was 35.45 ± 17.9 years, and there were 1158 (76.1 %) men among the victims. Motorbike accidents accounted for 869 (57.1%) injuries and 833 (54.8 %) accidents occurred in rural regions. The in-hospital mortality rate was 60 (3.9%). The results of this study showed that 95% of inequity came from factors used in this study and 2.04% disadvantages were for rural crashes. Severity of crash and time to admission had relationship with death, while the effects of time to admission was higher in rural region and severity of the accident had more effect on mortality in urban regions in comparison with rural ones. The high rate of fatal accidents could be decreased by deleting the gap of access to health care services between urban and rural regions. This study suggested that more efforts of health system are needed to reduce the gap.

  3. Risk Factors of Road Traffic Accidents Associated Mortality in Northern Iran; A Single Center Experience Utilizing Oaxaca Blinder Decomposition

    PubMed Central

    Sherafati, Faranak; Homaie Rad, Enayatollah; Afkar, Abolhassan; Gholampoor-Sigaroodi, Ramin; Sirusbakht, Soheil

    2017-01-01

    Objectives: To investigate the differences in death after receiving emergency services in traffic accidents between urban and rural regions, and decompose factors of the gap in Langerood, Northern Iran. Methods: This cross-sectional study was conducted in Langrood, Northern Iran during a 1-year period from 2013 to 2014. The hospital data of traffic crashes were used. Data contained those patients who survived at the scene of accident. Injury severity score, time to admission, age, gender, season of crash and type of collision were variables used in this study. Oaxaca decomposition technique was used to show the amount of inequity. In addition, three regression models were used to show the reason of inequity. Results: Overall 1520 patients with road traffic accidents were admitted to our center during the study period. The mean age of the patients was 35.45 ± 17.9 years, and there were 1158 (76.1 %) men among the victims. Motorbike accidents accounted for 869 (57.1%) injuries and 833 (54.8 %) accidents occurred in rural regions. The in-hospital mortality rate was 60 (3.9%). The results of this study showed that 95% of inequity came from factors used in this study and 2.04% disadvantages were for rural crashes. Severity of crash and time to admission had relationship with death, while the effects of time to admission was higher in rural region and severity of the accident had more effect on mortality in urban regions in comparison with rural ones. Conclusion: The high rate of fatal accidents could be decreased by deleting the gap of access to health care services between urban and rural regions. This study suggested that more efforts of health system are needed to reduce the gap.    PMID:28507999

  4. Use of health services by adult Latin American immigrants residing in Seville.

    PubMed

    González-López, José Rafael; Rodríguez-Gázquez, María de Los Ángeles; Lomas-Campos, María de Las Mercedes

    2014-01-01

    This work sought to describe the use of health services by adult Latin American immigrants from Seville. This was a descriptive cohort study with the participation of 190 adult Latin American immigrants from 25 to 44 years of age, residing in the city of Seville (Spain) in 2011. A self-report survey was applied. Within the past year, 67% of the individuals have visited a physician and 23% have attended nursing consultation. A total of 14% of the immigrants who called on a healthcare center reported that their experience was worse than that of others. La annual prevalence by accidents was: 10% domestic, 4% traffic-related and 9% occupational; nearly half these accidents justified emergency care or hospitalization due to their severity. The logistic regression model revealed that health services were used mostly by: women, those in poor self-perceived health status, those with secondary level of education, the elderly, and those who were single. The population studied presents adequate use of health services, although it would be recommendable to implement prevention activities by nurses in the immigrant's work and family environment to reduce the accident incidence described by this group.

  5. 31 CFR 594.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency medical services. 594.507 Section 594.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS...

  6. 31 CFR 594.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency medical services. 594.507 Section 594.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS...

  7. 31 CFR 546.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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 Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DARFUR SANCTIONS REGULATIONS...

  8. 31 CFR 545.517 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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 Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TALIBAN (AFGHANISTAN) SANCTIONS...

  9. 31 CFR 510.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency medical services. 510.507 Section 510.507 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS...

  10. 31 CFR 551.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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 Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SOMALIA SANCTIONS REGULATIONS...

  11. Illicit drugs in Emergency Department patients injured in road traffic accidents.

    PubMed

    Papa, Pietro; Rocchi, Loretta; Rolandi, Laura Maria; Di Tuccio, Marcello; Biffi, Marco; Valli, Antonella

    2017-01-01

    Urine and blood samples from 1730 drivers involved in road accidents (July 2012 - December 2015) were analyzed for the evaluation of driving under influence of drug of abuse according to the Lombardia Region guideline. The 22.5% (95% CI 20.5 to 24.5) of urine screenings tested positive for at least one class of drugs. 10.6% (95% CI 9.2 to 12.1) of the 1730 drivers were under the influence of drug, being blood concentration above the cut-off limit for at least one active substance; the proportion of illicit drugs in blood was cocaine 5.7 % (95% CI 4.7 to 6.9), cannabinoids 3.7 % (95% CI 2.9 to 4.7), opiates 1.4% (95% CI 0.9 to 2.1), methadone 1.4% (95% CI 0.9 to 2.1), amphetamines 0.2% (95% CI 0.04 to 0.5). Trend in proportion showed similar percentage (about 5%) of cocaine and cannabinoids consumption in the last two years. Poly-drug of abuse consumption emerged in the 10.4% (95% CI 6.4 to 15.7) of the positive blood and alcohol was above the legal limit in 47% (95% CI 39.6 to 54.5) of the subjects driving under the influence of drugs.

  12. Improving rural emergency medical services (EMS) through transportation system enhancements.

    DOT National Transportation Integrated Search

    2014-05-01

    Improved emergency medical services (EMS) will impact traffic safety and public health in rural : communities. Better planned, designed, and operated roadway networks that connect hospitals with : communities in need will enhance EMS performance. To ...

  13. Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: a decision-making approach.

    PubMed

    Barrett, Barbara; Byford, Sarah; Crawford, Mike J; Patton, Robert; Drummond, Colin; Henry, John A; Touquet, Robin

    2006-01-04

    We present the cost and cost-effectiveness of referral to an alcohol health worker (AHW) and information only control in alcohol misusing patients. The study was a pragmatic randomised controlled trial conducted from April 2001 to March 2003 in an accident and emergency department (AED) in a general hospital in London, England. A total of 599 adults identified as drinking hazardously according to the Paddington Alcohol Test were randomised to referral to an alcohol health worker who delivered a brief intervention (n = 287) or to an information only control (n = 312). Total societal costs, including health and social services costs, criminal justice costs and productivity losses, and clinical measures of alcohol consumption were measured. Levels of drinking were observably lower in those referred to an AHW at 12 months follow-up and statistically significantly lower at 6 months follow-up. Total costs were not significantly different at either follow-up. Referral to AHWs in an AED produces favourable clinical outcomes and does not generate a significant increase in cost. A decision-making approach revealed that there is at least a 65% probability that referral to an AHW is more cost-effective than the information only control in reducing alcohol consumption among AED attendees with a hazardous level of drinking.

  14. Circuit board accident--organizational dimension hidden by prescribed safety.

    PubMed

    de Almeida, Ildeberto Muniz; Buoso, Eduardo; do Amaral Dias, Maria Dionísia; Vilela, Rodolfo Andrade Gouveia

    2012-01-01

    This study analyzes an accident in which two maintenance workers suffered severe burns while replacing a circuit breaker panel in a steel mill, following model of analysis and prevention of accidents (MAPA) developed with the objective of enlarging the perimeter of interventions and contributing to deconstruction of blame attribution practices. The study was based on materials produced by a health service team in an in-depth analysis of the accident. The analysis shows that decisions related to system modernization were taken without considering their implications in maintenance scheduling and creating conflicts of priorities and of interests between production and safety; and also reveals that the lack of a systemic perspective in safety management was its principal failure. To explain the accident as merely non-fulfillment of idealized formal safety rules feeds practices of blame attribution supported by alibi norms and inhibits possible prevention. In contrast, accident analyses undertaken in worker health surveillance services show potential to reveal origins of these events incubated in the history of the system ignored in practices guided by the traditional paradigm.

  15. Mobile phone use for contacting emergency services in life-threatening circumstances.

    PubMed

    Wu, Olivia; Briggs, Andrew; Kemp, Tom; Gray, Alastair; MacIntyre, Kate; Rowley, Jack; Willett, Keith

    2012-03-01

    The potential health benefits of mobile phone use have not been widely studied, except for telemedicine-type applications. This study seeks to determine whether initial contact with emergency services via a mobile phone in life-threatening situations is associated with potential health benefits when compared to contact via a landline. A record-linkage study was carried out in which data from all emergency dispatches for immediately life-threatening events from a United Kingdom county ambulance service were linked to the Patient Admission System at two major local hospitals. Mortality (at the scene, at the emergency department [ED], and during hospitalization); transfer to the ED; admission (inpatient care, and intensive care unit); and length of stay were analyzed for calls classified as Code Red (immediately life-threatening) by initial exposure (mobile phone vs. landline), while controlling for potential confounding variables. Of 354,199 ambulances dispatched to attend emergency incidents, 66% transported patients to the hospital while 2% stood down due to death at the scene. Mobile phone compared to landline reporting of emergencies resulted in significant reductions in the risk of death at the scene (odds ratio [OR] 0.77), but not for death in the ED or during inpatient admission. The risk of being transferred to the ED and subsequent inpatient admission were significantly lower with reporting from mobile phones compared to landline (OR 0.93 and OR 0.82, respectively). In this study, evidence of statistical association was demonstrated between the use of mobile phones to alert ambulance services in life-threatening situations and improved outcomes for patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Ethical challenges in Emergency Medical Services: controversies and recommendations.

    PubMed

    Becker, Torben K; Gausche-Hill, Marianne; Aswegan, Andrew L; Baker, Eileen F; Bookman, Kelly J; Bradley, Richard N; De Lorenzo, Robert A; Schoenwetter, David J

    2013-10-01

    Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. This article describes some of the common situations with ethical underpinnings encountered by EMS personnel and managers including denying or delaying transport of patients with non-emergency conditions, use of lights and sirens for patient transport, determination of medical futility in the field, termination of resuscitation, restriction of EMS provider duty hours to prevent fatigue, substance abuse by EMS providers, disaster triage and difficulty in switching from individual care to mass-casualty care, and the challenges of child maltreatment recognition and reporting. A series of ethical questions are proposed, followed by a review of the literature and, when possible, recommendations for management.

  17. Three Types of Memory in Emergency Medical Services Communication

    ERIC Educational Resources Information Center

    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…

  18. 31 CFR 510.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... services. 510.507 Section 510.507 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 510.507 Authorization of emergency medical... property and interests in property are blocked pursuant to § 510.201(b) is authorized, provided that all...

  19. 31 CFR 510.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... services. 510.507 Section 510.507 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 510.507 Authorization of emergency medical... property and interests in property are blocked pursuant to § 510.201(b) is authorized, provided that all...

  20. 31 CFR 510.507 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... services. 510.507 Section 510.507 Money and Finance: Treasury Regulations Relating to Money and Finance... Licenses, Authorizations, and Statements of Licensing Policy § 510.507 Authorization of emergency medical... property and interests in property are blocked pursuant to § 510.201(b) is authorized, provided that all...

  1. 31 CFR 593.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency medical services. 593.508 Section 593.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF CHARLES...

  2. 31 CFR 593.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency medical services. 593.508 Section 593.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF CHARLES...

  3. 31 CFR 593.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Authorization of emergency medical services. 593.508 Section 593.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF CHARLES...

  4. 31 CFR 593.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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 Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF CHARLES...

  5. 31 CFR 593.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Authorization of emergency medical services. 593.508 Section 593.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF CHARLES...

  6. 31 CFR 547.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Authorization of emergency medical services. 547.508 Section 547.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO...

  7. 31 CFR 547.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Authorization of emergency medical services. 547.508 Section 547.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO...

  8. 31 CFR 547.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Authorization of emergency medical services. 547.508 Section 547.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO...

  9. 31 CFR 547.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Authorization of emergency medical services. 547.508 Section 547.508 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO...

  10. 31 CFR 547.508 - Authorization of emergency medical services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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 Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO...

  11. [Occupational accidents in Barcelona (Spain), from 1992 to 1993].

    PubMed

    Sampaio, R F; Martin, M; Artazcoz, L; Moncada, S

    1998-08-01

    The statistics related to labor accidents as with any other notification system ought to be the basis for programs and policies with a view to the adoption of preventive measures. In order to establish preventive norms, however, the health system needs data from researchers focussing on the dynamics of and the pitfalls revealed by specific events. Within this context the main objective of this study is to proceed with an in-depth analysis of the labor accidents verified in Barcelona (Spain) using for this purpose a descriptive statistics model to test variables such as type of accident, economic sector, economic enterprise and type of labor contract. The data source utilized was the notification system for labor accidents with grave consequences such as death of the victim registered in Barcelona during the period 1992-1993. Labor accidents registered for male workers numbered 848. A log-linear model was applied to this data base. The results show a positive association between traumatic accidents with the construction, traffic and services sectors. A positive association was also found between traumatic accidents and the size of the company concerved the small ones being the worse type in terms of worker's injuries. Regarding the nontraumatic accidents, the study showed a positive correlation between large-sized enterprises and type of temporary worker and the civil construction sector as compared to workers with long term work contracts within industry and services. There was some evidence, also, of a positive association between small and medium sized companies and temporary work and the occurrence of work accidents.

  12. RENEB accident simulation exercise.

    PubMed

    Brzozowska, Beata; Ainsbury, Elizabeth; Baert, Annelot; Beaton-Green, Lindsay; Barrios, Leonardo; Barquinero, Joan Francesc; Bassinet, Celine; Beinke, Christina; Benedek, Anett; Beukes, Philip; Bortolin, Emanuela; Buraczewska, Iwona; Burbidge, Christopher; De Amicis, Andrea; De Angelis, Cinzia; Della Monaca, Sara; Depuydt, Julie; De Sanctis, Stefania; Dobos, Katalin; Domene, Mercedes Moreno; Domínguez, Inmaculada; Facco, Eva; Fattibene, Paola; Frenzel, Monika; Monteiro Gil, Octávia; Gonon, Géraldine; Gregoire, Eric; Gruel, Gaëtan; Hadjidekova, Valeria; Hatzi, Vasiliki I; Hristova, Rositsa; Jaworska, Alicja; Kis, Enikő; Kowalska, Maria; Kulka, Ulrike; Lista, Florigio; Lumniczky, Katalin; Martínez-López, Wilner; Meschini, Roberta; Moertl, Simone; Moquet, Jayne; Noditi, Mihaela; Oestreicher, Ursula; Orta Vázquez, Manuel Luis; Palma, Valentina; Pantelias, Gabriel; Montoro Pastor, Alegria; Patrono, Clarice; Piqueret-Stephan, Laure; Quattrini, Maria Cristina; Regalbuto, Elisa; Ricoul, Michelle; Roch-Lefevre, Sandrine; Roy, Laurence; Sabatier, Laure; Sarchiapone, Lucia; Sebastià, Natividad; Sommer, Sylwester; Sun, Mingzhu; Suto, Yumiko; Terzoudi, Georgia; Trompier, Francois; Vral, Anne; Wilkins, Ruth; Zafiropoulos, Demetre; Wieser, Albrecht; Woda, Clemens; Wojcik, Andrzej

    2017-01-01

    The RENEB accident exercise was carried out in order to train the RENEB participants in coordinating and managing potentially large data sets that would be generated in case of a major radiological event. Each participant was offered the possibility to activate the network by sending an alerting email about a simulated radiation emergency. The same participant had to collect, compile and report capacity, triage categorization and exposure scenario results obtained from all other participants. The exercise was performed over 27 weeks and involved the network consisting of 28 institutes: 21 RENEB members, four candidates and three non-RENEB partners. The duration of a single exercise never exceeded 10 days, while the response from the assisting laboratories never came later than within half a day. During each week of the exercise, around 4500 samples were reported by all service laboratories (SL) to be examined and 54 scenarios were coherently estimated by all laboratories (the standard deviation from the mean of all SL answers for a given scenario category and a set of data was not larger than 3 patient codes). Each participant received training in both the role of a reference laboratory (activating the network) and of a service laboratory (responding to an activation request). The procedures in the case of radiological event were successfully established and tested.

  13. Audit of litigation against the accident and emergency radiology department.

    PubMed

    Cantoni, S; De Stefano, F; Mari, A; Savaia, F; Rosso, R; Derchi, L

    2009-09-01

    The aims of this study were to reduce and monitor litigation due to failure to diagnose a fracture, to evaluate whether the cases were due to radiological error or other problems in the diagnostic and therapeutic management of patients and to identify organisational, technical or functional changes or guidelines to improve the management of patients with suspected fracture and their expectations. We analysed the litigation database for the period 2004-2006 and extracted all episodes indicating failure to diagnose a fracture at the accident and emergency radiology department of our centre. The radiographs underwent blinded review by two experts, and each case was jointly analysed by a radiologist and a forensic physician to see what led to the compensation claim. We identified 22 events (2004 seven cases; 2005 eight cases; 2006 seven cases). Six cases were unrelated to radiological error. Six were due to imperceptible fractures at the time of the examination. These were accounted for by the presence of a major lesion distracting the examiner's attention from a less important associated lesion in one case, a false negative result in a patient examined on a incompletely radiolucent spinal board and underexposure of the coccyx region in an obese patient. Six cases were related to an interpretation error by the radiologist. In the remaining cases, the lesion being referred to in the compensation claim could either not be established or the case was closed by the insurance company without compensation. Corrective measures were adopted. These included planning the purchase of a higher performance device, drawing up a protocol for imaging patients on spinal boards, reminding radiologists of the need to carefully scrutinise the entire radiogram even after having identified a lesion, and producing an information sheet explaining to patients the possibility of false negative results in cases of imperceptible lesions and inviting them to return to the department if symptoms

  14. Regionalization of services improves access to emergency vascular surgical care.

    PubMed

    Roche-Nagle, G; Bachynski, K; Nathens, A B; Angoulvant, D; Rubin, B B

    2013-04-01

    Management of vascular surgical emergencies requires rapid access to a vascular surgeon and hospital with the infrastructure necessary to manage vascular emergencies. The purpose of this study was to assess the impact of regionalization of vascular surgery services in Toronto to University Health Network (UHN) and St Michael's Hospital (SMH) on the ability of CritiCall Ontario to transfer patients with life- and limb-threatening vascular emergencies for definitive care. A retrospective review of the CritiCall Ontario database was used to assess the outcome of all calls to CritiCall regarding patients with vascular disease from April 2003 to March 2010. The number of patients with vascular emergencies referred via CritiCall and accepted in transfer by the vascular centers at UHN or SMH increased 500% between 1 April 2003-31 December 2005 and 1 January 2006-31 March 2010. Together, the vascular centers at UHN and SMH accepted 94.8% of the 1002 vascular surgery patients referred via CritiCall from other hospitals between 1 January 2006 and 31 March 2010, and 72% of these patients originated in hospitals outside of the Toronto Central Local Health Integration Network. Across Ontario, the number of physicians contacted before a patient was accepted in transfer fell from 2.9 ± 0.4 before to 1.7 ± 0.3 after the vascular centers opened. In conclusion, the vascular surgery centers at UHN and SMH have become provincial resources that enable the efficient transfer of patients with vascular surgical emergencies from across Ontario. Regionalization of services is a viable model to increase access to emergent care.

  15. Incident reporting in one UK accident and emergency department.

    PubMed

    Tighe, Catherine M; Woloshynowych, Maria; Brown, Ruth; Wears, Bob; Vincent, Charles

    2006-01-01

    Greater focus is needed on improving patient safety in modern healthcare systems and the first step to achieving this is to reliably identify the safety issues arising in healthcare. Research has shown the accident and emergency (A&E) department to be a particularly problematic environment where safety is a concern due to various factors, such as the range, nature and urgency of presenting conditions and the high turnover of patients. As in all healthcare environments clinical incident reporting in A&E is an important tool for detecting safety issues which can result in identifying solutions, learning from error and enhancing patient safety. This tool must be responsive and flexible to the local circumstances and work for the department to support the clinical governance agenda. In this paper, we describe the local processes for reporting and reviewing clinical incidents in one A&E department in a London teaching hospital and report recent changes to the system within the department. We used the historical data recorded on the Trust incident database as a representation of the information that would be available to the department in order to identify the high risk areas. In this paper, we evaluate the internal processes, the information available on the database and make recommendations to assist the emergency department in their internal processes. These will strengthen the internal review and staff feedback system so that the department can learn from incidents in a consistent manner. The process was reviewed by detailed examination of the centrally held electronic record (Datix database) of all incidents reported in a one year period. The nature of the incident and the level and accuracy of information provided in the incident reports was evaluated. There were positive aspects to the established system including evidence of positive changes made as a result of the reporting process, new initiatives to feedback to staff, and evolution of the programme for

  16. Saving tourists: the status of emergency medical services in California's National Parks.

    PubMed

    Heggie, Travis W; Heggie, Tracey M

    2009-01-01

    Providing emergency medical services (EMS) in popular tourist destinations such as National Parks requires an understanding of the availability and demand for EMS. This study examines the EMS workload, EMS transportation methods, EMS funding, and EMS provider status in California's National Park Service units. A retrospective review of data from the 2005 Annual Emergency Medical Services Report for National Park Service (NPS) units in California. Sixteen NPS units in California reported EMS activity. EMS program funding and training costs totaled USD $1,071,022. During 2005 there were 84 reported fatalities, 910 trauma incidents, 663 non-cardiac medicals, 129 cardiac incidents, and 447 first aid incidents. Sequoia and Kings Canyon National Parks, Yosemite National Park, Golden Gate National Recreation Area, and Death Valley National Park accounted for 83% of the total EMS case workload. Ground transports accounted for 85% of all EMS transports and Emergency Medical Technicians with EMT-basic (EMT-B) training made up 76% of the total 373 EMS providers. Providing EMS for tourists can be a challenging task. As tourist endeavors increase globally and move into more remote environments, the level of EMS operations in California's NPS units can serve as a model for developing EMS operations serving tourist populations.

  17. Emergency psychiatric services for individuals with intellectual disabilities: perspectives of hospital staff.

    PubMed

    Lunsky, Yona; Gracey, Carolyn; Gelfand, Sara

    2008-12-01

    Strains on the mainstream mental health system can result in inaccessible services that force individuals with intellectual disabilities into the emergency room (ER) when in psychiatric crisis. The purpose of this study was to identify clinical and systemic issues surrounding emergency psychiatry services for people with intellectual disabilities, from the perspective of hospital staff. Focus groups were conducted with emergency psychiatry staff from 6 hospitals in Toronto, Canada. Hospital staff reported a lack of knowledge regarding intellectual disabilities and a shortage of available community resources. Hospital staff argued that caregivers need more community and respite support to feel better equipped to deal with the crisis before it escalates to the ER and that hospital staff feel ill prepared to provide the necessary care when the ER is the last resort. Input from hospital staff pointed to deficiencies in the system that lead caregivers to use the ER when other options have been exhausted. Both staff and caregivers need support and access to appropriate services if the system is to become more effective at serving the psychiatric needs of this complex population.

  18. Roller skating accidents and injuries.

    PubMed

    Sedlin, E D; Zitner, D T; McGinniss, G

    1984-02-01

    A consecutive series of 65 fractures, dislocations, and ligament tears produced by roller skating accidents treated by the Orthopaedic Department of the Mt. Sinai Services at City Hospital Center of Elmhurst, New York, is reviewed. It was learned that the injuries resulting from collisions occurring in a skating rink were more serious than those resulting from street accidents. Data indicated that lack of expertise is a prominent factor in the production of serious injury. However, the sport has inherent risk which is not eliminated by expertise. It was concluded that roller skating can and does produce disabling injuries. In order to reduce the number of injuries it will be required to reduce crowding in rinks, designate separate beginners' areas, use training wheels or clampon-type of skates when learning, encourage lessons, and separate beginners in the rinks.

  19. Risk communication in the case of the Fukushima accident: Impact of communication and lessons to be learned.

    PubMed

    Perko, Tanja

    2016-10-01

    Risk communication about the Fukushima Daiichi nuclear power plant accident in 2011 was often not transparent, timely, clear, nor factually correct. However, lessons related to risk communication have been identified and some of them are already addressed in national and international communication programmes and strategies. The Fukushima accident may be seen as a practice scenario for risk communication with important lessons to be learned. As a result of risk communication failures during the accident, the world is now better prepared for communication related to nuclear emergencies than it was 5 years ago The present study discusses the impact of communication, as applied during the Fukushima accident, and the main lessons learned. It then identifies pathways for transparent, timely, clear and factually correct communication to be developed, practiced and applied in nuclear emergency communication before, during, and after nuclear accidents. Integr Environ Assess Manag 2016;12:683-686. © 2016 SETAC. © 2016 SETAC.

  20. Designing smartphone mental health applications for emergency service workers.

    PubMed

    Deady, M; Peters, D; Lang, H; Calvo, R; Glozier, N; Christensen, H; Harvey, S B

    2017-08-01

    Emergency service workers are often exposed to trauma and have increased risk of a range of mental health (MH) conditions. Smartphone applications have the potential to provide this group with effective psychological interventions; however, little is known about the acceptability and preferences regarding such initiatives. To describe the preferences and opinions of emergency service workers regarding the use of smartphone MH applications and to examine the impact of age on these preferences. Participants were recruited from four metropolitan Fire and Rescue NSW stations and responded to questionnaire items covering three key domains: current smartphone use, potential future use and preferences for design and content as well as therapeutic techniques. Overall, approximately half the sample (n = 106) claimed they would be interested in trying a tailored emergency-worker MH smartphone application. There were few differences between age groups on preferences. The majority of respondents claimed they would use an app for mental well-being daily and preferred terms such as 'well-being' and 'mental fitness' for referring to MH. Confidentiality, along with a focus on stress, sleep, exercise and resiliency were all considered key features. Behavioural therapeutic techniques were regarded most favourably, compared with other therapies. Emergency workers were interested in utilizing smartphone applications focused on MH, but expressed clear preferences regarding language used in promotion, features required and therapeutic techniques preferred. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  1. Stormy weather: a retrospective analysis of demand for emergency medical services during epidemic thunderstorm asthma

    PubMed Central

    Nehme, Ziad; Bernard, Stephen; Abramson, Michael J; Newbigin, Ed; Piper, Ben; Dunlop, Justin; Holman, Paul; Smith, Karen

    2017-01-01

    Abstract Objectives To describe the demand for emergency medical assistance during the largest outbreak of thunderstorm asthma reported globally, which occurred on 21 November 2016. Design A time series analysis was conducted of emergency medical service caseload between 1 January 2015 and 31 December 2016. Demand during the thunderstorm asthma event was compared to historical trends for the overall population and across specific subgroups. Setting Victoria, Australia. Main outcome measures Number of overall cases attended by emergency medical services, and within patient subgroups. Results On 21 November 2016, the emergency medical service received calls for 2954 cases, which was 1014 more cases than the average over the historical period. Between 6 pm and midnight, calls for 1326 cases were received, which was 2.5 times higher than expected. A total of 332 patients were assessed by paramedics as having acute respiratory distress on 21 November, compared with a daily average of 52 during the historical period. After adjustment for temporal trends, thunderstorm asthma was associated with a 42% (95% confidence interval 40% to 44%) increase in overall caseload for the emergency medical service and a 432% increase in emergency medical attendances for acute respiratory distress symptoms. Emergency transports to hospital increased by 17% (16% to 19%) and time critical referrals from general practitioners increased by 47% (21% to 80%). Large increases in demand were seen among patients with a history of asthma and bronchodilator use. The incidence of out-of-hospital cardiac arrest increased by 82% (67% to 99%) and pre-hospital deaths by 41% (29% to 55%). Conclusions An unprecedented outbreak of thunderstorm asthma was associated with substantial increase in demand for emergency medical services and pre-hospital cardiac arrest. The health impact of future events may be minimised through use of preventive measures by patients and predictive early warning systems. PMID

  2. [Assessment of quality indicators in pediatric poisoning in an emergency service].

    PubMed

    Giménez Roca, C; Martínez Sánchez, L; Calzada Baños, Y; Trenchs Sainz de la Maza, V; Quintilla Martínez, J M; Luaces Cubells, C

    2014-01-01

    Assessment of quality indicators allows clinicians to evaluate clinical assistance with a standard, to detect deficiencies and to improve medical assistance. Patients who came to emergency services of a tertiary level hospital for suspicion of poisoning from January 2011 to June 2012 were assessed using 20 quality indicators of pediatric poisoning. Data collection was performed by retrospective review of clinical reports. A total of 393 patients were admitted for suspicion of poisoning (0.3% of all admissions).The standard was reached in 11 indicators and not reached in 6: administration of activated charcoal within 2hours of poison ingestion (standard=90%, result=83.5%); attention within the first 15minutes of arriving in the emergency service (standard=90%, result=60.4%); start of gastrointestinal decontamination within 20minutes of arrival in emergency services (standard=90%, result=29.7%); performing of electrocardiogram on the patients poisoned with cardiotoxic substances (standard=95%, result=87%); judicial communication of cases of poisoning that could conceal a crime (standard=95%, result=31.3%), and collection of the minimal set of information of poisoned patients (standard=90%, result=1.9%). Three indicators could not be evaluated as a consequence of the limited number of cases where they could be applied (<5). The main deficiencies are related to delay in assistance, collection of information and completion of judicial reports. Giving these patients priority, designing a checklist to collect the main points of their management, and creating obligatory fields for data in computerized medical records, are the main actions available to achieve pediatric poisoning quality indicators in this emergency service. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  3. Right service, right place: optimising utilisation of a community nursing service to reduce planned re-presentations to the emergency department

    PubMed Central

    Lawton, Jessica Kirsten; Kinsman, Leigh; Dalton, Lisa; Walsh, Fay; Bryan, Helen; Williams, Sharon

    2017-01-01

    Background Congruent with international rising emergency department (ED) demand, a focus on strategies and services to reduce burden on EDs and improve patient outcomes is necessary. Planned re-presentations of non-urgent patients at a regional Australian hospital exceeded 1200 visits during the 2013–2014 financial year. Planned re-presentations perpetuate demand and signify a lack of alternative services for non-urgent patients. The Community Nursing Enhanced Connections Service (CoNECS) collaboratively evolved between acute care and community services in 2014 to reduce planned ED re-presentations. Objective This study aimed to investigate the evolution and impact of a community nursing service to reduce planned re-presentations to a regional Australian ED and identify enablers and barriers to interventionist effectiveness. Methods A mixed-methods approach evaluated the impact of CoNECS. Data from hospital databases including measured numbers of planned ED re-presentations by month, time of day, age, gender and reason were used to calculate referral rates to CoNECS. These results informed two semistructured focus groups with ED and community nurses. The researchers used a theoretical lens, ‘diffusion of innovation’, to understand how this service could inform future interventions. Results Analyses showed that annual ED planned re-presentations decreased by 43% (527 presentations) after implementation. Three themes emerged from the focus groups. These were right service at the right time, nursing uncertainty and system disconnect and medical disengagement. Conclusions CoNECS reduced overall ED planned re-presentations and was sustained longer than many complex service-level interventions. Factors supporting the service were endorsement from senior administration and strong leadership to drive responsive quality improvement strategies. This study identified a promising alternative service outside the ED, highlighting possibilities for other hospital emergency

  4. Right service, right place: optimising utilisation of a community nursing service to reduce planned re-presentations to the emergency department.

    PubMed

    Lawton, Jessica Kirsten; Kinsman, Leigh; Dalton, Lisa; Walsh, Fay; Bryan, Helen; Williams, Sharon

    2017-01-01

    Congruent with international rising emergency department (ED) demand, a focus on strategies and services to reduce burden on EDs and improve patient outcomes is necessary. Planned re-presentations of non-urgent patients at a regional Australian hospital exceeded 1200 visits during the 2013-2014 financial year. Planned re-presentations perpetuate demand and signify a lack of alternative services for non-urgent patients. The Community Nursing Enhanced Connections Service (CoNECS) collaboratively evolved between acute care and community services in 2014 to reduce planned ED re-presentations. This study aimed to investigate the evolution and impact of a community nursing service to reduce planned re-presentations to a regional Australian ED and identify enablers and barriers to interventionist effectiveness. A mixed-methods approach evaluated the impact of CoNECS. Data from hospital databases including measured numbers of planned ED re-presentations by month, time of day, age, gender and reason were used to calculate referral rates to CoNECS. These results informed two semistructured focus groups with ED and community nurses. The researchers used a theoretical lens, 'diffusion of innovation', to understand how this service could inform future interventions. Analyses showed that annual ED planned re-presentations decreased by 43% (527 presentations) after implementation. Three themes emerged from the focus groups. These were right service at the right time, nursing uncertainty and system disconnect and medical disengagement. CoNECS reduced overall ED planned re-presentations and was sustained longer than many complex service-level interventions. Factors supporting the service were endorsement from senior administration and strong leadership to drive responsive quality improvement strategies. This study identified a promising alternative service outside the ED, highlighting possibilities for other hospital emergency services aiming to reduce planned re-presentations.

  5. Emergency Medical Services Program Administration Prototype Curriculum: Curriculum Guide.

    ERIC Educational Resources Information Center

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

    The curriculum guide was developed for training administrators (new entrants and incumbents), at the college level, in Emergency Medical Services (EMS) program administration. It is designed to be comprehensive and to include all knowledge and skills needed to perform the functions and tasks involved in EMS administration and management. The brief…

  6. Modeling factors influencing the demand for emergency department services in Ontario: a comparison of methods.

    PubMed

    Moineddin, Rahim; Meaney, Christopher; Agha, Mohammad; Zagorski, Brandon; Glazier, Richard Henry

    2011-08-19

    Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across geographic regions and time. Some persons do not rely on the service at all whereas; others use the service on repeated occasions. Issues regarding increased wait times for services and crowding illustrate the need to investigate which factors are associated with increased frequency of emergency department utilization. The evidence from this study can help inform policy makers on the appropriate mix of supply and demand targeted health care policies necessary to ensure that patients receive appropriate health care delivery in an efficient and cost-effective manner. The purpose of this report is to assess those factors resulting in increased demand for emergency department services in Ontario. We assess how utilization rates vary according to the severity of patient presentation in the emergency department. We are specifically interested in the impact that access to primary care physicians has on the demand for emergency department services. Additionally, we wish to investigate these trends using a series of novel regression models for count outcomes which have yet to be employed in the domain of emergency medical research. Data regarding the frequency of emergency department visits for the respondents of Canadian Community Health Survey (CCHS) during our study interval (2003-2005) are obtained from the National Ambulatory Care Reporting System (NACRS). Patients' emergency department utilizations were linked with information from the Canadian Community Health Survey (CCHS) which provides individual level medical, socio-demographic, psychological and behavioral information for investigating predictors of increased emergency

  7. [Self-reported substance abuse related emergencies: frequency and nature].

    PubMed

    Schäfer, G; Smoltczyk, H; Dengler, W; Buchkremer, G

    2000-04-01

    The aim of this study was to estimate the frequency and nature of self-reported and drug-related emergencies. 47 patients of a ward for opiate detoxification were interviewed about their experiences with drug-related emergencies. Typical categories had to be found like overdoses, seizures, accidents and suicide attempts respectively. 68% had own experience with drug-related emergency. A majority suffered opiate overdose with different extensions as unconsciousness or breath-depression. Alcohol and polydrug use was associated with overdose. Drug-related accidents were only reported by men. Half the number of drug-related emergencies were treated in hospital. Most emergencies occurred alone either in a home environment or outside. Harm reduction interventions like observed user rooms should be established. Furthermore other strategies to reduce the number of emergencies as sharing naloxon or resuscitation programs in wards for detoxification could also be an effective method to prevent near fatal or fatal overdoses in dependent subjects.

  8. Using Participatory and Service Design to Identify Emerging Needs and Perceptions of Library Services among Science and Engineering Researchers Based at a Satellite Campus

    ERIC Educational Resources Information Center

    Johnson, Andrew; Kuglitsch, Rebecca; Bresnahan, Megan

    2015-01-01

    This study used participatory and service design methods to identify emerging research needs and existing perceptions of library services among science and engineering faculty, post-graduate, and graduate student researchers based at a satellite campus at the University of Colorado Boulder. These methods, and the results of the study, allowed us…

  9. European Gravity Service for Improved Emergency Management - Status and project highlights

    NASA Astrophysics Data System (ADS)

    Mayer-Guerr, Torsten; Adrian, Jäggi; Meyer, Ulrich; Jean, Yoomin; Susnik, Andreja; Weigelt, Matthias; van Dam, Tonie; Flechtner, Frank; Gruber, Christian; Güntner, Andreas; Gouweleeuw, Ben; Kvas, Andreas; Klinger, Beate; Flury, Jakob; Bruinsma, Sean; Lemoine, Jean-Michel; Zwenzner, Hendrik; Bourgogne, Stephane; Bandikova, Tamara

    2016-04-01

    The European Gravity Service for Improved Emergency Management (EGSIEM) is a project of the Horizon 2020 Framework Programme for Research and Innovation of the European Commission. EGSIEM shall demonstrate that observations of the redistribution of water and ice mass derived from the current GRACE mission, the future GRACE-FO mission, and additional data provide critical and complementary information to more traditional Earth Observation products and open the door for innovative approaches to flood and drought monitoring and forecasting. In the frame of EGSIEM three key services should established: 1) a scientific combination service to deliver the best gravity products for applications in Earth and environmental science research based on the unified knowledge of the European GRACE community, 2) a near real-time and regional service to reduce the latency and increase the temporal resolution of the mass redistribution products, and 3) a hydrological and early warning service to develop gravity-based indicators for extreme hydrological events and to demonstrate their value for flood and drought forecasting and monitoring services. All of these services shall be tailored to the various needs of the respective communities. Significant efforts shall also be devoted to transform the service products into user-friendly and easy-to-interpret data sets and the development of visualization tools. In this talk the status of the ongoing project is presented and selected results are discussed.

  10. Cloud based emergency health care information service in India.

    PubMed

    Karthikeyan, N; Sukanesh, R

    2012-12-01

    A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the

  11. [Accidents and injuries in the EU. Results of the EuroSafe Reports].

    PubMed

    Bauer, R; Steiner, M; Kisser, R; Macey, S M; Thayer, D

    2014-06-01

    Accidents and injuries are a relevant although largely preventable public health problem. Information on the causes of accidents is the basis for accident prevention and product safety. The current report "Injuries in the European Union", edited by EuroSafe, the European Association for Injury Prevention and Safety Promotion, is a summary of key statistics on accidents and injuries at the EU level. In addition to international data on cause of death, the data of the European Injury Data Base (IDB) in particular are presented. The IDB is a unique data source for the EU based on an internationally standardized dataset of external causes and circumstances of injuries, which is collected in the emergency department of hospitals. Thus, the IDB covers the entire spectrum of accidents and injuries in sufficient detail as is necessary for the derivation of preventive measures and the knowledge of involved products. The currently available IDB data are collected by the participating Member States (2012: Austria, Cyprus, Denmark, Germany, Italy, Latvia, Malta, The Netherlands, Norway, Portugal, Slovenia, and Sweden) in self-interest (i.e., without legal obligation) with the support of the EU health programs. The central database for the IDB is run by the European Commission and provides public access to the aggregated data of the participating countries. Currently, over 100 IDB hospitals in the EU upload around 300,000 cases per year into the EU database. The IDB contains information on all accident sectors (transport, workplace, school etc.) with a focus on leisure and sports accidents. Depending on the accident sector, up to 25 variables (activities, products involved, means of transport etc.) and often also short narratives are recorded for each case. The report shows that 40 million people are treated in a hospital annually in the EU after accidents and violence, and that about 233,000 people die as a consequence of injury. There are large differences between countries

  12. [Factors related to dissatisfaction and anger in parents of children treated at paediatric emergency services].

    PubMed

    Fernández-Castillo, A; Vílchez-Lara, M J

    2015-01-01

    Anger in patients and relatives is very frequent in health emergency services and is often associated with aggressiveness and emotional alterations. The aim of the present study is to explore anger in parents while their children are receiving care in paediatric emergency services, seeking the specific dimensions of dissatisfaction that may predict the onset of anger in parents. A cross-sectional descriptive study using a self-report questionnaire in 711 parents of children seen in paediatric emergency departments. The self-report questionnaires used were the State-Trait Anger Expression Inventory-2 (STAXI-2) and the Satisfaction with Healthcare Services Scale. The statistical analysis included descriptive, correlational, variance and multiple linear regression models. A total of 53 parents (7,5%) showed a moderate or high anger level. The mean score for satisfaction was 37.12 (SD=7.33). It was found that higher levels of overall satisfaction were significantly associated with lower levels of anger (r=-.29, p=.00). Among the variables studied, dissatisfaction with access to the service (β=-.172, p=.00), with the healthcare staff (β=-.121, p=.01), and perceived severity of the child's health status (β=.157, p=.00) predicted higher levels of anger. On the basis of our results, it is important to continue working to substantially improve access for patients and their families to the emergency department, as well as the information and communication process with the healthcare staff should be included in intervention initiatives. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  13. AUTOMATED UTILITY SERVICE AREA ASSESSMENT UNDER EMERGENCY CONDITIONS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    G. TOOLE; S. LINGER

    2001-01-01

    All electric utilities serve power to their customers through a variety of functional levels, notably substations. The majority of these components consist of distribution substations operating at lower voltages while a small fraction are transmission substations. There is an associated geographical area that encompasses customers who are served, defined as the service area. Analysis of substation service areas is greatly complicated by several factors: distribution networks are often highly interconnected which allows a multitude of possible switching operations; also, utilities dynamically alter the network topology in order to respond to emergency events. As a result, the service area for amore » substation can change radically. A utility will generally attempt to minimize the number of customers outaged by switching effected loads to alternate substations. In this manner, all or a portion of a disabled substation's load may be served by one or more adjacent substations. This paper describes a suite of analytical tools developed at Los Alamos National Laboratory (LANL), which address the problem of determining how a utility might respond to such emergency events. The estimated outage areas derived using the tools are overlaid onto other geographical and electrical layers in a geographic information system (GIS) software application. The effects of a power outage on a population, other infrastructures, or other physical features, can be inferred by the proximity of these features to the estimated outage area.« less

  14. Development of Northeast Asia Nuclear Power Plant Accident Simulator.

    PubMed

    Kim, Juyub; Kim, Juyoul; Po, Li-Chi Cliff

    2017-06-15

    A conclusion from the lessons learned after the March 2011 Fukushima Daiichi accident was that Korea needs a tool to estimate consequences from a major accident that could occur at a nuclear power plant located in a neighboring country. This paper describes a suite of computer-based codes to be used by Korea's nuclear emergency response staff for training and potentially operational support in Korea's national emergency preparedness and response program. The systems of codes, Northeast Asia Nuclear Accident Simulator (NANAS), consist of three modules: source-term estimation, atmospheric dispersion prediction and dose assessment. To quickly assess potential doses to the public in Korea, NANAS includes specific reactor data from the nuclear power plants in China, Japan and Taiwan. The completed simulator is demonstrated using data for a hypothetical release. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Hazardous materials accidents: initial scene assessment and patient care.

    PubMed

    Leonard, R B

    1993-06-01

    Hazardous materials, i.e., chemicals that are toxic, corrosive, flammable, or explosive, are a ubiquitous aspect of modern life. They are manufactured throughout the United States, shipped by truck, train, barge, and pipeline, and stored at a wide variety of locations, including factories, military bases, and warehouses. Accidents involving hazardous materials present an added dimension of danger to emergency personnel arriving first at the scene, and have the potential to produce chemically contaminated patients who require special medical treatment. Personnel arriving first at the scene must understand how to evaluate the scene for fast and safe mitigation without endangering themselves. Chemically contaminated patients require prompt treatment, which, for optimal outcome, must begin at the scene. Although frequently the identification of the hazardous materials involved is not known initially, emergency personnel may safely provide medical care to the victims by understanding and following the principles of hazardous materials accidents and the pathophysiology of chemical injuries as presented in this paper.

  16. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...

  17. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...

  18. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...

  19. Trend of Elevator-Related Accidents in Tehran

    PubMed Central

    Khaji, Ali; Ghodsi, Syyed Mohammad

    2014-01-01

    Background: Elevator-related accidents are uncommon, but can cause significant injury. However, little data exist on these types of accidents. To compile and analyze accident data involving elevators in an effort to eliminate or at least significantly reduce such accidents. Methods: In this retrospective study we investigated 1,819 cases of elevator-related accidents during a four-year period (1999-2003) in Tehran. The data were obtained from the Tehran Safety Services & Fire Fighting Organization (TSFO) that is officially and solely responsible to conduct rescue missions of civilians in Tehran. Results: The number of elevator accidents has increased steadily during the four year study period. During these four years there was a positive upward trend for serious injuries and mortality resulting from elevator accidents. Technical problems were the main cause with 74.5%, followed by power loss and overcapacity riding with 11.5% and 7.9% respectively. Sixty-three individuals sustained serious injury and 15 people died as a result of elevator accidents. The number of accidents was significantly higher in summer (x2=18.32, P=0.032) and a considerable proportion of incidences (54%, 947 cases out of 1819) occurred between 5 and 12 pm. Conclusions: Establishment of an organization to inspect the settings, maintenance, and repair of elevators is necessary. PMID:25207331

  20. Patient experience of general practice and use of emergency hospital services in England: regression analysis of national cross-sectional time series data.

    PubMed

    Cowling, Thomas E; Majeed, Azeem; Harris, Matthew J

    2018-01-22

    The UK Government has introduced several national policies to improve access to primary care. We examined associations between patient experience of general practice and rates of visits to accident and emergency (A&E) departments and emergency hospital admissions in England. The study included 8124 general practices between 2011-2012 and 2013-2014. Outcome measures were annual rates of A&E visits and emergency admissions by general practice population, according to administrative hospital records. Explanatory variables included three patient experience measures from the General Practice Patient Survey: practice-level means of experience of making an appointment, satisfaction with opening hours and overall experience (on 0-100 scales). The main analysis used random-effects Poisson regression for cross-sectional time series. Five sensitivity analyses examined changes in model specification. Mean practice-level rates of A&E visits and emergency admissions increased from 2011-2012 to 2013-2014 (310.3-324.4 and 98.8-102.9 per 1000 patients). Each patient experience measure decreased; for example, mean satisfaction with opening hours was 79.4 in 2011-2012 and 76.6 in 2013-2014. In the adjusted regression analysis, an SD increase in experience of making appointments (equal to 9 points) predicted decreases of 1.8% (95% CI -2.4% to -1.2%) in A&E visit rates and 1.4% (95% CI -1.9% to -0.9%) in admission rates. This equalled 301 174 fewer A&E visits and 74 610 fewer admissions nationally per year. Satisfaction with opening hours and overall experience were not consistently associated with either outcome measure across the main and sensitivity analyses. Associations between patient experience of general practice and use of emergency hospital services were small or inconsistent. In England, realistic short-term improvements in patient experience of general practice may only have modest effects on A&E visits and emergency admissions. © Article author(s) (or their employer

  1. 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).

    PubMed

    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.

  2. Managing Emergency Situations in VANET Through Heterogeneous Technologies Cooperation

    PubMed Central

    Tropea, Mauro; De Rango, Floriano

    2018-01-01

    Nowadays, the research on vehicular computing enhanced a very huge amount of services and protocols, aimed to vehicles security and comfort. The investigation of the IEEE802.11p, Wireless Access in Vehicular Environments (WAVE) and Dedicated Short Range Communication (DSRC) standards gave to the scientific world the chance to integrate new services, protocols, algorithms and devices inside vehicles. This opportunity attracted the attention of private/public organizations, which spent lot of resources and money to promote vehicular technologies. In this paper, the attention is focused on the design of a new approach for vehicular environments able to gather information during mobile node trips, for advising dangerous or emergency situations by exploiting on-board sensors. It is assumed that each vehicle has an integrated on-board unit composed of several sensors and Global Position System (GPS) device, able to spread alerting messages around the network, regarding warning and dangerous situations/conditions. On-board units, based on the standard communication protocols, share the collected information with the surrounding road-side units, while the sensing platform is able to recognize the environment that vehicles are passing through (obstacles, accidents, emergencies, dangerous situations, etc.). Finally, through the use of the GPS receiver, the exact location of the caught event is determined and spread along the network. In this way, if an accident occurs, the arriving cars will, probably, avoid delay and danger situations. PMID:29738453

  3. Service-Learning and Emergent Communities of Practice: A Teacher Education Case Study

    ERIC Educational Resources Information Center

    Kaschak, Jennifer Cutsforth; Letwinsky, Karim Medico

    2015-01-01

    This study investigates the unexpected emergence of a community of practice in a middle level mathematics and science methods course. The authors describe how preservice teacher participation in a collaborative, project-based service-learning experience resulted in the formation of a community of practice characterized by teamwork, meaningful…

  4. The work programme of NERIS in post-accident recovery.

    PubMed

    Schneider, T; Andronopoulos, S; Camps, J; Duranova, T; Gallego, E; Gering, F; Isnard, O; Maître, M; Murith, C; Oughton, D; Raskob, W

    2018-01-01

    NERIS is the European platform on preparedness for nuclear and radiological emergency response and recovery. Created in 2010 with 57 organisations from 28 different countries, the objectives of the platform are to: improve the effectiveness and coherency of current approaches to preparedness; identify further development needs; improve 'know how' and technical expertise; and establish a forum for dialogue and methodological development. The NERIS Strategic Research Agenda is now structured with three main challenges: (i) radiological impact assessments during all phases of nuclear and radiological events; (ii) countermeasures and countermeasure strategies in emergency and recovery, decision support, and disaster informatics; and (iii) setting up a multi-faceted framework for preparedness for emergency response and recovery. The Fukushima accident has highlighted some key issues for further consideration in NERIS research activities, including: the importance of transparency of decision-making processes at local, regional, and national levels; the key role of access to environmental monitoring; the importance of dealing with uncertainties in assessment and management of the different phases of the accident; the use of modern social media in the exchange of information; the role of stakeholder involvement processes in both emergency and recovery situations; considerations of societal, ethical, and economic aspects; and the reinforcement of education and training for various actors. This paper emphasises the main issues at stake for NERIS for post-accident management.

  5. Hospitalization and pharmacotherapy for borderline personality disorder in a psychiatric emergency service.

    PubMed

    Pascual, Juan C; Córcoles, David; Castaño, Juan; Ginés, Jose M; Gurrea, Alfredo; Martín-Santos, Rocio; Garcia-Ribera, Carlos; Pérez, Victor; Bulbena, Antonio

    2007-09-01

    This study aimed to determine factors associated with hospitalization and decisions to prescribe psychotropic medication for patients with borderline personality disorder seeking care at psychiatric emergency units. A total of 11,578 consecutive visits were reviewed over a four-year period at a psychiatric emergency service in a tertiary hospital in Spain. Some patients were repeat visitors. Data collected included sociodemographic, clinical, social, and therapeutic information and the Severity of Psychiatric Illness (SPI) score. Borderline personality disorder was the diagnosis in 1,032 of the visits (9%) to the emergency department, which corresponded to 540 individuals. Of these visits, 11% required hospitalization. Multivariate statistical logistic regression analysis showed that the decision to hospitalize was associated with risk of suicide, danger to others, severity of symptoms, difficulty with self-care, and noncompliance with treatment. The decision to prescribe benzodiazepines was related to male sex, anxiety as the reason for seeking care, little difficulty with self-care, few medical or drug problems, and housing instability. Factors related to the prescription of antipsychotics were male sex, risk of endangering others, and psychosis as the reason for the visit. Factors associated with the prescription of antidepressants were depression as the reason for seeking help and little premorbid dysfunction. Patients with borderline personality disorder had greater clinical severity, but the percentage of hospitalizations was lower than for patients without the disorder. Although a psychiatric emergency service is not the ideal setting to initiate pharmacotherapy, in practice, psychiatrists often prescribe medications in this setting. The SPI was a good tool to assess the severity of illness of these patients.

  6. Emergency/disaster medical support in the restoration project for the Fukushima nuclear power plant accident

    PubMed Central

    Morimura, Naoto; Asari, Yasushi; Yamaguchi, Yoshihiro; Asanuma, Kazunari; Tase, Choichiro; Sakamoto, Tetsuya; Aruga, Tohru

    2013-01-01

    The Fukushima Daiichi Nuclear Power Plant (1F) suffered a series of radiation accidents after the Great East Japan Earthquake on 11 March 2011. In a situation where halting or delaying restoration work was thought to translate directly into a very serious risk for the entire country, it was of the utmost importance to strengthen the emergency and disaster medical system in addition to radiation emergency medical care for staff at the frontlines working in an environment that posed a risk of radiation exposure and a large-scale secondary disaster. The Japanese Association for Acute Medicine (JAAM) launched the ‘Emergency Task Force on the Fukushima Nuclear Power Plant Accident’ and sent physicians to the local response headquarters. Thirty-four physicians were dispatched as disaster medical advisors, response guidelines in the event of multitudinous injury victims were created and revised and, along with execution of drills, coordination and advice was given on transport of patients. Forty-nine physicians acted as directing physicians, taking on the tasks of triage, initial treatment and decontamination. A total of 261 patients were attended to by the dispatched physicians. None of the eight patients with external contamination developed acute radiation syndrome. In an environment where the collaboration between organisations in the framework of a vertically bound government and multiple agencies and institutions was certainly not seamless, the participation of the JAAM as the medical academic organisation in the local system presented the opportunity to laterally integrate the physicians affiliated with the respective organisations from the perspective of specialisation. PMID:23184925

  7. [Factors related to the use of pediatric emergency services: results from the Spanish National Health Survey].

    PubMed

    Expósito-Ruiz, Manuela; Sánchez-López, Juan; Ruiz-Bailén, Manuel; Rodríguez-Del Águila, María Del Mar

    2017-01-01

    To determine the frequency of use of Spanish pediatric emergency services, and to describe user profiles and geographic variations. Descriptive study based on data from the Spanish National Health Survey. We calculated descriptive statistics and analyzed crude and adjusted odds ratios (ORs). Thirty-five percent of the 5495 respondents had come to an emergency department in the past year, and 88.1% of them had used the services of a Spanish national health service hospital. Factors associated with higher use of emergency services were male sex of the patient, (OR, 1.202; 95% CI, 1.047-1.381), a higher educational level of parents (OR, 1.255; 95% CI, 0.983-1.603), and younger age of the child (OR, 0.909; 95% CI, 0.894-0.924). Emergency department use varied widely from one Spanish community to another. There was a positive correlation between use and the presence of a foreign-born population (ρ=0.495, P=.031). The rate of emergency department use is high in Spain. Variability between geographic areas is considerable, and some variation is explained by population characteristics.

  8. Sick notes, general practitioners, emergency departments and fracture clinics

    PubMed Central

    Walker, C A; Gregori, A; O'Connor, P; Jaques, K; Joseph, R

    2007-01-01

    Background General practitioner waiting times are increasing. The two national surveys regarding general practice showed that the number of patients waiting for ⩾2 days for an appointment rose from 63% to 72% between 1998 and 2002, with 25% waiting for ⩾4 days. The Department of Health recognised that many patients discharged from hospitals and outpatient clinics required to visit their general practitioner for the sole purpose of obtaining a sick note. The report entitled Making a difference: reducing general practitioner paperwork estimated that 518 000 appointments (and 42 000 GP h) could be saved by ensuring that these patients were issued with a sick note directly from hospital rather than being referred to their general practitioner. This practice was to be adopted from July 2001 and included patients discharged from wards as well as those seen in outpatient departments. Method 50 emergency departments and fracture clinics in Scotland and England were contacted to assess whether these guidelines had been adopted. Only hospitals with both accident and emergency and fracture clinics were included; nurse‐led and paediatric departments were excluded. Results Of the 25 Scottish emergency hospitals contacted, 4 (16%) accident and emergency departments and 8 (32%) fracture clinics issued sick notes. This was compared with 5 of 25 (20%) accident and emergency departments and 12 of 25 (48%) fracture clinics in England. Four Scottish and five English accident and emergency departments stated that it was policy to give sick notes, three Scottish and four English departments said that it was policy not to give them and the rest (72% in Scotland and 64% in England) stated that they had no clear policy but “just don't give them”. Conclusion The 2001 guidance from the joint Cabinet Office/Department of Health has not been fully incorporated into standard practice in Scotland and England. If all emergency departments and fracture clinics were to issue

  9. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...

  10. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...

  11. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...

  12. Comparing Methodologies for Evaluating Emergency Medical Services Ground Transport Access to Time-critical Emergency Services: A Case Study Using Trauma Center Care.

    PubMed

    Doumouras, Aristithes G; Gomez, David; Haas, Barbara; Boyes, Donald M; Nathens, Avery B

    2012-09-01

    The regionalization of medical services has resulted in improved outcomes and greater compliance with existing guidelines. For certain "time-critical" conditions intimately associated with emergency medicine, early intervention has demonstrated mortality benefits. For these conditions, then, appropriate triage within a regionalized system at first diagnosis is paramount, ideally occurring in the field by emergency medical services (EMS) personnel. Therefore, EMS ground transport access is an important metric in the ongoing evaluation of a regionalized care system for time-critical emergency services. To our knowledge, no studies have demonstrated how methodologies for calculating EMS ground transport access differ in their estimates of access over the same study area for the same resource. This study uses two methodologies to calculate EMS ground transport access to trauma center care in a single study area to explore their manifestations and critically evaluate the differences between the methodologies. Two methodologies were compared in their estimations of EMS ground transport access to trauma center care: a routing methodology (RM) and an as-the-crow-flies methodology (ACFM). These methodologies were adaptations of the only two methodologies that had been previously used in the literature to calculate EMS ground transport access to time-critical emergency services across the United States. The RM and ACFM were applied to the nine Level I and Level II trauma centers within the province of Ontario by creating trauma center catchment areas at 30, 45, 60, and 120 minutes and calculating the population and area encompassed by the catchments. Because the methodologies were identical for measuring air access, this study looks specifically at EMS ground transport access. Catchments for the province were created for each methodology at each time interval, and their populations and areas were significantly different at all time periods. Specifically, the RM calculated

  13. Paragliding accidents in remote areas.

    PubMed

    Fasching, G; Schippinger, G; Pretscher, R

    1997-08-01

    Paragliding is an increasingly popular hobby, as people try to find new and more adventurous activities. However, there is an increased and inherent danger with this sport. For this reason, as well as the inexperience of many operators, injuries occur frequently. This retrospective study centers on the helicopter rescue of 70 individuals in paragliding accidents. All histories were examined, and 43 patients answered a questionnaire. Nineteen (42%) pilots were injured when taking off, 20 (44%) during the flight, and six (13%) when landing. Routine and experience did not affect the prevalence of accident. Analysis of the causes of accident revealed pilot errors in all but three cases. In 34 rescue operations a landing of the helicopter near the site of the accident was possible. Half of the patients had to be rescued by a cable winch or a long rope fixed to the helicopter. Seven (10%) of the pilots suffered multiple trauma, 38 (54%) had injuries of the lower extremities, and 32 (84%) of them sustained fractures. Injuries to the spine were diagnosed in 34 cases with a fracture rate of 85%. One patient had an incomplete paraplegia. Injuries to the head occurred in 17 patients. No paraglider pilot died. The average hospitalization was 22 days, and average time of working inability was 14 weeks. Fourteen (34%) patients suffered from a permanent damage to their nerves or joints. Forty-three percent of the paragliders continued their sport despite the accident; two of them had another accident. An improved training program is necessary to lower the incidence of paragliding accidents. Optimal equipment to reduce injuries in case of accidents is mandatory. The helicopter emergency physician must perform a careful examination, provide stabilization of airways and circulation, give analgesics, splint fractured extremities, and transport the victim on a vacuum mattress to the appropriate hospital.

  14. Truck Drivers' Experiences and Perspectives Regarding Factors Influencing Traffic Accidents: A Qualitative Study.

    PubMed

    Karimi Moonaghi, Hossein; Ranjbar, Hossein; Heydari, Abbas; Scurlock-Evans, Laura

    2015-08-01

    Traffic accidents are a major public health problem, leading to death and disability. Although pertinent studies have been conducted, little data are available in Iran. This study explored the experiences of truck drivers and their perspectives regarding factors contributing to traffic accidents. Eighteen truck drivers, purposively sampled, participated in semi-structured interviews. Data were analyzed using qualitative content analysis. A main theme, lack of ability to control stress, emerged as a factor influencing the incidence of traffic accidents. This main theme was found to have three subthemes: poor organization of the job, lack of workplace facilities and proper equipment, and unsupportive environment. Although several factors were found to contribute to traffic accidents, their effects were not independent, and all were considered significant. Identifying factors that contribute to traffic accidents requires a systematic and holistic approach. Findings could be used by the transportation industry and community health centers to prevent traffic accidents. © 2015 The Author(s).

  15. The Low Proportion and Associated Factors of Involuntary Admission in the Psychiatric Emergency Service in Taiwan

    PubMed Central

    Wang, Jen-Pang; Chiu, Chih-Chiang; Yang, Tsu-Hui; Liu, Tzong-Hsien; Wu, Chia-Yi; Chou, Pesus

    2015-01-01

    Background The involuntary admission regulated under the Mental Health Act has become an increasingly important issue in the developed countries in recent years. Most studies about the distribution and associated factors of involuntary admission were carried out in the western countries; however, the results may vary in different areas with different legal and socio-cultural backgrounds. Aims The aim of this study was to investigate the proportion and associated factors of involuntary admission in a psychiatric emergency service in Taiwan. Methods The study cohort included patients admitted from a psychiatric emergency service over a two-year period. Demographic, psychiatric emergency service utilization, and clinical variables were compared between those who were voluntarily and involuntarily admitted to explore the associated factors of involuntary admission. Results Among 2,777 admitted patients, 110 (4.0%) were involuntarily admitted. Police referrals and presenting problems as violence assessed by psychiatric nurses were found to be associated with involuntary admission. These patients were more likely to be involuntarily admitted during the night shift and stayed longer in the psychiatric emergency service. Conclusions The proportion of involuntary admissions in Taiwan was in the lower range when compared to Western countries. Dangerous conditions evaluated by the psychiatric nurses and police rather than diagnosis made by the psychiatrists were related factors of involuntary admission. As it spent more time to admit involuntary patients, it was suggested that multidisciplinary professionals should be included in and educated for during the process of involuntary admission. PMID:26046529

  16. Analysis of construction accidents in Spain, 2003-2008.

    PubMed

    López Arquillos, Antonio; Rubio Romero, Juan Carlos; Gibb, Alistair

    2012-12-01

    The research objective for this paper is to obtain a new extended and updated insight to the likely causes of construction accidents in Spain, in order to identify suitable mitigating actions. The paper analyzes all construction sector accidents in Spain between 2003 and 2008. Ten variables were chosen and the influence of each variable is evaluated with respect to the severity of the accident. The descriptive analysis is based on a total of 1,163,178 accidents. Results showed that the severity of accidents was related to variables including age, CNAE (National Classification of Economic Activities) code, size of company, length of service, location of accident, day of the week, days of absence, deviation, injury, and climatic zones. According to data analyzed, a large company is not always necessarily safer than a small company in the aspect of fatal accidents, experienced workers do not have the best accident fatality rates, and accidents occurring away from the usual workplace had more severe consequences. Results obtained in this paper can be used by companies in their occupational safety strategies, and in their safety training programs. Copyright © 2012 National Safety Council and Elsevier Ltd. All rights reserved.

  17. Mental illness and principal physical diagnoses among Asian American and Pacific Islander users of emergency services.

    PubMed

    Chen, Huey Jen

    2005-12-01

    The stigma of mental illness is one of the factors that prevents Asian Americans/Pacific Islanders (APIs) from seeking formal mental health services. A somatic complaint is more acceptable in expressing psychiatric/emotional distress. Admission diagnoses in API emergency service users with secondary psychiatric diagnoses were identified from the 2001 National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). The sample consisted of 10,623 adult APIs. The study examined the differences in the six leading principal physical admission diagnoses between API emergency service users with psychiatric diagnoses and those without psychiatric diagnoses. Several of the study findings create concern (e.g., the higher percentage of APIs with psychiatric diagnosis who were discharged against medical advice, the high percentage admitted with medication intoxication). Further study is needed to provide guidance for clinical practice.

  18. Proposed use of adrenaline (epinephrine) in anaphylaxis and related conditions: a study of senior house officers starting accident and emergency posts

    PubMed Central

    Gompels, L; Bethune, C; Johnston, S; Gompels, M

    2002-01-01

    Senior house officers (SHOs) (n=78) at the start of their accident and emergency (A&E) post were given an anonymous five case history questionnaire, containing one case of true anaphylaxis, and asked to complete the medication they would prescribe. In the case of anaphylaxis, 100% would administer adrenaline (epinephrine) but 55% would do so by the incorrect route. In the remaining cases, 10%–56% would be prepared to administer adrenaline inappropriately. Only 5% were able to indicate the correct route and dose of adrenaline according to Resuscitation Council guidelines (UK). This has implications for training as the survey took place before the start of the A&E posting. Anaphylaxis is over-diagnosed and poorly treated despite Resuscitation Council guidelines. PMID:12151658

  19. Which skills boost service provider confidence when managing people presenting with psychiatric emergencies?

    PubMed

    Poremski, Daniel; Lim, Xin Ya; Kunjithapatham, Ganesh; Koh, Doris; Alexander, Mark; Cheng, Lee

    2016-12-01

    The way service seekers interact with the staff at emergency services has been shown to influence the standard of care, especially in the case of certain psychiatric manifestations. Staff reactions to psychiatric complaints have been linked to their comfort dealing with these types of service users as well as their competencies understanding the illness. It is therefore vital to understand which skills increase confidence in treating psychiatric emergencies. Twenty-six open-ended convergent interviews were conducted with staff working in a psychiatric emergency department. Thematic analysis was used to analyze the data. Participants reported several non-technical skills which developed from exclusively serving people with psychiatric emergencies: 1) Vigilance allowed staff to be sensitive to minor changes in behavior which precede psychiatric emergencies. 2) The ability to negotiate and find tangible solutions was particularly important when dealing with psychiatric complaints which may not have tangible resolutions. 3) The ability to appraise social support networks allowed staff to plan follow-up actions and ensure continuity of care when support was available. 4) The ability to self-reflect allowed participants to learn from their experience and avoid burnout, frustration, and fatigue. Participants also reported several other clinical skills which they gained during training, including teamwork, de-escalating techniques and risk assessment. Tentatively speaking, these skills improve staff's confidence when treating psychiatric emergencies. Certain skills may be generalized to staff working in medical emergency departments who frequently encounter psychiatric complaints. © 2016 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd on behalf of Australian College of Mental Health Nurses Inc.

  20. Emergency Medical Services Utilization in EMS Priority Conditions in Beirut, Lebanon.

    PubMed

    El Sayed, Mazen; Tamim, Hani; Chehadeh, Ahel Al-Hajj; Kazzi, Amin A

    2016-12-01

    Early activation and use of Emergency Medical Services (EMS) are associated with improved patient outcomes in EMS priority conditions in developed EMS systems. This study describes patterns of EMS use and identifies predictors of EMS utilization in EMS priority conditions in Lebanon METHODS: This was a cross-sectional study of a random sample of adult patients presenting to the emergency department (ED) of a tertiary care center in Beirut with the following EMS priority conditions: chest pain, major trauma, respiratory distress, cardiac arrest, respiratory arrest, and airway obstruction. Patient/proxy survey (20 questions) and chart review were completed. The responses to survey questions were "disagree," "neutral," or "agree" and were scored as one, two, or three with three corresponding to higher likelihood of EMS use. A total scale score ranging from 20 to 60 was created and transformed from 0% to 100%. Data were analyzed based on mode of presentation (EMS vs other). Among the 481 patients enrolled, only 112 (23.3%) used EMS. Mean age for study population was 63.7 years (SD=18.8 years) with 56.5% males. Mean clinical severity score (Emergency Severity Index [ESI]) was 2.5 (SD=0.7) and mean pain score was 3.1 (SD=3.5) at ED presentation. Over one-half (58.8%) needed admission to hospital with 21.8% to an intensive care unit care level and with a mortality rate of 7.3%. Significant associations were found between EMS use and the following variables: severity of illness, degree of pain, familiarity with EMS activation, previous EMS use, perceived EMS benefit, availability of EMS services, trust in EMS response times and treatment, advice from family, and unavailability of immediate private mode of transport (P≤.05). Functional screening, or requiring full assistance (OR=4.77; 95% CI, 1.85-12.29); acute symptoms onset ≤ one hour (OR=2.14; 95% CI, 1.08-4.26); and higher scale scores (OR=2.99; 95% CI, 2.20-4.07) were significant predictors of EMS use. Patients

  1. Cost reduction strategies for emergency services: insurance role, practice changes and patients accountability.

    PubMed

    Simonet, Daniel

    2009-03-01

    Progress in medicine and the subsequent extension of health coverage has meant that health expenditure has increased sharply in Western countries. In the United States, this rise was precipitated in the 1980s, compounded by an increase in drug consumption which prompted the government to re-examine its financial support to care delivery, most notably in hospital care and emergencies services. In California for example, 50 emergency service providers were closed between 1990 and 2000, and nine in 1999-2000 alone. In that State, only 355 hospitals (out of 568) have maintained emergency services departments (Darves, WebMB, 2001). Reforming hospital Emergency Department (ED) operations requires caution not only because the media pay a lot of attention to ED operations, but also because it raises ethical issues: this became more apparent with the enactment of the EMTALA which stipulates that federally funded hospitals are required to give emergency aid in order to "stabilize" a patient suffering from an "emergency medical condition" before discharging or transferring that patient to another facility. While in essence the law aims to preserve patient access to care, physicians assert that the EMTALA leads to more patients seeking care for non-urgent conditions in EDs (GAO, Report to Congressional Committees, 2001), leading to overcrowding, delayed care for patients with true emergency needs, and forcing hospitals to divert ambulances to other facilities resulting in further delays in urgent care. Also, fewer physicians are willing to be on-call in emergency departments because the EMTALA law requires on-call physicians to provide uncompensated care. Thus there is a need to find a balance between appropriate care to be provided to ED patients, and low costs since uncompensated care is not covered by state or federal funds. This concerns, first and foremost, hospitals that provide a greater amount of uncompensated care (e.g. hospitals serving communities with a higher

  2. The effect of occupational cultures on coordination of emergency medical service aircrew.

    PubMed

    Fonne, V M; Myhre, G

    1996-06-01

    The purpose of the study was to see whether one can determine different occupational cultures in the Emergency Medical Air Ambulance Service and whether these differences in orientation among the crewmembers may have an impace on effective crew coordination. Due to different requirements of the Emergency Medical Service (EMS), each crewmember joins the duty with different backgrounds, interests and expectations. The operational stresses of this kind of service, however, demand teamwork and may easily expose the crew's ability to coordinate their actions to work as a team. The initial study consisted of 60 operational crewmembers from the Norwegian Air Ambulance Service. Hofstede's questionnaire Values Survey Module was administered for an evaluation of occupational culture. The analysis reveals group differences at the occupational level in the perception of power distribution, team orientation and achievement preferences. We conclude that differences in certain work goals might be attributed partly by specific attitudes and values from the occupational categories' professional background, which influence the interpretation of established rules and procedures in the service. The results are further discussed in relation to the crewmembers' different task demands and areas of responsibility, and emphasis is put on organizational responsibility for enhancing safety and efficiency in the service.

  3. Analysis of Occupational Accident Fatalities and Injuries Among Male Group in Iran Between 2008 and 2012

    PubMed Central

    Alizadeh, Seyed Shamseddin; Mortazavi, Seyed Bagher; Sepehri, Mohammad Mehdi

    2015-01-01

    Background: Because of occupational accidents, permanent disabilities and deaths occur and economic and workday losses emerge. Objectives: The purpose of the present study was to investigate the factors responsible for occupational accidents occurred in Iran. Patients and Methods: The current study analyzed 1464 occupational accidents recorded by the Ministry of Labor and Social Affairs’ offices in Iran during 2008 - 2012. At first, general understanding of accidents was obtained using descriptive statistics. Afterwards, the chi-square test and Cramer’s V statistic (Vc) were used to determine the association between factors influencing the type of injury as occupational accident outcomes. Results: There was no significant association between marital status and time of day with the type of injury. However, activity sector, cause of accident, victim’s education, age of victim and victim’s experience were significantly associated with the type of injury. Conclusions: Successful accident prevention relies largely on knowledge about the causes of accidents. In any accident control activity, particularly in occupational accidents, correctly identifying high-risk groups and factors influencing accidents is the key to successful interventions. Results of this study can cause to increase accident awareness and enable workplace’s management to select and prioritize problem areas and safety system weakness in workplaces. PMID:26568848

  4. Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: a retrospective medical record study.

    PubMed

    Kao, Yee-Hsin; Liu, Yao-Ting; Koo, Malcolm; Chiang, Jui-Kun

    2018-03-12

    For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. This case-control study was based on a retrospective medical chart review (January 2010 to December 2012) of advanced cancer patients who were receiving palliative home care in a community hospital in south Taiwan. The use of emergency medical services by these patients was dichotomized into either normal hours (8 a.m. to midnight, Monday to Friday, excluding public holidays) of palliative home care or outside normal hours. Logistic regression analyses were performed to evaluate factors associated with emergency services use during out-of-hours period of palliative home care. Of the 94 patients receiving palliative home care, 65 had used emergency services at least once during the 3-year study period. Of these 65 patients, 40% used emergency services during out-of-hours of palliative home care. Patients with distressing conditions (defined as the occurrence of any two conditions of dyspnea, change of consciousness, or gastrointestinal bleeding) were significantly more likely to use emergency services during out-of-hours of palliative home care. Patients at risk of developing dyspnea, change of consciousness, or gastrointestinal bleeding should be provided with relevant information regarding these symptoms and signs.

  5. Emergency intraosseous access in a helicopter emergency medical service: a retrospective study.

    PubMed

    Sunde, Geir A; Heradstveit, Bård E; Vikenes, Bjarne H; Heltne, Jon K

    2010-10-07

    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. 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. 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 < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up. 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

  6. Emergency intraosseous access in a helicopter emergency medical service: a retrospective study

    PubMed Central

    2010-01-01

    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 < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up. 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

  7. 77 FR 59001 - Fee for Services To Support FEMA's Offsite Radiological Emergency Preparedness Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-25

    ... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2012-0028] Fee for Services To Support FEMA's Offsite Radiological Emergency Preparedness Program AGENCY: Federal... Emergency Preparedness (REP) Program. DATES: This hourly rate is effective for FY 2014 (October 1, 2013, to...

  8. 75 FR 19985 - Fee for Services To Support FEMA's Offsite Radiological Emergency Preparedness Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0007] Fee for Services To Support FEMA's Offsite Radiological Emergency Preparedness Program AGENCY: Federal... Radiological Emergency Preparedness (REP) Program. DATES: This hourly rate is effective for FY 2010 (October 1...

  9. Road traffic accidents in children: the 'what', 'how' and 'why'.

    PubMed

    Lee, Yue Yen; Fang, Eric; Weng, Yanyi; Ganapathy, Sashikumar

    2018-04-01

    Road traffic accidents (RTAs) in Singapore involving children were evaluated, with particular focus on the epidemiology, surrounding circumstances and outcomes of these accidents. Key factors associated with worse prognosis were identified. We proposed some measures that may be implemented to reduce the frequency and severity of such accidents. This was a retrospective study of RTAs involving children aged 0-16 years who presented to the Children's Emergency at KK Women's and Children's Hospital, Singapore, from January 2011 to June 2014. Data was obtained from the National Trauma Registry and analysed in tiers based on the Injury Severity Score (ISS). A total of 1,243 accidents were reviewed. RTA victims included motor vehicle passengers (60.4%), pedestrians (28.5%), cyclists (9.9%) and motorcycle pillion riders (1.2%). The disposition of emergency department (ED) patients was consistent with RTA severity. For serious RTAs, pedestrians accounted for 63.6% and 57.7% of Tier 1 (ISS > 15) and Tier 2 (ISS 9-15) presentations, respectively. Overall use of restraints was worryingly low (36.7%). Not restraining increased the risk of serious RTAs by 8.4 times. Young age, high ISS and low Glasgow Coma Scale score predicted a longer duration of intensive care unit stay. The importance of restraints for motor vehicle passengers or helmets for motorcycle pillion riders and cyclists in reducing morbidity requires emphasis. Suggestions for future prevention and intervention include road safety education, regulation of protective restraints, use of speed enforcement devices and creation of transport policies that minimise kerbside parking. Copyright: © Singapore Medical Association.

  10. Geographical variation of diabetic emergencies attended by prehospital Emergency Medical Services is associated with measures of ethnicity and socioeconomic status.

    PubMed

    Villani, Melanie; Earnest, Arul; Smith, Karen; de Courten, Barbora; Zoungas, Sophia

    2018-03-23

    Geographical variation of diabetic emergencies attended by prehospital emergency medical services (EMS) and the relationship between area-level social and demographic factors and risk of a diabetic emergency were examined. All cases of hypoglycaemia and hyperglycaemia attended by Ambulance Victoria between 1/01/2009 and 31/12/2015 were tabulated by Local Government Area (LGA). Conditional autoregressive models were used to create smoothed maps of age and gender standardised incidence ratio (SIR) of prehospital EMS attendance for a diabetic emergency. Spatial regression models were used to examine the relationship between risk of a diabetic emergency and area-level factors. The areas with the greatest risk of prehospital EMS attendance for a diabetic emergency were disperse. Area-level factors associated with risk of a prehospital EMS-attended diabetic emergency were socioeconomic status (SIR 0.70 95% CrI [0.51, 0.96]), proportion of overseas-born residents (SIR 2.02 95% CrI [1.37, 2.91]) and motor vehicle access (SIR 1.47 95% CrI [1.08, 1.99]). Recognition of areas of increased risk of prehospital EMS-attended diabetic emergencies may be used to assist prehospital EMS resource planning to meet increased need. In addition, identification of associated factors can be used to target preventative interventions tailored to individual regions to reduce demand.

  11. Work-related accidents and occupational diseases in veterinarians and their staff.

    PubMed

    Nienhaus, Albert; Skudlik, Christoph; Seidler, Andreas

    2005-04-01

    We assessed the occupational hazards in veterinary practice by analysing accident insurance data in order to stimulate strategies to prevent occupational accidents and diseases in veterinarians and their staff. Approximately 10,000 veterinary practices comprising about 27,500 veterinarians and their staff are covered by the Institution of Statutory Accident Insurance of the Health and Welfare Service (BGW). Each year about 2,000 accident and occupational disease claims are filed by these veterinarians and their staff. The claims for the 5-year period from 1998 to 2002 are analysed in this paper. For 2002, the incidence rate for accidents in the workplace was 105.4 per 1,000 full-time workers, a rate 2.9-times higher than for general practitioners of human medicine. When only severe accidents resulting in a loss of work time of more than 3 days were analysed, the relative risk increased to 9.2. Approximately 66% of the reported accidents are due to scratches, bites, or kicks from animals. Claims of occupational disease are filed 2.7-times more often by veterinarians and their staff than by general practitioners and their staff. The occupational diseases filed most often concern the skin (39%), followed by allergic respiratory diseases (30.5%), and infectious diseases (19.1%). Prevention strategies for veterinarians should focus on accidents caused by animals. The prevention of occupational diseases should focus on skin diseases, respiratory disease, and infections.

  12. [Interventions for mental health sequelae of accidents].

    PubMed

    Angenendt, J

    2014-06-01

    Emergency psychology and psychotraumatology deal with the psychological sequelae of traumatic experiences, i.e., the prevention and early intervention of posttraumatic mental health disorders. Accidents are the most prevalent traumatic events in the general population that may result in a range of severe trauma and adjustment disorders. Accidents happen suddenly, unexpectedly, and can gravely threaten health, personal integrity, and life. The prevalence of intermittent and chronic psychiatric disorders in the aftermath of severe accidents varies between 5 and 30 %. Victims suffer from unknown and frightening posttraumatic symptoms, often irreversible handicaps as a consequence of their injuries, impairments in everyday functioning, and negative impact on the quality of life. The direct and indirect burden for society is high. Comprehensive secondary prevention, starting with early detection and early intervention of post-accident disorders, is not well established in clinical care. In case of severe accidental injuries, emergency and medical treatment has absolute priority. But all too often, severe mental health problems remain undetected in later treatment phases and therefore cannot be addressed adequately. In primary care, knowledge of specific psychodiagnostic and treatment options is still insufficient. Prejudices, denial, and fear of stigmatization in traumatized victims as well as practical constraints (availability, waiting time) in the referral to special evidence-based interventions limit the access to adequate and effective support. This overview presents the objectives, concepts, and therapeutic tools of a stepped-care model for psychological symptoms after accidental trauma, with reference to clinical guidelines.

  13. Domino effect in chemical accidents: main features and accident sequences.

    PubMed

    Darbra, R M; Palacios, Adriana; Casal, Joaquim

    2010-11-15

    The main features of domino accidents in process/storage plants and in the transportation of hazardous materials were studied through an analysis of 225 accidents involving this effect. Data on these accidents, which occurred after 1961, were taken from several sources. Aspects analyzed included the accident scenario, the type of accident, the materials involved, the causes and consequences and the most common accident sequences. The analysis showed that the most frequent causes are external events (31%) and mechanical failure (29%). Storage areas (35%) and process plants (28%) are by far the most common settings for domino accidents. Eighty-nine per cent of the accidents involved flammable materials, the most frequent of which was LPG. The domino effect sequences were analyzed using relative probability event trees. The most frequent sequences were explosion→fire (27.6%), fire→explosion (27.5%) and fire→fire (17.8%). Copyright © 2010 Elsevier B.V. All rights reserved.

  14. Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil.

    PubMed

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thumé, Elaine; Thomaz, Erika Bárbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-08-22

    Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access

  15. Treatment for cases of violence by Brazilian emergency services focusing on family relationships and life cycles.

    PubMed

    Avanci, Joviana Quintes; Pinto, Liana Wernersbach; Assis, Simone Gonçalves de

    2017-09-01

    This article analyzes data regarding cases of domestic violence treated by the emergency services through the following: the sociodemographic characteristics of the people who were treated; the events themselves; the evolution of care (from childhood to old age by gender); and the factors that differentiate cases of domestic violence compared to those committed by non-family members. Data from 24 Brazilian state capitals and the Federal District were analyzed, comprising 86 emergency services: a total of 4,893 individuals were surveyed. Of those people who were treated by emergency services, 26.6% suffered domestic violence: 40.0% were children/adolescents, 57.2% were adults and 2.8% were elderly. The adjusted model, which compared victims of violence committed by other family members with those who were not family members, showed that males were less likely to suffer from domestic violence; those that had fewer years of education were at increased risk; and that women were more likely to commit domestic violence compared to the category of "both genders". This study reinforces the fact that health sector professionals need to be able to deal with domestic violence by providing support, performing good practices, abiding by care protocols, taking care of injuries, and facilitating access to other services.

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

    ERIC Educational Resources Information Center

    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…

  17. Absence from work due to occupational and non-occupational accidents.

    PubMed

    Jørgensen, Kirsten; Laursen, Bjarne

    2013-02-01

    The aim of the present study was to investigate absence from work in Denmark due to occupational and non-occupational accidents. Since the beginning of the last decade, political focus has been placed on the population's working capacity and the scope of absence due to illness. Absence from work is estimated at between 3% and 6% of working hours in the EU and costs are estimated at approximately 2.5% of GNP. Victims of accidents treated at two emergency departments were interviewed regarding absence for the injured, the family and others. All answers were linked to the hospital information on the injury, so that it was possible to examine the relation between absence and injury type, and cause of the accident. In total, 1,479 injured persons were interviewed. 36% of these reported absence from work by themselves or others. In mean, an injury caused 3.21 days of absence. Based on this the total absence due to injuries in Denmark was estimated to 1,822,000 workdays, corresponding to approximately 6% of the total absence from work due to all types of illness. Non-occupational injuries resulted in more absence than did occupational injuries. Absence due to accidents contributed to a considerable part of the total absence from work, and non-occupational accidents caused more absence than did occupational accidents.

  18. [The meaning of accidents with biological material to nursing professionals].

    PubMed

    Magagnini, Maristela Aparecida Magri; Rocha, Suelen Alves; Ayres, Jairo Aparecido

    2011-06-01

    The aim of this study is to understand what meaning work accidents with exposure to biological material has to nurses. This is an exploratory study with a qualitative approach, and it used Bardin's content analysis. 87 accidents with biological material occurred in the period between 2001 and 2006; among them, eight were seropositive for Hepatitis B and C and HIV/AIDS. An interview with guiding questions was used to collect data. When inquiring these professionals about the meaning of these accidents, four categories emerged: risk situation, danger perception, fatality, and feelings. Although it is not a strategy of clarification, it is a fact that work organization and educative actions have considerable impact in reducing this type of accident, also reducing damage to the life of nurses involved in these accidents.

  19. The Use of Autonomous Systems in Emergency Medical Services: Bridging Human Intelligence and Technology

    DTIC Science & Technology

    2015-12-01

    significant impact on emergency medical services ( EMS ). EMS provider organizations must be prepared to not only interact with AS by having response... EMS will be high, that the number of opportunities to improve required emergency response and deliver expedient medical care will be diminished, and...that strengths may be nonexistent. The thesis focuses on the analysis of what AS are, how they are used in the provision of EMS today, how they may be

  20. An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

    PubMed

    Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

    2011-12-01

    The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  1. Challenges to effective crisis management: using information and communication technologies to coordinate emergency medical services and emergency department teams.

    PubMed

    Reddy, Madhu C; Paul, Sharoda A; Abraham, Joanna; McNeese, Michael; DeFlitch, Christopher; Yen, John

    2009-04-01

    The purpose of this study is to identify the major challenges to coordination between emergency department (ED) teams and emergency medical services (EMS) teams. We conducted a series of focus groups involving both ED and EMS team members using a crisis scenario as the basis of the focus group discussion. We also collected organizational workflow data. We identified three major challenges to coordination between ED and EMS teams including ineffectiveness of current information and communication technologies, lack of common ground, and breakdowns in information flow. The three challenges highlight the importance of designing systems from socio-technical perspective. In particular, these inter-team coordination systems must support socio-technical issues such as awareness, context, and workflow between the two teams.

  2. Injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia: a prospective hospital based study.

    PubMed

    Seid, Mohammed; Azazh, Aklilu; Enquselassie, Fikre; Yisma, Engida

    2015-05-20

    Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world's roads, and the risk of dying as a result of a road traffic injury is highest in Africa. A prospective hospital based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 20.0. Hierarchical multiple regression analysis was used to identify predictors of fatalities among the road traffic crash victims. A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims' ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4%. Hierarchical multiple regression analysis showed that age of the victims (ß = 0.16, p < 0.05), systolic blood pressure on admission (ß = -0.35, p < 0.001) and Glasgow coma scale (ß = -0.44, p < 0.001) were statistically significant predictors of fatalities among the victims. This study showed diverse injury characteristics and high morbidity and mortality among the victims attending Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. The

  3. An identification of stressors associated with student nurses in an accident and emergency department and comparison of stress levels.

    PubMed

    Scullion, P A

    1994-04-01

    This study has two main focuses; comparing the experience of two groups of student nurses and identifying stressors associated with Accident and Emergency (A & E) nursing. One group was on an enrolled nurse conversion course and the other group was on a full length Registered General Nurse (RGN) course. Both groups shared the same clinical area and the study involved only one A & E department. Particular stressors associated with this type of nursing were identified and were in keeping with previously published evidence. Other causes of stress could be attributed to the working environment and quality of working relationships. An indication emerged that anticipation of stressful events, and not just actual experience, is very significant in the cognitive processes involved in the perception of stress. A correlational survey design was used and a questionnaire incorporating a stress scale was devised. No significant association between reported stress levels and the age of students was found. Place of residence as a variable also revealed no influence on student stress. However, a marked difference, of statistical significance, was shown between the stress levels of the two groups. Interpretation of the data points to prior experience as a key mediating factor in the perception and experience of stress. Following discussion, recommendations regarding further research and changes affecting both the theoretical and practical settings are made.

  4. Managing Bipolar Youths in a Psychiatric Inpatient Emergency Service

    ERIC Educational Resources Information Center

    Masi, Gabriele; Mucci, Maria; Pias, Paola; Muratori, Filippo

    2011-01-01

    Among the youths referred to our Psychiatric Inpatient Emergency Service, we focused on bipolar disorder (BD), to explore predictive elements for the outcome. Fifty-one patients (30 males, 21 females, age range 8-18 years, mean age 14.2 plus or minus 3.1 years) received a diagnosis of BD, according to historical information, prolonged…

  5. Comparison of helicopter and ground emergency medical service: a retrospective analysis of a German rescue helicopter base.

    PubMed

    Mommsen, Philipp; Bradt, Nikolas; Zeckey, Christian; Andruszkow, Hagen; Petri, Max; Frink, Michael; Hildebrand, Frank; Krettek, Christian; Probst, Christian

    2012-01-01

    In consideration of rising cost pressure in the German health care system, the usefulness of helicopter emergency medical service (HEMS) in terms of time- and cost-effectiveness is controversially discussed. The aim of the present study was to investigate whether HEMS is associated with significantly decreased arrival and transportation times compared to ground EMS. In a retrospective study, we evaluated 1,548 primary emergency missions for time sensitive diagnoses (multiple trauma, traumatic brain and burn injury, heart-attack, stroke, and pediatric emergency) performed by a German HEMS using the medical database, NADIN, of the German Air Rescue Service. Arrival and transportation times were compared to calculated ground EMS times. HEMS showed significantly reduced arrival times at the scene in case of heart-attack, stroke and pediatric emergencies. In contrast, HEMS and ground EMS showed comparable arrival times in patients with multiple trauma, traumatic brain and burn injury due to an increased flight distance. HEMS showed a significantly decreased transportation time to the closest centre capable of specialist care in all diagnosis groups (p<0.001). The results of the present study indicate the time-effectiveness of German air ambulance services with significantly decreased transportation times.

  6. Refusal of medical treatment in the pediatric emergency service: analysis of reasons and aspects.

    PubMed

    Gündüz, Ramiz Coşkun; Halil, Halit; Gürsoy, Cüneyt; Çifci, Atilla; Özgün, Seher; Kodaman, Tuğba; Sönmez, Mehtap

    2014-01-01

    Refusal of treatment for acutely ill children is still an important problem in the emergency service. When families refuse medical treatment for their acutely ill children, healthcare professionals may attempt to provide information and negotiate with the family concerning treatment refusal and its possible adverse outcomes, and request consent for refusal of medical treatment. There is insufficient data about refusal of treatment in our country. The purpose of this study was to analyze the causes of treatment refusal in the pediatric emergency service. We collected data recorded on informed consent forms. During a 2-year-study period, 215 patients refused treatment recommended by acute health care professionals. The majorty of patients were in the 0-2 year age group. Hospitalization was the type of treatment most commonly refused; restrictions regarding family members staying with their children during hospitalization and admission to another hospital were the major reasons for refusal of treatment. Clarifying the reasons for treatment refusal may help us to overcome deficiencies, improve conditions, resolve problems and build confidence between healthcare providers and service users, increasing users' satisfaction in the future.

  7. Emergency mental health nursing for self-harming refugees and asylum seekers.

    PubMed

    Procter, Nicholas G

    2005-09-01

    This article describes the structure and function of emergency mental health nursing practice for self-harming refugees and asylum seekers on Temporary Protection Visas. Emergency nurses working in accident and emergency departments or as part of crisis intervention teams will see self-harming refugees and asylum seekers at the very point of their distress. This clinical paper is intended to support nurses in their practice should they encounter an adult asylum seeker needing emergency mental health care. Practical strategies are highlighted to help mental health nurses assess, care, and comfort refugees and asylum seekers in this predicament. Mental health nurses should, where possible, work closely with asylum seekers, their support workers, and accredited interpreters and translators to ensure the appropriate use of language when dealing with mental and emotional health issues without further isolating the asylum seeker from appropriate services. To help strengthen continuity and integration of mental health supports for refugees and asylum seekers, well-resourced care must be experienced as coherent and connected. A coherent, interdisciplinary and team-orientated approach will synthesize different viewpoints to shape clinical practice and create workable solutions in local situations.

  8. Transport of pregnant women and obstetric emergencies in India: an analysis of the '108' ambulance service system data.

    PubMed

    Singh, Samiksha; Doyle, Pat; Campbell, Oona M R; Rao, G V R; Murthy, G V S

    2016-10-21

    The transport of pregnant women to an appropriate health facility plays a pivotal role in preventing maternal deaths. In India, state-run call-centre based ambulance systems ('108' and '102'), along with district-level Janani Express and local community-based innovations, provide transport services for pregnant women. We studied the role of '108' ambulance services in transporting pregnant women routinely and obstetric emergencies in India. This study was an analysis of '108' ambulance call-centre data from six states for the year 2013-14. We estimated the number of expected pregnancies and obstetric complications for each state and calculated the proportions of these transported using '108'. The characteristics of the pregnant women transported, their obstetric complications, and the distance and travel-time for journeys made, are described for each state. The estimated proportion of pregnant women transported by '108' ambulance services ranged from 9.0 % in Chhattisgarh to 20.5 % in Himachal Pradesh. The '108' service transported an estimated 12.7 % of obstetric emergencies in Himachal Pradesh, 7.2 % in Gujarat and less than 3.5 % in other states. Women who used the service were more likely to be from rural backgrounds and from lower socio-economic strata of the population. Across states, the ambulance journeys traversed less than 10-11 km to reach 50 % of obstetric emergencies and less than 10-21 km to reach hospitals from the pick-up site. The overall time from the call to reaching the hospital was less than 2 h for 89 % to 98 % of obstetric emergencies in 5 states, although this percentage was 61 % in Himachal Pradesh. Inter-facility transfers ranged between 2.4 % -11.3 % of all '108' transports. A small proportion of pregnant women and obstetric emergencies made use of '108' services. Community-based studies are required to study knowledge and preferences, and to assess the potential for increasing or rationalising the use of '108' services.

  9. Police referrals at the psychiatric emergency service in Taiwan.

    PubMed

    Wang, Jen-Pang; Wu, Chia-Yi; Chiu, Chih-Chiang; Yang, Tsu-Hui; Liu, Tzong-Hsien; Chou, Pesus

    2015-12-01

    The police are the frontline workers in crisis situations involving patients with severe mental illness and act as a primary referral source for psychiatric emergency services (PES) in the community. The aims of this study were to investigate the distribution and characteristics of police referral among psychiatric patients in Taiwan. The study cohort consisted of patients who visited the PES of Taipei City Psychiatric Center from January 2009 to December 2010. The associations between the factors of demographics, clinical characteristics, and psychiatric service utilization and police referral were evaluated. Among the 7656 psychiatric emergency visits, 3029 (39.6%) were referred by the police. These patients referred by police were more likely to be male and aged between 30 to 49 years. Clinical factors related to police referrals including a higher triage assessment level, chief problems included violence, disturbance, substance use, less anxiety, and a diagnosis of unspecified psychosis. The triage assessment level and chief problems assessed by nurses were major predictors. These patients tended to be referred from the catchment area and during the nighttime shift, were discharged during the daytime shift, and stayed longer in the PES. Disposition arrangements such as discharge against medical advice and involuntary admission were also associated with police referrals. Patients referred by the police to the PES were those with more severe psychiatric problems and illnesses assessed by psychiatric nurses and psychiatrists. They tended to have more complex service utilization at the PES. © 2015 Wiley Publishing Asia Pty Ltd.

  10. World commercial aircraft accidents. Second edition, 1946--1992

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kimura, C.Y.

    1993-01-01

    This report is a compilation of all accidents world-wide involving aircraft in commercial service which resulted in the loss of the airframe or one or more fatality, or both. This information has been gathered in order to present a complete inventory of commercial aircraft accidents. Events involving military action, sabotage, terrorist bombings, hijackings, suicides, and industrial ground accidents are included within this list. Included are: accidents involving world commercial jet aircraft, world commercial turboprop aircraft, world commercial pistonprop aircraft with four or more engines and world commercial pistonprop aircraft with two or three engines from 1946 to 1992. Each accidentmore » is presented with information in the following categories: date of the accident, airline and its flight numbers, type of flight, type of aircraft, aircraft registration number, construction number/manufacturers serial number, aircraft damage, accident flight phase, accident location, number of fatalities, number of occupants, cause, remarks, or description (brief) of the accident, and finally references used. The sixth chapter presents a summary of the world commercial aircraft accidents by major aircraft class (e.g. jet, turboprop, and pistonprop) and by flight phase. The seventh chapter presents several special studies including a list of world commercial aircraft accidents for all aircraft types with 100 or more fatalities in order of decreasing number of fatalities, a list of collision accidents involving commercial aircrafts, and a list of world commercial aircraft accidents for all aircraft types involving military action, sabotage, terrorist bombings, and hijackings.« less

  11. Roles and Resources of Federal Agencies in Support of Comprehensive Emergency Medical Services.

    ERIC Educational Resources Information Center

    National Academy of Sciences - National Research Council, Washington, DC. Div. of Medical Sciences.

    Divided into two major parts, this report summarizes the findings, recommendations, and conclusions of the National Academy of Sciences and National Research Council's analysis of the current function and potential capacity of congressionally appointed federal agencies relative to providing emergency medical care services. More specifically, the…

  12. Historical development and current status of emergency nursing in Turkey.

    PubMed

    Selimen, Deniz; Gürkan, Aysel

    2009-09-01

    As the demand for high quality Accident and Emergency Departments and nursing staff increases throughout Turkey, the need for more specialized emergency nurse training has also increased. Although there have been a number of positive developments regarding emergency nursing standards, the general quality of emergency nurse training needs to be improved and job definitions amended to better reflect the specialist duties of emergency nurses.

  13. Major Accidents (Gray Swans) Likelihood Modeling Using Accident Precursors and Approximate Reasoning.

    PubMed

    Khakzad, Nima; Khan, Faisal; Amyotte, Paul

    2015-07-01

    Compared to the remarkable progress in risk analysis of normal accidents, the risk analysis of major accidents has not been so well-established, partly due to the complexity of such accidents and partly due to low probabilities involved. The issue of low probabilities normally arises from the scarcity of major accidents' relevant data since such accidents are few and far between. In this work, knowing that major accidents are frequently preceded by accident precursors, a novel precursor-based methodology has been developed for likelihood modeling of major accidents in critical infrastructures based on a unique combination of accident precursor data, information theory, and approximate reasoning. For this purpose, we have introduced an innovative application of information analysis to identify the most informative near accident of a major accident. The observed data of the near accident were then used to establish predictive scenarios to foresee the occurrence of the major accident. We verified the methodology using offshore blowouts in the Gulf of Mexico, and then demonstrated its application to dam breaches in the United Sates. © 2015 Society for Risk Analysis.

  14. 10 CFR 76.91 - Emergency planning.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... The Corporation shall establish, maintain, and be prepared to follow a written emergency plan. The emergency plan submitted under § 76.35(f) must include the following information: (a) Plant description. A... responsibilities of all individuals supporting emergency response should an accident occur, including...

  15. 10 CFR 76.91 - Emergency planning.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... The Corporation shall establish, maintain, and be prepared to follow a written emergency plan. The emergency plan submitted under § 76.35(f) must include the following information: (a) Plant description. A... responsibilities of all individuals supporting emergency response should an accident occur, including...

  16. A priority dispatch system for emergency medical services.

    PubMed

    Slovis, C M; Carruth, T B; Seitz, W J; Thomas, C M; Elsea, W R

    1985-11-01

    A decision tree priority dispatch system for emergency medical services (EMS) was developed and implemented in Atlanta and Fulton County, Georgia. The dispatch system shortened the average response time from 14.2 minutes to 10.4 minutes for the 30% of patients deemed most urgent (P less than or equal to .05); resulted in a significant increase in the use of advanced life support units for this group (P less than or equal to .02); decreased the number of calls that required a backup ambulance service; and significantly increased conformity to national EMS response time standards for critically ill and injured patients (P less than or equal to .0009). Due to dispatch error, 0.3% of calls were dispatched as least severe but subsequently were found to be most urgent.

  17. Characteristics of motorcyclists involved in accidents between motorcycles and automobiles.

    PubMed

    Oliveira, Amanda Lima de; Petroianu, Andy; Gonçalves, Dafne Maria Villar; Pereira, Gisele Araújo; Alberti, Luiz Ronaldo

    2015-01-01

    traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the region of Belo Horizonte, Brazil. The questionnaires included demographic information (age, gender, skin color, education level, profession) and questions about years of licensed driving practice, how often they would drive an automobile, how long they had had a motorcycle driver's license, how often they would ride a motorcycle, the number of prior accidents involving a car, and the number of prior accidents not involving a car. of the 100 consecutive accidents studied, 91 occurred with men and 9 with women, aged between 16 and 79 (m = 29 ± 11) years. Regarding their reason for using a motorcycle, 83% reported using it for transport, 7% for work, and 10% for leisure. Most of these accident victims had secondary or higher education (47%). Of the motorcyclists who held a car driver's license, 68.3% drove the vehicle daily or weekly and held the license for more than one year. Sixty-seven percent of the accident victims used a motorcycle daily and had a motorcycle driver's license for at least one year. among the motorcyclists injured, most were men aged 20 years or older, with complete secondary education, and experienced in driving both motorcycles and cars, indicating that recklessness while driving the motorcycle is the main cause of traffic accidents.

  18. Air ambulance nurses as expert supplement to local emergency services.

    PubMed

    Wisborg, Torben; Bjerkan, Bjørn

    2014-01-01

    Flight nurses in the Norwegian National Air Ambulance Service are specialist nurse anesthetists or intensive care nursing specialists. For air ambulance bases far from hospitals, these nurses present otherwise unavailable competencies. This study reports a 6-year experience with flight nurse participation in local emergencies beyond the transportation phase. The fixed-wing air ambulance base in Alta, Northern Norway (20,000 inhabitants), with 2 aircraft and 2 on-call teams is 150 km by road from the nearest hospital. We did a prospective registration of all emergency nonflight missions near the air ambulance base from January 1, 2005, to December 31, 2010. The 217 completed missions corresponded to 3 missions per month, half during daytime. Twenty-three percent of patients were under age 18, injury rate was high (36%), 63% had potentially or manifest life-threatening conditions, and 11% died during treatment. One third of all missions (67/217) resulted in an air ambulance flight to the hospital. Mission frequency did not significantly reduce flight availability, and precision in case selection for this special service was good. The use of flight nurses in the local community promotes equal access to advanced medical services for populations far from hospitals. Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  19. Woodworking injuries: a comparative study of work-related and hobby-related accidents.

    PubMed

    Loisel, F; Bonin, S; Jeunet, L; Pauchot, J; Tropet, Y; Obert, L

    2014-10-01

    The primary objective of this study was to describe the injury characteristics and demographics of patients injured during woodworking activities, upon their arrival to the emergency department in a regional of France where this industry is prevalent. The secondary objective was to compare patient and injury characteristics for work-related and hobby-related accidents. A cohort of 87 patients who had suffered a woodworking accident over a two-year period was evaluated; 79 were available for follow-up. The context and circumstances of the accident, nature and location of the injuries and patient demographics were recorded. Hobby-related accidents accounted for two-thirds of the accidents (51/79). Most of the injured workers were either loggers (35%) or carpenters (46%). The hand was injured in 53 cases (67%). Work-related accidents resulted in significantly more serious consequences in terms of hospital stay, work stoppage, resumption of work or retraining than hobby-related accidents. For the workplace accidents, 86% occurred on new machines; more than 25% of the machines involved in accidents at home were over 15 years. Sixty-eight per cent of workers were wearing their safety gear, while only 31% of those injured during recreational woodworking wore the appropriate gear. Several elements of prevention should be improved: information about the need to maintain the equipment, protect the worker with suitable clothing, and learn which maneuvers are considered hazardous. Safety gear should be regularly inspected in the workplace. Copyright © 2014. Published by Elsevier SAS.

  20. Casualty and surgical services in Perthshire general practitioner hospitals 1954-84

    PubMed Central

    Blair, J.S.G.; Grant, J.; McBride, H.; Martin, A.; Ross, R.T.A.

    1986-01-01

    The results are reported of a study of casualty and surgical services in five general practitioner hospitals in Perthshire — Aberfeldy, Auchterarder, Blairgowrie, Crieff and Pitlochry. Details of the total workload, the nature of the conditions treated and the referral rate to major hospitals are given. Figures for the Royal Infirmary, Perth, the main referral hospital for the county, are also given for comparison. The surgical service at one of the rural hospitals is described. Experience has demonstrated the usefulness of these hospitals in providing casualty and surgical services to both the local population and to visitors, and their superiority in providing these services over health centres because staff and beds are available 24 hours a day. Rural general practitioner hospitals merit a continuing share of resources and bed allocation as they spare major hospitals surgical and medical work. The general practitioners serving the hospitals studied here undertook almost 40% of the total accident and emergency workload in the Perth and Kinross area of Scotland. PMID:3735224